Like mother, like daughter

Laura Ment, MD, is one of Yale School of Medicine’s preeminent leaders. She is professor of pediatrics and neurology and associate dean for admissions and financial aid. She directs YSM’s START program, and she participated in Yale’s Status of Women in Medicine initiative. And she is mother to Anna Duncan, MD ’15, who is completing her residency in pediatrics at Children’s Hospital of Philadelphia.

The two joined Yale Medicine Magazine to talk about their experiences as women and physicians at Yale School of Medicine and in the New Haven community. They described how the medical profession has kept pace with changes in opportunities for women in the outside world.

YMM Thank you so much for joining us, it’s a real honor! Dr. Ment, what was Yale School of Medicine like for women when you arrived?

LAURA MENT, MD I came here in 1979, just out of residency. I had been a pediatric resident and neurology resident at Massachusetts General Hospital. You may not know this, but Yale has the oldest newborn intensive care unit in the United States. The physician who was chief of the newborn intensive care unit, Joseph Warshaw, who went on to be chair of pediatrics at Yale School of Medicine and then dean at Vermont, called me up as a second-year neurology resident and said, “I understand you’re interested in neonatal neurology. My babies are surviving. Would you like to come work for me?”

ANNA DUNCAN, MD ’15 That’s lucky ... not how it works anymore!

LM It was incredibly lucky, and I feel very fortunate. I began as an assistant professor in 1979. Medicine has changed tremendously in the last 40 years—not just in terms of who could practice, but also in terms of what is possible.

YMM How did that work, then? He scouted you, like, in professional athletics?

LM He was aware of what I was doing. He’d been at Mass General before Yale, so he knew the people there, and they told him about my interests. It still works this way to a certain extent, but then, word of mouth counted for a great deal more than it does today.

YMM My impression is that the cultural shift around institutions being more assertively equal opportunity across a broad spectrum—economic, racial, religious, gender—started in the early ’60s.

LM In terms of women going to medical school, I think the real ramp-up started in the 1970s. This followed better opportunities for female undergraduates in the 1960s.

AD You were one of two women in your medical school class at Brown.

LM That’s true, and at Mass General they always had one woman in each class of neurology residents. So, there I was. When I was a resident, I was able to see institutions change from “it’s possible for women to be physicians” to “it’s a priority for us to recruit and train more women as physicians.”

YMM How did you feel, being part of that vanguard?

LM I loved it. My parents were extremely supportive. My father was a pediatrician. I went to Brown in 1966, and freshman week Dean Rosemary Pierrel, who was near the end of her career, gave this wonderful talk. She said, “You can do anything you want to do. You can be anything you want to be. Be lawyers, be doctors.” I believed her, and our family ended up in New Haven. Anna was born here.

YMM Dr. Duncan, what was it like for you, growing up and seeing Dr. Ment, your mother, experience professional success in this context? Did that have an impact on you?

AD She and my dad always encouraged us to be whatever we wanted to be. My brothers and I grew up going to the hospital with our mom on weekends, and we’d sit at the nurses’ station or her secretary’s desk. Yale and medicine were a big part of our childhood. I ended up studying architecture as an undergraduate—ultimately, though, I came back to medicine and decided that it was what I really wanted to do.

YMM How did you make that pivot from architecture to medicine? They’re both science-heavy, but very different disciplines.

AD Growing up we always traveled and went to lots of museums, and I learned that I really loved the arts. I went to college at Brown, where your concentration didn’t have to be your career. I combined art and medicine through volunteering, and over time the two merged for me. I also did some research in neonatology and ended up entering medicine myself. And I happened to know that Yale School of Medicine was a great fit for me. Like Brown, Yale encouraged adult learners and had great funding opportunities as well as the flexible “extra” year that most people take. About two-thirds of Yale’s MD students do research between their third and fourth years and have an additional or bonus fifth year of research. I worked in developmental biology with Mustafa Khokha, who is a pediatric intensive care specialist, geneticist, and great mentor. His lab studies the genetics of congenital heart disease and uses an animal model to understand signaling mechanisms leading to a child’s phenotype.

