A logical path to success in academic medicine

Top tier scientists at academic medical centers sometimes begrudge the time spent away from their labs to pass on their wisdom in the classroom to the next generation. Virginia Brooks is indisputably not one of them. She’s passionate about teaching, a quality that has earned her a raft of excellence in teaching awards.

It’s a labor of love, but it doesn’t come easily, she claims. One reason she went into science, she laughs, was because she was so challenged in English. “I don’t want to tell you what my English GRE score was. Little did I know that, oh yeah, what would I do 90 percent of my time? Communicate. I have to think a lot about the words I use. I’m not naturally articulate. Even now I still spend a lot of time thinking through the words I will use and the logical progression. I work really hard at that.” 

“It’s important to be logical and efficient. It goes without saying that you have to work hard, but you also have to learn to prioritize, to multi-task, but to pace yourself.”

Her strength in the classroom, she believes, is her ability to give well organized presentations. She teaches renal physiology to  medical students and, with Dr. David Ellison, teaches graduate students about blood pressure regulation.

Her teaching chops got their first workout when she was a graduate student in physiology at the University of Michigan. A unique aspect of the Michigan graduate curriculum was a strong emphasis on teaching, including a required course on strategies to improve teaching effectiveness. Which is how she ended up delivering some lectures to undergraduates on introductory chemistry as background for their physiology course. Facing a lecture hall packed with 500 students was a true baptism under fire, yet somehow it made her realize she really enjoyed teaching.

She attributes her success both as a scientist and as a teacher to a logical mind, the ability to prioritize, a bottomless capacity for hard work, a nagging fear of failure and the willingness to seek out help when necessary, which is almost daily, she says.

Toolmaker’s daughter

Ginny Brooks is unusually self-effacing for someone who is at the top of her game as a scientist, is conducting path breaking research on, among other things, the role of the sympathetic nervous system in blood pressure regulation; has, with her husband, raised two “awesome” daughters -- and, on top of all that, has beaten back cancer. She’s a 18-year breast cancer survivor.

The daughter of an auto industry toolmaker, she grew up in the Detroit suburb of Troy, Michigan, and as a child was excited by the idea of becoming a nurse. She went to college not far from home at Oakland University --  “near the Silverdome,” she proudly points out, the stadium that for years was the home of the NFL’s Detroit Lions. Her undergraduate degree was in chemistry. She spent a year after that in a medical technology internship at nearby St. Joseph Mercy Hospital, but concluded that the repetition of assaying multiple test tubes wasn’t the right fit for her after all.

A physiology course she had taken at Oakland taught by “an amazing teacher” named Barry S. Winkler, a professor of biomedical sciences, with whom she still keeps in touch, had a profound effect. “He kind of pushed me,” she recalls. When her boyfriend, now husband, went off to graduate school at the University of Michigan in Ann Arbor, she decided to follow and landed, serendipitously it turned out, in “one of the best physiology departments in the country.”

“In terms of career progression, that was one of the luckiest things that ever happened to me,” she says.

The importance of the right mentors

"Seek out good mentors who not only are able scientists but also are skilled at teaching you the ropes, who can open doors for you, introduce you to people who can be helpful, help you get grants and how to get your research published."

Ginny Brooks gives credit to luck for many of the turns her career has taken. The luck to be in the right places at the right times. The luck to have matched up with inspiring mentors. “They were all really excellent in different ways,” she says.

Her graduate mentor, Richard L. Malvin, now a professor emeritus in Michigan’s physiology department, specialized in the kidneys and how they function. He pointed her toward a knowledge gap that would become the subject of her Ph.D. thesis. It was on how angiotensin, a hormone produced by the kidneys, affects brain control of the kidneys, leading to increased retention of sodium and elevated blood pressure. It opened up avenues of research that she continues to travel today. Dr. Malvin paved the way toward advancement in many other ways. He would say, “Look Ginny, I’ve been asked to give a talk, but why don’t you do it?” As a result, Ginny Brooks delivered not one, but two, symposium talks at national meetings, even before completing the requirements for her Ph.D.
 
After Michigan, she came west to do her post-doctoral work at the University of California, San Francisco.  “Another lucky thing,” she says. William Francis Ganong, a well-known neuroendocrinologist and chair of the UCSF physiology department at the time, had assembled an unusually dynamic faculty. For at least a decade it was ranked the top physiology department in the country by the National Academy of Sciences. Among those Ginny Brooks rubbed shoulders with was David A. Ramsay, the Oxford educated physiologist, who later became president of the University of Maryland. “He was the one that really pulled me up the ladder even after I left UCSF, helping me get funding and papers published.”

Her post-doc mentor – Ian A. Reid – helped sharpen her critical and research focus. His interest was the renin-angiotensin system, the complex array of hormones that rush to stabilize blood pressure and fluid balance when there is a hemorrhage, for example. Dr. Brooks’ research probes more specifically into the role of the renin-angiotensin system plays in the sympathetic nervous system’s regulation of blood pressure. Another line of inquiry she pursues is how blood pressure regulation in women is altered during pregnancy, something she began looking at after hanging out with the fetal physiology group shortly after arriving at OHSU and attending their journal clubs.

Dr. Brooks received her PhD in 1978 and has been a faculty member at OHSU since 1984. In that time, she says, women have become a considerably larger presence in academic medicine. That fact alone, she says, has smoothed the pathway for young women coming into the profession, but it’s still not entirely a cakewalk, particularly for women with young children.

Palpable but not crippling discrimination

"Dr. Brooks, you’re one of only three women we have, and they’re just out to get you."

Over the years, the discrimination she encountered as she climbed the ladder was palpable but not crippling, she says.

