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Gathering Data Before the sphygmograph was developed, physicians assessed pulse strength by placing their fingers on a patient’s wrist and feeling for arterial resistance. The sphygmograph offered a more consistent method to assess, compare, and present information about the strength of the pulse. Dr. Mary Putnam Jacobi used the device in her research. Screw recording. Stylus. smoked paper transporter. smoked paper. pressure sensor. ivory rests. pressure dial. clockwork mechanism.

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Dr. M. Joycelyn Elders Dr. Emily Dunning Barringer became the first woman to ride with ambulance crews as an emergency physician, in New York City, working from a horse-drawn wagon in the neighborhoods of the Lower East Side. Originally, Emily Dunning thought she would become a nurse. It was Dr. Mary Putnam Jacobi who recommended Cornell University’s medical preparatory course for her education instead. Dr. Jacobi believed Emily Dunning would choose to become a doctor. In 1897 she enrolled at the College of Medicine of the New York Infirmary. The day after she completed her residency, in 1904, she married Dr. Benjamin Barringer. Quickly, she became frustrated that his prospects were so much better than hers. She said, “He could count on a splendid training in one of the big general hospitals... with post-graduate work abroad, in whatever line he elected... And I? What did I see ahead?” Her opportunities seemed greatly limited. Again, Dr. Mary Putnam Jacobi advised Dr. Barringer, urging her to take the competitive internship exams held by New York’s large area hospitals even though women had never been allowed to compete. Together, the two women pressured several hospitals to open their internships to women. Dr. Barringer became the first woman medical resident at Gouverneur Hospital in New York City. Her male colleagues harassed her assigning her difficult schedules for on-call and ward duties. She continued with her work, despite these difficult circumstances and was widely reported in the local papers as something of a novelty as a woman ambulance physician. During World War II, Dr. Barringer made headlines again, lobbying Congress for military commissions for women physicians. While women could serve as contract surgeons in the Women’s Army Auxiliary Corps, they were not commissioned employees, and so were not given the same benefits as men. In 1943, the Sparkman Act was signed into law, allowing women the same benefits as men in the Army and Navy. Dr. Emily Dunning Barringer created a legacy of helping women achieve equal status, in the medical profession, and in the U.S. military; Opportunities passed on to the generations to come.

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Dr. Marie E. Zakrewska In 1862, Dr. Marie Zakrzewska opened her own hospital, The New England Hospital for Women and Children. It was the first hospital in Boston, and only the second in America to be run by women physicians. Dr. Zakrzewska had been part of the first generation of women physicians in America. Barred from working in existing hospitals and excluded from teaching jobs at medical schools, some of these women went on to found dispensaries, hospitals, and schools to train women students and employ women physicians. Marie Zakrzewska was born in Berlin, the daughter of a midwife. As a young woman, she accompanied her mother on her rounds. She trained at the Royal Charité Hospital, and in 1852 become a midwife. When her promotion to Head Midwife not long after she had finished her training was met with disapproval from some of the faculty, she left to study medicine in the United States. Although opportunities in America were also limited, Marie Zakrzewska was aided by Dr. Elizabeth Blackwell, the first woman to graduate from medical school in America. With Dr. Blackwell’s help, she enrolled at Cleveland Western Reserve College, traditionally, an all-male medical school. Marie Zakrzewska was one of only six women admitted to the school in the 1850s. She graduated with her M.D. in 1856. Dr. Blackwell and her sister Emily became an inspiration to Dr. Zakrzewska by planning to found a small hospital where women physicians could work and learn. Dr. Zakrzewska joined their effort, and the New York Infirmary for Women and Children opened in 1857. She served as resident physician at the hospital for two years. She moved to Boston to accept the position of Professor of Obstetrics at the New England Female Medical College. Her students, encountering the same obstacles as other women physicians, found it difficult to get work after graduation. Dr. Zakrzewska also disagreed with the founder of the New England Female Medical College over the school’s curriculum. She had proposed courses in dissection and microscopy to enhance the training of students and keep up with the developing field of scientific medicine. But the director intended to limit women physicians to a lower educational level. Three years later, she resigned, to open her own hospital. The New England Hospital for Women and Children flourished under Dr. Zakrzewska’s direction. There, women physicians who were excluded from the majority of hospitals, could acquire clinical experience. She believed that women physicians must have the same training and base of scientific knowledge as their male counterparts to achieve the same levels of research and standards of practice.

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Dr. Ann Preston In 1869, Dr. Ann Preston, the first woman Dean of the Woman’s Medical College of Pennsylvania, campaigned for the right for her students to attend lectures at all-male institutions. When they were first granted admittance, women medical students attending a clinic were greeted by the male students with hisses and paper wads. Dr. Preston refused to be deterred, and successfully argued for the fair treatment and equal skill of her students. She was born a Quaker in 1813, and attended Quaker schools in Pennsylvania. From an early age, she campaigned for social reform. She wrote petitions and lectures for the Clarkson Anti-Slavery Society and joined the temperance movement. Wanting to educate women about their own bodies, she began teaching physiology and hygiene to all-female classes. In 1847, Ann Preston applied to four medical colleges in Philadelphia. But her applications, like those from all other women, were rejected. To provide opportunities for women to study medicine, a group of Quakers founded the Woman’s Medical College of Pennsylvania. Ann Preston enrolled in the first class. She graduated in 1851, at the age of 38. She stayed on at the school, and in two years was appointed professor of physiology and hygiene. Public and professional attitudes toward women physicians remained negative, for the most part. Eight years after the medical school was established, the Philadelphia Medical Society spoke out against it, effectively barring women students from educational clinics and medical societies in the city. Undeterred, Dr. Ann Preston organized a board of wealthy supporters to fund and run a woman’s hospital, where her students could gain clinical experience. The hospital opened in 1861. Two years later, Dr. Preston established a School of Nursing. In 1865, Dr. Ann Preston became the first woman Dean of the Woman’s Medical College. Committed to expanding her students’ educational opportunities, Dr. Preston negotiated and won the right for them to attend general clinics at the Blockley Hospital in Philadelphia. In 1869, she made a similar arrangement with the Pennsylvania Hospital. There, the women endured harassment from the male students. As one student later recalled, “We were allowed to enter by way of the back stairs, and were greeted by the male students with hisses and paper wads, and frequently during the clinic were treated to more of the same... The Professor of Surgery came in and bowed to the men only...” Dr. Ann Preston publicly criticized the response of the men and the attitudes behind it, arguing that women students could easily keep up with the men but that the men refused to welcome their equally capable women colleagues. Thanks to Dr. Preston and her students, women studying alongside men gradually became a more frequent sight in the medical clinics and colleges of the late 1800s.

