Inside UVA

Winner of the Women's Center's Zintl Award
Hostler blazes trails in medicine and at U.Va.

By Rebecca Arrington

Jim Carpenter

Dr. Sharon Hostler, medical director of the KCRC and professor of pediatrics, shows her joy at receiving a bouquet of flowers from her children, who were unable to attend the ceremony Feb. 17 at which she received the Women's Center's Elizabeth Zintl Award.

With stuffed animals and toys sharing wall space with official diplomas and other honoraria, Dr. Sharon Hostler's office is as inviting to a child as an adult. Her homespun touches are testaments, intentional or not, to her family-centered approach to medicine. There's even a framed rejection letter from Ben & Jerry's hanging on the wall explaining why Dr. Hostler, medical director of the Kluge Children's Rehabilitation Center and McLemore Birdsong Professor of Pediatrics, will do more good for humanity as a physician than as CEO of the ice cream company.

The University community agrees.

Dr. Hostler was chosen as this year's recipient of the Elizabeth Zintl Award. Presented by the Women's Center Feb. 17, the annual award honors a woman at U.Va. who demonstrates an unusually high degree of service to the University and whose excellence in her work makes a significant impact. The award honors the late Elizabeth Zintl, who was U.Va. chief of staff until her death in 1997.

Interdisciplinary clinics

Because many of the children's needs don't fit neatly into one medical specialty, KCRC continues to develop interdisciplinary clinics that serve as national models of family-centered care. For children less than 3 years old, the Infant and Young Child Clinic teams a developmental pediatrician with infant education and psychology services. KCRC developed its Down Syndrome Clinic in consultation with a community group for parents of children with Down Syndrome. The clinic's work is so well known that other academic medical centers often ask for its Down Syndrome Life Care Plan when they develop their services.

Other clinics include: the Autism Spectrum Disorders Clinic, developed with input from a parent support group; the Attention Deficit/Hyperactivity Disorder Clinic, which offers specialized care to hyperactive children; and the Spasticity Clinic, which brings together developmental pediatrics, neurology, pediatric orthopedics and neurosurgery. There are also multidisciplinary clinics for spina bifida, cerebral palsy and limb deficiency (for amputees). KCRC has its own in-house brace-making shop.

Dr. Hostler "has given abundantly to our community," said Sharon Davie, director of the Women's Center. "Her efforts on behalf of academic women in medicine, and her efforts to better the environment for all in medicine, have had a strong impact. She has brought this same commitment to numerous University-wide committees, task forces and conferences, in a way that has shaped the working environment for women and men at U.Va. for the better," Davie said. "I admire her courage."

Dr. Robert Carey, dean of the Medical School, called Hostler "a staunch advocate² for children with serious illness or rehabilitation needs. "A physician's physician, Sharon is simply the best at what she does."

Hostler, who met Zintl when they served together on the President's Advisory Committee on Women's Concerns, said the award is gratifying because it recognizes "acts of teamwork, behind-the-scene contributions and dedication to the University, above self-serving interests."

The award, which carries a $1,000 prize, comes from an endowment fund established by David A. Harrison III, a friend of Zintl's and one of U.Va.'s most generous donors.

Leading the treatment of children

Under Hostler's 25-year leadership of the KCRC, the approach to treating patients has shifted to family-centered care. "Our philosophy recognizes that the family is the constant in a child's life while health care providers vary over time," Hostler said.

Children from birth to 21 years of age are treated at the KCRC. Some need special therapy or rehabilitation after injuries, accidents or surgery. Others have chronic illnesses such as diabetes and cystic fibrosis. Many families come to the center to find out why their child is having difficulties with walking, talking, learning, eating or with behavior, Hostler said. The KCRC has an "incredible team that has earned a strong international reputation," she said.

From old house to family-centered hospital

Legend has it that the Kluge Children¹s Rehabilitation Center owes its beginnings to a poker game. In the 1930s William Rucker, who owned a 17-acre estate on the current site of the center, played cards with Dr. Meredith Aldrich, U.Va.¹s first pediatric surgeon. Aldrich persuaded Rucker that the area needed a long-term care facility for children. When Rucker died in 1941, he willed his estate to the University to be used as such. Kids with tuberculosis of the spine were treated there.

About a decade later, the state health department closed the facility because it didn¹t meet safety standards. In the 1950s, however, U.Va.¹s orthopedics department raised money through Golden Gloves boxing tournaments to help build what is now the rear section of the current facility.

The U.Va. Rehabilitation Center for Handicapped Children opened in 1957. The stone wall that now lines the front of the property on Ivy Road was built with stones from the original Rucker house, demolished to make way for the new center.

In 1964, Dr. William Thurman steered the center in a new direction. The center began treating children with chronic diseases and physical disabilities. Dr. Robert Merrill became the center¹s first full-time medical director in 1965, the same year the center became part of the University Hospital, with formal residency rotations and active medical student involvement. Dr. Sharon Hostler, now medical director, was among the first interns, at which time most of the children lived at the center and few outpatients were seen.

In the late 1970s, the center began treating adolescents. The 1980s saw the rise of family-centered care and a new emphasis on research and training in physical and occupational therapy. Albemarle County residents John and Patricia Kluge donated $2.5 million to the center in 1988, and it was then named for them and dedicated on April 15 of that year.

Today, the KCRC continues to grow. It currently has 200 staff members and continues to reach out around the state with developmental clinics in Winchester and Warrenton. At present, it receives roughly 20 percent of the 13,000 outpatients it serves each year from outside Virginia, and offers training to nearly 400 health care professionals annually.