Dr. Brooks reflected on one event at OHSU that took its toll. It occurred years ago, she recalled, when the year’s crop of male medical students proved to be particularly belligerent. They peppered her with hostile questions each time the class met in what seemed like a feeding frenzy to her. “ I finished one lecture, and I asked some of the women students in the front row, ‘What’s going on?’ and they said, ‘Dr. Brooks, you’re one of only three women we have, and they’re just out to get you.’ 

“But that doesn’t happen anymore,” she says. "Times have changed in that regard.”

Looking back, Dr. Brooks says, “I’m very happy with the way my career has gone. I’m satisfied. I feel like we’ve made some discoveries  that have influenced what other people have done..”

What she does have real regrets about is not spending more time with her kids as they were growing up. “I don’t know how I could have, but I wish I had.”

She and Dan Schwass, the guy she followed to the University of Michigan, were married while they were in graduate school. She gave birth to her first child, Erin, when she was at UCSF and a second child, Katharyn, was born shortly after Dr. Brooks arrived at OHSU.

Accept the need for help

"Accept the fact, particularly if you have young children that you need help – help and understanding from your spouse, help with childcare, and help from the institution."

She is grateful for the flexible schedule she has had as an academic scientist, something her clinical colleagues don’t enjoy. “Very early in my career I had a laptop instead of a regular computer and I could go to soccer games and work, or while the kids were taking a nap I’d work, or if Erin was sick I could be home working. That’s a huge advantage.”

Still, she says, women in academia, especially if they have children, need to recognize and accept the fact that they need help to succeed. “You also need to accept that you’re never going to be the best scientist or the best parent that you can be because you’ll have to make sacrifices on both ends and you have to get over the guilt about that if you can.” More and more, she says, this is true for both men and women.

“I have seen some women leave science because they have a child and it is hard.  When I was a young assistant professor there wasn’t any recognition of how hard it was. The numbers have improved, but if an institution wants to help young academics – men or women – help them with child care.”  It was a challenge when she and her husband were starting out and struggling to make ends meet. “If you make enough,” she advises young women, “hire as much help as you can.”

Has Dr. Brooks employed any conscious strategies for making her way in the profession? “Finding mentors is really important, a mentor to help teach you how to do your job, introduce you to people, and open doors for you. Being efficient is really important, which means being able to prioritize. Serve on a lot of committees. That’s important. And network, network, network. You need to make friends. And you have to seek help, from men, from women, from colleagues.”

But her career path also offers another bit of guidance perhaps: Don’t overdo it. Shortly after she had won tenure, Ginny Brooks took a sabbatical and it was during that time she discovered that she had breast cancer. She had taken the sabbatical, she says, expressly “to shed all the committees I was on, local and national.”  She had been on a path toward national leadership in her professional society, the American Physiological Society. The cancer scare initiated a lot of soul searching.

“One of the decisions I made was to forego those sorts of administrative positions. I decided that I wasn't willing to make the sacrifices of time and perhaps research progress to devote to those sorts of things.”

“When you think about successful women with young children in academia, or even in other professions, there’s almost always a helpful spouse there,” she says.

Ginny Brooks counts herself lucky on that score as she has been in her choice of mentors. Today, with their children now grown, she and her husband take full advantage of Oregon’s natural wonders – as they did when they had their kids in tow. They hike, fish, kayak and cross country ski, using their little log cabin in Sisters as a jumping off point.

Lessons learned, lessons shared: Advice from Dr. Brooks

What advice would Dr. Brooks give to young women starting out in academic science?

• It’s important to be logical and efficient. It goes without saying that you have to work hard, but you also have to learn to prioritize, to multi-task, but to pace yourself.
• Seek out good mentors who not only are able scientists but also are skilled at teaching you the ropes, who can open doors for you, introduce you to people who can be helpful, help you get grants and how to get your research published.
• Accept the fact, particularly if you have young children that you need help – help and understanding from your spouse, help with childcare, and help from the institution.
• Make friends among your colleagues and those in your field at other institutions. Network, network, network.
• Join committees and seek out leadership roles, but don’t overdo it at the expense of your research – or your health.
• Maintain some balance between your personal life and your career. If winning a Nobel Prize is your goal, you need to understand the sacrifices. Even if it’s not, and you have a family, you may need to accept that you’re never going to be the best scientist or the best parent that you can be because of the sacrifices you’ll have to make on both ends. Get over the guilt about that.
• As much as you are able, take advantage of a flexible schedule to most efficiently blend family time with work time.

Profile written by Harry Lenhart

A medical detective on the trail of academic master, for herself and other women

In her last year as an undergraduate at the University of New Mexico, Sima Desai, M.D. R '98 was a volunteer "cuddler" in the university hospital's neonatal unit where she cared for babies born to drug addicted mothers. "The babies were often inconsolable," she recalled, "and you would sit for hours rocking them and holding them." The experience became indelibly imprinted in her memory. Its effect on her is also emblematic of a compassion and sensitivity that has dominated the entire tapestry of her career.

That experience made it painfully difficult for her to choose internal medicine over pediatrics when the time came to set the course of her career. She was sure pediatrics would be her specialty. But she was surprised in med school by how much she enjoyed her internal medicine rotations. "It was the complexity of thinking that I found so challenging. I felt it was like being a medical detective, listening to stories and trying to tease out what was important and what you could let go of."

Now, nearly two decades later, Dr. Desai leads one of the most highly touted internal medicine residency programs in the country where the mission is teaching not just the clinical sciences but also the pure art of teasing out the truths of a patient's condition. To that end, one of the overarching themes in talks she gives to medical students and residents is the fundamental importance of listening with care to the stories patients tell.

"You might hear a patient's story while proceeding through your differential diagnosis, ordering and interpreting tests and providing a treatment plan," she said in remarks at the 2011 OHSU School of Medicine hooding ceremony for graduating medical students. But hearing, she asserted, is not the same as listening. That involves probing for what she calls "the story under the story, the one that might light the way to the correct diagnosis." It's that kind of interaction, she said, that makes the patient-doctor relationship most effective – and potentially a life-saving one.

