Dr. P. Formica (She's A Woman)

By Maryann Brinley

On her first day of a surgery internship rotation at Queens General Hospital Center in 1954, she walked out onto the ward where the chief took one look and said,

"Oh my God, Formica is a woman." Laughing, from this distance of nearly half a century and a medical career filled with honors, awards, presidencies, parenting, grandparenting and female firsts, Palma Formica, MD, can still feel the sting. In fact, this is a scene that could epitomize the story of her life.

Never a "bra-burning feminist" or a woman in search of discrimination, the same doctor who hugs and kisses the family practice residents in her charge also admits, "You have to be smart if you are a woman because somebody is going to attack you no matter what you do." The only woman ever to become president of the Medical Society of New Jersey and a leader in women's issues within the American Medical Association (AMA), she remembers getting butterflies in her stomach as she turned the knob to go into a conference room, knowing that she would be the only female present. Yet, she says, "You have to have guts and while I hate to use sex or gender as a reason for doing things, whatever I've achieved, it's been because of male colleagues pushing me." After hours of quiet conversation in her sunny New Brunswick office, whose walls are punctuated with photos taken of herself with powerful people (ahem, men) including former President Bill Clinton and one-time U.S. Surgeon General C. Everett Koop, it's not difficult to see how Formica used the men in her life not as enemies but as catalysts.

First it was her father, her hero:"a most unusual Italian man," a Pennsylvania steelworker, stonemason and Sicilian by birth, who believed that "books don't weigh as much as shovels." Born in Johnstown, PA, Formica grew up understanding that education was essential. "My father used to say, 'Do the best you can and if you want it, go for it.'" What she wanted from age 6, after having scarlet fever, was to be a doctor. Nobody ever told her that women were not doctors and even though she knew no women doctors, medicine was the only career she ever considered. Her father, who promised his support but only until she got married, did believe that a career in pharmacy might offer more regular hours. Her mother, who had only an eighth continued on page 42 grade education, was "also a great person. She got to do everything in her life that she wanted because my father encouraged her," she says.

After graduation from Johnstown Catholic High School in 1946, Formica attended the University of Pittsburgh and completed her Bachelor of Science in two and a half years. When she applied to American medical schools, she had three strikes against her. "I was told – and they really told us these things! – that my chances for admittance weren't good because I was Catholic, Italian and a woman." There were quotas for each category and being a woman "who would probably get married, have kids and give up medicine," may have been the biggest hurdle. Schools didn't want to waste spots on girls. "Sometimes I think that a lot of women my age who went through medical school didn't get married because they were brainwashed into thinking: don't waste your education." Yet, Formica was determined to have it all.

At the University of Rome, which has been issuing degrees in medicine since 1521, she was one of two American students. Though she had cousins who were doctors in Italy, she left America expecting a backward country. "Rome was not like that," she says. The education and the experience were fabulous. At first in a wash of culture shock, she found herself "deaf, dumb and blind" figuratively speaking. Soon, she could dress like an Italian, look like an Italian but when "I opened my mouth, I'd hear, 'Ooooo, you're one of those ugly Americans.'"

Within the walls of Rome's University City, professors were held in God-like esteem and "earphones in the orthopedic classrooms translated into five different languages." The academic pace was rigorous. Studying hours and hours for oral examinations given only in Italian and in an amphitheater where other students could observe, Formica remembers going blank mentally looking for the words for carbon monoxide. It was during a forensic medicine exam, in her last semester. "I said, 'CO' in Italian but I just couldn't think of carbon monoxide. The professor went into a loud tirade about all the terrible Americans coming to Rome and not learning the language." Two weeks later, she ran into this same man, a handsome, imposing figure swooping past, followed by an entourage of underlings. After stepping aside, in flawless Italian, she said, "O segue, Professore." ("Honor to you, Professor.")

Summoned to join his group, she was asked, "Where are you from?" Then, the professor congratulated her, saying, "I wish all Americans could speak Italian as well as you do." At that point, she quickly countered, "I wish you had remembered that when you almost failed me in my exam."

