Changing Medicine, Changing Life
Confronting the multiplying challenges of health care, women physicians have joined the highest ranks of medical administration and research. As leaders, they make choices that benefit communities across America and around the world. As healers, they identify and respond to many of the most urgent crises in modern medicine, from the needs of underserved communities, to AIDS and natural and man–made disasters.
Their influence reaches across the profession out into our lives, redefining women’s roles and society’s responsibilities. By changing the face of medicine, women physicians are changing our world.
Changing Medicine, Changing Life
Caring for People
Calling upon the art as well as the science of medicine, women physicians treat the whole patient and the whole spectrum of health care needs. The perspectives they bring to care for the living and comfort for the dying encompass all aspects of the medical and emotional well–being of the healthy, the ill, and the at–risk.
This multifaceted approach is reshaping the way that both practitioners and patients strive to improve the quality of life and deal with disease and injury, while widening the scope of medical care for individuals and communities.
Dr. Lori Arviso Alvord
Dr. Lori Arviso Alvord bridges two worlds of medicine—traditional Navajo healing and conventional Western medicine—to treat the whole patient. She provides culturally competent care to restore balance in her patients’ lives and to speed their recovery.
Lori Arviso Alvord, M.D.
Learning about Dr. Alvord’s Heritage
Navajo blanket
Navajo blanket designs incorporate many patterns and have become increasingly vibrant as newer, cheaper dyes have been developed. Making a three by five foot rug–shearing the sheep, spinning the wool, dying the yarn, weaving the textile–takes at least three hundred hours to complete. These blankets are sold around the world as valuable works of art.
Lori Arviso Alvord, M.D.
Corn pollen pouch
In Navajo tradition, corn pollen is collected by dusting it off the corn tassel for use in prayers and healing. In Dr. Alvord’s description of the ninth and final evening of the Night Chant healing ceremony, a young patient sprinkles corn pollen on groups of dancers.
Lori Arviso Alvord, M.D.
Navajo sandpainting
Navajo sandpaintings are used in healing or blessing ceremonies. They can be made with crushed stone, crushed flowers, gypsum, pollen, sand, and dyes. After the experience, the paintings are respectfully destroyed. Permanent sandpaintings are an art form, and do not feature the sacred imagery used in ceremonially.
Lori Arviso Alvord, M.D.
Bear pendant
The Organization of Student Representatives, a student branch of the Association of American Medical Colleges, presented this pendant to Dr. Alvord as a gift after she delivered a lecture.
Lori Arviso Alvord, M.D.
Dr. Elizabeth Kübler-Ross
Elisabeth Kübler–Ross, a Swiss–born American psychiatrist, pioneered the concept of providing psychological counseling to the dying. In her first book, On Death and Dying (published in 1969), she described five stages she believed were experienced by those nearing death—denial, anger, bargaining, depression, and acceptance. She also suggested that death be considered a normal stage of life, and offered strategies for treating patients and their families as they negotiate these stages. The topic of death had been avoided by many physicians and the book quickly became a standard text for professionals who work with terminally ill patients. Hospice care has subsequently been established as an alternative to hospital care for the terminally ill, and there has been more emphasis on counseling for families of dying patients.
Ken Ross Photography
Dr. Margaret Hamburg
Margaret Hamburg, one of the youngest people ever elected to the Institute of Medicine (IoM, an affiliate of the National Academy of Sciences), is a highly regarded expert in community health and bio–defense, including preparedness for nuclear, biological, and chemical threats. As health commissioner for New York City from 1991 to 1997, she developed innovative programs for controlling the spread of tuberculosis and AIDS.
Margaret Hamburg, M.D.
Dr. Margaret Hamburg
Dr. Margaret Hamburg is a leader in public health who developed programs for controlling the spread of tuberculosis and HIV/AIDS in the 1990s.
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I discovered my true passion when I shifted out of the clinical setting and moved into public health. People used to sometimes ask me, “Don’t you feel like you’ve thrown away all that medical training? You’re not taking care of patients anymore.” And instead, I feel like I’ve just expanded my universe of patients, and I’m not just focused one-on-one, but really looking at the needs of whole populations. And when I was New York City’s Health Commissioner, for example, I had almost eight million patients! During the period when I was dealing with HIV/AIDS there was this extraordinary realization of our vulnerability to infectious diseases, and new diseases that we’d never seen before, and also the recognition that diseases like AIDS had many, many aspects that had nothing to do with medicine and medical care. And I really got interested in working at the intersection of medicine and social and legal and economic issues. I really came to understand that you couldn’t effectively address health simply by working within the medical system. When I was in New York City as Health Commissioner, I first got interested and concerned about the threat of biological weapons. I was Health Commissioner actually the first time that the World Trade Center was bombed, so the possibility of domestic terrorism was very real to me. I started thinking about domestic terrorism as it related to the subject closest to my heart— health, medicine, and infectious disease—and I immediately could identify all kinds of vulnerabilities to biological agents intentionally used to do harm. And so we actually began a program in New York City when I was there to prepare against the possible threat of bioterrorism, but we saw it as the extreme end of the spectrum of infectious disease threats that we faced. In the biological program here at NTI (Nuclear Threat Initiative) we are focused on a couple of critical activities. A portion of our efforts and resources are focused on prevention, and nonproliferation of biological weapons, and funding programs and trying to help develop policies to address those concerns. But given how hard it may be, ultimately, to prevent the use of a biological agent as a weapon, we also have to think about how can we recognize it and respond as quickly and as effectively as possible.
