I grew up surrounded by doctors. My father was a physician and renal physiologist who spent most of his professional life at the National Institutes of Health (NIH), and our house entertained a parade of prominent and scientists. None of my three older siblings entered medicine, but from an early age, it was assumed by many around me that I would be a doctor. However, I arrived somewhat late to that decision myself. I majored in combined literature in college and spent most of my spare time playing the oboe in the Yale Symphony Orchestra and chamber groups around the campus while “keeping my options open” by taking science courses on the side. I ultimately decided that I wanted to go to medical school, but to this day, I don’t remember any specific “aha” moment that led to that decision, although I was ultimately and happily convinced that the choice was the right one.
My subsequent decisions were guided by a series of mentors who inspired my career. My first medicine attending in medical school was Dr. Bernie Forget, who introduced me to hematology. As a resident at the Brigham and Women’s Hospital, inspired by the dedication and expertise of Dr. Joel Rappeport, I determined to train in hematology. Once again keeping my options open, I decided to spend two years in the lab to see if I wanted to pursue a research career; I was fortunate to be accepted into Dr. Phil Leder’s laboratory, where I became hooked on molecular biology. With my characteristic “laser focus,” I then left the lab and spent a year as the medical chief resident at Brigham and Women’s Hospital. During that year, I married my husband, who was teaching architecture at Princeton, so we split the difference and moved to Yale, where both of us had been undergraduates. He joined the architecture faculty, and I started as an assistant professor in medicine. In an incredible (and again unscripted) stroke of luck, I chose Dr. Ed Benz as my mentor, and he has remained my career mentor, advisor, and close friend ever since. It was Ed who truly trained me in research, who helped me write my first grants, who sustained and supported me until one got funded, and who introduced me to ASH. In a move that transformed my whole family’s life, he also encouraged me to share a lab with him in the summer on Mt. Desert Island, where we continued to join up and train students in the lab long after he left Yale. My family ultimately bought a home in Maine where we’ve spent some of our happiest times.
In trying to encapsulate my career, there are three “themes” that seem to recur: 1) a constant balancing act between my love of laboratory science and my love of clinical medicine; 2) the challenges of being a woman in science and medicine; and 3) most important, carving out time to enjoy the richness of life provided by my wonderful and infinitely supportive family.
The Lab and the Clinic
When I started at Yale, most of my time was devoted to laboratory work. I struck out in a new direction under Ed’s guidance and concentrated on characterizing the transcriptional pathways governing neutrophil maturation and neutrophil-specific gene expression. I had a growing laboratory that peaked at 15 to 20 staff and was promoted through the ranks based on my bench research. At the same time, I have always loved clinical medicine, which played into the hands of my institution: Despite full NIH funding, I was tasked with increasing clinical responsibility that threatened my lab productivity and became an untenable burden. In 2007, I moved back to the Brigham to become chief of the division of hematology; this transition transformed my career. In my 10 years at the Brigham, I have grown both the clinical and basic science programs and have devoted more of my time to teaching and mentoring. My academic focus has evolved toward clinical research, as I have carved out a clinical niche in hemophagocytic syndromes. In looking back, my career has taken many different shapes, which is one of my favorite things about clinical medicine: If you feel an inclination to change directions, you can do so without having to train in a new career!
Women in Science and Medicine
I went to high school and college during the early years of the feminist movement and naively assumed that everyone’s growing awareness and sensitivity would smooth the road as I went. I was therefore taken by surprise by the number of “firsts” that I would have to stake out along the way. I was in one of the earliest entering classes of women at Yale. I was the first woman chief resident at the Brigham. Additionally, I was the first woman in almost 20 years (there had been only one other in the history of the department) to receive academic tenure in the department of medicine at Yale. I have often commented on the glass-half-full or -empty situation, and it should not have escaped notice that my mentors were men. Ed was unfailingly supportive of both my career and those of countless women; seeing men who “get it” has always been an encouraging aspect of the slow evolution of equity. I feel that I was incredibly lucky to have his guidance and support, but most important, his respect and friendship. In counterpoint to this is the often-shocking reminders that the paradigm of medicine is still overwhelmingly male, and women are often expected to succeed on men’s terms and not their own. I have heard many residents and fellows who are women complain that supervising male colleagues is much more difficult than supervising other women because they don’t seem to “listen”—still echoing the lament of my (few) female fellow residents and me, more years ago than I like to admit! I have devoted much of my professional life mentoring and coaching women to have the courage to be unflinching in defending their own style, and to call out male colleagues who are disrespectful. Although I am a clear testament that a woman can have a career guided by male mentors, I hope that increasing the ranks of women mentors can promote a more comprehensive change in the discourse.
