The
Detective
Doctor
words by Barbara Hurley / photograph by Pete Byron
Mary Ann Michelis, MD,
clinical associate professor, medicine,
UMDNJ-New Jersey Medical School
Was it nature or nurture that propelled Mary Ann Michelis onto New York magazine’s “Top Docs” list?
Her mother was the first in her Pennsylvania mining town to go to
college, graduating from the University of Pittsburgh — a microbiology major and valedictorian. Her father, a high school principal, wrote a doctoral dissertation that explored prejudice against girls in teaching mathematics. Together they chose for their two daughters the high school with the highest math and science scores, areas in which the girls had consistently excelled — and both became physicians.
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y parents expected more of me than I ever thought possible,” Michelis confessed. But by the time she was a freshman in high school, she told her mother that she wanted to be a doctor.
Her choice was reinforced by divine intervention – a nun with a PhD in Spanish who taught science with an unearthly flair. From Michelis’s class of 40 in an all-girls school, six went on to become physicians.
Michelis’s own journey to become a leading allergy and immunology specialist began with the understanding, as her parents put it, that “she could go anywhere that she could afford.” In other words, work and scholarships would finance her education, a combination that led to a BS from the University of Pittsburgh and an MD from its school of medicine in 1975.
The first two years of her medical education, before her transfer to Pittsburgh, were spent at the Medical College of Pennsylvania. She recalls the long bus ride to Philadelphia for an interview at another medical school only to be asked by the admissions officer: “Are you going to medical school to meet a husband?” That very question captures what it was like “then,” when women comprised less than 5 percent of medical school students. Ironically, she met her husband, a kidney specialist, at the University of Pittsburgh Medical School.
When Michelis graduated from medical school, she understood that certain specialties were “off limits” for women. But she had found her niche on the immunology/allergy rotation at Pittsburgh. “I grew up on Nancy Drew books,” she explains. “I loved figuring out ‘who did it.’ And those doctors were just like detectives.”
Michelis went on to a fellowship in allergy and immunology at New York-Cornell Weill Hospital and then to a post-doctoral fellowship at Rockefeller University. There she co-authored one of the first articles describing HIV, which appeared in The New England Journal of Medicine, and an article about the detection of HIV in women that was published in the Annals of Internal Medicine. She was subsequently recruited to Hackensack University Medical Center in 1981 to direct the Clinical Diagnostic Immunology Laboratory.
Although she believes that some aspects of medical leadership are still an “old-boy” network, Michelis rose through the ranks at Hackensack and became chief of immunology and then chief of allergy/immunology. At present, she is senior attending physician in internal medicine and director of the Center for Allergy, Asthma and Immune Disorders and the Air Express Bus, a mobile asthma care unit that travels to schools, housing projects, and churches in Hackensack to screen for allergies and to diagnose and treat asthma. She was elected president of the hospital’s medical board in 2003.
Michelis attributes her own success as a top physician in her field to her ability to listen, a special skill that, she says, women bring to medicine. “Women talk things out. Our best friends are someone we talk to, someone we listen to as well,” she says. “I had great mentors, both male and female, who taught me how to interview patients. I listen to my patients with an open mind and I look for clues.”
Like Nancy Drew, her detective’s instincts have solved some intriguing mysteries.
One patient was referred for what her physician suspected was an allergy. She had redness in one eye. Odd, thought Michelis, an allergy probably would have affected both eyes. Looking for clues, she noticed an original diagnosis of tinnitus, a ringing or buzzing in the ears. “Tell me what it sounds like,” the doctor asked the patient.
When the patient replied, “Whoosh,” Michelis immediately took the woman to radiology where an aneurism behind the eye was discovered. “I’m sure the surgeon who ultimately operated was puzzled by the referral from an allergist,” she says.
Another referral was a middle-aged woman who had been told she had AIDS because of recurrent opportunistic infections, a diagnosis that had understandably strained her marriage. She and her husband had come to see Michelis because of her expertise in immunology. There was nothing in the woman’s history that seemed to put her at risk for exposure to the HIV virus, Michelis learned. Then the husband reported that his wife had been “acting crazy.” Michelis listened carefully as the patient reported mood swings, weight gain, and other symptoms that didn’t appear to indicate AIDS. Sure enough, a tumor on her pituitary gland was discovered that, when addressed, relieved all her symptoms.
Michelis shares her expertise — especially the importance of listening — as she shepherds students through rotations at Hackensack. “Students have changed today,” she observes, “largely because they grew up in the computer age, with email and text messaging.” She believes that they are somewhat unprepared, both males and females, for the one-on-one personal communication that is necessary to develop good diagnostic skills. “However, they come with a science background,”she continues, “that is way beyond what I had.”
Something else she sees as different today for women in medicine. “In my day, women had two careers – home and profession,” she remarks. “But now there is more sharing of domestic duties.” Michelis worked full time and took off only eight weeks when each of her two daughters was born. Her older daughter, now 28, is a Columbia University graduate who is a special education teacher in New York City. Her 22-year-old, a biology major at Dartmouth, recently started medical school at George Washington University. “When I returned to work after they were born,” she remembers, “I was still expected to buy the holiday and birthday gifts for my husband’s family in my spare time.”
Speaking of spare time, Michelis, who has more than 30 scientific articles already to her credit, would like to write a book, actually two books. “Did you know that in the 108-year history of the Nobel Prize only seven women have won this recognition in medicine?” she asks. She would like to delve into the mystery of “why” in a book she would call “No-belles.”
The second book she is considering: “Transplantation Immunology for Dummies.”
“Not exactly Nancy Drew,” she adds.