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Dr. Leona Baumgartner
From 1954 to 1962, Leona Baumgartner, M.D., served as the first woman commissioner of New York City’s Department of Health. She used her position to bring no–nonsense health and hygiene advice to millions of Americans via regular television and radio broadcasts, and by sending health care professionals to visit schools and church groups. Throughout her career she broadened the scope of public health by teaching preventive medicine in easy–to–understand brochures, and helped to improve the health of New York’s poorest and most vulnerable.
National Library of Medicine, Images from the History of Medicine, B02511
Dr. Leona Baumgartner
Dr. Leona Baumgartner was the first woman to become commissioner of the New York City Department of Health and pioneered health education programs and health services in poor communities.
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Throughout her career, Dr. Leona Baumgartner found innovative ways to capture the public’s attention and deliver her message of good health and hygiene. Elvis Presley was even persuaded to pose for a photograph as he received his polio vaccination to encourage young people to participate in the vaccination program. Dr. Baumgartner began her career in public health during the Depression, working as a pediatric intern in New York City. Home visits in Manhattan’s poorest neighborhoods brought her face to face with the effects of poverty. The families she visited often could not get basic medical care or afford healthy foods. In 1937, Dr. Baumgartner joined the New York Department of Health. She was director of public health training, and taught child and school hygiene. She rose through the ranks, coordinating city-wide health services, disease clinics, school health programs, and parenting education classes. She visited professional groups and spoke out at public forums, talking to parents and health care professionals about keeping children healthy. In 1954, Dr. Baumgartner was appointed Health Commissioner of New York City— the first woman ever to hold the job. She appeared regularly on television, teaching about preventive medicine and became the well-known face of public health in New York City. Her public appeals were key to the success of health campaigns for vaccination and fluoridation. Throughout New York, Dr. Baumgartner and her staff inspected food products and restaurants, and posted information about sanitary practices in the workplace. To aid health care workers in communicating with immigrant mothers, her staff trained midwives to be aware of cultural differences. She also worked with President Lyndon B. Johnson to reverse government policy and provide funding for birth control programs in other countries. Dr. Leona Baumgartner has been hailed as “one of those amazing women who managed to juggle several appointments and careers while maintaining a family and social life.” Her lifelong dedication to public health, combined with her tact and diplomacy, made her influential at the highest levels of government.
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Dr. Christine Karen Cassel
“Pursuing difficult questions — in science and in policy — takes one to interesting places,” says Christine Cassel, M.D., a renowned expert in geriatric medicine and medical ethics. She works to improve quality of life for elderly patients, challenging out–of–date ideas about what can be expected in the aging process.
Christine Karen Cassel, M.D.
Dr. Christine Karen Cassel
Dr. Christine Karen Cassel is a leading expert in geriatrics and medical ethics and was the first woman president of the American College of Physicians.
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When I first began in this field, the standard rounds we would make in the hospital: we would come in, talk with the patient, listen to their heart and their lungs, maybe feel the abdomen. If the patient was in a wet bed it wasn’t our problem, it was a nursing problem. You would leave the room never knowing whether the patient was able to walk or not. And if the patient was confused, all too often you said, “Well, that’s sundowning, that happens with older people.” So the whole range of functional issues that really make a difference between whether an elder person can live alone, or has to be in a nursing home, were things that we didn’t have a clue about how to address. Urinary incontinence, mental confusion, and walking or ambulation, and the strength of somebody’s ability to get themselves to the bathroom, or even out of bed. And maybe I’m just a sensible woman or something, but it just seemed to me there needed to be a lot more attention on these common problems of older people, which we weren’t learning enough about. And so the idea of having a field of geriatric medicine where I could do that, that would be morally needed and make a contribution to people who needed help. At the same time that it would be full of important ethical issues that needed study and analysis, and that were philosophically challenging. The reason why intergenerational connection is so important is to give real meaning and vitality to our aging society. Because we’re moving from a society where a hundred years ago 5 percent of the population was over 65, to 20 years from now 20 percent of the population will be over 65. That means one out of five people, everywhere you go—in the movie theaters, in the grocery stores, in the airports, on the golf courses— wherever you are, are going to be “senior citizens.” To marginalize and make irrelevant one-fifth of the population is just not a smart thing for our society to do. Plus, people are healthier and more independent as they age these days, and that’s going to continue, too. So we can’t afford as a society not to take advantage of the skills and contribution of that whole segment of our population. So it’s very important to me that we find ways that younger people can interact with older people, to counteract stereotypes, ageism, negative attitudes about their own aging, and to help reinforce the connections within their own families. Many of my colleagues in medicine say to me, “How can you do this. It’s so depressing, and it’s so frustrating, because nobody ever gets better.” Well, if you look at most of medicine, there are very few dramatic cures anymore. What we’ve done is we’ve managed to make people able to live better with chronic illness—with heart disease, even with cancer. And geriatrics is just like that. When you help somebody live better, with multiple medical problems, or even help them die better, at the end of their life, their family and that patient are hugely grateful. And I find it very rewarding and so I tell people "what do you mean?" I think this is actually a very rewarding and satisfying field.