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Dr. Sarah Read Dolley Sarah Read Adamson was born in 1829 and became the third woman in America to earn an M.D. degree. Her family were Quakers living in Schuykill Meeting, Chester County, Pennsylvania. She was educated at The Friends’ School in Philadelphia. Sarah Adamson became interested in medicine when her teacher, Graceanna Lewis, gave her a physiology book to study at home. Her uncle, Hiram Corson, was a physician, and she had also read an anatomical book from his library. He agreed to tutor her, and took her on as an apprentice. This experience prepared her to study at the newly-opened Central Medical College in Rochester, New York, where she graduated from in 1851. Though a few women had broken through barriers to receive a medical education, no woman had ever completed a hospital internship. Dr. Adamson’s uncle again supported her, sponsoring her application for an internship at Blockley Hospital in Philadelphia. She became the first woman intern in America. In 1852, she married Dr. Lester Clinton Dolley, a professor of anatomy and surgery at Central Medical College. Together they traveled to Europe to gain further medical training, attending clinics in Paris, Prague, and Vienna. Upon their return, they set up a medical practice in Rochester, where they worked together until his death in 1872. For the next year, Dr. Sarah Dolley served as Professor of Obstetrics at the Woman’s Medical College of Pennsylvania, but soon returned to Rochester to re-establish her practice. Women were still barred from working in most hospitals. Knowing how critical the knowledge and experience she had gained through her internship was, Dr. Dolley worked to open more hospital positions to women. In 1887, she helped a group of women open their own dispensary, an outpatient clinic for the working poor. She also helped found one of the first general women’s medical societies: The Practitioners’ Society of Rochester, which later became the Blackwell Society. On her seventy-eighth birthday, Dr. Sarah Adamson Dolley led the Blackwell Society in launching the Women’s Medical Society of the State of New York. She was given the honor of being its first president.

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Dr. Mary Amanda Dixon Jones In 1888, Dr. Mary Dixon Jones performed a hysterectomy, removing a seventeen-pound tumor from her patient’s uterus. It was the first operation of its kind performed in America. Mary Dixon began her career as an apprentice to two leading male physicians. In 1854, she married a lawyer, John Quincy Adams Jones. They moved west to Illinois and Wisconsin, and had three children. In 1862, ten years after she had first begun studying medicine as an apprentice, Dixon Jones left to study at the Hygeio-Therapeutic Medical College in New York. After graduation, she moved to Brooklyn to start a private practice. Dr. Dixon Jones focused on obstetrical and gynecological surgery, a specialty that was developing rapidly at the time. She read about newly developed, innovative operations described in medical literature. She heard about new techniques taught in medical schools. But some of her patients had complicated and distressing gynecological problems that she was unsure how to treat. So, after ten years of successful private practice, she went back to school, enrolling at the Woman’s Medical College of Pennsylvania. She also studied with Dr. Mary Putnam Jacobi, to discover more about the latest in pathology and clinical diagnosis. After her graduation in 1875, she returned to private practice. For nine years, she also worked at the Woman’s Hospital of Brooklyn. Dr. Dixon Jones’ surgical skills and her use of innovative procedures earned her an impressive reputation and a successful practice. In 1888, she described her precedent-setting hysterectomy surgery in The New York Medical Journal, noting that within fifteen days of the surgery, the patient was almost fully recovered. In 1895, a Brooklyn newspaper slandered her surgical work. Dr. Dixon Jones sued for libel, but lost the case. As a result, her practice dwindled and she was forced to retire, so she turned to research. She studied diseases of the reproductive system and investigated the connections between surgical specimens under the microscope and many of the diseases she had treated. She was one of the few gynecological surgeons of her time to take up the laboratory study of specimens.

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Dr. Rebecca J. Cole Sadly, as is the case with many records of the achievements of African Americans of her generation, no images have survived of Dr. Rebecca J. Cole. She was the second African American woman to receive an M.D. degree in the United States, in 1867. Rebecca Cole was born and raised in Philadelphia. She completed her secondary education at the first co-educational high school for African Americans in the city. She enrolled at the Woman’s Medical College of Pennsylvania near the end of the Civil War. She trained with Dr. Ann Preston, the first woman dean of the school, and in 1867, was the first African American to graduate. Dr. Cole, like many of her fellow women students of medicine was able to continue her training by joining an institution founded for women patients and practitioners. To gain clinical experience, she took a job at the New York Infirmary for Women and Children, established by physicians Elizabeth Blackwell and her sister Emily, with the help of Dr. Marie Zakrzewska. Dr. Elizabeth Blackwell assigned Dr. Cole the role of health visitor in the local community. She was responsible for dispensing practical advice to mothers living in poverty about the best ways to keep their families healthy. Dr. Blackwell thought Dr. Cole had the ideal character for such work, and mentioned in her autobiography that she had “carried on this work with tact and care.” Dr. Rebecca Cole practiced in South Carolina for a number of years, before returning to Philadelphia. In 1873, she opened a Women’s Directory Center to provide medical and legal services to women and children in need. In January 1899, Dr. Cole was appointed superintendent of a home in Washington, D.C. run by the Association for the Relief of Destitute Colored Women and Children. In her years of caring for families living interrible poverty in the city of Washington, she was most appreciated for the difference she was able to make. As mentioned in one of the annual reports from the association:"Dr. Cole herself has more than fulfilled the expectations of her friends. With a clear and comprehensive view of her wholefield of action, she has carried out her plans with the good sense and vigor which are a part of her character."

