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Portraits from AAWR |
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Kimberly E. Applegate, MD, MS, FACR – 2003 President of AAWR
The 2003 presidential year was a wonderful and fulfilling experience, but not without a few challenges. We had a third management contract negotiation during the year, having moved from the ACR a few years prior to RSNA, IMM and finally a new administrative assistant with IMM. Consequently, some of our institutional memory was lost and we worked very hard to improve the organizational structure with more information on our website and creation of a leadership ladder structure. Melissa R. de Christianson created a fantastic 20 th anniversary FOCUS newsletter and we updated the Survival Guide for Women Radiologists with a second edition. We continued to support the RSNA’s annual meeting (a) lactation rooms and (b) child care program provided by Accent on Childcare Arrangements. Organizationally, we created a History Committee chaired by Dr. Ann Lewicki, a Past Presidents Circle chaired by Teresita Angtuaco and split the Finance and Strategic Planning Committee into two separate ones. We created web-based exhibits on the career of Lucy Frank Squire and augmented the Marie Curie electronic exhibit. Finally, every woman chair of an academic radiology department was invited and agreed to become a member of the AAWR.
Why did you choose radiology? When I applied to medical school, I had planned to become an internal medicine physician. I did not know much about specialties in medicine, only about primary care and obstetrics. In the 3 rd year of med school, we rotated on the 6 core rotations: medicine, surgery, OB/GYN, family practice, psychiatry, and pediatrics. I found myself acting as the 'gopher', going and getting the lab, path, and radiology results. I most enjoyed taking a chest radiograph to the radiologist and he could tell me so many things about my patient! It was amazing to me. Perhaps, growing up watching the original Star Trek television series was also an influence. I had been intrigued by the doctor who could do so much without the need for surgery. It fit my ideal of medicine: to do more with less (pain and invasion of the patient). What attracted you to pediatric radiology as a subspecialty? Later, while training in diagnostic radiology, I spent 3 months
at a children's hospital. The radiologists there were just outstanding
physicians. They were not only experts in their field, they could
quote the literature as evidence for why they interpreted an imaging
test as they did. They consulted the referring clinical doctor
and proactively suggested a different diagnosis or an alternative
test. Finally, they discussed the tests they performed on patients
and provided results directly to the patient's families. Yes, radiologists
talked to patients and their families! I watched these superb individuals
work so respectfully together as a group; they clearly loved what
they did. I was hooked. The short answer is: Curiosity killed the cat. Much of what drives
me to learn and try to do my work better, is curiosity. I love
learning; I love helping others and this career allows me to do
both. The academic environment also allows me to do research to
improve the care of children, to share what I know, and learn from
others, and to be a part of policymaking. There are many. First, there is the constant fast-paced clinical
work. Second, there is the pressure to do more service for the
institution and many national committees and organizations. Third,
there is my desire to do research. These different aspects of my
work compete for my time. And they take time away from my family.
It seems that there is never the right balance between work and
personal/family time. There have been many. At first, the challenges
were obvious and sometimes seemed ridiculous: Being paid less
than my colleague because he had purchased a new house and had
2 kids to support. Being told in medical school that I needed
to act more paternal and less maternal. Jokes in poor taste that
were told by male residents or staff at the expense of women;
unwanted advances by surgeons in the operating room. As I have
gotten older, the challenges are more subtle, but equally effective
in providing barriers to achieving one’s career goals.
Perhaps most important, the differences in how women communicate
as compared to men, have an impact on the respect and advancement
of women in medicine. Being heard and acknowledged as an equal
(never a better physician) is still unusual. Perhaps in a few
specialties with a majority of women it occurs: obstetrics and
pediatrics. That is a moving target; there are times when my family needs
special time and times when things are going along smoothly; I
liken it to a bit of a roller coaster. The most important thing
that makes my life work well is my husband: if he were not supportive
of what I do and believe that what I do is important, it would
never work. We are both academic physicians with professional goals.
Yet, we share the many responsibilities of the home and our 3 children.
It can get rather crazy at times and it requires a lot of juggling,
patience, extreme organization, and hard work, but I would not
want it any other way. I also look for support from my friends
and colleagues who understand our lifestyle; too many people criticize
it and I have learned to ignore them. Typical: read plain radiographs and ultrasound exams all day;
work with residents; talk with families of children who are having
imaging tests (to both ask them what is going on with the child
and to report our test findings to them, decreasing their anxiety);
meeting with a research colleague to discuss problems or results
of the project; signing reports; always doing some sort of committee
work. The day flies by and I always hope to learn something new
or re-learn something I have forgotten! Best moments: achieving positive change that those in positions of power flat out stated could not be done. It is like David beating Goliath. Examples are the work I did in a mission hospital in Nepal; working within organized radiology societies to make it (a) more friendly toward women and (b) more public health oriented; supporting a colleague when it was terribly unpopular but it was the right thing to do; competing successfully for awards and grants. What I cherish is the wish for us all to succeed in our professional and personal goals; in order to do that, we need to work together in the AAWR community of women. One of the best books I can recommend toward this philosophy is ‘She wins, you win: the most important rule every [business]women needs to know’ by Gail Evans, the first women executive vice president of CNN. Worst moments: finding myself unable to communicate in a positive
way with my colleagues. There have been so many and so rapid that it is astonishing. The apprenticeship model was in full force when I was a med student and resident; I see med students as students now and much less involved in the PRACTICE of medicine. I am concerned that there will be less 'ownership' of medicine by younger physicians. There will certainly be less research by the next generation of physicians (it will be done by PhDs, not MDs). The fast pace is difficult to sustain; limits the teaching; limits the communication with other med specialties; limits the time to learn new things and talk to patients; academic medicine is in crisis and I liken the feeling I have to a vacuum effect: private practice's lifestyle and money are pulling physicians away. There are generational attitudinal differences in how we spend our time. The younger physicians are much better at protecting their time and less willing to invest their time and energy in their career when compared to older physicians. They also want to be paid more (but may have more debt than older physicians). Perhaps these differences are healthy, especially the demand to either work part-time or more available childcare. What advice would you give to a young woman today headed toward a career in radiology? The short answer: Go for it. Just do it! The longer answer: There is no richer, more multi-faceted, and rewarding work than radiology. Please talk to people to find out what it is like and what the different options are both locally and nationally. Visit web sites for different specialties. We are proud to have a great web site at: www.aawr.org. We have added an exhibit on Marie Curie for school children to understand her life and the many barriers women faced in her time. While we have come a long way since then, we also have along way to go to promote equal opportunity for all people in medicine and radiology. Please see the MIT web site (search under 'Nancy Hopkins') and the recent Nature article by Ben Barres for detailed and fascinating discussions on the barriers to women in science. Finally, remember to say a quiet thank you to those women who made the way easier for those who now follow. They sacrificed much to gain a MD degree and I have listened to many stories that would astonish young women today.
Kimberly E. Applegate, MD, MS, FACR is Associate Professor in the Department of Radiology at Indiana University
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