In residency, a shot of confidence

The sensitivity and compassion extolled in Dr. Desai's speeches is mirrored in her kind and genteel demeanor. She is self-deprecating to a fault, despite a formidable list of honors and achievements. She credits many of her successes to mentors who stepped in at critical points in her career urging her to reach beyond her own self-imposed limits. She blossomed during her residency at OHSU in large degree, she insists, because of the confidence others had in her abilities.

It was her selection as chief resident that did the most to bolster her sense of self-worth. "Becoming a chief resident was not something I thought about. I saw people who wanted to be chief residents because they were the smartest people. In internal medicine, it's an honorary additional year. "We had so many amazing people in my class, I thought, please! Never in a million years." When she was prodded, she insisted, "That's not me. I'm not the person you think I am. Then I thought maybe I should at least try and if I don't get it, fine. And then the shock. I got it."

A work ethic beyond reproach, rooted in her parents’ example

"First and foremost, seek mentors early. Whatever feelings you have about yourself, it's possible not all of it is correct."

She concedes that an almost punishing work ethic – one instilled by her parents' example – has been the personal quality most instrumental in her success. "My parents are the primary reason that I am where I am now – because it's basically been hard work. Their work ethic was beyond reproach and I think they taught my sister and me, not by being overt but by actually doing the work they did and having the same expectation of us."

Dr. Desai's parents immigrated to the United States from India in the 1960s when her father, who already had a master's degree in geology, came to study for a second master's degree in mining engineering at what then was the Missouri School of Mines and Metallurgy. He took a job in the copper mining facilities in Silver City, N.M., the town where Dr. Desai was born. The family moved three years later to Carlsbad, N.M., where she and her younger sister Nina grew up. Her mother, a Sanskrit scholar – a specialty for which there was little call in New Mexico, Dr. Desai quips – ultimately became a technical librarian at the U.S. Department of Energy's Waste Isolation Pilot Plant in Carlsbad, one of the world's deepest geological repositories for radioactive waste. Both Dr. Desai and her sister worked at J.C. Penney as young teenagers and had side jobs all through high school and college. "We never spent money. We used all of it for our educations."

As a child of immigrant parents, Dr. Desai's sense of "otherness" cast a shadow over her youth. "Discrimination was a fair constant for much of my growing up years," she says. "We were the only dark-skinned people in the area." Dr. Desai and her sister endured taunts at school, and their father faced even worse treatment. Outside their home they always felt they were being judged. "We would really dress up just to go grocery shopping, for example, because we felt not looking your best was unacceptable. Our family was integrating into a society that was not my parents' for sure, and I was straddling two worlds. "Learning to adapt in both, she thinks, has made it hard for her to think in absolutes. "It's why I view the world in shades of gray." She recoils from judging people, she says; she tries to understand them and adapt.

Gender discrimination didn't manifest itself during her years in college or medical school, although she does remember a palpable feeling of discomfort in med school during her surgical rotations, where the men far outnumbered the women. But she has become more aware of it in recent years. "Women may dominate half of medicine, but that doesn't mean things are okay. There'sstill a lot of work to do. Subtle things continue to happen. It was only recently that I ran into one of the most overt instances of discrimination I've had as a woman. "Dr. Desai is reticent about sharing details but says it resulted in a degree of loss. "I've had some recovery, but I'm paying attention to these things now when I wasn't before."

Finding the teacher within

If getting the nod to be a chief resident was the capper on her residency years at OHSU, it was the invitation she got from Dr. Alan J. Hunter that she looks back on as one of the biggest breaks of her career. He asked her to join him and other clinicians in shaping a teaching program at OHSU for hospitalists – internists who take care of patients while they are hospitalized. "It launched every other aspect of what I do now," she says. "It was an opportunity of a lifetime."

She along with Drs. Rebecca Harrison, Scott Sallay and Peter Sullivan, assisted Dr. Hunter in developing the Medicine Teaching Service, the precursor of the Division of Hospital Medicine, now headed by Dr. Hunter. "The idea was to develop a cadre of people whose primary interest was to teach," said Dr. Desai. OHSU was among the pioneers in a specialty that has proliferated across the country since then; the number of hospitalists has grown from a few hundred to over 30,000.

Until then Dr. Desai didn't see herself as a teacher, although she was moving in that direction without realizing it, she says. Her focus had been on being the best physician she could be. But in the process she was learning things she really wanted to share. As chief resident, she was tapped to do much more educating and found that teaching really was her calling. One of the secrets of being a good teacher, she believes, is not trying to bowl people over with your knowledge but keeping a sensitive eye out for those who aren't getting it and figuring out what can be done to help them.

“Stirring the pot from behind”

"Be aware that, even though the number of women in medical schools and residency programs now is about equal to the number of men, discrimination continues to happen."

Has Dr. Desai followed any particular strategies for climbing her way up the rungs of the career ladder? "I wish I could say that I was purposeful, that I knew I was going to do this thing and then that thing. I never thought to myself, one day I will be X. "It has mostly been the intervention of mentors who helped push her career along, she says.

One strategy she does credit, however, is the time and energy she has devoted to committee work. She started out with the Code 99 committee, which deals with issues surrounding patients who enter respiratory or cardiac arrest and which she chaired for three years. In 2005, she served on the search committee for a new OHSU president. She served on the OHSU Diversity Advisory Council and co-chaired the Women in Academic Medicine Committee. She is active in the American College of Physicians, was chair of the ACP Council of Young Physicians, and is a member of the Oregon chapter of the Governor's Council and chair of the Program Planning Committee.

The OHSU committees she served on helped her step outside her internal medicine environment and learn more about the institution. "It allowed me to be more effective in my own system." Her work with the national and local ACP, she says, has exposed her to many extraordinary people and has allowed her to grow in ways that she otherwise might not have, she thinks. "When you are outside of your institution, people don't know anything about you and it allows you to try on new ways of being and to push yourself in ways that you otherwise wouldn't."

