Neurology: Unmasking Elusive Enzyme Reveals Known Villain Epidemiology: Cancer Risk May Be Higher for Young Smokers Health Policy: Use of Hormone Replacement Therapy Not Determined by Clinical Factors Sowing Better Seeds Angiogenesis Inhibitors May Slow Clogging of Arteries Nipping Anorexia in the Bud Vitamins May Protect Against Heart Disease Microbial Enzymes Choosier than Believed Conference on Academic Values Set Town Meeting on Gay and Lesbian Issues To Be Held at HMS Appointments to Full and Endowed Professorships In Memoriam: Robert A. Dorwart Nobelists Tapped To Speak at Soma Weiss Day Program Honors and Advances News Brief Students Teach Community Youngsters About Good Oral Health Why Not Harvard Medical? Front Page

FORUM Why Not Harvard Medical? Some Minority Graduates Would Not Even Have Considered the Question if HMS Had Not Asked It Talmadge King (left), Woody Myers (right), and Guadalupe Sanchez (photo unavailable) have built exemplary careers, facilitated by affirmative action. On May 24, 1968, six weeks after the assassination of the Reverend Martin Luther King Jr., HMS faculty initiated an affirmative action program at the School, voting to admit 15 African Americans and increasing class size from 125 to 140 to accommodate the change. In the fall of the following year, 16 minority students joined the incoming class.    This year, HMS is celebrating the 30th anniversary of affirmative action at the School to call attention to the accomplishments of its minority graduates. As part of the celebration, Focus is running a series of profiles, each covering representative graduates from one of the three decades since the affirmative action program began. Below are the stories of minority graduates from the 1970s. For 30 years, Harvard Medical School has been seeking applicants like Talmadge King Jr. and Woodrow "Woody" Myers, both African Americans, and Guadalupe Sanchez, a Hispanic, who are graduates of the 1970s. King, HMS '74, is now chief of medical services at San Francisco General Hospital and vice chairman of the Department of Medicine at the University of California, San Francisco. Myers, HMS '77, is director of health care management for Ford Motor Company. And Sanchez, HMS '78, is a clinical instructor in dermatology at the Washington University School of Medicine and a solo practitioner.    For Sanchez, a career in medicine was not even on the radar screen when she was growing up. Her family had immigrated from Mexico to Florida when she was four. Every year from May through October, until she was in fourth grade, they had worked as migrant farm hands.     Without the intervention of several teachers, Sanchez might never have gone away to college. In her tightly knit community of Hispanic immigrants, responsibility to family came before education. And for a female, boarding at an educational institution was tantamount to compromising one's virtue.     But her teachers, all graduates of Berry College, a teacher's college in Georgia, insisted on taking Sanchez there for a visit, and she loved it. "When you are living on a tight budget, if someone has to go to the doctor, it blows your budget." —Guadalupe Sanchez At Berry, Sanchez became premed only after she realized she was doing better than the other premed students. Her attraction to medicine had to do with the difficulties of growing up in a large, poor family. "There was always a child who was ill," she says. "When you are living on a tight budget, if someone has to go to the doctor, it blows your budget. My dad would come home and say, 'Is anybody sick?' Growing up with that anxiety made me want to conquer it." Sanchez also says that as a small child, she had "operated" on her dolls.     When the time came, Sanchez applied exclusively to Southern medical schools. Then, Alvin Poussaint, now an HMS clinical professor of psychiatry at Judge Baker Children's Center and faculty associate dean for student affairs, telephoned her out of the blue and invited her to consider Harvard.     Like Sanchez, King's horizons had been limited growing up in a "tiny" Southern town, his located in Georgia. Unlike Sanchez, he had expected to go to college, and had even aspired to being a doctor or getting a PhD in psychology.     But King says he never would have thought of going to Harvard without Harvard's intervention. The University sponsored the Health Careers Summer Program for minority students, mostly from predominantly black, Southern colleges. "We [the Southern blacks] were a small group among all the people taking classes at Harvard summer school. Succeeding at Harvard made me feel it would be possible to compete anywhere," King says. "Also, meeting HMS professors and hearing them encourage us to go forward was a subtle but tremendous boost to all of us." The Need to Favor Diversity Myers was the only one of the three students who had actually planned to apply to Harvard. Myers had attended Stanford University, where he became chairman of the black premedical organization.     Yet Myers insists he would not have been accepted without affirmative action. "The smart African Americans did not just appear in 1969. Harvard made a decision at that point to increase its diversity.     "Had it not been for the hard work of Al Poussaint and [former medical dean] Bob Ebert, there would not have been the affirmative action effort that resulted in my coming to Harvard," Myers says.     Myers's interest in medicine began early. His father, a small businessman, would take Myers to the pediatrician, where they would sit in the waiting room calculating the throughput, his father extolling the benefits of practicing medicine in terms of money, status, and scientific interest.     