Chapter 4: Medical School, A Fellowship, and A First Research Project
Files
Description
Dr. Kleinerman traces her path to medical school and into her clinical fellowship (1974−1975 Clinical Fellowship, Rheumatology, Duke University).
She first explains the process of getting into medical school at Duke University, Durham, North Carolina (MD 1974). She describes the curriculum and notes that the small number of women. She explains her view of different specialties and her selection of pediatrics. She recalls instances of gender bias encountered, then describes how she met Dr.Ralph Snyderman, who was instrumental in introducing her to immunology and setting up her collaboration on a research project conducted during her clinical fellowship in the rheumatology laboratory.She then talks about how her research results were controversial. She concludes with additional memories of gender bias.
Identifier
KleinermanES_01_20140521_C04
Publication Date
5-21-2014
City
Houston, Texas
Interview Session
Eugenie Kleinerman, MD, Oral History Interview, May 21, 2014
Topics Covered
The Interview Subject's Story - Professional PathExperiences re: Gender, Race, Ethnicity The Researcher Evolution of Career Women and Minorities at Work Discovery and Success Experiences Related to Gender, Race, Ethnicity
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
So tell me how you got yourself together without a mentor and got yourself into medical school. How did that happen and—
Eugenie Kleinerman, MD:
I just, you know, did it. There was nobody to cry to, you know. It wasn’t like today where, you know, my son could call me, you know, every ten minutes, “What do I do? How do I do it? The computer’s—,” whatever. It was expensive to call, so I called my parents maybe once every two or three weeks, so there was nobody else. I had to rely on myself, and I figured, “Okay, either you’re going to do this or you’re not.” So I just got the applications, read the books, signed myself up for the SATs, studied as best I could, got the interviews, flew to the cities by myself. I just sort of did it. I didn’t think about it.
Tacey Ann Rosolowski, PhD:
So were you still laser-focused on Duke, because that’s where you got your MD?
Eugenie Kleinerman, MD:
I was laser-focused on Duke, I was absolutely laser-focused on Duke, and I got on the waiting list. Did not get in. I got into Case Western Reserve, so I said, “Okay, I’ll go to Case Western Reserve.” Great medical school. Probably got in because of my dad. I mean, you know, it’s okay. It’s fine. Use every—it doesn’t matter as long as I work hard and finish. So I was all set to go to Case Western Reserve. Two weeks before the start date, the chief of pathology that my dad knew at Duke, who was now the dean of the medical school, called my dad and said—now, this is the story he told me. They had gone for diversity, and they had taken somebody with an American Indian ancestry, and he failed his whatever it is, so there’s an opening, and I was the first one on the waiting list. “Jerry, I know it’s only two weeks and I know she’s set to go to Case Western Reserve, but I wanted to let you know it’s open.” I said, “I’m there.” So I had two weeks. My dad bought my microscope, so I had to—and then you had to fly from Cleveland to Washington, D.C. and change planes and get on a plane to Durham. So there I was with my microscope, not knowing how am I going to carry on the microscope that’s got to fit under the seat, because you can’t put it—there were no overheads there, you know; they were open. So there was no closed bins. So I don’t know—
Tacey Ann Rosolowski, PhD:
Right. The microscope’s delicate equipment.
Eugenie Kleinerman, MD:
I don’t know how I did it, but I got there, and I arrived in the Durham Airport, and I walked out and I’m looking around. It’s outside. The Durham Airport was—you know, they had like a rain shield, but everything was open air. It was the Raleigh-Durham Airport. So, okay, now where do I get my luggage? And so you walk outside and a man hands you your luggage. No carousels like in St. Louis, not the big airport like in Cleveland, Hopkins Airport. So, you know, and I met some people and they were going to University of North Carolina, and I was going to Durham, and so we shared a cab, and he dropped me off at my dorm at Duke. My parents didn’t take me.
Tacey Ann Rosolowski, PhD:
Wow. Forging an independent woman there, yeah. So tell me about medical school.