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Dr. Helen Octavia Dickens Dr. Helen Dickens began her medical career by providing care to those who had no means to obtain treatment. Once, as she visited a house without electricity, she had to drag a bed to the window to deliver a baby by the light from the streetlight outside. Because her parents had struggled to make a living in low-paying jobs, they insisted that their daughter receive a good education. She attended a desegregated high school, applied to the best schools and hospitals and was not intimidated by the idea of training at predominantly white schools. In 1934, when she earned her M.D. from the University of Illinois, Dr. Helen Dickens was the only African American woman in her class. She completed her internship at Provident, a black hospital on the south side of Chicago. Working among the poor, she treated tuberculosis and provided obstetric and gynecological care. Moving to Philadelphia, Dr. Dickens worked for six years at Aspiranto Health Home, treating patients living in poverty, with little access to medical care. To expand her training in obstetrics and gynecology, she returned to Provident Hospital in Chicago. In 1943, she married a fellow resident, Dr. Purvis Sinclair Henderson. They moved to New York City and Dr. Dickens began a residency at Harlem Hospital. She left to get a Master of Science degree from the University of Pennsylvania, then returned to complete her residency at Harlem in 1946. Four years later, Dr. Helen Dickens became the first African American woman to be named a Fellow of the American College of Surgeons. Throughout her career, Dr. Dickens focused on the problems she had seen in her obstetrics and gynecology practice. She wanted to educate young women to give them the knowledge to control their fertility and sexual health. Her extensive research resulted in intervention strategies to help schools, parents, and health professionals reduce the incidence of teen pregnancies, and sexually transmitted diseases. Moving back to Philadelphia, Dr. Dickens taught at the University of Pennsylvania. In 1969, she was appointed Dean of the Office for Minority Affairs. In that role, she reached out to minority students to encourage them to pursue medical careers. Thanks largely to her efforts, minority student enrollment increased from just three students to sixty-four within five years. In 1985, Dr. Helen Dickens was named Professor Emeritus.

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Dr. Eliza Ann Grier Dr. Eliza Ann Grier had once been a slave. She went on to become the first African American woman licensed to practice medicine in the state of Georgia. After emancipation, Eliza Grier decided to become a teacher, studying for seven years at Fisk University in Nashville, Tennessee. But she aspired to a career as a physician, believing she could be of most benefit to others and earn a fair wage if she had a medical education. “When I saw colored women doing all the work in cases of accouchement ... or, childbirth and all the fee going to some white doctor who merely looked on, I asked myself why should I not get the fee myself.” So, in December of 1890, Eliza Grier wrote to the Woman’s Medical College of Pennsylvania. “I have no money and no source from which to get it,” she wrote, “Only as I work for every dollar.” She asked the dean “if there was any possible way for an emancipated slave to receive any help into so lofty a profession.” She was admitted, but to pay the tuition, Eliza Grier alternated each year of study with a year of picking cotton. Despite these hardships, she did not lose sight of her goal. After seven years of work and study, she graduated in 1897, and returned to Atlanta. Later that year, Dr. Eliza Ann Grier became the first African American woman licensed to practice medicine in the state of Georgia. After only four years, Dr. Grier fell ill and was unable to maintain her medical practice. Determined to keep up with her work, she called on various supporters for help. She wrote to Susan B. Anthony, leader of the National American Woman Suffrage Association, to ask for her help, but died soon thereafter. As she said in 1898: “I went to Philadelphia, studied medicine hard, procured my degree, and have come back to Atlanta, where I have lived all my life, to practice my profession... Some of the best white doctors in the city have welcomed me, and say that they will give me an even chance in the profession. That is all I ask.” The North American Medical Review reported: “She will hang out her shingle for general practice, and says she will make no discrimination on account of color.” Dr. Eliza Grier realized a remarkable achievement.

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Dr. Gerty Radnitz Cori was the first American woman to receive the Nobel Prize in Medicine. She and her husband, Dr. Carl Cori, shared the prize for their discovery of the cycle of carbohydrates in the human body. They had been classmates at the German University of Prague, where Gerty Cori was one of only a few women students. She received her M.D. in 1920. The couple married and began to work in clinics in Vienna. In 1922, concerned that war would break out in Europe for a second time, they immigrated to Buffalo, New York. Carl Cori accepted a position at the State Institute for the Study of Malignant Diseases. Gerty Cori joined him six months later, after securing a job as an Assistant Pathologist. Although the couple was frequently discouraged from working together, they had a dynamic research partnership that proved immensely profitable in their work. Specializing in biochemistry, the husband and wife team began to study how glucose is metabolized in the human body. In 1929, they developed their theory of “the cycle of carbohydrates,” now known as the Cori Cycle. The theory explains how carbohydrates supply energy to muscles during exercise, and then are regenerated and stored until needed again by the muscles. It was the first time the cycle of carbohydrates in the human body had been fully explained and understood, and proved especially useful for the treatment of diabetes. Despite their collaborative partnership in defining the cycle, Carl Cori initially received more professional recognition than Gerty Cori. He was encouraged to abandon the team approach and work alone. He was even offered a job only on the provision that he stop working with his wife. The Cori’s continued in their successful collaboration, however, and in 1931 moved to St. Louis. Carl Cori took up the post of Chair of the Pharmacology Department at Washington University School of Medicine. Over the next sixteen years, Gerty Cori worked alongside him as a research assistant. Together, they made further discoveries that clarified the processes of carbohydrate metabolism, that they had originally laid out in the description of the Cori Cycle. In the mid-1940s, Carl and Gerty Cori received great recognition for their work. Carl Cori was appointed Chair of the new Biochemistry Department in 1946, and Gerty Cori was appointed to a full professorship. The following year, they were awarded the Nobel Prize for the Cori Cycle. They were the first married couple ever to win the Nobel Prize in Medicine.