Myers was unmoved until the time he stepped on a nail at age 10. His pediatrician was unavailable that day, so he had to go to the ER at the only hospital in Indianapolis that treated blacks. "They wanted me to soak my foot in water with Epsom salts," Myers says. "I put my foot in the water, and it was ice cold. I jerked it back. The nurse looked up at me and said, 'We ran out of hot.' "Meeting Harvard professors and hearing them encourage us to go forward was a subtle but tremendous boost to all of us." —Talmadge King     "That was when I first became sensitized to equity and fairness in medicine. I saw medicine as an opportunity to change things."     After Harvard, Myers got an MBA at Stanford. Subsequently, he became chairman of quality assurance at San Francisco General Hospital, an experience that once again placed medicine's inequities in stark relief. Then he spent five years as commissioner of health for Indiana, where he helped create a state law to ensure that Ryan White and others like him could not be barred from school for having HIV. He then served as health commissioner for New York City under Mayor Dinkins.     At Ford, Myers manages health care benefits for the company's 680,000 U.S. employees. His goals, he says, are to "buy better health status for employees," instead of buying procedures and services—and to eliminate unnecessary costs.     Information technology is critical to these efforts. For example, the claims data show that many women of appropriate age do not receive mammograms. Also, many patients with mild gastroesophageal reflux disease are inappropriately receiving Prilosec, a new, costly drug for severe disease that has been heavily advertised. Myers deals with these kinds of problems by figuring out why they exist and determining the best way to change doctor–patient behavior. Caring for People Sanchez says she was strongly influenced by her Harvard adviser, Irwin Freedberg, a dermatologist. When she initially met with him, the first thing he did was to suggest that they make an appointment to treat her acne. "He cared," she says, simply. Her own gift with patients received recognition during a rotation on urology. "I had a physician adviser who had a reputation for being a misogynist," she says. "At one point, he pulled me aside and said, 'You should think about being a urologist because you are very good with patients.' Coming from him, that was a really big compliment."     In 1985, Sanchez went to Washington University in St. Louis. There she published research on epidermolysis bullosa with Eugene Bauer, who is now dean of medicine at Stanford University. But Sanchez says that she loved the clinic so much she decided to devote herself to patients.     Sanchez says her background is invaluable for dealing with the poor immigrants she sees as a clinical professor at Washington University and in her private practice. She describes the discomfort of an immigrant's teenage son, who had to interpret for his father during a medical examination. "You could tell he was embarrassed and impatient. I told him I'd had to do the same thing as a child and had also been embarrassed about it. That opened him up."     Working in private practice allows Sanchez the time to understand the context in which her patients' problems arise. Since she often treats whole families, she says, her understanding of her patients' medical needs is increased, and her treatments are more effective.     Sanchez's career could have served as a model for King's original aspirations. He had intended to return to Georgia to work in underserved communities. But as a pulmonary fellow at the University of Colorado Health Sciences Center, he got caught up in a medical mystery. He treated a woman who had interstitial lung disease (ILD), a progressive, scarring process that led to her death. "Nobody knew what to do, or even what it was," he says.     King joined the Colorado faculty in 1979, where he established himself as an independent investigator, funded since 1980 by the NIH. He also co-authored the first major textbook on ILD.    "The smart African Americans did not just appear in 1969. Harvard made a decision at that point to increase its diversity." —Woody Myers King soon became active in the American Thoracic Society, a 13,000-member international professional and scientific society, and is the organization's immediate past president. King's presidency occurred at a critical juncture for the society. As it grew, the society's mission became increasingly constrained by its relationship with the American Lung Association, the parent organization. King focused on gaining independence for the society while maintaining ties with the lung association.     King also served as executive vice president for clinical affairs at the National Jewish Medical and Research Center, Denver.     In the mid-1990s, King grew restless. The looming milestone of his 50th birthday placed his original goals in sharp relief. "Working at National Jewish, I saw early the problems of managed care. I worried that the working poor would suffer as this system spread throughout the country."     In 1997, King moved to the University of California, San Francisco, and San Francisco General Hospital. "San Francisco General is the safety-net health care system for the city. I felt that given the strong commitment to health by the city and county of San Francisco, the outstanding faculty, and one of the best training programs in the country, the hospital could find better ways to manage the care of this segment of the population."     Nevertheless, in working toward this goal, King must deal with badly strained finances: although patients are "sicker than ever before," they are sent home sooner, "often without the back-up care that would keep them out of the hospital."     If all this sounds daunting, it clearly energizes King.     "We're emphasizing prevention of disease and management of patients outside the hospital setting," says King, who visited HMS in March to speak to students and trainees about lung disorders. "All of us get discouraged, but we have a fantastic staff. I know I can't change the world by myself, but I think collectively we can do a lot." —David Holzman Back to Top