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Inspiring women with confidence, education The following articles are the second in a series dedicated to National Women’s History Month and this year’s theme, “Generations of Women Moving History Forward,” which seeks to recognize the wisdom and tenacity of generations of women who have come before and those who will follow in celebrating the equality, courage, determination and steadfastness of women in American culture. by Heather Woolwine Public Relations Sometimes, influencing future generations or setting a good example doesn’t require a high profile. Sometimes, it is simply the act of watching a few pursue an uncharted course that sets so many others down the same path.     Dr. Kathleen Wiley   Kathleen Wiley, M.D., MUSC Internal Medicine, has been a physician for more than 20 years. She is warm, easy going, and has sought little else in her career but to be the best physician and educator that she possibly could. Her quiet, yet confident, determination to become these things not only ensured her success, but enabled her to become part of a group of women who sought to become doctors when most in society doubted they could do it. It has been Wiley’s charge to move women in medicine forward simply by being herself, and inspiring other women along the way through mentoring and education.   “When I was young, my best friend’s brother was studying to be a doctor. There was a little hero-worshipping going on, so I had this sense of awe and feeling of not being worthy to do something like that,” Wiley said. “While I was completing my master’s degree and working in a research lab, I had two experiences that changed things for me. First, I realized while working as a teaching assistant in a lab that medical students and physicians were not gods as I had previously thought. And I realized that I didn’t care for working in a lab. When the M.D./Ph.D. I was working for asked me what I wanted to do, I told him I was thinking of medical school. He told me to go for it; and I did.”   By believing that a career in medicine was something she could do, Wiley set about gaining acceptance to the University of Kentucky Medical School in Lexington. The Louisville, Ky., native realized her heart was set on caring for others in a primary care setting early in her schooling. She believes that by voicing her calling during rotations, she encountered less resistance than other female students may have.   “Part of the reason that I think I didn’t run into resistance in certain areas, for instance when I was doing a surgery rotation, was because from the beginning I knew I didn’t want to go into that, but I thought it was neat. So, the surgeons let me do a lot—probably because they didn’t see me as a threat to their specialty and I had made it clear that surgery would not be where I ended up,” she said. “There may have been a few moments here or there where some subtle act of gender bias was going on, but I didn’t feel that in my class. We were close and unconventional from the beginning with a high percentage of women, two attorneys and an ex-football player. In my class, 25 of 110 students were women and that was a pretty big percentage for that time period. Now, most medical schools see half of their admissions as being women. I met a couple of people during my residency who didn’t seem to like women, but as a whole it wasn’t a big deal. You just didn’t pay attention to it, and you stayed focused. None of my classmates or colleagues ever made me feel bad about being a woman. You just knew you could do it, and no one could stop you.”   After completing her internship and residency at MUSC, Wiley joined the faculty in Internal Medicine. “I have really valued all of the opportunities to care for patients, to become their friend and to be that person who is there when they need someone,” she said. “I enjoy primary care so much and love the idea that my patients feel like they can call me when they need to. That trust is so important. I had a patient today who called and couldn’t wait to tell me what he was having done while he was in Greenville. He wasn’t looking for anything other to let me know what was going on and I could tell that it was making him feel better about what was happening just by talking to me about it.”   If caring for patients is her first love, than teaching future physicians is a strong second. Wiley has served as director of Introduction to Clinical Medicine courses. She has received an excellence in teaching award and numerous nominations for the Golden Apple award, and from 1993 to 2000 she served as the medical director of the Parallel Curriculum, a problem–based learning track for medical students.   “Dr. Victor DelBene (dean of students at the time) was always trying to find me jobs; in fact, he’s the one whom got me involved with the Parallel Curriculum, one of the most rewarding student experiences I’ve ever had,” Wiley said. “It was an innovative educational experience that provided us, as faculty, the opportunity to work closely with medical students and watch them learn autonomously. It’s so rewarding to see the ‘aha’ moments.”   The Parallel Curriculum was designed to teach medical students by allowing their personal motivation and drive to illuminate the right questions to ask in order to find the answers needed for case study applications, based on real patients. “It wasn’t about lectures, and ‘Here, study this.’ They figured out the answers through critical thinking and literature research. Unfortunately, it was perceived as expensive and too faculty intensive, so after eight or nine years it came to an end,” she said.   In her active clinic practice, Wiley was medical director of the Medical Acute Care Unit, and currently serves as the director of the University Diagnostic Center.   “Attention to detail is important in internal medicine and I would say that it’s one thing that will always save you, but there is a limit to that. You have to make sure everything is done completely, even if you’re in a hurry, and do it right the first time without rushing through it. You might be tired, but you’ll never be sorry,” she said.     