Eugenie Kleinerman, MD:
So I was in a dorm, and actually my roommate was a first-year law student, and her husband was fighting in the Vietnam War. She was a black student. So she had a very difficult time. But I met three other girls, three other women, and we forged a bond and we’d study together, and, you know, it was just magical. I mean, I couldn’t believe it. Here I was at Duke. And the atmosphere was amazing, and it still is there, which is why I just love the medical school. Very focused on learning, very focused on the students, not this—I mean, there were some professors that were this hierarchy, but mostly it was, “We want you to do well.” It was a different curriculum. The Duke curriculum was you do all your basic science the first year. At most medical schools, you do it in two years. So, for example, we had twelve weeks of anatomy, where most medical schools, you have a whole year of anatomy. So we crammed in. A lot of people say, “I’d never want to do my internship again.” I’d always say, “I’d never want to do my first-year medical school again.” Very, very intense. And we went to class Monday through Saturday, had Saturday classes, so it really was—you know, you’re in the library studying, and, of course, I’m looking up every other word. You’re in anatomy, anastomosis. What the hell is anastomosis? I had my medical dictionary, looking. Okay, fascia. What is fascia? But it was hard for all of us. We were all, all—and actually there were some students who were not science majors. There were a couple of guys who graduated from Princeton, and they were English majors, so for them, I mean, brilliant, brilliant guys. For them it was even more foreign. But we all sort of worked together in this one dorm.
Tacey Ann Rosolowski, PhD:
How many women?
Eugenie Kleinerman, MD:
There were 14 women in my medical school out of 115.
Tacey Ann Rosolowski, PhD:
What was the atmosphere like for women?
Eugenie Kleinerman, MD:
So in the class it was fine. I mean, in terms of my male colleagues, there was never any discrimination, “You’re not as good as we are. What are you doing here?” It was very respectful, very respectful. We were colleagues. We were all in this together. We were friends. You know, we’d help each other. That was the other thing. So at Duke, the grading was high pass, pass, fail. So most of us were going to get a pass, so there’s none of this grade-grubbing. We’d study in groups. We’d help each other. Nobody had this, “I’m not going to help you because I’m afraid you’re going to have more points than I am.” It was a wonderful, collaborative environment.
Tacey Ann Rosolowski, PhD:
I mean, I’m just really interested that you’re describing these collaborative experiences, and, of course, you’re tracking yourself towards a research career and a clinical career that’s very, very reliant on exactly that kind of building of collaboration and networks and collegiality, I mean, all those things you described at the beginning of the session. So do feel that was something you learned? Is that part of how you thought about things even from the very beginning? Where did that piece come from in your own career?
Eugenie Kleinerman, MD:
I don’t know. I guess it just was there, so there was no question. I mean, you know, I just didn’t think about it.
Tacey Ann Rosolowski, PhD:
It sounds like you found it very exciting and formative for your own thinking.
Eugenie Kleinerman, MD:
Oh, yeah, and I remember thinking, “These people are really smart. No wonder I was on the waiting list. What am I doing here?” But, you know, it was just a wonderful experience. Now, that was my colleagues and that was a lot of the professors. On the clinical side, however, you had a chief of surgery who said openly, “I will never take a woman as one of my residents.” And there was a very strict hierarchical order that surgeons were on—that’s when night call was every other night.
Tacey Ann Rosolowski, PhD:
Had you considered being a surgeon?
Eugenie Kleinerman, MD:
No, not really.
Tacey Ann Rosolowski, PhD:
But does it help the atmosphere any to hear that?