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Dr. JoAnn Elisabeth Manson
Dr. JoAnn Manson has been a leading researcher in the two largest women’s health research projects ever launched in the United States—the first large scale study of women begun in 1976 as the Harvard Nurses’ Health Study, and the National Institute of Health’s Women’s Health Initiative, which involved 164,000 healthy women. Until the early 1990s, research on human health was usually done from all–male subject groups, and the results generated were thought to apply to both sexes. Federal regulation now mandates the inclusion of women in all research studies, as men and women may react differently to certain diseases and drug remedies, a fact Dr. Manson’s research efforts have helped to establish.
JoAnn Elisabeth Manson, M.D., Dr.P.H.
Dr. Joann Elisabeth Manson
Dr. JoAnn Elizabeth Manson is a leading researcher in women’s health and public health.
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When I was in medical school in the late 1970s, it was very common to use the male model for teaching. For instance, there was the classical “70 kilogram man,” and you know, the doses of drugs that would be used for a male of that body size, and also the risk factors for diseases, and the treatment of various diseases in males. The Nurses’ Health Study was started in 1976, with 121 thousand female registered nurses. It was really the first large-scale observational study of women, looking at risk factors for many chronic diseases— breast cancer, colon cancer, heart disease, diabetes, and previously, most of these studies had been in men. I feel very strongly that there needs to be more of an emphasis on prevention and health promotion than there’s been in the past. The paradigm has been treatment of disease, more so than prevention. And there is increasing evidence that lifestyle factors play an enormous role in prevention of disease. I’ve often said that regular physical activity is as close to a magic bullet for good health as we’ve come in modern medicine, despite all the technological advances. The list of conditions that can be prevented or at least improved through regular exercise is really an expansive one. You’re talking about reduced risk of diabetes, heart disease, stroke, obesity, several forms of cancer— particular colon cancer and breast cancer, osteoporosis, and many others. And the portfolio is enormous. Our understanding of the benefits of exercise also has evolved over the years. We used to believe that vigorous and prolonged exercise was necessary in order to improve health. That you needed to get your heart rate at least 70 to 80 percent maximum, you needed to do the exercise continuously, at least 20 minutes, 3 times a week, and it had to be quite vigorous. We now know that even moderate intensity exercise, such as brisk walking— and it can be broken up into maybe 15 minutes or even 10 minutes at a time—can have important health benefits including the prevention of heart disease, and stroke, and diabetes, and various forms of cancer, and osteoporotic fractures. So I think we’re learning more and more about the benefits of moderate exercise—which is good news from a public health standpoint. Because many people will not engage in vigorous exercise. And setting the bar too high, can serve as a deterrent of getting started.
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Dr. JudyAnn Bigby
JudyAnn Bigby, M.D., is director of the Harvard Medical School Center of Excellence in Women’s Health. She is devoted to the health care needs of underserved populations, focusing especially on women’s health. She is also nationally recognized for her pioneering work educating physicians on the provision of care to people with histories of substance abuse.
JudyAnn Bigby, M.D., Photo by Michael T. Quan and Courtesy of Patriots Trail Girl Scout Council
Dr. JudyAnn Bigby
Dr. JudyAnn Bigby serves as the director of Harvard Medical School’s Center of Excellence in Women’s Health and works to address the health care needs of vulnerable populations.
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I see patients part-time. I only spend two mornings a week seeing patients. And with all my other responsibilities, I keep doing that because my patients are the ones who inspire me. I see mostly women. I have a lot of women of color, who may not be that well off, and you know, they are really incredible people. They have a lot of adversity in their lives—they are very ill, many of them, but they have so much positive that they think about their lives. So that’s one thing that keeps me going and inspires me. One of the things that I am trying to do is to try to get physicians to see things from the patient’s perspective. Not just how it feels to have a heart attack, or breast cancer, or something like that. But also how the circumstances of a patient’s life impacts everything that happens to them, from the moment they walk into a health care facility. It may determine how comfortable they feel speaking to the secretary. It may determine how comfortable they feel asking a doctor a question. It may impact how comfortable they feel accepting instructions or advice from a doctor. They may decide that because of a past experience, or a family member’s experience, that they aren’t going to trust that doctor and not follow the advice. In our study, where we were trying to find out what types of things contribute to dissatisfaction with doctors by women of color—Black and Latina women—we found that both doctors and patients make assumptions about each other. The women seemed more aware that they were making the assumptions; they felt that race was a very important issue in the way that they built their assumptions. The doctors did not feel that they were making assumptions based on race, but on other issues. But in the end, what happens is, because of these assumptions, when the two individuals are communicating, they’re not communicating about it the same way. Their assumptions are different. It definitely colors the way they interact with the other person. And I think that one of the things that needs to happen is people need to be able to recognize their assumptions and talk about them, so that people can get on the same page when they’re communicating. For those people who are worried that healthcare is such a negative field now—because of managed care, or not being paid enough money, or having a lot of pressure to see more patients—I think that we need people to go into medicine who will turn around and say, “Well, if this is not the right way to do it, if this is not best for the patients, then we have to change.” And we need more people like that.
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Changing Medicine, Changing Life
Transforming the Profession
Many women physicians strive to balance their personal and professional lives, as well as the needs of individual patients and entire communities. They are promoting reforms to eradicate the professional barriers that many of them faced in their own careers and working to change the way that medicine is taught and practiced.