"It was beautiful," Formica re-members.

Back in the U.S. in 1953, there was a shortage of doctors everywhere. Queens General had three hospitals but only 16 interns where 34 were needed. "Talk about putting in 80 hour weeks," she recalls, "we worked even longer. Starting on a Friday morning, you wouldn't leave until Monday afternoon and literally worked until you dropped." Yet, she will never forget the sense of camaraderie and there, down in the x-ray department, she met John Rihacek, a 6' 4" Czech working as a clerk while completing his college degree. "Not everybody was on his okay list but I was the only intern who could get x-rays after five o'clock," she says.

Married near the end of a resi-dency in internal medicine, Formica became pregnant with Tad, her first of three. "My son has a certificate for nine months of internal medicine in utero," she laughs. "That may be why he is a lawyer." Only five percent of physicians were women and young doctors like Formica were expected to hide their expectant motherhood. On the job until the day she delivered, she had saved vacation and sick time, hoping to stay home with pay for a few weeks. "Lo and behold," she says, the hospital would not let her use sick days to recover from birth. Disillusioned, she took her two weeks' vacation and made some hard decisions. Interns earned $12 a month then and though a resident's pay was $55, she still couldn't afford to hire help and continue to work. "We decided to have another baby," she says. Eighteen months later, Gregory was born but she was struggling. "Going out of my head caring for babies, changing dirty diapers, washing clothes, and preparing meals, I had spent my whole life studying and there I was being a housewife," she recalls. Meanwhile, because of an old-fashioned sense of the kind of work men just didn't do, her husband offered little support. She had to get back to medicine or go crazy. "Even my parents who were good about sending care packages –which always included nylon stockings for me – would chide, 'When are you going to make enough money to buy your own stockings?'"

She took the exam for a medical license in New Jersey. Because she had no money and few options to find a place to practice, her priest wrote to 80 parishes. A pastor in Old Bridge answered in 12 pages, front and back, explaining how his area desperately needed a doctor. "Anyone who writes a 12 page letter deserves a visit," she says, and when she arrived in town, a house near the rectory was going up for sale. "This was something I just had to do." A week before closing on the property, however, financial arrangements fell apart. Once again, her pastor came through with the down payment via a loan from his sister. "God love him. He was the guy who kept me honest and who did a lot of listening in those years."

When she hung up her shingle, Formica used only a first initial and last name. "If patients thought I was a woman, they might not come." Sticking with her maiden name professionally because that's what is on her diploma, Formica was never compelled to have it legally changed to Rihacek. Meanwhile, the first patient to walk into her new office was a man with puzzling symptoms. Not difficult for Formica, he was diagnosed and news of his subsequent cure soon circulated in town. The word was out: If Kennedy, U.S. President at the time, could have a woman doctor, then so could Old Bridge.

"My heart and soul have always been with the family," she says, as a physician as well as a mother. Before her daughter Alycia was born 10 years after Gregory, she was pregnant unsuccessfully so many times that colleagues called her, "The Pregnant Dr. Formica! The nail that held my kingdom together was my housekeeper Helen. If I got a call in the middle of the night, she would come to the house and wait until I returned from the hospital." When asked to choose between the Department of Internal Medicine and a new Department of Family Medicine, she chose family. "You need to know how to put your hand on a patient's shoulder and how to hug and kiss. I like making house calls. I know it's part of being Italian but humans need to be touched. You don't just hand out Kleenex when someone is crying."

After her husband died of cancer in 1979, because of concern for her patients and her commitment to training more family doctors, she offered her busy Old Bridge practice to the new residency training program in family medicine. A single mother working 80 to 90 hours a week, "I looked inward. I considered my patients to be family and my thought was, ‘Who will take care of them?’" Because she didn't see enough family doctors wedded to her philosophy of sharing and nurturing, she balanced her patient load with a new job as an assistant professor of clinical medicine. Ten years later, after a measure of frustration, she made full professor.