While reflecting on the progress that has been achieved on behalf of women in medicine, some specialties still remain difficult for women to break into, Wiley said. Still, women now have opportunities to obtain leadership positions in their place of work or in national organizations or societies. Citing numerous women that she has admired at the national and regional level as having influenced her career, Wiley said, “They taught me the importance of keeping a woman’s perspective, but not letting that overtake you. Women’s needs in academia and in private practice roles are different from men’s when it comes to issues like job-sharing, child care, etc. Balancing a career and a life is an important issue facing the current generation of female physicians. Many people can take this job and make it an excuse not to go home, but it doesn’t have to be that way.”   Wiley sees the current challenges of women in medicine, achieving balance and obtaining leadership positions, as a good sign that things are continuing to change for the better, and that how women are perceived in society has passed a defining moment. “I’ll notice things have changed when I hear TV or radio ads say, ‘My doctor says this and she…’ and it’s hearing the ‘she’ that strikes me as funny or odd. You just didn’t hear that until recent years. I guess it’s a good indication that things are changing within our culture, and for women physicians.”     To achieve her own balance between work and a personal life, Wiley enjoys spending time with her husband, staying active in her faith-based community, and enjoying the outdoors. Doctor encourages women to stand out by Heather Woolwine Public Relations Florence “Flo” Hutchison, M.D., is known throughout campus as the compassionate and capable chief of staff at the Ralph A. Johnson Veteran’s Affairs Medical Center and the MUSC associate dean for Veterans Affairs. What many don’t know, however, is that Hutchison left the deep South for many years in order to pursue a career unencumbered by the constraints and expectations placed on Southern women in the 60s and 70s.   Dr. Flo Hutchison   Born in New Orleans and raised in Jackson, Miss., as the oldest of five children, Hutchison had streaks of independence early on. Her father, a professor of tropical medicine at the University of Mississippi School of Medicine, and her mother, a social worker, encouraged Hutchison and her siblings to open their minds from the beginning. “The culture of the deep South for women at that time was you could be pretty, but not smart,” Hutchison said. “The perception was men could go out and succeed in whatever they wanted. Women could be smart and engaged, but only on a volunteer or community basis, not professionally.”   As Hutchison grew into a young woman considering her options, she decided to drop out of Millsaps College, located in her hometown, following her first year. “My parents were understandably very upset, but they continued to be supportive by helping to get me a job in [Dr.] Arthur Guyton’s lab,” she recalled. “Working as a lab tech for a man who today is widely considered the father of modern physiology was an incredible experience for me. I worked on real world studies looking at how the kidneys help to regulate blood pressure. I performed animal experiments, and I learned so much. I think my father knew that if he could just get me exposed to those things, that it would be enough to engage me and get me back into school. He was right.”   She later returned to Millsaps College and earned a biology degree, and continued to work in the lab. “I really loved working in the lab; the excitement of getting an experiment to work and finding the answers to the questions asked. It was around this time that I realized that I didn’t want to work as a lab tech forever. I wanted to be the Ph.D. or M.D. deciding what the original question was going to be and then following it through to find the answers.”   Encouraged by a number of mentors, including young post doctoral fellows in Guyton’s lab, Hutchison entered medical school at the University of Mississippi and graduated in 1980. “I remember one male student telling another female student who was married and had children that she was wasting a spot for a man, because she would never practice,” she said.   Hutchison took stock of her options once again. “I wanted to get out of the South, and I had always felt a little bit like a round peg in a square hole because of the expectations placed on women at that time,” she said. “In California, I didn’t believe that people would expect me to get married and have a bunch of children.”   Hutchison began a residency at St. Mary’s Hospital and Medical Center in San Francisco. “I lived down the street from Jefferson Starship and became immersed in a very different culture with a completely different ethnic mix. I came from a city of thousands to a city of millions. It was a huge change,” she said.   During residency, Hutchison found it difficult, even in California, to find female role models in medicine. Those who did exist were overwhelmed with increasing numbers of women looking for guidance in the clinical and research world. “I was a senior resident, trying to decide what to do, when I got this call from this strange man with children hollering in the background,” Hutchison recalled. “He introduced himself as George and approached me about a nephrology fellowship with the Veterans Administration Medical Center in Martinez [Calif.].”   In the early 1980s, only a handful of female nephrologists existed in academic medicine. Less than 20 percent of trained nephrologists across the country were women, according to Hutchison. “It’s kind of surprising, but that was good for that time period,” she said. “George [Kaysen] was most pivotal in terms of my academic career, because he was demanding but able to have fun. He was candid and honest, and he challenged me. I remember my first paper on which I’d worked so hard, draft after draft after draft. He tore it up right in front of me. I was totally deflated, but soon realized that it wasn’t meant to be malicious. He could have said something nice and given me a pat on the head for all the hard work, but I wouldn’t have learned to write.”   