Drawing on their own interests and experiences, women physicians are instituting changes that have far–reaching benefits for the health and happiness of families, communities, and medical practitioners themselves.
Dr. Perri Klass
As a pediatrician, writer, wife, and mother—Perri Klass has demonstrated how medicine is integral to the health of families and communities, and how doctors themselves struggle to balance the conflicting needs of profession, self, and family. With her love of literature and her involvement with literacy, Klass is acutely aware of the importance of reading to personal and professional success. As medical director of Reach Out and Read, a national program which makes books and advice about reading to young children part of every well–child visit, she encourages other pediatricians to foster pre–reading skills in their young patients.
Reach Out and Read National Center
Dr. Susan M. Briggs
Susan M. Briggs, a trauma surgeon at Massachusetts General Hospital, established and became the first director of the International Medical Surgical Response Team (IMSuRT), an emergency response team that, on short notice, organizes and sends teams of doctors, nurses, and other health professionals from throughout New England to emergencies around the globe.
Susan M. Briggs, M.D., M.P.H.
Dr. Edith Irby Jones
In 1948, nine years before the “Little Rock Nine” integrated Central High School in Little Rock, Arkansas, Edith Irby Jones became the first black student to attend racially mixed classes in the South, and the first black student to attend the University of Arkansas School of Medicine. Her enrollment in a previously segregated southern medical school made news headlines across the nation.
Edith Irby Jones, M.D.
Edith Irby Jones, M.D.
Dr. Edith Irby Jones
Dr. Edith Irby Jones was the first woman to be elected president of the National Medical Association and the first African American to graduate from University of Arkansas School of Medicine (now the University of Arkansas for Medical Sciences.)
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I really didn’t think about when I applied to medical school that there was a possibility of my not being accepted. The University of Arkansas was one of the ones that was on my list to apply to. It didn’t dawn on me that there might be a question about my race. It was close to home, but MOST of all why I accepted it— it had a tuition of 500 dollars. On the day of orientation, Dr. Schenalt, the dean at that time called me in and said, “We have some situations. The state law requires us...” At that time, blacks and whites could not eat together in a public situation. They could not use the same toilet facilities, by state law. So I accepted that. I didn’t have any choice. I was not trying to desegregate, I was not trying to change any laws, I felt... I just wanted a medical education. The kitchen help would always put on fresh flowers every day. A change of flowers, never the same. It either came from their yard, or from someplace, but always... never a word spoken, never an encouraging word saying, “we’re proud of you,” nothing said, nothing to say “if you need help, come to us,” none of that. It was just a sort of unspoken, “we are here.” The reason that I have stayed in Houston, and the reason that I have stayed in “third ward” Houston, is because it allows me to do what I want to do. I see those who cannot afford to go to the other areas, even in Houston, to get medical care. I see those who cannot pay a parking fee because there is a charge for parking. I see people who are ashamed to go in and say, “I don’t have any money, but I’m sick.” People give me my passion. To be able to encourage someone who would not have achieved their potential. To be able to help the physical body to heal, that would not have been healed, or a family would have lost that member. To send someone off having the same feeling that I have— that the world is mine.
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Dr. Leah J. Dickstein
Psychiatrist Leah J. Dickstein is a former president of the American Medical Women’s Association and vice president of the American Psychiatric Association. Her innovative Health Awareness Workshop Program, at the University of Louisville, is based on her experience attending medical school while raising a family. The popular program, which covers everything from individual well–being to personal relationships, as well as race and gender issues, has made the University of Louisville one of the nation’s most family–friendly medical colleges.
Leah J. Dickstein, M.D., M.A.
Dr. Leah J. Dickstein
Dr. Leah J. Dickstein developed a program to help medical students balance their studies and family lives and was president of the American Medical Women’s Association.
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For six years, Leah Dickstein taught sixth grade in Brooklyn, to help support her family while her husband, Herbert Dickstein, attended medical school. After he had completed his training, Leah Dickstein enrolled in medical school, and the couple came up with a range of strategies to balance the responsibilities of caring for their three children while building their careers. Leah Dickstein had a clear sense of her own priorities, and so Saturdays and summers were saved for family activities, which she considered more important than graduating at the top of her class. Dr. Herbert Dickstein brought the boys to the hospital to visit Dr. Leah Dickstein when she was on call during her residency. Over the years, she developed other ways to cope with the everyday challenges of combining a career in medicine with family life. Those experiences led her to develop an innovative program to teach medical students and their partners how to cope with the demands of medical school—while maintaining their relationships and family commitments. Since 1981 she has been the Director of the Health Awareness Workshop. Her program addresses everything from study skills and time management to community resources, mentoring, exercise, and nutrition. The message is that students must take care of their own physical and mental health before they can learn to take care of others. Dr. Leah Dickstein’s work has made the University of Louisville one of the most family-friendly medical colleges in the nation.
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Dr. Barbara Barlow
Barbara Barlow was the first woman to train in pediatric surgery at Babies Hospital, Columbia University Medical Center (now called Babies’ and Children’s Hospital of New York). By researching and documenting the causes of injuries to children in Harlem, and increasing public education about their prevention, she has helped to dramatically reduce accidents and injuries to inner–city children in New York and throughout the United States.
Barbara Barlow, M.D., M.A.
