A Career in Hematology With Unexpected Turns
Published on: July 01, 2013
George E. Becker Professor of Medicine Director, Stanford Cancer Institute
Past President of ASH
From the time I was eight, there was no question that I would become a physician. Encouraged by a surgeon father who led an academic department at Tufts while remaining completely devoted to his patients, I entered Harvard Medical School, one of 10 women in my class. It was there that I encountered William Castle, a true pioneer in hematology and discoverer of intrinsic factor. Not only did Dr. Castle tell the incredible story of his clinical investigations that dovetailed with those of Whipple, Minot, and Murphy and led to the cure of pernicious anemia, he also nobly submitted himself to the torture of second-year students drawing his blood.
Later, as a resident at the University of Washington, I encountered many other facets of hematology. The discovery and characterization of colony-stimulating factors had catalyzed the creation an entire new field of research, and at the University of Washington, John Adamson introduced me to the world of experimental hematopoiesis. It is no coincidence that a number of today’s prominent academic hematologists, including three other ASH presidents, Ken Kaushansky, Evan Sadler, and Jan Abkowitz, also benefited from John’s expert training and mentorship.
As wonderful as the University of Washington was, I was anxious to explore new environments in conjunction with my husband, a geneticist who had just completed a postdoctoral fellowship. Following two years of research in Zurich, we settled in Ann Arbor, Michigan, where I met William Kelley, then the chair of medicine. Bill is a rheumatologist who worked on purine metabolism. Fortuitously, the link between two inherited disorders of purine metabolism (deficiencies of adenosine deaminase and purine nucleoside phosphorylase activity) and two immunodeficiency diseases (severe combined immunodeficiency disease and primary depletion of T lymphocytes) had just been discovered. It was a short conceptual leap from understanding the pathobiology of these disorders to envisioning novel therapeutic strategies for lymphoproliferative disorders. Thus, the transition to Bill’s laboratory diverted my research from hematopoiesis to the study of enzyme inhibitors such as 2’-deoxycoformycin (pentostatin) and purine analogs such as guanine arabinoside (AraG) and their clinical application in the treatment of lymphoid malignancies. Motherhood also worked its way into my life while in Ann Arbor. Combining motherhood with a career as a physician-scientist presented many challenges and many rewards. With probable contributions from both nature and nurture, our two children have ended up in academic careers in the natural sciences.
After a number of years in Michigan, we moved to the University of North Carolina at Chapel Hill, where I had the opportunity to merge a great hematology program, which had been developed under Harold Roberts, with a less well-developed oncology program. This leadership opportunity introduced me to a dimension of academia that has proven to be particularly rewarding as I came to understand how one can have an impact in medicine that extends beyond teaching, the care of patients, and research. The ability to help build programs and to influence the careers of others was unexpectedly rewarding. As a division chief in the department of medicine and as associate director for translational research in a terrific cancer center with an exceptional director, Shelley Earp, I came to realize how challenging, yet important, it can be to integrate the interests and activities of scientists and clinicians and to promote collaborations aimed at improving the treatment of patients with cancer. Thus, the opportunity to help build a cancer center at Stanford in collaboration with yet another remarkable hematologist, the late Karl Blume, came at an opportune time in my career. I continue to partition my time among administration responsibilities, patient care, and research in acute leukemia and myelodysplastic syndromes at Stanford, in an environment that is wonderfully rich both in hematologists and in scientists interested in hematopoiesis and immunity.
Of all the experiences I have had during my career, the opportunity to be involved with ASH has clearly been a highlight. Working with Jim George on the Clinical Research Training Institute; interacting with a host of energetic, enthusiastic, dedicated hematologists and ASH staff; and attending the annual meeting without fail have enriched my career and my life. The recent pace of discovery in hematologic malignancies has been breathtaking, and my hope is that future generations of hematologists will be able to look back on the cure of chronic leukemias and myeloma as I looked back on the cure of pernicious anemia as a triumph of curiosity, imagination, and tenacity. There can be no better career than one in hematology.
Thoughts From a Former Protégé
Daniel A. Pollyea, MD, MS
Assistant Professor of Medicine, Division of Hematology and Oncology, Clinical Director of Leukemia Services, University of Colorado School of Medicine
In retrospect, I have no idea how I came to be sitting on a couch in the office of the director of the Stanford Cancer Center, talking to the director herself about a proposal I was considering sending as the focus of my application for a position in ASH’s Clinical Research Training Institute. Perhaps someone had mentioned offhandedly that I might want to run my idea by Bev Mitchell, as she had expertise in a field in which I had voiced some burgeoning interest. I certainly had no business, as a first-year fellow, being there at all, occupying a highly coveted time slot on her extraordinarily busy schedule with my meandering, half-baked ideas. But as we talked, first about my proposal, then about leukemia, then about research and career development, I got the sense that Dr. Mitchell regarded this meeting, with a somewhat rudderless first-year fellow, as important as anything she had to do that day. And as I left her office and walked back outside into the sunny afternoon, it occurred to me that I had just gotten myself a mentor.
And what a mentor she is. Despite my inexperience, Bev took me into her laboratory, helping me develop a project that may not have been particularly consistent with the focus of her lab, but one that uniquely suited my needs. She taught me how to think critically and scientifically about my own work and that of others. Through it all, Bev maintained the ability to filter out all of her many other administrative, research, and clinical responsibilities, laser focusing on the concerns of her mentees. Generous with her advice and expertise, she always had time, no matter what grant was due or what meeting required her attendance.
Many of the important lessons I learned from Bev were not based on pearls of wisdom expressed from her mouth to my ear but rather came from observations made by watching her interactions with others. These lessons took shape as a series of clearly discernable patterns: 1) Bev never asks anyone to do anything that she did not or would not do herself; 2) she treats everyone with the utmost respect and consideration; and 3) she motivates others through positive reinforcement, without relying on confidence-shattering admonitions or reprimands. As a junior faculty member now, I find these leadership-by-example lessons of critical importance and recognize that these are crucial elements of being an effective mentor and leader. Over the years, I have been the beneficiary of the committed attention and guidance that all of Bev’s mentees enjoy. Her impact on my career, as well as the careers of many before me and many more in the future, is a wonderful legacy for a remarkable mentor.
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