Although Dr. Desai wants more attention to be paid to the needs of women in academic medicine, for one thing, she does not regard herself as someone who bucks the system. "I have never been a wave-maker and I think that stems from my family. But I sure do appreciate wave-makers and am always amazed at the clarity they have to see when something is wrong. I'm happy to jump on their coattails, stirring the pot from behind. If there were something I could change, I would love to be a wave-maker."

She struggles to maintain a good balance between work and her personal life. Her six-year old-son has happily found many playmates. "I'm lucky if I get a hello and he's gone again," she said. As he's gotten older, however, the tug of wanting to spend more time with him has only grown stronger. She is making more time for him and her partner of 16 years, a retired critical care nurse, in the early evenings, which she compensates for by working later into the night. "That actually works for me and it works for my family and it seems to give me the kind of balance I need."

As she looks back on all she's accomplished so far in her career, Dr. Desai offers one parting thought. "I could not have done any of this without the support of my partner who has been there for me every step of the way, allowing me growth and unconditional love."

Lessons Learned, Lessons Shared: Advice from Dr. Desai

Dr. Desai's advice to young women in academic medicine?

• First and foremost, seek mentors early. Whatever feelings you have about yourself, it's possible not all of it is correct. Having mentored a number of women medical students and residents, I think they suffer a lot more than men do from the imposter syndrome. They think: 'I'm not good enough, I'm not this, I'm not that.' I deal with this a lot more in women than I do in men. Women I have mentored have not seen their potential in the way that I think they could. They need a knowledgeable outsider who can say to them, yes, you are correct about this, but, no, you're wrong about that. That's essential.
   
• Be aware that, even though the number of women in medical schools and residency programs now is about equal to the number of men, discrimination continues to happen. Things are a lot better, but that doesn't mean things are okay. What happens to women now is far more subtle and harder to define. It's very important that women keep a sharp eye out for these things and meet in discussion groups to talk about ways to address the problems they identify.

Profile written by Harry Lenhart

Reflections on a trailblazing career in surgery

Ask Karen Deveney, MD, what personal qualities she believes have most contributed to her success as a physician, surgeon, teacher and director of arguably one of the best surgical residency programs in the country, and she has a ready answer: “Competitiveness, assertiveness and tenacity, otherwise known,” she laughs, “as stubbornness.”

When she is told, “You can’t do that; nobody has ever done that before,” it’s like waving a red flag in front of a bull. This statuesque woman – who ran 21 marathons at a blazing seven-minute-a-mile pace when she was younger and still, in her 60s, runs to stay in shape – has been proving naysayers wrong her entire career. Her strategies for success, if she had any, have been quite basic: “Do everything to the best of your ability and don’t slack off. ‘Okay’ is not good enough and I really don’t have a lot of respect for people for whom ‘satisfactory’ is a good grade.”

After a brief detour as an inner city school teacher, she has spent nearly four decades perfecting her skills in the operating room and helping young medical students and residents learn how to become good doctors.

"They wouldn’t let me have a rest because they wanted me to cry ‘uncle,’ so they could say, ‘Well, what’s the matter, aren’t you strong enough to do this?'"

Aspiring to be a doctor, however, never occurred to Dr. Deveney, née Suhr, when she was growing up in the 1940’s and 50’s in then tiny Gresham, Oregon. “I didn’t know women could even be doctors,” she says. Teachers were the only educated women she knew so it was only natural for this whip-smart young farm girl to gravitate toward a career in the classroom, perhaps as a high school English teacher, she thought.

With that in mind, she went off to Stanford University, was invited into the English honors program, spent a year abroad studying German language and culture at Stanford’s campus in Stuttgart, did her senior thesis on Vladimir Nabokov, and met Clifford Deveney, a classmate, ultimately a soul mate, and in their senior year at Stanford, her husband.

When Cliff enrolled in medical school at the University of California, San Francisco, Karen dutifully went over to Berkeley for the education courses she needed to get her certification and took a job teaching English at a San Francisco junior high school. “I realized right away that that was not what I was cut out to do,” she says. “It was a pretty rough situation.”

It was then, at something of a low point in her life, that Cliff suggested, “Why don’t you just do what you’ve always wanted to do.” She had inklings along the way that a medical career held some appeal. “If you could be a doctor, why would you want to do anything else?” she had told Cliff when he was struggling to make up his mind whether to go to medical school or get a PhD in math. That advice should have rung a bell for her as well, she remembers.

Storming the gates of UCSF

She occasionally found herself when she was younger gritting her teeth when hospital patients assumed she was a nurse rather than a doctor.

Once, having decided to go for it, she applied her trademark grit and determination. She worked as a billing clerk and switchboard operator at a little Catholic hospital to pay for pre-med courses and in 1968, three years behind Cliff, stormed the gates of UCSF medical school, one of 10 women in a class of 142, and knew that she had found her calling.

She sailed through medical school and was only the second woman ever to complete the surgical residency at UCSF, which was not a bed of roses, given the 120-hours-plus work weeks and the hazing to which she was subjected. “There were a lot of people who felt that women just weren’t by nature designed to be surgeons. They didn’t have enough stamina, they weren’t tough enough, they didn’t have the emotional stability, they were too delicate.” 

Karen was forced to do things the male residents didn’t have to do, she recalls, like holding up a patient’s arm interminably during a particular procedure while the surgeon and his first assistant made an incision into the arm pit and removed a rib to take pressure off certain, arteries, veins and nerves. The male residents assigned that duty would be allowed to take a breather periodically. “But they wouldn’t let me have a rest because they wanted me to cry ‘uncle,’ so they could say, ‘Well, what’s the matter, aren’t you strong enough to do this?’ I would never give them the satisfaction.”