Dr. Barbara Barlow
Dr. Barbara Barlow founded the Injury Free Coalition for Kids and helped increase public education on how to prevent childhood injuries.
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In 1975 I came to Harlem as Chief of Pediatric Surgery. I wanted to work in a public hospital, because I didn’t want to do private practice. I wanted to offer medical care to children who perhaps would not get it because they couldn’t afford to pay, or because they had poor insurance, and so I looked at the public hospitals in New York City, and I chose Harlem. As Director of the Service, of course, I knew every child who came into the hospital and so I saw children falling out windows, being hit by cars, being injured in playgrounds. And in those days, we had a lot of children being shot and assaulted. And I felt that there must be some way we can make this community safer for children because this is not an appropriate thing to happen to anyone’s child. When children came in severely injured, dying from injuries, permanently disabled from injuries—it broke my heart. Really. I used to cry with the parents, and I couldn’t bear anymore to see this happening without trying to do something to make things better. So I constantly wrote grants to find funding to make an Injury Prevention Program that would involve the community and would make it a safer place for children. Basically, what the staff did, is they went block to block and mapped the community. We didn’t find any commercial maps of Harlem in those days. The maps of Manhattan cut off at 110th Street, so that we had to make our own maps. So we knew where the playgrounds were, where the schools were, where the churches were, so we would understand the community block by block, and we did that. And we also used consumer product safety standards, and evaluated every playground in Harlem, and we took pictures. And of course, they all violated consumer product safety standards. And while we did that, we involved the community in the process. We all have a responsibility to people in the community. Everybody has a responsibility for building good communities, good places to raise children. Everybody has a responsibility to see that every child has a chance in this life, has a good education, has good after-school things to do, good sports, good recreation— that’s all our responsibilities. Not just the doctors’. Harlem is a very special community. It’s like a small town. And they said maybe it was so successful because it was Harlem. My career as a pediatric surgeon and as a surgeon has been so enriched by my work in the community, with the community, for children. I would have never been able to predict this when I was a student. But it came naturally, in the course of what I was doing and what I was seeing.
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Dr. Marianne Schuelein
As a pediatric neurologist at Georgetown University Hospital in the 1960s and 1970s, Dr. Marianne Schuelein came to understand the problems of affordable child care from her own experience as a working mother. In 1973, as vice president of the District of Columbia chapter of the American Woman’s Medical Association, she decided to present the issue directly to Albert Ullman (D–Oregon), chair of the Ways and Means Committee of the U.S. House of Representatives. In 1976, Congress passed a law allowing child care tax deductions, enabling more women to work outside the home.
Marianne Schuelein, M.D.
Marianne Schuelein, M.D.
Dr. Marianne Schuelein
Dr. Marianne Schuelein campaigned for childcare tax deductions, which Congress pass into law in 1976, enabling more women to work outside the home.
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I knew from when I was very young that I wanted to do something useful. I think that was my main goal. I remember once telling a guidance counselor I wanted to find my place in society. And that didn’t mean society with a capital S, it meant I wanted to do something for the society. She misunderstood me. I liked science, I was good at science. When I was quite young, maybe 12, I loved horseback riding, and I memorized all the bones of a horse because I wanted to. But I also was thinking at one time of being a social worker. And the combination of science and social work— the most logical thing seemed to be medicine. In the 60s, when I had my first child, I earned about $15,000 a year. About half of that went for childcare most of the rest went for income tax. I thought this was particularly difficult. I was fortunate to be making at least $15,000, but most of my contemporaries couldn’t make that much, and a lot of them didn’t work for that reason. And I felt that something really needed to be done about it. Somebody suggested that I make an appointment with the head of the House Ways and Means Committee. So I met him and I told him what I thought. We perhaps met together for 10 or 15 minutes, and I went home and nothing happened for a while. But within the next few years childcare did become, at least in part, deductible. Some years ago I was at a party and met a woman who had been his assistant. When we were introduced she said, “I know your name. You were the one who was influential in getting the bill passed that allowed women to deduct childcare.” You don’t have to have connections, you don’t have to money, you don’t have to have a high office. You can make things change. One should never assume that things cannot be changed. When things are wrong, they can always be changed, that’s what people do. And it only takes somebody with enough passion, with enough bulldog perseverance to make that difference.
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Changing Medicine, Changing Life
Taking the Lead
In recent decades, women physicians have risen to the very top ranks of the institutions that lead medical research and define the highest standards of practice. Deciding which issues to focus upon, they direct research and funding and are instrumental in implementing the policies, developing the drugs and treatments, and drafting the legislation to meet emerging medical challenges.
From high–profile, influential positions, women physicians provide examples and encouragement, as well as career opportunities, for other women who hope to practice medicine.
Dr. Antonia Novello
When Dr. Antonia Novello was appointed Surgeon General of the United States by President George Bush in 1990, she was the first woman—and the first Hispanic—ever to hold that office. Her appointment came after nearly two decades of public service at the National Institutes of Health, where she took a role in drafting national legislation regarding organ transplantation.
Antonia Novello M.D., M.P.H., Dr.P.H.
Antonia C. Novello, M.D., M.P.H., Dr.P.H.
Dr. Catherine D. DeAngelis
In her role as the first woman editor of the Journal of the American Medical Association, Catherine DeAngelis, M.D., has made a special effort to publish substantive scientific articles on women’s health issues. The journal plays an important role in bringing new research to light, and featured articles can lead to fundamental changes in treatment. Under her editorship, the journal published a landmark study questioning the benefits of hormone replacement therapy in 2002. She also served as editor of the Archive of Pediatrics and Adolescent Medicine, from 1993 to 2000.