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Dr. Louise Pearce volunteered to go alone to the Belgian Congo in 1920 to test a new drug she hoped would cure African sleeping sickness, a disease that was often fatal. She received her M.D. from The Johns Hopkins University in 1912. Looking for work, she wrote to Dr. Simon Flexner, Director of the Rockefeller Institute in New York City, requesting a research position. Dr. Flexner supported her application, and Dr. Louise Pearce became the first woman to work directly with him. In 1910, an arsenic-based drug called Salvarsan was found to be an effective treatment for syphilis. Scientists had hopes of developing other arsenic-based drugs. Dr. Flexner asked his research team to try and find an arsenical compound for use against African sleeping sickness. They succeeded. Tryparsamide, they found, destroyed the infectious agent of sleeping sickness in animals. In 1919, these results were announced in the Journal of Experimental Medicine. A severe outbreak of African sleeping sickness broke out in the Belgian Congo in 1920. While in Africa, Dr. Pearce administered and studied the effects of the tryparsamide on seventy patients. The results were spectacular: the parasites were driven from circulating blood within days and totally eradicated within weeks. Symptoms cleared up and general health was restored in a large proportion of even the most severe cases. Belgian officials were impressed by the results. Dr. Pearce was awarded the Ancient Order of the Crown and elected a member of the Belgian Society of Tropical Medicine. Three decades later, in 1953, she was invited to Brussels to receive the King Leopold III Prize and an award of ten thousand dollars. After her success in the Belgian Congo, Dr. Pearce returned to the Rockefeller Institute, and was promoted to Associate Member in 1923. Teamed with Dr. Wade Hampton Brown, she studied susceptibility and resistance to infection. They discovered they could transplant certain cancers from one rabbit to another. The Brown-Pearce tumor was the first known transplantable tumor, aiding research into malignant tumors in cancer laboratories around the world. By 1940, more than two dozen hereditary diseases and deformities were studied in the tumors of the research team’s rabbits. After the death of Wade Hampton Brown in 1942, Dr. Pearce focused on writing up their research findings, until her retirement in 1951. After a short illness, she died at her home in New Jersey in 1959.

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In the 1800s, diphtheria was a deadly infectious disease without cure. Dr. Anna Wessels Williams isolated a strain of the diphtheria bacillus crucial to the development of an antitoxin that helped eradicatethe disease in New York City. Dr. Williams worked at the New York City Department of Health, in the first municipal diagnostic laboratory in America. She researched the spread of infectious diseases like diphtheria and polio, then sought ways to protect people and lower the rates of infection. Dr. William H. Park was the director of the lab, and the two collaborated. Together, they worked on developing an antitoxin for diphtheria. In her first year of work, Dr. Williams isolated the strain and by the fall of that year, physicians across Manhattan issued the diphtheria antitoxin free of charge, helping to eradicate the disease among the city’s poor. Dr. Williams was appointed to a full-time staff position as assistant bacteriologist. She shared credit with William H. Park for the discovery, which became known as the Park-Williams Strain. She recognized the collaborative nature of laboratory research, and later said she was “happy to have the honor of having my name thus associated with Dr. Park.” In 1896, Dr. Williams traveled to the Pasteur Institute in Paris hoping to develop an antitoxin for scarlet fever. The research going on in Paris inspired her, and she became interested in rabies. Returning to the U.S., she brought back a culture of the rabies virus and worked to develop a better way to diagnose it. Her method surpassed the original test, and became the model technique for the next thirty years. She was promoted to Assistant Director of the New York City Department of Health laboratory in 1905 and continued to work alongside Dr. Park. Together they wrote a textbook on micro-organisms for students, physicians, and health officers that quickly became a classic text. In 1929, they published “Who’s Who Among the Microbes,” thought to be one of the earliest books on the topic written especially for the public. In 1914, Dr. Williams was elected president of the Women’s Medical Society of New York. In 1931, she was elected to the laboratory section of the American Public Health Association, and the following year became the first woman appointed chair of the section. In addition to her groundbreaking research, she helped build some of the most successful teams of bacteriologists—including many women—working in the country at the time.

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Dr. Helen Rodriguez-Trias wanted to study medicine because it combined the things she loved the most—science and people. She graduated from the University of Puerto Rico in 1959 and moved to New York, where she married and had three children. After seven years, she returned to the University of Puerto Rico to study medicine. She saw it as a direct way to contribute to society—by helping individuals instead of working through groups or organizations. She received an M.D. with the highest honors in 1960. During her residency, Dr. Rodriguez-Trias established the first center in Puerto Rico for the care of newborn babies. Under her direction, the hospital’s death rate for newborns decreased 50 percent within three years. In 1970, she returned to New York City to serve the Puerto Rican community in the South Bronx. Working at Lincoln Hospital, she led community campaigns against lead paint, unprotected windows and other health hazards. She also taught at City College, raising students’ awareness of the real conditions in the neighborhoods they served. Dr. Rodriguez-Trias saw the critical links between public health and social and political rights, and expanded her work to a broader international community. She said, “I think my sense of what was happening to people’s health... was that it was really determined by what was happening in society— by the degree of poverty and inequality you had.” Working as an advocate for women’s reproductive rights, she campaigned for change at a policy level. She worked especially for low-income populations in the United States, Central and South America, Africa, Asia, and the Middle East. She fought for reproductive rights, worked with women with HIV, and joined the effort to stop sterilization abuse. Government-sponsored sterilization programs led to hundreds of unwanted sterilizations. (Dr. Helen Rodriguez-Trias) “Sterilization has been pushed really internationally as a way of population control. And there is a difference between population control and birth control. Birth control exists as an individual right. It’s something that should be built into health programming. It should be part and parcel of choices that people have. And when birth control is really carried out, people are given information, and the facility to use different kinds of modalities of birth control. While population control is really a social policy that’s instituted with the thought in mind that there’s some people who should not have children or should have very few children, if any at all. I was working in Puerto Rico in the medical school in those years, the decade of 1960 to 1970. And one of the things that seemed pretty obvious to us then was that Puerto Rico was being used as a laboratory. And it was being used as a laboratory for the development of birth control technology.” In 1979, Dr. Rodriguez-Trias testified before the Department of Health, Education and Welfare for the passage of federal sterilization guidelines, which she helped to draft. These require a woman’s consent to sterilization, offered in a language she can understand, and set a waiting period between the consent and the operation. Toward the end of her life, she said, “I hope I’ll see in my lifetime a growing realization that we are one world. And that no one is going to have quality of life unless we support everyone’s quality of life. Not on a basis of do-goodism, but because of a real commitment. It’s our collective and personal health that’s at stake.” In 2001, President Clinton presented her with a Presidential Citizen’s Medal for her work on behalf of women, children, people with HIV and AIDS, and the poor. Later that year, Helen Rodriguez-Trias died of complications from cancer.