In a specialty as male dominated as surgery was then, Dr. Deveney was determined to be viewed as a surgeon first, not a woman surgeon. “I didn’t want to be singled out…I think that has had some bearing on the attitudes that I carried through the rest of my career, not wanting to ask for special favors or entitlements. I want to get positions I get on merit, not because I’m a woman.”

She occasionally found herself when she was younger gritting her teeth when hospital patients assumed she was a nurse rather than a doctor. She tells the story of a call that interrupted a dinner party she and Cliff were giving after both had become practicing surgeons. She answered the phone and the caller asked for “Dr. Deveney” and, without thinking, she responded, “Just a moment, I’ll get him.” As she went back to the dining room, she thought, “Wait a minute, what am I saying?” and returned to the phone to ask which Dr. Deveney. “You still have conventional ways of thinking that are environmentally and historically dictated and those things take awhile to be obliterated.”

Wired to be self reliant

Dr. Deveney is incensed at the stories she’s heard about first and second year female medical students being advised by some faculty members not to be surgeons if they want to have children, or, in one case, “because you’re too nice.”

Dr. Deveney’s stubborn independence has sometimes proven a handicap, she concedes. “I didn’t want anybody to help me with anything. That’s how I’m wired and I can’t help it.” Contrary to current fashion, the idea of a mentor “to get somewhere where you want to go” has for her always been a foreign concept. “I really never was clued in on how you played the game…and that’s kind of my generation, I think.”

She never embraced any particular role models, although she counts her mother as the one person, who had the most outsized influence on her. Her mother played tennis and golf and could drive the ball as far as the men could, she recalls. After her father – the biggest volume rose bush grower in Oregon at the time – died in a tractor accident when Karen was in medical school her mother carried on by herself. “I think the toughness and the stubbornness in me emanated from her.”

Ironically, Dr. Deveney, who has been a pioneer in her field and is known nationwide for her expertise in graduate medical education, has never been ambitious either for rank or monetary rewards. “The last thing I would ever want to do is be a department chair. “You take everything you’re good at and have no time to do it to take on stuff that’s hard…especially the headaches.” Nurturing young people and helping them achieve their goals has been “the pinnacle of what I have wanted to do,” she says. Teaching – at least of bright motivated medical students and residents – turned out to be her calling after all.

Dr. Deveney has been recognized with a multitude of outstanding teacher awards in every place she has taught from UCSF to the University of Pennsylvania Medical School to OHSU, where she and Cliff (Clifford Deveney, MD, Professor of Surgery) have been faculty members since 1987.

“I feel that you would have difficulty finding anyone who is more selflessly dedicated to resident education and resident welfare than she,” said Dr. Frank Lewis, Executive Director of the American Board of Surgery in 2005 when Karen was awarded the prestigious Parker J. Palmer Courage to Teach Award by the Accreditation Council for Graduate Medical Education.

As for money? “I don’t measure myself by that,” Karen says, “so I didn’t ever care about it. I never negotiated a salary. I was grateful to have a job. That’s kind of the way I was raised. You don’t talk about those things.”

Having children was never on her list of priorities either. “Number one was my relationship with my husband and that small immediate family which I had, and then it was really my career and being as good at it as I could.” But she empathizes with the young women coming into the profession today who do want children. She is incensed at the stories she’s heard about first and second year female medical students being advised by some faculty members not to be surgeons if they want to have children, or, in one case, “because you’re too nice.”

“The sky’s the limit”

"Don’t be quite as independent as I was. People who build little networks can progress faster in academic medicine. If you have to figure it out for yourself, it takes longer."

For women in surgery, Karen says, a sea change has occurred in the decades since she was a resident.

Women surgeons were a rarity when she started. A decade later there were more but they were tokens. The resident selection committee at UCSF that Karen sat on as the only woman marveled at their good fortune, she recalled, when a superlatively talented African American woman turned up in the applicant mix. “Great,” they guffawed, “we can get both of our tokens in one person.” It was a moment of chagrin for her, but she didn’t have the guts, she said, to voice her disapproval.

Another 10 years on and a retrograde faculty member on an OHSU selection committee could only mutter to a colleague in the privacy of the men’s bathroom, “Whatever happened,” he asked angrily, “to the good old red blooded American boys we used to have applying in surgery?” Today, even the private muttering is gone, Karen says, replaced by pride in the diversity the program has achieved. Karen is proud that nearly half of OHSU’s surgery residents today are women.

“Women now just need to follow their hearts and do what they want to do and not feel artificially constrained and think, ‘Oh, I can’t do this because I’m a woman.’ Because you want to have a family is no reason to do anything that you don’t otherwise want to do. Right now all opportunities are open and the sky’s the limit.”

Lessons learned, lessons shared: Advice from Dr. Deveney

What advice would Dr. Deveney give to young women starting out today?

• Work as hard as you can, play as hard as you can.
• Don’t let anyone scare you into believing that procedural specialties like surgery aren’t for you if you’re interested in having a family. As team-based medicine becomes ever more the norm, a balanced lifestyle will be less and less difficult to achieve. You can be a surgeon and still do all the things you want to do.
• Don’t be quite as independent as I was. People who build little networks can progress faster in academic medicine. If you have to figure it out for yourself, it takes longer.
• Learn and perfect your craft so that you are capable of dealing with all the things that might be thrown your way. After your residency and you are starting in as a practitioner, you’re still not fully mature in your skills and judgment and that really is an evolving process. You really have to concentrate your attention on building your skills, whether at operating, taking care of patients, or, if in academic medicine, giving lectures and teaching.
• Ultimately, after striving and striving to improve in your career, you’re going to reach a place where you’re in a comfort zone that gives you the liberty to try out new things and be innovative and feel safe in doing that.

Profile written by Harry Lenhart

By opening her own doors, she’s found success in academic medicine

When her spine was fractured in six places in a terrible biking accident, Susan Orloff's career as a surgeon seemed to be over even before it started. Her orthopaedic surgeon told her she would never be able to endure the pain of standing at the operating table for any length of time, and she might as well give up her career as a surgeon.