Catherine DeAngelis
Catherine DeAngelis, M.D., M.P.H.
Dr. Ruth L. Kirschstein
As director of the National Institute of General Medical Sciences from 1974 to 1993, Dr. Ruth Kirschstein was the first woman institute director at the National Institutes of Health (NIH). Throughout her career, she has worked as an administrator, fundraiser, and scientific researcher, investigating possible public health responses in the midst of crisis and conservatism.
Ruth L. Kirschstein, M.D.
Dr. Ruth L. Kirschstein
Dr. Ruth L. Kirschstein served as director of the National Institute of General Medical Sciences, becoming the first woman director of an institute at the National Institutes of Health (NIH).
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Transcript
I wanted to be a doctor from a very young age, even before I went to high school. And I’m not sure exactly what motivated me. I had a father who was a chemist. I had a mother who was extremely ill through most of my childhood, and spent a long time in the hospital. It may have been that, that motivated me partly, as well. When I applied for medical school women were not very commonly applying for school—I actually applied to every medical school in the United States. At least one of them wrote me and said, “We only take men.” And that sort of was not a very good thing, and it didn’t make me very happy. Today, over 50 percent of each medical school class are women. When I went to medical school it was a very small number in my class, which started in 1947, which was the first post-World War II class. It actually had 10 out of 110, which was pretty big, but when you think about it, 5 of them were nurses who had been in the military, were able to get the GI Bill to go to medical school, and decided they didn’t really want to answer to anybody else anymore— they wanted to be their own bosses. So it is a real difference now. In addition, Ph.D. biological and chemical scientists make up about 40 percent of our graduate programs in those areas. But the problem is that women are still not in sufficient leadership positions in medical schools and in universities. There are very few women deans of medical schools. There are not many chairwomen of departments, and where we have been very successful, and I am absolutely thrilled, there are something like ten women presidents of major universities—we need more. If you have a population of leaders who are all men, they are never going to think of women. They are never going to think of minorities. They are only going to think of people like themselves. And so that told me, when I got the job as director of the National Institute of General Medical Sciences, that I had to see that we changed the culture. And that we thought about women for jobs, and we thought about minorities for jobs. Actually, people said to me when I became the director of NIGMS—the National Institute of General Medical Sciences—people said, “Well, you’re going to hire only women.” And I said, “No; I’m going to give women an equal opportunity to men. But I don’t believe in having an institute that’s all men or all women. We are equal.” And so I did that, quite deliberately.
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Dr. Helen M. Ranney
Dr. Helen Ranney’s landmark research during the 1950s was some of the earliest proof of a link between genetic factors and sickle cell anemia. She went on to become the first woman to chair the department of medicine at the University of California, San Diego, and was the first woman president of the Association of American Physicians from 1984 to 1985.
Helen M. Ranney, M.D.
Dr. Helen M. Ranney
Dr. Helen M. Ranney made pivotal contributions to sickle cell anemia research and became the first woman president of the Association of American Physicians.
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Transcript
During my career in medicine, I practiced probably what would be mostly called academic medicine. I had a research program in addition to a clinical program. In the clinical program I saw patients who had ’hematologic,’ that is, blood, disorders. These would be patients who had diseases of the red blood cells—sickle cell anemia, or thalassemia, some patients who had leukemia or who had bleeding disorders. In my class in medical school there was a class of 120 and there were 5 women. And that was about standard, plus or minus a few— that was about standard for most of the Ivy League schools. I don’t think that one was aware of being treated differently than men by any of the faculty. There were clearly some of the students who rather resented the fact that there were women in the class, but you know, one didn’t really take that terribly seriously. They were the kind of students one didn’t take seriously. I think that probably I was slower to be recognized academically then I would have been, had I been a man... but I didn’t really notice it. I never really cared about whether I was an associate professor or not. The only place where I was sure that I probably was discriminated against was at times in the salary scales. At times it was fairly clear to me that men of the similar rank, and if anything, somewhat lesser accomplishment, were making more money. And I was aware that that happened from time to time. On the other hand, I had enough money, so it didn’t really matter. I was offered the position in San Diego because they wanted a chair of the department of medicine, and it, again, was a new school. My devotion has been to new things that were getting started. There was a lot to be done, and a lot of new faculty to be recruited, and a lot of building to be done. I think it’s important to mentor the young physicians who are interested in research, and who need some time to get the tools, the necessary tools, and to learn how the research is done. And also how grants are obtained, and how grants are administered, and how the American system requires some administrative kind of role model for a person who’s entering it for the first time.
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Dr. Audrey Forbes Manley
Dr. Audrey Forbes Manley received a music scholarship to study at Spelman College in Atlanta. She took the opportunity to expand her education and interests and moved into the sciences. She was appointed Assistant Surgeon General in 1988, and is the first African American woman to hold a position of that rank in the United States Public Health Service. In 1997, she returned to Spelman, after forty years in medicine, to serve as president of the college.
Parklawn Health Library
Dr. Audrey Forbes Manley
Dr. Audrey Forbes Manley was the first African American woman to achieve the rank of assistant surgeon general (Rear Admiral in the Public Health Service.)