Balancing Work and Family
I have fashioned my career around a commitment to family, which has been the most important part of my life. My husband has unflinchingly supported my career, even when my move to Boston required commuting between Boston and New Haven. My children never complained when I was on service or writing a grant. We always carved out time together — our kids made their first trips to Europe as toddlers (our friends told us we were crazy), and Alan and I are lucky that they still like to travel and vacation with us now that they are grown. And we all gravitate to spend time in Bar Harbor whenever we can.
Hematology has been varied and exciting and I have found it a source of continuing new opportunities and challenges. I have loved working in the lab; caring for patients; teaching students, residents, and fellows; and building an academic division. Among these activities, one of the most important and rewarding has been mentoring. Having been fortunate to have wonderful mentors that inspired and guided my career, it has been one of my greatest ambitions to “pay it forward” through mentorship of residents, fellows, and junior faculty.
Thoughts from a Former Protégé
Elisabeth M. Battinelli, MD, PhD
Assistant Professor of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA
I first met Dr. Nancy Berliner as a third-year hematology/oncology fellow hoping to secure a faculty position. What first struck me from that meeting was how seamlessly she combined all aspects of her position. In our conversation, she wove together aspects of her life as a leading clinical hematologist as well as a successful scientist. Within minutes, our conversation veered between the most exciting cases in the hospital, the latest scientific breakthroughs, and the struggles of obtaining scientific funding all within the same thought process. It was clear that she was at the top of her game in everything she did. As a young physician scientist, I remember wondering, “What’s her trick? How can I become like her?” I immediately knew that I had struck academic gold. Luckily, I was offered the position and have now had the opportunity to work with Nancy for nearly 10 years.
Anyone who interacts with Nancy is surely impressed by her vast depth of knowledge of hematology; this is undoubtedly what makes her an ideal editor for Blood. Those of us lucky enough to work with her often seek her counsel on complicated cases. Her extensive hematologic experience is best on display each Wednesday afternoon when the clinical faculty and fellows come together to discuss the most complicated case on the inpatient service. There is not a topic or case discussed in which Nancy cannot impart extensive personal knowledge of the disorder. She always seems to be able to recall data from articles published years ago and apply them to the case at hand. During those meetings, there often arise differences of opinion in management strategy. What is always evident is that Nancy will listen to the opinions of others and seek advice from experts within the group. Younger members of the audience may cringe at these interactions between faculty. What emerges, however, is Nancy’s nonjudgmental nature. Her only goal is that the right course is taken for the patient. Not being one to hold a grudge, she often leaves these meeting with the colleague with whom she has just sparred, laughing together as they walk out of the conference room. Her trust, respect, and confidence in her faculty never wavers. These meetings are safe places to express our thoughts, make mistakes, and most importantly, learn from each other.
Outside of work, Nancy’s highest priority is her family. She enjoys traveling with her husband Alan Plattus, who hosts educational trips to remote places on the globe. A meeting with Nancy often involves a story about her latest trip and the excitement that she experienced. Nancy is one of the best travel guides in the hospital, often giving us recommendations for our next trip. Most importantly, she is proud of the accomplishments of her children. A party at Nancy’s loft in the city is always hosted not only by her and her husband, but her daughter who interacts with young and old members of the faculty alike with poise and beauty.
Having had her children while still establishing her career path, she understands that young faculty also struggle with prioritizing family needs with work schedules. On numerous occasions, she has shown me and others in our division that it is okay to prioritize one’s home life. One such occasion occurred early in my academic career. I was supposed to be writing a grant and I had asked Nancy for comments on a draft. I had to slip out of the office to attend a performance at my daughter’s preschool. When my phone rang and her name flashed across the screen I remember feeling anxious at having to admit that I was not in the office working as the grant deadline approached. I fumbled through the beginning of the conversation only to have Nancy ask what my daughter was performing and have me to bring a video of the performance to our next meeting. She never flinched. She never judged. In her mind, there is no doubt that you can do it all. Balancing clinical responsibilities, a research lab, and a growing family can often seem insurmountable. Yet, with guidance from Nancy, even the impossible seems possible. Because of the confidence she has in you, you believe in yourself. You get the job done because she expects nothing less.
When asked to write this piece as Nancy’s protégé, I was honored to receive the opportunity. I took pause, however, because I would hope to never be her “former protégé” but instead always remain her “current protégé.”