She was in the second year of her fellowship in abdominal organ transplantation at the University of California, San Francisco, nearing the end of a decade of training. With grit and determination she soldiered her way through a long period of rehabilitation, regaining her strength, relearning how to use her hands and to hold her head up again. She would not be denied. She was going to be a surgeon. "You can do the impossible sometimes if you just stick to it and put your mind to it," she says.

A gentle but fierce tenacity and a gritty self-reliance have manifested themselves at critical milestones in her progress from her youth in La Jolla, Calif.

Role models have also been important. "My mom, who recently turned 86 years old, has always been my major role model. A wonderful mother of six, she double boarded in internal medicine and radiology, retiring as a professor of radiology from University of California, San Diego, at the age of 80. She is the kindest person I know."

Her grit had shown itself earlier when she dismayed a dean at the Harvard Medical School who called to share the good news that she had been admitted. She astonished him by saying, "I'm gonna have to think about it. Could I call you back tomorrow?" She had already been accepted by the UCSF School of Medicine and wasn't so sure that she wanted to leave the West Coast. She consulted her father, the chair of surgery at the University of California, San Diego, and one of the founders of its medical school. "You really should go to Harvard," he advised. "It will open doors for you."

"I think that I can open my own doors," she countered, "and I really want to go to UCSF." Which is what she did.

Later when she applied for a residency in surgery at UCSF, the department chair, Paul Ebert, challenged her. "Why would you want to go into surgery? Why wouldn't you go into radiology or anesthesia? Those are much better careers for a woman."

"Thanks," she told him, "but I'll take that risk." She plunged ahead, was one of two women chosen for surgery residencies at UCSF that year and, she says, "I've never looked back."

Never Give Up

"Stick to your values and stay focused on the things that will bring you a sense of satisfaction in the work you're doing."

Dr. Orloff's dedication to keep on keeping on has shaped the way she practices medicine. She will not accept failure. Dr. Orloff completed high school in three and a half years, worked on neuroendocrinology and peptide biology research at the Salk Institute in La Jolla during high school and college, graduated magna cum laude from UCSD in biology carrying a Phi Beta Kappa key, and with honors and an Alpha Omega Alpha key from the UCSF School of Medicine.

After graduating in 1984, she opted for a residency in internal medicine. She did rotations at San Francisco General Hospital, putting her on the front lines in the battle against the AIDS epidemic, which at that point was at crisis proportions.

"This was in an era when we couldn't help these patients," she said. "The medications themselves had side effects that sometimes killed them. One night I was very sad after I'd lost my sixth or seventh AIDS patient, a young guy in his 20s. I felt like I wasn't accomplishing what I had set out to do, which was to help people. And I happened to walk by the operating room, where the surgeons were taking out a very inflamed appendix, from a young and very ill man – they're really doing something for someone, I thought."

Shortly thereafter, she embarked on her residency in general surgery at UCSF. For the next seven years, she developed and honed her skills, largely under the tutelage of Haile Debas, M.D., an internationally renowned gastrointestinal surgeon who, during most of the time Susan was there, chaired the UCSF Department of Surgery and later served as dean of the medical school and UCSF Chancellor. He was to become the person Susan looks back on as her principal mentor.

"He's one of the most gracious human beings I've ever known as well as one of the most intelligent and committed – he epitomizes integrity and vision, all the things I value. I think of him as my second father, and my son Jackson's third grandfather."

She worked for two years in Dr. Debas' laboratory looking at the enterogastric reflex and how it affects the hormone physiology of the stomach, intestines and the rest of the body. She learned how to do intestinal transplants and microsurgery working with Bernard Jaffe, M.D., on a visiting fellowship that Dr. Debas arranged at the State University of New York Health Science Center at Brooklyn.

Organ Transplantation

"Solicit help when you need it, but promote teamwork, which is very important because effective teamwork benefits everyone on the team."

Then she zeroed in on a study of the liver, the organ that would become the prime focus of her career. "It's one of the core organs that sustains life. I'm very liver-centric." To steep herself in the anatomy of the liver, she did a two-year stint as a fellow in abdominal organ transplantation at UCSF preparing for every possible surgical procedure involving the liver and biliary tract. Transplantation surgery attracted her because it offered some redemption for tragedy, the death of someone usually in the prime of life. One donor could offer an extension of life for other people.

Did she encounter gender issues as a resident in the testosterone-fueled confines of the operating room? Sure, she says. There were instances of unwelcome flirtations and surreptitious groping by male faculty members who held power over her and of rejected suitors who thwarted her projects.

The surgical suite was a much different place then, she says. "There were attending surgeons who expressed anger overtly, had temper tantrums, threw instruments across the room, yelled at the OR staff, used swear words. That kind of behavior was accepted and at times was the norm. I didn't feel it was ever directed at me and it didn't really affect me. I just did my job."

But there were sacrifices. "I didn't even dream of having a family during my residency. There was no time, and, really, no woman resident had children. It wasn't talked about or even thought about, nor was it in the least bit an acceptable option."

Fast forward to the present. Dr. Orloff is now married to Dr. Robert Hart, professor of surgery and orthopaedic spine surgeon at OHSU, and they have Jackson, their 9-year-old son, and their daughter Annie, who recently graduated from the Juilliard School in New York as a cellist, and she is matriculating at Mt. Sinai Medical School in 2013. "I would have loved to have had more children, but I'm fortunate for the children I have," she says. "I am also so fortunate to have a husband with whom I can relate to on so many fronts: academic, musical, political, intellectual, and personal."