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(Dr. Mary Steichen Calderone) “What is this film really saying? First of all, that sex is normally and properly a part of each one of us, from babyhood on. Secondly, that understanding and acceptance of the normal sexuality of children of all ages is a must for every adult. What children need from us is information to answer all of their questions. This is a must. Just to protect them against the misinformation and wrong attitudes that are all around us.” In the 1950s, an era when talking publicly about sex was taboo, Dr. Mary Steichen Calderone spoke out about sexuality as an inherent part of being human. As Medical Director of Planned Parenthood, she began to change the way that Americans talked about sex. Because of the climate of the time, her ideas were controversial, especially so because a woman was not supposed to mention such things. But her advice was common sense, applicable to both sexes, and she delivered it with medical acumen, ease, and candor. As a physician, she brought a medical perspective to the subject to explain human sexuality as a natural part of life. Planned Parenthood provided contraception and sexual health information and resources for the public. Dr. Calderone also addressed the concept of separating sex from reproduction. She promoted sex as a healthy, normal part of life, worthy of public discussion. In 1964, Dr. Calderone left Planned Parenthood to create The Sex Information and Education Council of the United States. The Council provided information for schools and for young people. Through her own books, Dr. Calderone advised parents on positive ways to talk to their children about sex. Her efforts helped young people gain the confidence and knowledge to enjoy safe and healthy sex lives in adulthood. Mary Steichen Calderone won many awards, including, the Woman of Conscience Award in 1968, and the Elizabeth Blackwell Award for Distinguished Service to Humanity. In 1971, the Ladies Home Journal named her one of “America’s 75 Most Important Women.” Four years later, she was listed among the “50 Most Influential Women in the U.S.” The atmosphere that is so vital today, that allows for informed discussions about reproductive health, unwanted pregnancy, HIV, AIDS and other sexually transmitted diseases, follows from initiatives begun in the 1950s by Dr. Mary Steichen Calderone. (Dr. Mary Steichen Calderone) “Most of all, children need parents who can show love—for each other, and for their children. For in such a home, sharing knowledge of this great and universal human experience can only serve to strengthen family ties.”

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“As a young girl, I would nurse and help the birds that fell out of trees,” recalled Dr. Dorothy Boulding Ferebee. While her friends played with toys, she healed injured animals. At an early age, she knew she wanted to become a doctor. After graduating fifth in her class from Tufts University School of Medicine in 1924, Dorothy Boulding, like other qualified African American physicians across the country, was denied internships at white hospitals. Determined to find equal opportunity to complete her training, Dr. Boulding took an internship at Freedman’s Hospital in the Capitol Hill neighborhood of Washington, D.C. One of the few hospitals administered by African Americans, it provided health care to the city’s black community. In 1925, after completing her internship, Dr. Boulding opened her own practice in the Capitol Hill neighborhood. The community was very poorand did not have an ambulance service. Dr. Boulding was determined to bring basic care to those who could not afford it. (Dr. Dorothy Ferebee) “So I learned a great deal about the needs of the negro people in Washington, because most of them were concentrated in Southeast. So it was there that I learned there was very little opportunity for the children. Even though they were in school, they weren’t learning anything. And then it occurred to me, there’s something wrong with this town. Anytime a child goes hungry, and the mother has to work and leave her child home like this we need some place for children. We need a day care center.” Concerned about the needs of families in the community, she set up the Southeast Neighborhood Society, with playgrounds and day care for children of working mothers. In 1925, Dr. Boulding joined the faculty of Howard University Medical School, where she met, and later married Claude Thurston Ferebee, a dentist and university instructor. In 1934, she was appointed Medical Director of the Mississippi Health Project. (Dr. Dorothy Ferebee) “Going to Mississippi was quite an ordeal. In all of those counties, the influential people were the plantation owners. They’re the ones that decided what could be done,what could not be done. So, reluctantly they allowed us to start a clinic. But they would not allow the blacks on the plantation to leave their job of picking cotton and hoeing the weeds—would not allow them to come to any of the five clinics that we had proposed. So here we were, in Mississippi with all the materials that we had bought, the drugs that we had bought, all of the things necessary for the health of young children, and couldn’t use them because these plantation owners would not allow the negroes to come to us. So we had a little consultation, and we said, ‘Well, if they can’t come to us, we’ll go them.’ So it was an educational teaching job as well as a health job.” Despite threats by hostile whites, project workers launched vaccine programs against smallpox and diphtheria throughout poor communities. They also treated venereal disease and widespread malnutrition. Members of the Alpha Kappa Alpha Sorority financed, designed, and implemented the Project for two to six weeks every summer from 1935 to 1942. In 1949, Dr. Ferebee was appointed Director of Health Services for the Howard University Medical School. When she was in her sixties, President John F. Kennedy appointed her to the Council for Food for Peace, and she toured Africa for five months, lecturing on preventive medicine. Doctor Dorothy Boulding Ferebee died in 1980, at the age of ninety.

