Healing
Kids’ Minds
words by Susan Preston / photograph by Pete Byron
Deborah Mulgrew, DO,
assistant professor of psychiatry,
UMDNJ-School of Osteopathic Medicne
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hen she was a senior in high school, Deborah Mulgrew sat on the steps of a three-bedroom row house in Gloucester, NJ, home to her parents, five siblings and her grandmother, to think about what she would do with her future.
“From my perspective, society gave me only three choices,” she says, “teacher, secretary or nurse.” Science had been her favorite subject, so she studied nursing, became a psychiatric crisis nurse at Mercy Catholic Medical Center in Philadelphia, married her high school sweetheart, Joe, and had two children — a boy and a girl.
Having a stressful job, as well as being a wife and mother of young children would be challenging enough for most women, but not for Mulgrew. Her interest in science motivated her to enroll at Rowan University. “In half jest, I told people I was studying to become a marine biologist and move my family to the ocean.”
Suddenly, her world changed completely. Her six-year-old daughter Kaitlin, now 23, was diagnosed with leukemia. She was treated at the Children’s Hospital of Philadelphia for three years. “It was a very difficult time,” Mulgrew admits. “I still remember two very long weeks when she developed chicken pox and would not let me leave her side. I wanted to stop taking classes, but my biology professor told me I was an excellent student and a tough cookie and should keep up my course work.
When Kaitlin slept, I studied calculus by the light in the bathroom in her hospital room.” Kaitlin went on to graduate from the U.S. Merchant Marine Academy. She is a mate on a tug boat in South Jersey, an ensign in the U.S. Naval Reserve and newly engaged to a Staten Island Ferry chief engineer.
Before she got to the academy, Kaitlin convinced her older brother Joseph, 26, to apply to the academy ahead of her. “Another tough moment,” Mulgrew says. “As part of their physical training, the cadets run. Joseph developed shin splints, which turned out to be a vascular tumor in his leg. The tumor was removed, a bone graft performed and he’s okay today.” His illness prevented him from pursuing a career in the Navy and so he is a second-year student at Rutgers University Law School with plans to pursue a career in admiralty law or intellectual property.
For more than a decade, Mulgrew continued to take courses in her free time, finally amassing so many credits (160) that at age 33, Rowan awarded her a Bachelor of Science degree in biology with a minor in chemistry. “Now what?” she thought. The experience with her daughter’s illness made her realize having family and friends around was more important than moving to the ocean and being a marine biologist. The same Rowan biology professor who called her a smart, tough cookie pushed her to consider going to medical school. “I wasn’t sure if I wasn’t too old.” But Mulgrew took the MCATs, scored well, and had some decisions to make. She applied to New Jersey’s three medical schools and a handful of others. She never expected to get in, but was invited for an interview by most of them.
What to do now? “Two ‘old’ lady friends lived across the street from my family. By old I mean they were in their 50s,” the now 49-year-old Mulgrew says with a smile. “They suggested we take a road trip and visit some of these schools. So we went to Kansas City, Des Moines, and somewhere in Ohio. We had a blast.”
When she visited the UMDNJ-School of Osteopathic Medicine (SOM), it was still a hole in the ground, but it was close to home. She accepted the invitation to become a member of the SOM Class of 1997. “I remember during the White Coat Ceremony that Dean Humphrey said he was very proud that this was the largest number of women in a first-year class in the school’s history.” Twenty-three per cent of the 66 students were women. Her fears about being too old for medical school proved groundless. Her anatomy lab partners included Tim Arnold, a father of five; Jacqueline Karri, two years younger than Mulgrew and a high school teacher; and Pat Ambrosia, an accountant.
Medical school is challenging for many students because of the workload, but even more so for Mulgrew, who also kept her nursing job. “We needed my medical insurance along with my husband’s because of Kaitlin’s history of cancer. I worked Friday evenings, 16-hour shifts on Saturday and Sunday, and every vacation.” She couldn’t afford to miss class. “I learned by listening. I didn’t have a lot of extra time to study more than that.”
