What was my biggest obstacle?
My parents thought it an odd thing for their daughter to want to be a doctor, and a part of me agreed with them. This was in the early 1960s, before the women's movement that began later in the decade, and it was still generally assumed that doctors should be men. Women who wanted to be doctors felt a special burden to explain themselves. A related problem was that I had to pay for medical school myselfsomething that would be virtually impossible today.
How do I make a difference?
I'm not sure any individual can make much of a difference over the long run, but like most people, I try. I have done that mainly through writing about various aspects of medicine that I believe should be changed or reformed. I try to analyze the problems as logically as I can to persuade readers who are not already committed to a particular point of view. As an editor of the New England Journal of Medicine, I was fortunate enough to have a ready-made outlet for my thoughts.
Who was my mentor?
I had two mentors. The first, in terms of chronology, was Dr. Stanley L. Robbins, who was chairman of the Department of Pathology at Boston University School of Medicine [BUSM] when I was a student there. I helped him with the third edition of his textbook, now called The Pathologic Basis of Disease, and later created with him and co-authored a smaller, more clinical version of the book, called Basic Pathology. My second mentor was Dr. Arnold S. Relman, who was head of the Renal Division in the Department of Medicine at BUSM. I worked with him on a paper that was published in the New England Journal of Medicine [NEJM] when I was an intern. Years later, when he became editor of the NEJM, he offered me a job on the editorial staff, which was the beginning of my 21-year association with that journal.
How has my career evolved over time?
Like most women of my generation, my career did not take a straight line. There were many detours that were made necessary primarily by my having my first child at the end of my second year of training in internal medicine. I dropped out of that program and spent a few years working at home on Basic Pathology. Later I did a residency in pathology (sometimes using my own textbook). From there I went to the New England Journal of Medicine, first as assistant deputy editor, later as executive editor, and finally as editor-in-chief, before I retired from that post in 2000. I am now senior lecturer in social medicine at Harvard Medical School. Thus, my original desire to take care of sick people one at a time was never realized!