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Dr. Fernande Pelletier went to Africa in 1961 as a Medical Mission Sister. A graduate of the Georgetown University Medical School, she was thirty years old when she left home to begin her service. Her destination was the city of Berekum, Ghana, where she has now lived and served for over forty years. Throughout her service, Dr. Pelletier has had to overcome language, technological, and cultural barriers. She learned the local dialect, Twi, so she could talk directly with her patients, and the midwives and nurses she has trained over the years. She immerses herself in the local culture, trying to understand the ways that her patients think about their illnesses. Her dedication to her work has been celebrated by the Ghanian Government, who awarded Dr. Pelletier the Grand Medal for outstanding rural medical work. In addition to medical supplies, Dr. Fernande Pelletier provides AIDS education, home visits to new mothers, and training for new medical health workers. Using the Holy Family Hospital Outreach Vehicle for travel, she reaches remote areas without hospitals and doctors, caring for her patients’ needs in any way she can. Dr. Pelletier respects the spiritual beliefs of her patients and concentrates on relieving their illnesses or injuries. She explains, “By our action, we express our religious belief. Not ’I heal you and now you join my religion’... But by action; by healing people out of love and making them whole. That, I think, speaks louder.” Dr. Pelletier continues to serve the goals of the Medical Mission Sisters, making good health care accessible to poor patients in remote areas.

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Joycelyn Elders was born a tenant farmer’s daughter in rural Arkansas. At age five, she worked in the cotton fields while attending a segregated school thirteen miles from home. During harvest time, from September to December, she often missed school. She did well enough, though, to earn a scholarship to the all-black, liberal arts Philander Smith College in Little Rock. Making it through college was a family affair. Joycelyn Elders cleaned floors, while her brothers and sisters did extra work in the fields and chores for neighbors to help earn her bus fare. In college, she worked hard and especially enjoyed biology and chemistry. She hoped to become a lab technician. Her ambitions dramatically changed when she heard a talk by Dr. Edith Irby Jones, the first African American to attend the University of Arkansas Medical School. Though Elders had never even met a doctor until she was sixteen years old, she decided it was possible to become a physician, like Dr. Jones. In 1956, like her role model, she enrolled at the University of Arkansas Medical School. Two years before, the Supreme Court had declared “separate but equal” education unconstitutional. Despite that ruling, Elders was prohibited from sharing dining facilities with the other students on campus. In spite of the inauspicious circumstances early in her life, Dr. Elders was appointed Surgeon General of the United States by President Bill Clinton in 1993. In this prominent post, Dr. Elders continued to promote the issues she had been committed to in her previous work as head of the Arkansas Department of Health, where she had been especially concerned with the health of young people and campaigned for the introduction of a range of innovative educational programs to the school curriculum. Within five years, she nearly doubled childhood immunizations in Arkansas, expanded the state’s pre-natal care program, and increased home-care options for the chronically and terminally ill. As Surgeon General, Dr. Elders concluded it was her responsibility to get people to listen and talk about difficult subjects, since only then can change come about. She again concentrated on the health of young people and led the national debate on the prevention of substance abuse, and sex education for teenagers. Some considered her focus on these issues controversial, and she left office after 15 months. She returned to the University of Arkansas as a faculty researcher and was appointed professor at the Arkansas Children’s Hospital. Now retired from practice, Dr. Elders is a professor emeritus at the University of Arkansas School of Medicine and remains active in public health education.

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As a young physician, Dr. Irené Ferrer was the first woman to serve as chief resident at Bellevue Hospital, where she was given a prestigious opportunity: to work with a leading team of cardiologists who were developing the cardiac catheter. Had it not been for the lack of male candidates during World War II, it is unlikely that a woman physician would have been given such a chance. But Dr. Ferrer played a vital role in the project. The catheter was an important step toward open-heart surgery and earned the team a Nobel Prize in 1956. Dr. Ferrer also collaborated with IBM to make computerized interpretation of electrocardiograms possible for the first time. From 1953 to 1986, she was director of the Electrocardiographics Department at Doctors Hospital. Since 1986, she has served as an honorary consultant at Presbyterian and St. Luke’s-Roosevelt and is professor emeritus at Columbia University. Special among her many honors, is the M. Irené Ferrer Professorship in Women’s Health and Gender-specific Medicine at Columbia University, established in her name by the Partnership for Women’s Health founded and directed by Dr. Marianne Legato. Dr. Marianne Legato was one of the many younger physicians Dr. Irené Ferrer mentored in an extraordinary way throughout her career. When Marianne Legato left medical school because she could not afford the tuition, Dr. Ferrer convinced the Dean to let Legato return and paid for the rest of her education. (Dr. Marianne Legato): “And Dr. Ferrer herself went back and personally called on the Dean of NYU and said, ‘I’m gonna pay for this, young woman’s education. I will guarantee a good performance, and I want you to take her back’, which he did. After that I became really a member of the Ferrer family, and they were a wonderful, wonderful force in my own life and in my own development. It was a wonderful family to which I had sort of been added, and they really made my career possible.” Dr. Ferrer’s contribution to the development of the cardiac catheter and the compelling example she gave to medical students was based on her extraordinary relationship with her patients. (Dr. Marianne Legato): “She became devoted to many of her patients, whom she dearly loved. Her love of patients was really remarkable and one of the things about her that made her so engaging as a role model for us. So that combination of intellectual brilliance and real love of the patient was sort of a winning combination for those of us who were lucky enough to be her students.”