Mulgrew wasn’t sure what specialization she wanted to pursue, but when she had completed her clinical rotations in years three and four, she was certain. “I knew I couldn’t be an ob/gyn because when the baby emerged, I’d forget about attending the mother because I wanted to be with the baby. I also realized that in my years as a psychiatric nurse, my experiences with children in crisis were the most meaningful.”
Over the next three years, she completed a residency in pediatrics at Cooper University Hospital in Camden, serving as chief resident her third year. “My pediatric residency was the toughest part of my training. I was on every third night and there was always a patient.” As a pediatrician, Mulgrew thought she would work with children with cancer, “but I realized I couldn’t. I had post-traumatic stress disorder because I’m also Kaitlin’s mom.” She applied for a four-year fellowship in general psychiatry and child/adolescent psychiatry at SOM and was only the third person ever selected for this program (with only one selected since that time).
When her training was complete, Mulgrew took on a different challenge from working with kids with cancer, but one equally difficult—working with kids who have been sexually, physically and emotionally abused. In 2004, she became the first and only child psychiatrist at the CARES (Child Abuse Research and Educational Services) Institute. “The Institute had been awarded a major contract from the state’s Division of Youth and Family Service (DYFS), which was committed to upgrading its services in the wake of a high profile child abuse case in Camden,” Mulgrew says. “Before I accepted the job, I considered private practice, but only briefly, even though, at the time, there was a serious shortage of child psychiatrists practicing in South Jersey. In fact, if you were a private pay patient, a family might wait as long as eight months for an appointment.”
Mulgrew picked the right specialty and the right job for her. Over the past four years, she has treated 350 to 400 new patients a year from a seven-county region in South Jersey. “As a psychiatrist, my primary responsibility is to evaluate whether medication is appropriate and then monitor its usage. At first, I was frustrated a bit by that because I wanted to do some counseling as well. Fortunately, since I have met the DYFS goal, I have been able to spend time at the Institute actually working with the children.”
Her passion for her profession is evident. “In our culture, and so many cultures, children are not seen as valuable. If they have a mental health problem, they often become more disenfranchised. That’s just wrong.” But, the ability of children to recover even from the toughest circumstances is remarkable to her. “Kids have great reserve, a capacity for healing even when it’s a mental health problem. I really feel that I can help effect change in a child’s life. What could be more rewarding?”
Part of the attraction of her position is the opportunity it presents to be in academic medicine as well as clinical practice. Mulgrew is an assistant professor of psychiatry. She enjoys being a mentor to SOM students and teaches medical residents. To climb the academic promotion ladder and also gain tenure, however, requires that she conduct and publish research as well. “I am ambitious and would like to strengthen my academic credentials. But right now I am doing what I want to do every day and getting done what I want accomplished — helping children have access to the critical medical care they need to heal and grow.”
When she does carve out time for research, she knows what her focus will be — developing prevention guidelines to foster emotional health in children. “Over the last several years, we’ve made great strides in promoting the physical health of children by doing research on prevention, early intervention, and healthy living. I want to do the same for mental health — use research to develop guidelines that foster emotional wellness in children.”
Her practice, her many interests from upholstering furniture to global traveling, and her family provide Mulgrew with a very full life. “When my husband and I bought our second house 15 years ago, we subdivided to be able to build two homes where one had stood. My parents live in the second house.”
Her children are living at home again. When Kaitlin graduated from the U.S. Merchant Marine Academy, she gave her mother and father each a ring with an inscription. One says “My ambition is…” and the other “to make you proud of me.” Mulgrew’s face lights up at those words. “I am very proud of them both and I know they’re proud of their mother, the physician.” Then she mentions jokingly that she’s considering whether to go to law school. “Joe is there. Kaitlin wants to apply. A background in law could be beneficial in my practice. Maybe we’ll make it a family affair."