To get what you deserve, sometimes you have to take a clipboard in hand and announce, "Gentlemen, we have a problem," she admits. As a founder of the UMDNJ-Robert Wood Johnson Medical School Family Practice Residency Program at St. Peter's University Hospital, Formica still loves training young doctors, always reminding them, "If you feel you have the qualifications to reach a goal, don't be afraid to step forward."

Venturing into the world of local, state and then national medical politics, Formica can paint precious scenes in backstage battles between the sexes. Because of one of her first AMA conventions, "I have a miniature bed at home," she announces.

The story goes that she was appointed to an Ad Hoc Committee on Women with six other women. Not important enough to warrant an official conference room, the group was relegated to Formica's hotel bedroom for discussions, where they mapped out plans to change the organization. The memory of sitting all over that room, from the floor to the bed, still makes her smile. That little bed is her souvenir. Eventually elected to the AMA Board of Trustees, she credits a soft-touch approach to sexual politics. The first time she ran for the job and was roundly defeated, her mandatory concession speech to the convention was peppered with genuinely polite thank-you's. While another unsuccessful female candidate angrily pronounced that women would have to drag yelling and screaming men into 21st century medicine, Formica simply told them she had loved the opportunity to run, adding ever-so-sweetly, "I'll be back." Next time, of course, she won. "I went to the AMA to make changes," she says, "And I did." Female membership is at 28 percent and the organization is more openly accepting of international medical graduates, another pet peeve. Her first speech on the floor as a trustee tackled this touchy topic of foreign medical graduates. "Look at me," she told the audience. "I'm one of those 'FMGs'.I sat down to thundering applause because this had been an issue about to split the AMA into 'Us versus Them.' Let's face it, we're all 'Us.' "

Never fearful about standing up to prejudice or power, when a bank turned down her loan request because she wouldn't ask her husband to co-sign the paperwork, she didn't call a lawyer. "I phoned the president of the bank. This was the seventies," she explains, "before anti-discrimination clauses were written into banking policies but what wasn't right, wasn't right." Male colleagues didn't need wives' signatures for business loans, so why should she? The bank manager was subsequently fired and the loan, based on her financial record alone, was approved.

Her life has "been a tremendous learning experience," she says. Oldest son Tad is a father of two sons: a 13-year-old and an 8-year-old who is the spitting image of his Uncle Gregory. Greg is a rheumatologist who announced that he wanted to follow her into medicine one midnight ride to the hospital when she could hardly keep her eyes open and he was driving. "You love what you do and I think I will too," he told her then. "He does and he makes house calls, too," she says proudly. Daughter Alycia is a fine artist and teacher, who will open a gallery in Old Bridge someday, Formica hopes.

In Italian tradition, the first daughter in a man's family is often named after his mother. Her great grandmother was Palma Formica and because her father Salvatore came from a sprawling Sicilian family, "I have cousins out there who are also Palma Formica. In fact, there are lots of us," she says. Oh really? Unimaginable.

No one can really compare with UMDNJ's Palma Formica, MD, and...of course she's a woman.

FORMICA'S FEATS

A professor of clinical and family practice medicine at UMDNJ's Robert Wood Johnson Medical School (RWJMS) and a founder of their family practice residency sponsored by RWJMS at St. Peter's University Hospital, Palma Formica has a list of credits including:

€ First woman president of the Middlesex Medical Society

€ First female trustee of the Medical Society of New Jersey (founded in 1766) and the only woman ever elected its president

€ First female alternate delegate from New Jersey to the AMA

€ First woman chair of the Department of Family Practice at St. Peter's University Hospital

€ President of the medical- dental staff at St. Peter's University Hospital

€ Member of the AMA Board of Trustees for nine years

€ Recipient of numerous honors including the Benemerenti Medal awarded by Pope John Paul II, the UMDNJ Pioneer Women in Medicine Award, the March of Dimes' Virginia Apgar Award for New Jersey Women of Achievement, Best Doctors in America, the Don Quixote Award for Physician of the Year in New Jersey Living Magazine, and the Edward J. Ill Distinguished Physician's Award from the Academy of Medicine.