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One day I was in the living room with my mother. I grew up in the projects, which is what used to be called low-income housing for poor people. And we only had three small rooms, and that day she fainted in the living room. And I had no idea what was wrong. It was very frightening to me, and back then we didn’t have 911 and so I didn’t really know what to do. But the long and short of this is that she had cancer of the cervix. We were poor, we were uninsured, she was not getting health care. And from that point on, I knew that I wanted to do something to change that situation. At that time there were not many women in medicine. There certainly weren’t many African Americans. So I had no role models, and I had no encouragement to go into medicine. My counselors all said, oh, no, don’t worry about that. You’ll never get admitted as a woman. You’ll never get admitted as an African American, or as an African American woman, and besides, you’re too poor to go. You know, you’ll never have the money. But the motivation—I knew I really wanted to do this. And I had wonderful mentors that said, don’t let your dreams go. And I guess in all fairness, back then, it did seem like an impossible dream at the time. So that these issues were very clear early on to me, and they have remained prominent in my career. And I have spent a career trying to change this, and trying to get health care to disadvantaged, underserved people throughout the nation. I spent some time at the National Institutes of Health. And one of the projects that I did while I was there was working with sickle cell disease, especially looking at the problem that babies with sickle cell disease die very suddenly—especially they’re at risk in the first three years of life. I led a study where we looked at can’t we prevent this? If by giving babies penicillin prophylactically, before they get the fever, before they get the infection—can’t we save some lives? This study was so successful we stopped it midway—because the results were so compelling. The babies that got the penicillin prophylactically definitely did not have the infections, and it was a study that saved lives. And it is saving lives now. Worldwide. You know, because sickle cell disease is a worldwide problem. I always tell students that your heroes and your sheroes are not just in the history books, they’re not just on TV, but they’re all around you. And to look for them, and to ask them to mentor you. Don’t just passively and say, oh, I wish I could have that person, ask them. And I always remind them, you know, that they’ll always say yes. Because we’re always so flattered, and we say, oh, yes. I would be glad to be your mentor.

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In the 1970s, Dr. Janet Rowley brought a new understanding to the role of genetics in disease when she demonstrated that the translocation of chromosomes played a significant role in some cancers. A dedicated student, she received a scholarship to the University of Chicago when she was fifteen years old, and completed the last two years of high school and the first two years of college in an accelerated program of study at the University. She stayed on to complete her pre-medical training and attend the medical school and graduated with an M.D. degree in 1948. She married Donald Rowley, also a physician, the day after graduating from medical school. For twenty years, Dr. Rowley chose to work part-time, in order to be with her children. When the youngest was twelve, she turned to full-time research. She became interested in genetics while working at the Dr. Julian Levison Foundation, a clinic for children with developmental disabilities. In 1961, funded by the National Institutes of Health, she traveled to Oxford, England, to study chromosomes at a radiobiology laboratory. There, she investigated the pattern of DNA replication in normal and abnormal human chromosomes. A year later, at the end of the project, Dr. Rowley returned to the University of Chicago to continue her research. In the early 1970s, she brought a new perspective to the understanding of cancer by demonstrating that the abnormal chromosome implicated in certain types of leukemia was also involved in a translocation, in some cases. By 1990, over seventy chromosomal translocations had been identified across different types of cancer. Today, Dr. Rowley continues her research at the University of Chicago. She holds the position of the Blum-Riese Distinguished Service Professor, and serves as the Interim Deputy Dean for Science. In 1998, Dr. Janet Rowley was awarded the prestigious Lasker Award for her work on translocation and cancer.

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Dr. Katherine Detre is a research leader in large-scale studies investigating disease and risk factors across populations. She grew up in Budapest, Hungary during the Nazi occupation in World War II. To cope with the loss of some of her closest family members, she devoted herself to her studies. In Budapest, she trained at Pazmany Peter Medical School. In 1949, she received an International Student Service Award to study in Canada. Three years later, she received her medical degree from Queen’s University Medical School in Ontario, and followed that with a Residency in Internal Medicine at Queen Mary Veterans Hospital. Shortly after, she came to the United States and married Dr. Thomas Detre. In 1956, she moved to Yale University where she specialized in Biometry, the application of statistics to the biological sciences. In 1960, Dr. Katherine Detre traveled to Hiroshima, Japan to study heart disease. Returning to Yale, she earned a Master of Public Health Degree in 1964, and a doctorate in 1967. Today, Dr. Detre serves as a Professor of Epidemiology at the University of Pittsburgh. In 2000, she was awarded a major grant for an expansive study of coronary artery disease and diabetes. The research spans forty areas nationwide, and includes three thousand patients. Recently, she received the highest honor awarded by the University; that of “Distinguished Professor.” The prestigious title honors her “extraordinary, internationally-recognized, scholarly achievement.”

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In the 1970s, Dr. Janet Rowley brought a new understanding to the role of genetics in disease when she demonstrated that the translocation of chromosomes played a significant role in some cancers. A dedicated student, she received a scholarship to the University of Chicago when she was fifteen years old, and completed the last two years of high school and the first two years of college in an accelerated program of study at the University. She stayed on to complete her pre-medical training and attend the medical school and graduated with an M.D. degree in 1948. She married Donald Rowley, also a physician, the day after graduating from medical school. For twenty years, Dr. Rowley chose to work part-time, in order to be with her children. When the youngest was twelve, she turned to full-time research. She became interested in genetics while working at the Dr. Julian Levison Foundation, a clinic for children with developmental disabilities. In 1961, funded by the National Institutes of Health, she traveled to Oxford, England, to study chromosomes at a radiobiology laboratory. There, she investigated the pattern of DNA replication in normal and abnormal human chromosomes. A year later, at the end of the project, Dr. Rowley returned to the University of Chicago to continue her research. In the early 1970s, she brought a new perspective to the understanding of cancer by demonstrating that the abnormal chromosome implicated in certain types of leukemia was also involved in a translocation, in some cases. By 1990, over seventy chromosomal translocations had been identified across different types of cancer. Today, Dr. Rowley continues her research at the University of Chicago. She holds the position of the Blum-Riese Distinguished Service Professor, and serves as the Interim Deputy Dean for Science. In 1998, Dr. Janet Rowley was awarded the prestigious Lasker Award for her work on translocation and cancer.