At 60, Dr. Hostler is still an attending physician, which for her includes covering a weekly day-long clinic, being on-call three months a year, 24 hours a day, and doing consultations.

"You maintain your vitality and retain reality about why you're here at the bedside," said Hostler, who's gone from a self-described know-it-all in her treatment of patients to a humble physician. "As I get older I realize we doctors aren't as essential as I'd once thought. We're part of the support system. My responsibility is to give the best information to the patient and family and let them make the best decision for themselves. I tell my patients that they need to be the CEOs of their bodies to educate others of their needs. ...

"At the KCRC, our team of professionals works together with parents to help children become as independent and competent as possible. We recognize that both medical and emotional needs must be addressed to promote healing, rehabilitation and adjustment to a disability. We emphasize reinforcing a child's strengths and coping skills, and all of the KCRC's treatment programs, educational programs, research, and advocacy efforts are directed toward these ends," Hostler said.

Innovative methods include the horticulture and artist-in-residence programs. With private donations, Hostler is building a permanent art collection at the KCRC. Selected patients' works are also included in the collection. "You get to know the children through their art, and it's diagnostic in that it develops fine motor skills," said Hostler, who plans to add to the KCRC's permanent collection with her Zintl Award money.

U.Va. service

In addition to practicing medicine, Hostler has served on numerous committees to improve the work environment at U.Va. Since the first task force report on the status of women in medicine (which Hostler helped prepare) was presented in 1991, things have improved in the Medical School, Hostler said. "My male peers, many of whom were sexist, became wonderful mentors and supporters when their daughters entered professional schools," she noted. Men and women junior faculty are also sharing more issues than they did 10 years ago, such as child care and travel to attain an international reputation, she said.

In March, a Medical School committee, on which Hostler will serve, will conduct another survey to be presented to Carey in December, a decade after the first report was issued. The new survey will include questions about pay equity, professional development and treatment of all medical students by their peers, mentors and teachers.

"One thing we can cheer about in the School of Medicine that the rest of the University hasn't achieved, is the overall average of women faculty who make it to full professor. It's 10 percent, versus 31 percent for men," she said. Twenty years ago, no women coming out of U.Va. achieved this goal, she said.

Hostler is chair of the Medical School's promotion and tenure committee, on which she's served for 10 years. Carey calls it "one of the best appointments² he's ever made. Hostler said her work on the committee has been the "most wonderful learning experience" of her life.

Having just read the work of the 53 candidates currently up for tenure, Hostler said she found their work "inspirational and intellectually exciting. I feel so proud to be part of this group.² Her goal as chair is to get part-time tenure approved here. "It's been successful at California and in the Northeast," she said.

Medical history

Dr. Hostler earned her A.B. in chemistry and English at Middlebury College and her M.D. from the University of Vermont. The only one in her family to go to college, she was a Gould Scholar (a merit- and need-based award) at Middlebury, "which meant I was so poor they paid for everything," she said.

Several people encouraged her along the way. One was a childhood friend's father, who was a doctor. "Dinnertime conversations at their house were stimulating,² she said. In fourth grade, Hostler went to work for him in his office. "I balanced his check book, weighed patients, answered the phone. He encouraged me in his stoic Vermont way."

Another physician also influenced Hostler's career choice. "My father died at 36 of Hodgkin's Disease. I was 12. His doctor, who'd been a classmate of my father's, was very dear to my family. We had no insurance and no car," but he provided the medical care anyway, Hostler recalled.

Hostler became a doctor despite the hardships of her family and her gender. She lost her scholarship, which would have continued for her, a woman, in any graduate field except medicine. She chose that path anyway and was the only female in her medical class.

Hostler came to U.Va. in 1965 and was appointed medical director of the Children and Youth Project in 1969. Participating doctors went into the community to set up clinics to provide health care -- a novel approach to medicine then, Hostler said. "I learned about the power of team, the power of inclusion, and learned about poverty and the need for basic human rights," she said.

In 1974, Hostler was asked to become medical director of the KCRC. Mentoring Hostler along the way have been a number of individuals, including U.Va. colleague, Dr. William Thurman. He "made me believe in myself, that I could go anywhere and do anything," Hostler said.

Hostler, herself, now serves as a mentor to many medical students at U.Va. and abroad. On the national level, she's an active member of the Association of American Medical Colleges, where she leads an annual mentorship seminar.

Revamping the CMC

The "most exciting" project currently on Hostler's plate is relocating a major portion of the Children's Medical Center to the same site as the KCRC. The new facility would include an ambulatory pediatric surgery center and day treatment program. The $40 million project, to be paid for with private funds, has made it through several internal planning phases and will soon go before the Board of Visitors for approval.

The seventh floor of the University Hospital, where the CMC now resides, would become a pediatric intensive care unit, Hostler said. "All other pediatric services would be here," she said, noting that it would position the Universtiy as the "premiere place to come for treatment between Duke and Hopkins."

When not on call

Dr. Hostler has a standing tennis date with friends every Wednesday and Sunday. She also enjoys reading and music in her spare time, as well as traveling with her husband, Joe Boardman, a cantor, "great linguist and gourmet cook," who sang opera in Europe earlier in his life, Hostler said. They met at a Club Med in Martinique and married in 1987.

Hostler also spends as much time as she can with her six grown children -- four stepchildren and two of her own, Kathleen (Kaki) and Dylan -- all from her first marriage to Alan Dimock, who died at age 34. Hostler credits her circle of friends in the University community with keeping her on track personally and professionally. Thanks to their support, I only left my baby at the hospital once after a long shift, she said with a smile.