Eugenie Kleinerman, MD:
Not really. But he would call you Ms. Kleinerman or Ms. Jones. During the second year, you did your rotations, so there were eight-week rotations, and at the end of every rotation, he would have a cocktail party in his house for the students that were there, and all of the surgical residents that were not on call that night had to attend the party and they had to bring their wives. So it was a very—now, he was a brilliant man, Dave Sabiston. He had come from Hopkins, a brilliant cardiovascular surgeon, and he was an outstanding teacher. I loved to hear him lecture. But, you know, I said, “I cannot believe this man is getting away with saying this. How can the university let him get away with saying this?” There were women residents in medicine, and I don’t think—well, no, that’s not true. Okay. So my first rotation I took my second year was internal medicine, because I had met my husband, and he said the only—I told—“What do you want to go into?” “I want to go into pediatrics.” “Oh, no, no, no. The only intellectual field is internal medicine. You have to go into internal medicine.” I’m, “All right. Fine.” I mean, you know, all I know is pathology and pediatrics, and I don’t want to do pathology, because I don’t want to deal with dead people and be behind a microscope. I want to be with people. So I took internal medicine, and it was GI bleeders and alcoholics and chronic liver failure and hysterical women with thyroid disease and chronic rheumatoid arthritis and chronic obstructive bowel disease. I’m going, “Oh, my god.” And the crowning blow was the first week I was on, there was a GI bleeder, an alcoholic, who came in, and, of course, in those days what you had to do is you had to take iced saline, put an NG tube down, and lavage, you know, to clamp down the vessels. And I had done that. I had stayed up with him all night, got him, you know—“Oh, Doctor, thank you so much, wonderful.” Got him out of the hospital. Three weeks later, I get my admission. Who is it? It’s this guy with GI bleeder. I said to myself, “I cannot deal with this. I have no patience for this. I have no patience for adults that will not take responsibility.” I don’t mind crying kids. You want to cry? Cry. It’s a child. I mean, I’m going to have to draw blood. Fine. You don’t feel well? Fine. It’s fine. My husband says, “I can’t stand those crying kids and their mothers. I can’t.” (Rosolowski laughs.) But to me, you know, I just wanted to slap. I said, “This is not good if you want to slap your patients.” (Rosolowski laughs.) This is not good.
Tacey Ann Rosolowski, PhD:
So you had always wanted to go into pediatrics—
Eugenie Kleinerman, MD:
Yes.
Tacey Ann Rosolowski, PhD:
—and never really wavered from that at all.
Eugenie Kleinerman, MD:
Except for this one—
Tacey Ann Rosolowski, PhD:
Except for that one glitch, yeah. (laughs)
Eugenie Kleinerman, MD:
No. No, no, no.
Tacey Ann Rosolowski, PhD:
When did the oncology piece come in?
Eugenie Kleinerman, MD:
Oh, the oncology piece didn’t come in till much later.
Tacey Ann Rosolowski, PhD:
Yeah, I was wondering about that.
Eugenie Kleinerman, MD:
No. So I thought I wanted to go into general pediatrics, and the Duke curriculum was as such, so your first year you did all your basic science, your second year you did all your required clinical electives: medicine, surgery, OB/GYN. The third year you either did research, and they had different tracks, virology study program, the immunology study program, or you took graduate courses. For example, the guys who wanted to become cardiovascular surgeons, they took two semesters of cardiophysiology, so they really delved into the cardiophysiology, how does the heart work. It was Duke’s philosophy, and still is, that you need to spend the third year really understanding the disease, or doing research and being an investigator. So I had wanted to work with one of the women pediatricians who was doing infectious disease because I was interested in virology, but she had already taken a student in her lab. On my medicine rotation, one of my rounding men was a man named Dr. Ralph Snyderman, who was a young rheumatologist who had just come from the NCI, who did research in inflammation, and he was my rounding man. He took an interest in me, and he said, “Genie, why don’t you come to the lab. Why don’t you come to my lab.” “No, no, no, no. I want to work with Dr. Cathy Wilfert.” “Oh, really?” So he said, “So are you working with Dr. Wilfert?” “No, she has somebody.” “Well, why don’t you come to our lab, you know, really.” “Well, I really want to do virology.” So he said, “Well, come talk to me.” So we sat down. He says, “Look, I’d always had this idea that when people get influenza, they always get super infected. And the influenza doesn’t kill them; it’s the viral infection, it’s the pneumonia. I have this thought that viruses, when they infect immune cells, they paralyze the immune system. So maybe we can collect—maybe we can—.” So he said, “Why don’t you go talk to Tom Kate,” who was an infectious disease physician. So I talked to him, and he said, “Yeah, I grow influenza and I do this.” And I talked to a pathologist who does herpes, blah, blah, blah. So I came to him and I said, “Look, maybe the three of us could work together.” He said, “Great idea.” So I put together a project working with these three men. I learned how to grow the viruses, I learned how to infect the animals, I learned how to do the immune assays in Dr. Snyderman’s lab, and I had the project and it worked. We showed that if you infected mice with influenza and then gave them a stimulus to create an inflammatory response, you couldn’t get an inflammatory response. Well, then Ralph just thought this was great, so he got me on TV to talk about paralyzing the immune system. There was a section in the paper. What was it? It was like when immune cells fail, pneumonia may strike. And I had a wonderful time. I had absolutely—again, it was this collegial time. And at Duke you could go summers and that would speed up your progression through medical school. So I actually finished all of my required courses the end of November. Ralph said, “Why don’t you become a rheumatology fellow and you’ll work in my lab. You’ll see rheumatology. They have to be adults. You’ll see rheumatology patients one day, and then you’ll come and you’ll continue working in my lab.” So I did, because my husband was a resident, so I had to wait till he finished. And it was an absolutely wonderful experience. I mean, this is in the heyday of science when a little bit of money went a long way and people, again, could do crazy ideas and didn’t have to worry about everything.
