words by Maryann Brinley / photograph by John Emerson
n order for a woman in medicine to have it all, “You have to learn to live with a certain measure of chaos,” warns Naomi Lawrence, MD, associate professor, clinical medicine, UMDNJ-Robert Wood Johnson Medical School (RWJMS), director of dermatology surgery at Cooper University Hospital in Camden, and happy mother of three boys, ages 15, 12 and 10. “The nanny quits. Things fall apart. You start over at square one at home again.” (But you still have to be ready for a long day of patients, residents, research and surgery starting at 7:30 a.m.) “My husband and parents are very supportive but you are constantly juggling to make it work,” she says laughing. Yet it’s obviously a chaos she treasures.
“I’m going to suggest that many women in the generation before me really had to give up everything to go into medicine,” she says. “I didn’t. But the women who taught me were often unmarried and without children.” A graduate of Tulane University School of Medicine in 1987, she did her residency there in New Orleans (she was chief resident in 1991-1992) when the gender tide had begun to change. “At least 50 percent of us were women by then,” she estimates. “For the most part, dermatologic surgery is still a male-dominated field today, though the number of women in general dermatology practice now may be as high as 70 percent.”
What completes this physician’s life as much as her husband, her children and her family is her medical practice. “Seriously, it may sound simplistic but I still feel that this is a job that I love. My specialty is the perfect union of science and all the other critical components. I have a complete view of the patient and can take care of them from A to Z. I see their tumors, treat them surgically and then follow them until we know we have their cancers cured. I do their reconstruction so there is an artistic element too.”
As a medical student, she gravitated toward surgery, traditionally a male bastion. “I was inclined to it, talent-wise,” she explains. “So I looked seriously at all the surgical fields and thought about otolaryngology and ophthalmology. I did realize that I favored an outpatient kind of setting in which to practice. You look around when you are in school and start saying ‘yes’ to one option or another and then ‘no’ to others.” At Tulane, where she was chosen for Phi Beta Kappa as an undergraduate, she continued to add on the honors in medical school, including the Alpha Omega Alpha society, being selected as one of only six junior med students.
Board certified in dermatology and dermatopathology, she is a member of the American Society of Dermatologic Surgery, the American Society of Dermatology, the American Academy of Cosmetic Surgery and the American College of Mohs Micrographic Surgery. Lawrence spent two years completing fellowships in dermatopathology and Mohs, the most advanced skin cancer treatment available. Because it minimizes the chances for cancer cells re-growing, the cure rate is close to 99 percent.
Memberships in these organizations are important, she believes. But she wishes she saw more women taking leadership positions in them. “I still think that the number of women in national societies is disappointing.” She’s served administratively as secretary of the American Society of Dermatologic Surgery. Yet, “It’s hard for women to get elected to these board positions, for a combination of reasons. Certainly it’s a question of time because when women are in their most productive career years, they are also raising kids. They don’t run for office often and even when they do run, they seem less likely to win.”
A good portion of her family — she’s one of four siblings — is still in New Orleans and she’s returned several times since Hurricane Katrina to help. “My sister was in one of the flood zones and had six feet of water in her house. Our husbands had to rip out her whole first floor.”
Back in 1993, when she was looking for an academic medical position, she was drawn to New Jersey because her father, Francis Lawrence, PhD, was president of Rutgers University. The elder Dr. Lawrence, who had earned his doctorate at Tulane in French in 1962, was provost there before accepting the Rutgers presidency which he held for 12 years. “So we thought it would be a good idea to move closer to my parents, who lived in central New Jersey though it turned out to be not as close as I thought.”
What drew her to RWJMS in Camden was the fact that the medical school was just developing a new residency program there in her specialty. “I was really excited about helping to start this with other dermatologists.” More than a decade later, she boasts, “We still have all of our original faculty members plus a few more, which is pretty unusual.” This program is small and accepts just one candidate for each of the three years of the residency. More often than not, she says, the winners of these spots have been women. “There are two men and one woman now but that’s the first time in years” for this gender ratio.
For the past decade, she and David Moscatello, MD, RWJMS, have received funding for their research on the possibility of using adult stem cells harvested from mature adipocytes (fat cells) for tissue augmentation. “Most people are aware of embryonic stem cells but adult cells can also be progenitor cells, capable of differentiating into bone, blood, cartilage or a number of other tissues. If we remove these cells, which can be found in abundance, break them up with enzymes and transfer them back into the body, there are a number of things we can do functionally and cosmetically. For one, it’s the perfect filler for an aging face and for traumatic injury, whether war- or accident-related, or post breast biopsy.” Approval for their first round of clinical trials in humans was just granted. And she’s excited about the fact that Jason Marquart, MD, one of her recent fellowship grads, just returned to practice at Walter Reed Army Medical Center where he will continue to work with the RWJMS team and also be able to treat injured Iraq and Afghanistan war victims.
The author of numerous research papers, magazine articles and book chapters, and editor of several dermatology journals, Lawrence speaks often at national and international meetings on everything from “How to Start a Cosmetic Practice,” “When Bad Things Happen to Good Surgeons - Liposuction,” and “Total Care of the Melanoma Patient,” to “The Skinny and the Fat on Liposuction” delivered to the attendees at Cosmetic Boot Camp in Jackson Hole, WY. “I just completed an FDA Phase III trial on the longterm safety of a new botulinum toxin which will compete against Botox. It’s called Reloxin.”
Yet, the focus of her professional life is mainly clinical. Three days a week, surgery starts by 7:30 a.m. and “I’ll do about 10 cases a day, sometimes finishing in the operating room by 3 but sometimes not until 5 or 6.”
Lawrence does have some fears for the future of medicine. “Who is going to choose medicine when people have to go into such tremendous debt to train? And, if we really want to attract the best and the brightest, we have to make sure it is a rewarding career, and not so hard for some doctors to make a living. When I was in med school, obstetrics was one of the most sought-after residencies and specialties. Now, nobody wants to go that route because they are being squeezed between reimbursement and the cost of malpractice.” Hopeful that these insurance issues will get straightened out, she asks, “Are we going to have to wait until there is no one left to deliver babies?”
Nevertheless, this wife, mother, daughter, sister, researcher and caring physician, voted one of New Jersey’s Top Docs by her peers, still recommends medicine to younger women coming along behind her because “this is a great career” — chaos included.