(continued from page 31)
“W
hat a waste!” These
words hit me hard as
I sat in the office of
one of my mentors, a
respected and highly
esteemed physician
in the Department of
Medicine at Vanderbilt University School of
Medicine. I was a fourth-year medical student, and I had just told
him that I was no longer going to pursue internal medicine. Instead,
my chosen field was dermatology. His response was devastating. I
weakly smiled and tried to defend my decision, but it was of no use.
In his mind, I was “taking the easy way out.”
A little background. My grandfather was one of eight children in
rural western Kentucky. His father died when he was 16, so he was
forced to work while attending school to provide for his family. In
World War II, he enlisted in the Army Air Corp, where he excelled
as a gunner on B-29 bombers. He was shot down over Japan and
survived for nearly a year in the prisoner of war camp. When he
came home, he weighed barely 90 pounds. He was a serious man
who did not talk about war, and only at age 84, did he tell me about
his imprisonment, as tears rolled down his face, the first time I
had ever seen him cry. He lived a life of working hard but was not
affectionate or warm. He ran every day through his 70s and early
80s. I remember as a 6-year-old going with him to the local track
trying to run laps to keep up with him.
My father inherited his grit and work ethic. He enrolled at the
University of Kentucky, graduated with a chemistry major in three
years and pursued medicine. Fortunately, he met my mother, a witty,
funny and beautiful woman who served as his intellectual equal but
provided some levity and humor to his previously somewhat cold
life. During the Vietnam War, my father was a flight surgeon in the
Air Force. After the war, my parents re-settled in Lexington where
they raised our family. My father was a runner like my grandfather.
(I would only later understand the therapy of running as an adult.)
He would often humor me by “running with me” when I was in
elementary school. He practiced endocrinology for decades and was
revered by his patients for his dedication and humanity.
As a child, I was fascinated by skin—in particular, the bizarre
growths all over my grandmother. She underwent skin cancer
surgeries, the result of a childhood on a farm, and a youth seeking
a tan with butter on her skin! My father encouraged my interest
in dermatology but was always realistic about the challenges and
sacrifices of being a physician.
I am my father’s daughter with the sense of humor of my mother.
I was always self-driven to work hard in everything I did. Laziness
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LOUISVILLE MEDICINE
always has and always will be a bad word. (I wonder if there is an
“anti-lazy” gene that someday will be identified, as it was clearly
passed down from my grandfather.) In high school, I received the
110% Award for the soccer team, an award given for effort and not
ability. My path led to Vanderbilt Medical School, four of the best
years of my life. I relished every rotation. I cried with joy when I
delivered my first baby. I would sit with patients at the VA and listen
to their stories. I took it all in. I realized that my best fit was clinical
medicine because of the connections I like to make with my patients.
My brain always briefly lingered on dermatology, but I sensed as a
medical student, that it was a field for the very smart students who
wanted an easy life. That completely conflicted with my values.
As I progressed in my rotations, my fate became clear after
two patient encounters. One was a crusty, curmudgeonly cardiac
transplant recipient from East Tennessee whom I adored. He was
covered in squamous cell carcinomas (SCC) and surgical scars as a
result of his immunosuppression, and ultimately died of metastatic
SCC from the skin. The other was a gentleman who presented with
reddish purple lesions on his arms—Sweet Syndrome—this led to
his diagnosis of acute myelogenous leukemia. I knew at this mo-
ment that dermatology would provide the intellectual challenge and
ability to care for patients. I felt that I had disappointed many of my
mentors outside of dermatology. I also knew, however, that despite
others’ perceptions, I could make a difference as a dermatologist.
The next several years taught me that life is unpredictable. The
day after I found out I matched at Vanderbilt in dermatology, my hus-
band was diagnosed with chronic myelogenous leukemia. Little did
I realize that four years prior, sitting in pharmacology and learning
about revolutionary imatinib, that it would save my husband’s life.
My internship in internal medicine at Vanderbilt, followed by
three years of dermatology training, were characterized by long
hours but a sense of purpose. The faculty at Vanderbilt Dermatol-
ogy were extremely supportive of my desire to pursue academic
dermatology and to teach. My husband and I decided to return to
Kentucky following residency, where I accepted a full-time faculty
position at the University of Louisville and joined Associates in Der-
matology. I sensed that Dr. Jeff Callen would be an excellent mentor
and support as I started my academic career, and fortunately, we
would be closer to family. I was 20 weeks pregnant with my second
child when we moved to Louisville, where I knew only two people
and was starting my first job. The day my daughter Reynolds was
born, she failed her newborn hearing test. We learned to my horror
that she had congenital cytomegalovirus (CMV) and was deaf, with
unpredictable motor and neurologic deficits. Those were some dark
months. However, we emerged with the assistance of our audiologist,
therapists, deaf community, First Steps, family and new friends.
Fast forward eight years. My husband (in remission) is a stay-at-