Tacey Ann Rosolowski, PhD:
This was ’74, ’75, for your clinical fellowship.
Eugenie Kleinerman, MD:
Yeah, right. And actually during that time, Bob Lefkowitz, who subsequently won the Nobel Prize in chemistry two years ago, he had just come as a new faculty member to Duke, and he was working down the hall from Ralph. And Ralph and I would come in on Saturday to write my papers. The lab meetings were fun because we would discuss ideas. Or we’d all gather in his office at the end of the day and, you know, there was technicians and other graduate students. I remember vividly—I recently told Ralph this story. So Bob Lefkowitz, he was the one who really discovered receptors, that there are proteins on the surface of cells that actually when other proteins come, they stick. So this was Bob’s concept. And people thought, “Receptors? What are you talking about, receptors?” So I remember we were having a heated discussion. I remember Ralph saying to him, “Bob, you mean to tell me if I take a handful of mud and I throw it on the wall and it sticks to wall, you’re going to tell me the wall has a receptor for mud?” But that gives you an idea of—and, you know, I was a medical student, and here I was involved in these scientific discussions with these brilliant people.
Tacey Ann Rosolowski, PhD:
Yeah, yeah. That just sounds like a—was that an unusual situation?
Eugenie Kleinerman, MD:
Not at Duke, I don’t think. I mean, I don’t know. But there wasn’t this hierarchy, “I am the lab chief and therefore what—.” There was no question that you could say, “Are you crazy? That’s a crazy idea. Why do you say that?” Never fear of—even as a student.
Tacey Ann Rosolowski, PhD:
What do you think these guys saw in you? I mean, Dr. Snyderman obviously pursued you to be connected with his work.
Eugenie Kleinerman, MD:
Well, I guess—I think he probably saw, because he was my rounding man, that I was very serious. In fact, he tells me, “You were so serious. You’d present, and I’d crack jokes and you wouldn’t laugh.” (Rosolowski laughs.) I wanted to be taken seriously. And the other reason was the chief resident at that time when I was on medicine, oftentimes what would happen was, you know, you’d be there late at night and you’d finish your notes. Now, there were no on-call rooms for women, so we couldn’t stay. I had to go home to my apartment, where my male counterparts had a room to sleep in because they shared it with a resident. And I remember sitting on the ward very late at night, I don’t know, twelve o’clock, eleven-thirty or whatever, finishing my notes, and I’d turn around and there’s nobody there. There’s only me. I’d think, “God, am I slow? I guess I’m slow. Okay, well, just finish up.” And then as I’m walking out, I go past the cafeteria and I see the chief resident was holding midnight rounds with all the other male students and not me. And I remember saying, “Okay, I got it. I got it.” There’s no point in complaining. Who to complain to?
Tacey Ann Rosolowski, PhD:
Right. Right.
Eugenie Kleinerman, MD:
So it was a mixed message. And OB/GYN, they took the first woman resident from the woman the class ahead of me. She was the first woman to be a resident in OB/GYN.
Tacey Ann Rosolowski, PhD:
Oh, my gosh. That’s ironic. (laughs)
Eugenie Kleinerman, MD:
(cell phone ringing) I’m just going to get this.
Recommended Citation
Kleinerman, Eugenie S. MD and Rosolowski, Tacey A. PhD, "Chapter 4: Medical School, A Fellowship, and A First Research Project" (2014). Interview Chapters. 1400.
https://openworks.mdanderson.org/mchv_interviewchapters/1400
Conditions Governing Access
Open