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Transcript
There were several such instances in my life and my professional career, where I was not only the first African American, but the first African American woman, and a couple of occasions I was the first woman. There’s always, I think, a lot of pressure to perform, to be better than the best, because you realize— at least I always felt—that you are opening a door. You also are setting a record. You are setting a watermark. You are setting an expectation. I was the first African American woman to be appointed as an Assistant Surgeon General in the U.S. Public Health Service. And this is a service that is more than 200 years old. That’s quite significant. Again, opening the door, setting a precedent. That you have to perform, because you are then opening the doors for other people. And if you don’t, you can easily, just as easily, close that door. An M.D. degree really prepares you to do anything in the world that you want to do. It is so very basic. The understanding of the body, the mind, how it functions, growth and development, the stages of life. With me, it was that, plus the experience in the Public Health Service. I think that either one without the other would not have prepared me to be a college president. If you’re only thinking of yourself—what material and monetary things you can get, if the Mercedes and the fur coat and the big house is what’s keeping you going— you’re not going to make it. Not too long. You’ll have some immediate successes. But for the long term, for life, you really have to have goals that are bigger than you, family, that have to deal with society and making a contribution that’s bigger than yourself.
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Dr. Frances K. Conley
In 1966, Frances Krauskopf Conley became the first woman to pursue a surgical internship at Stanford University Hospital, and in 1986, she became the first tenured full professor of neurosurgery at a medical school in the United States. In 1991, she risked her career when she drew public attention to the sexist environment which, she argued, pervaded Stanford University Medical Center.
Frances K. Conley, M.D., M.S.
Dr. Frances K. Conley
Dr. Frances K. Conley was the first woman to be a full tenured professor of neurosurgery at a medical school in the United States.
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Transcript
I had a number of professors who tried to talk me out of my decision to pursue a career in surgery, and I’m not exactly sure why, although I think that their perception of the lifestyle of the surgeon was not compatible with being a woman. At that point I was married, and I’m sure that the general assumption at that time was that if you’re married you are going to have a family, and that the two—a career in surgery and having a family—were incompatible. Surgery is just such fun. It is a wonderful discipline because you get a chance to do your thinking beforehand. You have to make fairly rapid decisions, and you have to live by those decisions. And what I really enjoyed about it was the planning and execution of "the perfect case." Of doing things meticulously, correctly, efficiently, and having a very happy outcome with it. And one’s ego gets very involved in surgery. And I guess my ego needed to be fed, and surgery did that for me very well. In 1991, I gave up my position as a tenured full professor of neurosurgery at the Stanford Medical School. And I did so because a person was elevated to be the chair of my department who I felt was a very sexist person. The dean had articulated the desire to create an environment at the medical school that was more hospitable to those of us who were different—i.e., women and minorities. And his putting this person into a position of the deanship was antithetical to what he had espoused as his intent. And so I quit. I had tremendous power at that particular time. I was a tenured full professor. And there were very few tenured full professors that were women who were neurosurgeons. I had been elected to a number of things at the University so I was very well known, and had a lot of support behind me, so that I dealt my hand with a fair amount of power behind it. The difference that I made when I took a stand on looking at or exploring the differential treatment that women received in medicine—the difference was, that it woke people up. All of a sudden, that which had been just accepted as part of the medical world, as normative behavior—that you can pat nurses on their butts, and you call people "honey" in front of patients, and that you can do this—that was normative behavior, and nobody questioned it. And I think the difference that I created was it made people stop in their tracks, and it made them think, Hey, is this right? Am I treating my women patients the same way I do my men patients—with respect, and with dignity—and am I giving them as much of me as I should be giving them? And so from that point of view, yes, I think it did make a big difference. Did I correct things? No, not totally.
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Dr. Bernadine Healy
Cardiologist Bernadine Healy is a physician, educator, and health administrator who was the first woman to head the National Institutes of Health (NIH). Known for her outspoken, innovative policymaking, Dr. Healy has been particularly effective in addressing medical policy and research pertaining to women.
Bernadine Healy, M.D.
Dr. Bernadine Healy
Dr. Bernadine Healy was the first woman to direct the National Institutes of Health (NIH).
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Transcript
My parents, and particularly my father, thought it was wonderful for a woman to be a doctor. And in those days, when I was growing up, it was really exceptional, unusual, for a woman to pursue a career in medicine. And as far as my father was concerned, it was the perfect place for me to go. It was a place where I could use my intelligence and my hard work, but also make a difference. When I went to Harvard Medical School there were roughly 10 percent— less than 10 percent—of the class were women. And in those days—although they probably don’t like to remember this— medical schools had quotas, and there was the prevailing attitude that women were taking up a spot that wasn’t necessarily going to be used as well as a spot filled by a man. Women had to have, I think, better academic credentials, and often go through much tougher screening. When I was at NIH (National Institutes of Health), there were a number of wonderful challenges, and a number of very difficult ones... the Women’s Health Initiative, which I, believe it or not, announced to the Congress of the United States roughly three weeks after I was Director, in which I said, “We need a moon walk for women.” And I laid out the general concept of the Women’s Health Initiative. That it would be holistic. That it would involve not one organ, or one disease, but in fact, major illnesses and issues of wellness that affect women—particularly in that over-50 range where most women, most people, face their illnesses, and see their lives demolished, often, by diseases that often can be prevented. Something that really paid attention to that huge gap in our knowledge, our clinical and our basic knowledge. I saw 9/11 through very, very personal, up-close experiences. And one of the things that I came away from that experience with is the incredible role that we, as physicians—because of our knowledge and our experiences, one-on-one with human beings, at the most critical time in their lives—how physicians can bring a certain comfort, just by being physicians, to people at that time. Not always to patients, but to people. I think any young person who is thinking about a career in medicine, should keep thinking. It is one of the most extraordinary careers, and one of the most amazing intellectual journeys—because medicine is something that keeps you humble all the time, because there’s always new information that makes you challenge yesterday’s thinking. It is something that is also so humane. I mean all of us, I believe, in our hearts are humanitarian. And how wonderful to be in a career that in almost any dimension of it—whether you’re the doctor at the bedside, or the scientist in the laboratory, or the public health doc tracking down the latest epidemic—that you are doing something that is pure in it’s fundamental purpose, which is helping another human being. And you may not always see that.