LM And since she won’t tell you, I will: The thesis she wrote based on that extra research won top honors. That is practically unheard of—for a woman to take top honors for her thesis.

YMM So if opportunities have increased in the past for women, and that’s beginning to bear fruit, so to speak, in more women entering the field of medicine through Yale, where do you see there being work to do in the future? Is there more work to be done?

AD There is more work to be done. How many women department chairs are there at Yale?

LM We’re very fortunate, we just appointed a brand-new woman chair of surgery.

YMM The first ever, I believe?

LM Yes, and, I think that is still unusual nationally. I was on the SWIM committee [Status of Women in Medicine] throughout the 1990s, and we have made incredible progress in this regard.

AD So there are more chairs of departments now, but it’s not equivalent.

LM We are extraordinarily proud that there are now five women department chairs.

YMM Which is progress from the 1970s, when you joined Yale as an assistant professor.

LM Yes.

AD My residency program is a great example. My class was initially almost 50, and probably 39 of them were women. So, it was a very large majority. There are still many more men in the higher positions there, but I have also seen many women as heads of departments as well. And that’s really great to see. So, it is happening.

LM A lot of it is getting through the pipeline. We built the pipeline, my generation, and we are working on fixing those parts of the proverbial pipeline to make sure they don’t leak, and the throughput is more reliable.

YMM I like that metaphor!

LM It’s a good one.

YMM So you both feel optimistic that while there is progress to be made, we are heading in the right direction.

LM There are opportunities for fellowships, training, and mentorship that were just ideas when I was a student and resident.

AD Speaking of mentorship, there is something we were talking about in the car coming over here. When I was young, they used to have a Take Our Daughters to Work Day. I think it started in 1993. And I came to the first one!

LM There were two girls here in the entire medical school. I read about the idea from The New York Times, a column written by Anna Quindlen called “Life In Your 30s.” She wrote about how there was going to be a Take Our Daughters to Work Day. I thought, “I’m going to bring Anna.” She didn’t go to school that day, which suited her fine, though Foote School was less enthusiastic about the idea!

AD They were really upset.

LM All the teachers at Foote School gave us a hard time, but I took her to work. And it turned out that there was one other person, John Fahey, a pediatric cardiologist, who brought his daughter, too. Nobody else. The next year there were more, but by then, Anna didn’t want to hang out with me ... she followed her father around.

AD Which was also very fun! He’s a pediatric neurosurgeon, so I got to go to the OR.

LM Gary Kopf is a pediatric cardiac surgeon at Yale School of Medicine. He took Anna, put her on a big stool behind him, and she got to watch him operate on ...

AD I was able to see him operate on a young congenital heart disease patient.

LM There she was standing on a stool in the OR, because people took the project seriously. Now they call it Take Our Daughters and Sons to Work Day.

AD I don’t know what people were saying about the utility of Take Our Daughters to Work Day at the time, but it had a huge impact on me. Seeing my mom accomplish what she has professionally, that’s been inspiring. What they say about role models is true.

LM This takes continuous work. You can’t forget where you came from, what you saw. Every woman who comes along, every female medical student, you can’t let her down. ... Of course, you don’t want to let anyone down, but you particularly have to be there for women because so few of them have role models in their family in the field of medicine, and it can be awfully difficult sometimes to be a pioneer, psychologically. There is a comfort in being able to say “Many others have done this, and so can I.” And now Anna has a daughter of her own!

YMM Really? Congratulations!

AD Thank you! She’s 4 months old. Having a daughter, especially as a resident, has shown me even more what my mom has had to go through, having a child while being within the intensity of a medical career. ... It’s given me even more respect for her. I’ve always looked up to her, but this has really underlined how difficult it must have been for her to walk the path she has.

LM As a parent and a citizen of New Haven, I would also like to say that raising our family on Livingston Street, seeing the undergrads and graduate students walking into New Haven or waiting for the shuttle on Whitney in the cold—all these young people asking questions, posing hypotheses and answering them—we are all so fortunate to be in this culture here at Yale. It has been a marvelous experience, and sharing this opportunity is the greatest gift one can give.