Michele Johnson, MD, became Yale School of Medicine’s first female and African-American full professor. Her fields are radiology and biomedical imaging and neurosurgery. Achievement runs in the family: her father, a neurochemist, was the first African-American to earn a PhD in chemistry from the University of Delaware. She sat down with Kathleen Raven to talk about the value of hard work, setting high standards, and navigating a professional world that tends not to look all that much like her.

What drew you to radiology? I was doing a sub-internship in pulmonary during my pediatrics residency. Once, I went with a radiologist to read chest X-rays. She looked at a film and noted the symptoms of cystic fibrosis and then she also pointed out the patient’s thin ribs, which are what you might find with sickle cell disease. She relied on her knowledge of imaging and of clinical diseases to solve the same type of medical mysteries that I had wanted to solve when I went to medical school. I withdrew all of my pediatric applications and applied to radiology. It wasn’t a frivolous decision. I was enchanted by the idea that I could be really good at doing this. I look at 2-D images, but I don’t see them that way. To me, they all look 3-D, like living things—that’s how my brain sees it.

What has been the biggest change in radiology since your first faculty position in 1985? When I was training as a fellow, the clinical magnetic resonance imaging (MRI) procedure was just beginning to be used in radiology. At the time, interventional radiology was included in two-year programs, but now it has morphed into a separate fellowship. But the biggest treatment change has been the mechanical thrombectomy for stroke. This involves a retriever tool to extract a blood clot in the brain. This device looks like a little wire. You go in and remove the clot, which you see on the device as it comes out. The patient who previously wasn’t able to move or talk can now do both. It’s the closest to Lazarus as you can get. That goes along with the development of the MRI.

What do you anticipate will be the next sea change for the field? I think it will be finding image biomarkers to use along with precision medicine testing and pathology. Researchers are looking for imaging correlates of molecular biomarkers using MRI or positron emission tomography. The field is searching for certain types of contrast agents, or drugs, that, once injected, will go to certain territories that will give us certain information about tissue type. This is going to help with making a diagnosis noninvasively without having to have a physical piece of tissue removed. I think this will filter down in clinical neuro-interventional radiology.

You are a female and a minority in medicine—is that significant? I came to Yale as an associate professor in 1999. I was promoted to full professor in 2014. During that time, I was busy. I didn’t go to the chair and say, “Can I get promoted now?” You know, one of the books I’ve read about four times is by Linda Babcock, called Women Don’t Ask. In it she talks about how two of her male colleagues with equivalent CVs to hers got promoted and she didn’t. She had a good relationship with her chair and so she asked him why he promoted them and not her. He said, “Because you didn’t ask.” It’s not about me and being promoted—it’s the idea that even today it’s not good enough to assume your efforts will be recognized for their value. I was the first African-American female full professor at Yale in 2014—is that something to be celebrated or embarrassed by? I don’t know. On the positive side, it sends a message to younger women that it’s possible for them.

Why is it important to celebrate women in medicine? Women are different from men, but we’re not so different that we can’t be successful and happy and raise our families. One thing that’s important is you’ve got to define what success means to you. I came from a family where education was at the forefront. My mother was valedictorian of her class and my father—there were three generations of people who went to college before him. The attitude was: Get your education because no one can take that away from you. And move forward with that attitude. It’s not approaching each day saying, “Who’s going to be mean to me?” It’s saying that I can do anything I put my mind to and the biggest impediment to my success is me.