Around this time, Hutchison acknowledged the need to stand out in her field. While attending her first national nephrologists’ meeting, she noticed that blending in was not for her. “There was this sea of four or five thousand blue and black suits. I promised myself right there that I was going to buy a red suit to wear to the next meeting. I wanted to be seen and heard. I think everyone should try to stand out in some way so their ideas are heard,” she said.   Hutchison continued her mentoring relationship with Kaysen once she accepted a position as assistant professor at the University of California at Davis and continued as a staff nephrologist at the Martinez VA.   Pivotal in her career was how her mentor always put her first. “I’ve seen people in academia who are supposedly mentoring, but … they are promoting their own agenda, instead of helping their younger colleague find opportunities to develop as a clinician and/or researcher,” she said. “George always put me first. He said, ‘Flo, you have to find your own track. Find a complicated question that you can have a great time chasing for your whole career. You need to be Flo, not that woman working with George’.”   After 10 years in California, Hutchison began to reevaluate her choices on the West coast. Watching some administrators, and even some colleagues, becoming too concerned with jockeying for personal glory, Hutchison said she didn’t want to be in an environment that sacrificed the desire to solve the mysteries of science for pursuit of fancy titles and praise. Realizing the importance of teaching and clinical care, she wanted to remain grounded.   Ultimately, an intricate web of contacts and networking opportunities crossed her path with David Ploth, M.D., MUSC Division of Nephrology director. “The timing was just right. I thought, ‘now here is a university with a fantastic mission, and a division that’s trying to grow a much needed specialty in a vastly underserved state,” she said. “It seemed overwhelming and exciting. [It’s still exciting, recalling] how wonderful it felt to become involved in something that was not going to be just another copy of all the other departments out there. It was an opportunity to be a part of a maturing university and a changing culture of medicine, which I still think is true. Even today, we look for people with that fire in their belly, people who are excited about what they are doing and being the next generation of teachers, as well as establishing research careers.”   Accepting a position as associate professor of medicine at MUSC, Hutchison originally divided her time between seeing patients at MUSC and the VA and teaching medical students. She met Betty Roof, M.D., an endocrinologist who served Hutchison as another influential mentor. “She was a lovely person, so kind and helpful. She was a good person to talk to,” she said. “Rosalie Crouch was another prominent figure whom I have much respect for, and I have truly admired all her efforts at MUSC.”   At the turn of the millennium, opportunities consumed Hutchison, and she quickly ascended to a full professorship, and entered her current positions as chief of staff for the Ralph H. Johnson VA Medical Center and the MUSC associate dean for VA Affairs.   An author of more than 50 publications, Hutchison has also responded to interim leadership requests with enthusiasm, including currently serving as the acting director for the VA. She chairs the VISN7 Health Systems Council for a group of eight VA medical centers throughout the Southeast, which is dedicated to moving forward in advanced delivery and quality of services. Hutchison has been instrumental in taking the centers within that group from average performance in terms of standards of care to the top tier of quality and safety, including a spot for the VISN7 as number two in the nation for quality of care.   Hutchison has numerous professional society memberships. She has received awards and honors for her research and teaching abilities, and now serves as a mentor for future physicians.   “The reality of the world is that cultural structure changes take a long time. An institution can wait four to five years before anyone is able to see the results of a change; imagine changing societal norms for women that have existed over thousands of years,” she said. “It took a while to break into the good old boys’ club, and a lot of men have put that aside and are promoters of women’s professional growth. I think they recognize the opportunities for both women and men with this acceptance. Things are changing a lot; I see a great deal of proactive efforts on the part of male leadership here to serve as role models and try to address issues women are facing, and provide better opportunities for women as a result of that.”   Hutchison also sees a difference in male medical students these days and how they view family issues as related to their careers.   “Men are starting to be more involved in family life and are seeing the importance of issues that women have always been concerned about. We’re all struggling to adjust academic medicine to better fit the biological needs of women so they can move up the ladder and on to a full academic career just like men do. Our male students and administration are now realizing the need for flexibility to meet all of those responsibilities. There’s a new generation that sees family roles differently, and as we move forward, this generation will change the way academia functions. It won’t necessarily be good or bad, just different. Us old codgers are just going to have to hang out and get out of the way.   “I find myself at an age where I am becoming one of the conservatives. Never thought that would happen,” Hutchison said with a laugh. “But, I still feel that the most important thing to remember in making a medical and research career is that you have to stand up, get yourself noticed and take on tasks that make you learn new skills. Make contributions that matter to your organization and continue to learn and develop as a person. And wear a red suit.”     Friday, March 16, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. 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