Published on: July 01, 2011
Executive Vice President for Research, Puget Sound Blood Center
My journey to hematology and blood research has been the result of a series of chance occurrences. I grew up in Peñasco, a small village at an elevation of 8,000 feet in the Sangre de Cristo Mountains of northern New Mexico that has been the home of my ancestors for countless generations. Peñasco was, and is, a poor village. When I was young, I did not have exposure to scientists or medicine. In retrospect, however, it is clear to me that my experiences as a child shaped my love for science and, eventually, hematology. My first scientific inquiry derived from the necessity of growing almost all of our own food, which exposed me to the behavior and breeding of all manner of farm animals; it taught me mammalian anatomy and allowed me to marvel at the wondrous ways that plants can manufacture food from dirt and air. My inquisitiveness was encouraged by my parents and challenged by my siblings. But none of this curiosity would have led me to a fulfilling career in hematology research had it not been for several key people who altered my path: my high school science teacher who encouraged me to apply to a summer program in science at a small science and engineering university in the state, my chemistry professor who offered me work in his laboratory so that I could pay my tuition, and my medical school counselor who encouraged my scientific leanings in a school devoted almost entirely to training primary-care physicians. Those experiences paved my way to a career in medicine, but the path to research was still murky.
It was an experience I had during my internal medicine residency at the University of Washington that sparked my interest in hematology. During the second year of residency, most UW residents did externships in distant community hospitals loosely affiliated with the residency program. I was sent to Billings, MT, to work with a local internist who had not anticipated my arrival. Being very busy, he sent me off to the hospital ICU to examine a young woman who appeared to be on the verge of death. Coincidently, I had just read about the rare disease thrombotic thrombocytopenic purpura (TTP). After a cursory examination of the patient, I concluded that she did indeed have TTP. The patient and I were both lucky; I was right, and she received the lifesaving therapy of plasmapheresis. This diagnostic coup led to a request from the local medical community that I deliver a medical grand rounds presentation on TTP. I read every article I could find on the topic, and on platelets, since they clearly played a role in the disease. I became fascinated with the disease and with platelets and resolved to study them. I applied and was accepted to the hematology fellowship program at UW, then headed by former ASH President Dr. John Adamson. While I was a fellow, I queried many of my attendings about the research in their labs; few were interested. But Gerald Roth was interested, and, as a bonus, he happened to work on platelets. It was Jerry’s idea that I apply for a fellowship program aimed at increasing the number of underrepresented minorities in medicine through the Robert Wood Johnson Foundation (now called the Harold Amos Medical Faculty Development Program). After one failed application, we enlisted the help of Dr. Earl Davie, renowned for his work on the basic science of blood coagulation. The second time was a charm, and it was through this program that I was able to meet many students with stories like mine; I am still in contact with many of these colleagues, including Arturo Molina, Alexis Thompson, and Griffin Rodgers.
The work I began with Drs. Roth and Davie led me to explore the molecular basis of platelet adhesion, first working on a platelet receptor, the glycoprotein Ib-IX-V complex, and then on its vascular wall ligand, von Willebrand factor (VWF). The work took me through several academic appointments, from the University of Washington to the University of California, San Francisco, and the Gladstone Institute for Cardiovascular Disease, to Baylor College of Medicine, and finally back to Seattle with the Puget Sound Blood Center and UW, where I have had the opportunity to oversee and guide the growth of the Blood Center’s Research Institute. These travels have afforded me many opportunities, including working with Joel Moake, whose seminal work on the pathogenesis of TTP pointed to the role of ultra-large and hyperadhesive multimers of VWF. My opportunity to work with him and with other colleagues on the pathophysiology of TTP brought me back to the patient that initially sparked my interest in hematology. This work has also highlighted another reason I find hematology so attractive: it provides a scientist an opportunity to work on almost anything, from physics to human illness. I take to heart the old adage about hematology being “the study of blood and the organs through which it flows.”
As important to my career as my mentors and scientific colleagues have been, equally important and rewarding have been the opportunities to mentor and influence the many individuals who have been through my lab or that I have met in the clinic or through teaching. And it was an honor for me to serve for seven years as co-chair of the American Society of Hematology’s Minority Recruitment Initiative (now the Committee on Promoting Diversity) with Cage Johnson. I have always wanted to serve in the role of “the happy accident” that spurred a student’s interest in science.
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