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Dr. Paula A. Johnson
Dr. Paula Johnson is a women’s health specialist and a pioneer in the treatment and prevention of cardiovascular disease. She conceived of and developed one of the first facilities in the country to focus on heart disease in women.
Brigham and Women’s Hospital
Dr. Paula A. Johnson
Dr. Paula A. Johnson is a pioneering specialist in cardiovascular disease and developed one of the first facilities dedicated to heart disease in women.
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Transcript
About a year ago, I become the executive director for the (Mary Horrigan) Connors Center for Women’s Health and Gender Biology, and it was really a dream come true. The mission of the center is to improve the health of women, and to transform medicine, so that sex and gender are routinely applied, where appropriate, in medicine. And it’s a pretty lofty goal... a pretty lofty mission, but it is absolutely inspiring to me. We are working in the clinical venues here at the Brigham and Women’s, not just in traditional women’s health areas, but really in every area of medicine that touches women. Whether it be all the surgical areas, whether it be medical subspecialties, and of course obstetrics and gynecology, to really think about what is it that women need? What are the models of care that we need to implement, not just in women’s health practices, but throughout our institution, and can that then serve as a model? Especially if we can measure it for other institutions to improve the health of women. We do a lot of work in partnership with our community women, where we really know that the rates of heart disease are far higher than they should be. Black women, for example, in our neighborhood—the neighborhood of Brigham and Women’s—die at a rate of four times that of their Caucasian counterparts, at a very young age. And this is kind of in the middle of what some people would call the “medical Mecca.” So we do a lot of work with our community women, to think about risk factor reduction. But to also think about what do they need in order to stay healthy? What do they need in order to understand and cook differently? And that might include, quite frankly, better incomes. And therefore how do we connect with other groups around what is kind of the basic standard by which we should be thinking women should live, in order to maintain and achieve health? When you are starting from behind, and medicine is moving forward at a lightning pace—how do you catch up, but then continue to move forward, so that you’re not continuously behind? And I think that we’re always talking about closing the gap. But closing the gap becomes much more difficult year after year. Because we’re not closing it, and medicine is moving forward. And I think there is just an inherent challenge there that we have not figured out. And I think it becomes even more difficult when you begin to talk about a stressed economic environment, and one in which the greater public may not recognize, (or appreciate or understand) the full degree of barriers that are out there for African Americans to achieve that health state.
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Dr. Joan Y. Reede
Dr. Joan Reede works to recruit and prepare minority students for jobs in the biomedical professions, and to promote better health care policies for the benefit of minority populations. In 2001, she became Harvard Medical School’s first dean for diversity and community partnership. She is the first African American woman to hold that rank at HMS and one of the few African American women to hold a deanship at a medical school in the United States.
Joan Y. Reede, M.D., M.P.H., M.S.
Dr. Joan Y. Reede
Dr. Joan Y. Reede was appointed Harvard Medical School’s first dean for diversity and community partnership and has worked to bring more minority students into the health professions.
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Transcript
I’m dean for Diversity and Community Partnership at Harvard Medical School. And it is designed to bring more diversity to the faculty at Harvard Medical School and its affiliated teaching hospitals—and there are 17 affiliated institutions— and to look at diversity efforts at the student, the resident, the faculty, and staff levels. But it also looks at engaging the community, and how we can work better with our surrounding community. But the truth of the matter is, if you’re going to bring diversity into medicine, you can’t just look at the faculty that are there—people at the end of the pipeline, because the numbers are too small. And so what you have to do is put in place programs that will bring more students into science. Help them understand the joy of science. Help them understand that you can love science, and do anything! So what we’ve put together at Harvard is a series of programs that says you have to address the total pipeline. And at the same time put together programs that say that it is part of our responsibility to our surrounding community. I think for youth today it can be very hard. And it can be very daunting to think “I have to match the achievements of someone else.” And so I think the first thing is to figure out, what is it that you like doing? What is it that you want to do? What do you want your life to be about? And then to understand that it’s going to take a lot of hard work. You can accomplish anything. I see people of color moving into positions that my mother, my grandmother, never dreamed would happen. I see young women who are doing amazing things, and leading amazing things. And that’s only going to grow. It’s not going to lessen over time, it’s going to grow. So I think there are more and more opportunities out there, and no one should let anyone, at any point in time, tell them what they can’t do.
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