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I faced my first obstacle the first day of medical school, and I remember sitting with three men in my class around a cadaver, as part of a gross anatomy course. And one of the men said to me, “You took the place of one of my friends, and because you’re here, he didn’t get into medical school. And this is not a place for women. Women should be home and taking care of the house.” So that was an introduction to medical school. And what I decided after that was that I was going to work very hard and become a very good student, and try to amount to something with my career, so that I wouldn’t feel I was taking anybody’s place but I was there rightfully, on my own. Before we developed the standardized patient concept, the evaluation of clinical skills was very subjective. Students were either good or not good. They would occasionally be observed by an attending physician, but there wasn’t a reproducible, reliable, valid way of assessing these skills and documenting whatever weaknesses existed, and then providing corrective feedback and education to the student. This technique allowed students to be compared to an absolute standard, and to have individualized feedback, and multiple observations by experienced people. I was motivated to create this method of teaching and evaluating because I wanted to make sure that there was an opportunity for students and residents to really learn these very critical clinical skills, and not perpetuate mistakes. I wanted somebody who was knowledgeable to be able to provide immediate feedback to them, and tell them what they did well, what they didn’t do well, and make sure that they did it better the next time. When I went to medical school there were very few career paths that were open to women, and most of the women in my class went into pediatrics because it was very acceptable for us to do that. The other acceptable field at that time was psychiatry. Young women today who go into medicine can do anything. They can be surgeons, they can do whatever they want to do, and they have lots of options, which we didn’t have so many years ago.

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Dr. Edithe J. Levit became the first woman president and CEO of a national medical association when she took over the leadership of the National Board of Medical Examiners. The Board was founded in 1915 to create national standards for medical licensing and education. Dr. Levit was responsible for making sure that the board kept up with changing times and the most useful innovations that could help measure students’ abilities. She was hired in the 1960s as one of the board’s first full-time medical professionals. Over the decades, she instituted creative innovations that have revolutionized the way medical students are evaluated. Among her many innovations were PMPs... or “Patient Management Problems.” They were designed to test how well medical students make decisions while examining and taking the history of a patient. PMPs became a highly effective way to test all students on the same skills, and hold them to the same standards. Dr. Levit later introduced computer-based testing, audiovisual tools such as films of meetings with patients, and the first self-assessment test of the American College of Physicians. Dr. Levit was successful in ushering in such sweeping changes by consistently proving their efficacy, and eloquently justifying a new approach. Within the first ten years, she rose through the ranks and in 1977, became President and CEO of the National Board of Medical Examiners. In 1986, Dr. Levit received the first ever Honorary Resolution from the American Medical Association’s Resident Physician Section for her commitment to the highest standards in medical education. She also was honored with a Special Recognition Award from the Association of American Medical Colleges. As Dr. Levit recalls, “I spent the last 25 years of my career with the National Board of Medical Examiners... those years were the most stimulating, creative, and rewarding time of my professional life.”

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Dr. Edithe J. Levit became the first woman president and CEO of a national medical association when she took over the leadership of the National Board of Medical Examiners. The Board was founded in 1915 to create national standards for medical licensing and education. Dr. Levit was responsible for making sure that the board kept up with changing times and the most useful innovations that could help measure students’ abilities. She was hired in the 1960s as one of the board’s first full-time medical professionals. Over the decades, she instituted creative innovations that have revolutionized the way medical students are evaluated. Among her many innovations were PMPs... or “Patient Management Problems.” They were designed to test how well medical students make decisions while examining and taking the history of a patient. PMPs became a highly effective way to test all students on the same skills, and hold them to the same standards. Dr. Levit later introduced computer-based testing, audiovisual tools such as films of meetings with patients, and the first self-assessment test of the American College of Physicians. Dr. Levit was successful in ushering in such sweeping changes by consistently proving their efficacy, and eloquently justifying a new approach. Within the first ten years, she rose through the ranks and in 1977, became President and CEO of the National Board of Medical Examiners. In 1986, Dr. Levit received the first ever Honorary Resolution from the American Medical Association’s Resident Physician Section for her commitment to the highest standards in medical education. She also was honored with a Special Recognition Award from the Association of American Medical Colleges. As Dr. Levit recalls, “I spent the last 25 years of my career with the National Board of Medical Examiners... those years were the most stimulating, creative, and rewarding time of my professional life.”

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Dr. Barbara Bates changed how medical professionals learn the skills of physical examination and diagnosis. And, she developed the role of Nurse-Practitioners. At the University of Rochester in the 1970’s, she came to think that special training could prepare nurses to share with doctors some of the responsibilities of patient care. She also became particularly interested in how physicians are trained to diagnose patients. As she taught the skills of physical examination and clinical thinking, she realized the standard teaching text used by students was not user-friendly. She began meeting with a group of ten nurses and five physicians. They called themselves “The Clandestine Group,” and they worked to completely re-think the teaching guides. The result of their efforts was a hand-drawn, informative, and easy-to-use text for nurse-practitioner students. The book’s organization was based on the popular bird-watching guide by Roger Tory Peterson. Introductory chapters addressed interview techniques, taking notes on health history, common and important symptoms, and assessment of mental health. Specific chapters also made it easy to look up anatomy and physiology. Techniques for physical exams were described in detail. The first edition of Dr. Bates’s “Guide to Physical Examinations and History Taking” was published in 1974. Since then it has become a standard textbook for nursing and medical training programs.

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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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.