But a balanced family life is still difficult to maintain given the 80-hour work week that she clocks, and her husband's time commitment to work is not far away from this. "Fortunately, I have a very supportive Chilean Nanny family, without which, I could not do what I do." She takes Jackson on hospital rounds with her every weekend – something she has done since he was three months old. "He cheers the patients up and gives them a youthful hope." But she concedes that she bent over backwards to maintain her schedule equitable to all of her work partners, so as not to appear to be any less dedicated a surgeon/colleague because she was a woman. "It was a difficult transition for me, not to be at home and not to see Jackson as much as I would like to."

Career at OHSU

"Figure out creative ways to serve other passions in your life besides work, whether it's your family, athletic pursuits, the enjoyment of nature. Play as hard as you work and maintain a healthy balance between the two."

Dr. Orloff arrived at OHSU in 1995, not long after completing her transplantation fellowship at the University of California San Francisco.  She was drawn to Portland by its progressiveness, its proximity to the ocean and mountains, and the presence of a longtime friend and a brother.

During her first years at OHSU, she saw cases gender and financial discrimination. A supervisor paid himself a salary eight times more than hers, despite an equal workload. She perceived a couple faculty members  as trying to thwart her success. Instead of resigning herself to the treatment, she sought the leadership of the transplantation division to change the professional culture and "make it fairer for everybody."

Today Orloff is a professor emerita, following a career in which she wore a multitude of hats:

• Professor of surgery and director and head of the Division of Abdominal Transplantation with a joint appointment in the Department of Molecular Microbiology & Immunology
• Former vice chair of research in the Department of Surgery
• Director of the Liver and Kidney Transplantation Program at the Portland VA Medical Center
• Head of a National Institutes of Health-funded lab studying the mechanisms and genomics of cytomegalovirus (CMV) virology and its effects on transplants
• Co-author of over 90 peer-reviewed papers and 18 book chapters
• Reviewer for 16 medical journals and editorial board member for three
• Member of the Board of Governors to the American College of Surgeons
• Chair of the American Society of Transplantation Liver-Intestine Community of Practice
• Regional representative for the United Network for Organ Sharing’s Region 6 to the Liver/Intestine Committee
• Member of the Executive Councils of the American Hepato-Pancreatic-Biliary Association, and the Society of University Surgeons (SUS) and chair and founder of the SUS Committee for Global Academic Surgery (SCGAS)
• Past president of the Portland Surgical Society

Did she adopt any particular strategies to climb to the top of her profession? "There really wasn't any calculation," she says. "I just worked hard and stuck to my standards and did what I felt was the right thing to do for the patients and the people around me." With that formula, Dr. Orloff found success in academic medicine.

Part activist, part feminist makes for a robust academic career

Frances J. Storrs, MD, or Fran, as she is known to everyone, has spent more than 40 years blazing trails. "My professional career has been incredibly satisfying to me. Things aren't always perfect in life, but I don't know of any major thing I would have done differently. I'm more pleased than anything that I've been able to have a professional life that worked well with my private life. It's given me a chance to put my family first, and my family remains central to my life."

She was the first woman to complete a residency in the medical school's dermatology department and is a path-breaking physician, researcher and mentor. Her skills in the classroom have earned her many teaching and service awards. She is known nationally and internationally for her work in contact dermatitis and discovering new workplace allergens. She has received virtually every honor her specialty can bestow, among them the Gold Medal of the American Academy of Dermatology (AAD), its highest award, as well as its Master in Dermatology Award. She won the Rose Hirschler Award of the Women's Dermatologic Society.

And along the way – through example and activism – she's fought to change the culture of academic medicine. Her notoriety began after a pivotal 1971 event. "The Arlington Club experience totally changed my life," she said.

1971: The Arlington Club epiphany

"It made me more active in terms of making sure things were going to be okay for women. It made me a feminist and I wasn't a feminist before that."

It happened a few years after Dr. Storrs had joined the OHSU faculty. She had been invited by a local dermatologist to a dinner at the Arlington Club honoring Dr. Harvey Blank, who was in town to participate in the annual School of Medicine Sommer Memorial Lectures. Dr. Storrs was mingling with colleagues at dinner when she was informed that the club was a men-only establishment and she would have to leave.

The descent down the club's wide staircase to the street below was a "totally life changing experience," she said. "It was a window going up, a true epiphany. It was really the first time in my life where I saw that my being a woman made a huge difference in terms of what my professional life might be."

The effect on Dr. Storrs was profound. "It made me more active in terms of making sure things were going to be okay for women. It made me a feminist and I wasn't a feminist before that."

Within months she had joined the board of the Oregon chapter of the American Civil Liberties Union and taken over as chair of the medical school's affirmative action committee. She helped the medical school adapt to Title IX of the Civil Rights Act which outlawed discrimination on the basis of sex at any educational institution receiving federal assistance.

"Title IX changed totally the way women were treated; we were able to use it very effectively in getting women into areas where they could never have been otherwise. At the time, some surgeons, for example, wouldn't let women medical students do hernia exams on men, so I would call up the head of the department and say, 'Are you aware of what Title IX is?' After hemming and hawing, he would say, 'Well, I think we can arrange for women to do hernia exams on men.'"

Dr. Storrs went on to become a dedicated community activist. She chaired a Citizens Task Force that probed the internal affairs policies of the Portland Police Bureau. She served as president of the Portland City Club, and in 2001 was honored as Portland City Club's Citizen of the Year.

Planning from a young age to balance work and family

"I saw the impact of my parents' professional life on our family life and I was fearful that if I became a doctor, I would marry a doctor and I thought that would be very difficult."

Dr. Storrs hadn't encountered many barriers growing up in a prosperous household in Spokane. "I grew up with the emphasis on my life that I would certainly work and that I could do whatever I liked."

Her mother and father both were family doctors with large practices. Both were graduates of the University of Oregon Medical School (precursor to OHSU School of Medicine) and of Whitman College where they had met. When her mother went on house calls and hospital rounds young Fran often went with her. Her mother, in particular, was always accessible. She might be in the middle of a physical exam but would immediately interrupt it whenever Fran called. "That kind of appreciation of the importance of family in the lives of working women and men was very unusual. It made that kind of attitude towards family a big part of my life as I was growing up as a physician."

Her parents were involved in church and civic organizations, not just medical societies. "My mother had a great sense of obligation to serve the community," Dr. Storrs recalled. She worked with the Salvation Army and the White Shield home for unwed mothers and was active in the PTA. Fran's father, the son of missionaries, enjoyed gardening and even developed a number of new species of iris.

The daily demands on family doctors that Dr. Storrs witnessed growing up, however, initially soured her on the idea of following in her parents' footsteps. "I saw the impact of my parents' professional life on our family life and I was fearful that if I became a doctor, I would marry a doctor and I thought that would be very difficult." Her love of science ultimately moved her to change her mind. But she set out from the beginning to tailor her career to fit around the needs of the full family life she was determined to have.

She chose Cornell University Medical College, now the Weill Medical College, partly because it was in New York City. She went there to learn, of course, and did well enough to keep going, but concedes, "I mostly enjoyed New York." She did a stint in Scotland on a cardiology rotation in Edinburgh and worked with a family practitioner in South Africa.

She ultimately settled on dermatology after posing a question to an endocrinologist that she met on a rotation: If his wife were a doctor, she asked, what specialty did he think would be ideal for her. Dermatology, he said. It was a perfect field for a woman who wanted to have a family and a controlled professional life. That is exactly what Dr. Storrs' goal was then. Discovering how interesting dermatology was and how much she loved it would come later as frosting on the cake.

Being true to herself, and recognizing the importance of mentors

She was drawn back to the Pacific Northwest after medical school by her love of the region's beauty. "I didn't want to live in Spokane, where my parents were, because I knew that would be too potent an influence." So she came to Portland where her brother lived, interned at Good Samaritan Hospital and worked with Dr. Ted Kingery, the leading dermatologist in Portland. Dr. Kingery introduced her to Dr. Walter C. Lobitz Jr., chairman of the dermatology department at what then was still the University of Oregon Medical School.

Dr. Storrs applied for a residency in the dermatology department and after a round of interviews, she was invited to become a resident. Dr. Lobitz would become Fran's lifelong mentor. He was "absolutely charismatic. His mind sparkled with ideas and interesting concepts. He saw to it that I did what you needed to do in order to advance in academics. He would bring articles to me and tell me I had to read this article, read this journal, have this be my special interest. And then he would set up places for me to travel in different parts of the world to go study with somebody and learn a particular thing. He'd put me on committees, put me in charge of lectureships. I would not have had any of the academic success in the measure I had if it hadn't been for Dr. Lobitz." It was through him that she met her future husband, John Storrs, a prominent Northwest architect. Storrs was a patient of Dr. Lobitz's.

Twenty-five years of sleep deprivation

"I was working every night until two and three in the morning and my buddies in private practice were fast asleep."

Her union with John Storrs came with three teenage stepchildren from his first marriage. Three years later they had a son, Leather. "In the evening I would be with my family for dinner and then be with all of them until they were all in bed, and then I just stayed up and worked most of the night to prepare a talk or do all the things an academic person has to do to advance. I wanted to tailor my life so that I could manage my family and private life. But when I look back at all the things I was doing, it was way too much. I was probably sleep deprived for 25 years. I was working every night until two and three in the morning and my buddies in private practice were fast asleep."

While balancing work and family in academic life was harder than she expected, academic medicine did prove to be suited for family life in one sense. Dr. Storrs, her husband and Leather traveled the world during the three sabbaticals she took as well as when she went to speaking engagements, which she accepted only if her husband and Leather could accompany her. "That allowed me to spend tons of time with my family during the time my son was growing up and it was very important as well to my marriage." It also meant that Leather missed about nine months of school, all told, while he was in grade school, but he got a rich exposure to foreign cultures.

Success in academic medicine – or any profession – is easier with the right life partner, Dr. Storrs said. "Probably the most important thing you can do going into any profession is choosing someone who understands what you're doing and is willing to assist." John Storrs, who died in 2003, reshaped himself into the helpmate Dr. Storrs needed. "He took on lots and lots of responsibility in our family, he was very involved."

Full circle: now giving back, as a mentor

"Get involved in community and civic activities. It helps keep you grounded."

Dr. Lobitz's impact on her career inspired in Dr. Storrs her great interest in promoting mentorship opportunities for others. She remembers not knowing when starting out that she needed a mentor. "It wasn't something I thought about. I wasn't searching for one. There were no women around to mentor me. But Dr. Lobitz knew what I needed and directed me."

Now, she's giving back. She takes pride in the mentorship program of the Women's Dermatology Society that she initiated. It pairs young men and women with senior women dermatologists. Almost 400 young dermatologists have participated in the program and most other dermatology sub-specialty societies have since copied it.

Lessons learned, lessons shared: Advice from Dr. Storrs

Dr. Storrs's advice to young women in academic medicine?

• If you want to achieve excellence, work hard.
• Select a good mentor after reaching the understanding in your own mind that that kind of guidance is what you need. Mentoring lasts awhile and is different from a role model. The relationship usually lasts about five years. The person you choose should be someone far enough along in their own career that he or she won't feel the need to compete with you. They don't necessarily have to be in the same field or specialty. They do have to be someone who can put up a mirror in front of you that can help you identify the things you need to do to succeed.
• If you want to be a leader in your specialty, join the organizations that can teach the skills you need. If you want to be a department chair, which I never did, or a dean, check out ELAM – the Executive Leadership in Academic Medicine Program for Women.
• Choose a life partner who understands what you're doing and is willing to help you and, maybe most crucial, has a sense of humor.
• Get involved in community and civic activities. It helps keep you grounded. 

Profile written by Harry Lenhart