U.Va. physicians Diane Snustad, Karen Rheuban and Laurel Rice

June 4, 2004

By Kathleen Valenzi

Last October, the National Library of Medicine, the world’s largest biomedical library, opened its doors on a 4,000-square-foot exhibition titled“Changing the Face of Medicine: Celebrating America’s Women Physicians.” The exhibition commemorates 150 years of women in the medical profession—a period that begins in 1853, when Elizabeth Blackwell, the first woman in the United States to receive a medical degree, opened a dispensary in a tenement district of New York City.

More than 300 women physicians are included in the NLM exhibition.Three of them—gynecologic oncologist Laurel Rice, M.D.; pediatric cardiologist Karen Rheuban, M.D.; and gerontologist Diane Snustad, M.D.—are professors on the University of Virginia School of Medicine faculty.

Ask these three why they were selected from among so many talented women physicians nationally, and each looks genuinely puzzled—even a bit self-conscious. All they know for sure is that last year, out of the blue, they received a letter from the NLM stating they had been nominated for the honor. “I think we are probably representative of a generation that saw a sea change in medicine,” speculates Dr. Snustad. “But beyond that, I have no idea how we were chosen. There are many wonderful women at UVa who could have been, and should have been, featured, such as Sharon Hostler, Dearing Johns, JoAnn Pinkerton, Claudette Dalton, Christine Peterson, and others.”

In fact, Drs. Rice, Rheuban and Snustad were nominated by a 24-member ad hoc advisory group formed in 2001 by Donald A.B. Lindberg, M.D.,director of the National Library of Medicine, and Tenley Albright, M.D., of the Harvard Medical School. The advisory group included leading physicians within a broad cross-section of academic medicine, one U.S. senator, the heads of various national medical associations, and a sampling of private practitioners and policymakers—each of whom was asked to nominate “exemplary physicians” for inclusion in the exhibition.

“We had developed three themes for the exhibition, and we presented them to the advisory board,” says Kevin Schlesier, coordinator for the NLM. “We said that we were aiming for different levels of diversity—for example, geographic diversity, diversity across medical specialties, across time periods—to help us illustrate those themes, and they came up with a list for us to use.”

The list was representative but by no means all-encompassing. “It would be
impossible to recognize the achievements of every woman physician,” the advisory group acknowledged. “We hope that by examining this exhibition, [visitors] will consider the physicians here as examples of the fuller fabric of women’s contributions to medicine and their personal achievements in society.”

The road for women physicians has not been easy, as the exhibition makes clear. “Before women could build careers as physicians they had to fight even to be allowed to attend medical school,” one exhibition panel reads. “After proving that they were as capable as men, they went on to campaign for additional training and other career opportunities.”

By the time Rice, Rheuban and Snustad were beginning their medical training, many of the most significant gender and racial barriers impeding women had been knocked askew, if not entirely pushed over. “When I got into the University of Minnesota Medical School in 1976, it was only the second or third year that women had been admitted in large numbers,” Snustad said, noting that women comprised a recordsetting 20 percent of her class. “Luckily for us, the class before ours had paved the way by dealing with any initial resistance.”

Such dealings, she says, included getting professors to stop showing “nudie pictures” during their lectures.

But even a more sensitive attitude in the classroom could not eradicate overnight the traditionally minded male physicians’ perception of women’s roles. “The American Medical Association was meeting in 1976 in Philadelphia for the Bicentennial, and my university sent some of its medical students there to take part,” Snustad continues. “I remember overhearing some men talking about how they thought the idea of women in medicine was a bad thing. One of them said, ‘They get all that education, and then they get married.’

The other one said, ‘It seems they solved that problem by admitting only the ugly ones.’”

Snustad chuckles at the memory, shaking her head almost in disbelief that such insensitivities were once commonplace.“Yes, back then, the medical profession was still a male bastion,” she says, “but that changed quickly.”

Nearly 30 years later, Rice, Rheuban and Snustad—as other women physicians included in the NLM exhibition— are having the last laugh. As the following profiles demonstrate, each ofthese women is an accomplished clinician or clinician-investigator, held in high regard by her colleagues and patients. Furthermore, each has achieved one of the most difficult goals for women in academic medicine today: despite the fact that their tenure clocks and biological clocks were ticking simultaneously, these three physicians have managed to strike a balance between their professional and personal lives. Each is a tenured professor, and each, whose spouse has an equally demanding career, is raising a healthy and active family.

If for no other reason than this—that they now serve as role models for the women, and men, coming up the medical ranks behind them—Rice, Rheuban and Snustad are, indeed, ‘changing the face of medicine.’

LAUREL WYSONG RICE

A native of Delhi, New York, Laurel Rice knew from an early age that she wanted to be a physician. The intellectual stimulation of medicine appealed to her, as did the opportunity to “have a job where you could help people,” she says. “You don’t take that for granted.”

Rice attended the University of Colorado at Boulder, where in 1979 she earned a bachelor of science degree in pharmacy. She next attended Colorado’s School of Medicine, where she was elected in 1981 to the Alpha Omega Alpha medical society for her scholastic achievements, and completed her medical degree in 1983.
From there, Rice headed to Boston, where she completed her internship and residency in Obstetrics and Gynecology, as well as a fellowship in gynecologic oncology, at Brigham and Women’s Hospital, Harvard Medical School.

“It was a major stroke of good luck that I found gynecologic oncology,” Rice says. “It is an extremely interesting and gratifying field of medicine, combining surgery, chemotherapy and general medical care in a group of patients with serious medical problems.” After completing her fellowship, Rice was on faculty at the Massachusetts General Hospital, where she received the 1991 Resident Teaching Award in Gynecology.

In 1993 Rice was recruited to Uva by gynecologic oncologist Peyton Taylor, M.D., where she continued her career as a clinician and educator, but also initiated a career in basic science. “She came very highly recommended,” Taylor says.“We were seeking a person who was well trained clinically and who was also interested in developing a basic science investigational program. She was a perfect match from a programmatic perspective, and then we met her, and the personal chemistry just clicked.”

Within a year of her arrival, Rice received the first of four grant awards that have since supported her research in the hormonal manipulation of endometrial carcinoma, the most common form of uterine cancer and the fourth most common of all cancers in women. At the present time, she is awaiting approval to move forward with a Phase II clinical trial, investigating the use of Rapamycin, an anti-tumor agent, in the treatment of patients with advanced or recurrent endometrial carcinoma.

In 1995, Rice received the School of Medicine Dean’s Award for Excellence in Teaching. Two years later, she was granted tenure and appointed director of the Division of Gynecologic Oncology. In 2001, she was promoted again to vice chairwoman of the Department of Obstetrics and Gynecology. One yearlater she became director of a fellowship program she developed in gynecologic oncology.

“The teaching responsibility is huge,” Rice says of the fellowship program. And she takes that responsibility seriously.

“Her students and residents say she is demanding in the OR, but they also respect her, because they can see that she is absolutely dedicated to her patients,” says Sharon Hostler, M.D., the McLemore Birdsong Professor of Pediatrics and head of the Division of Developmental Pediatrics. Rice views Hostler and Leigh Donowitz Grossman, M.D., professor of pediatrics and head of the Division of Pediatric Infectious Diseases, as two of her mentors. They are also two of several women on the medical faculty Rice would have chosen for inclusion in the NLM exhibit, had the decision been hers.

Rice loves the operating room. “I’m one of those people who likes to do things with his hands,” she says. “To me, surgery is creative problem-solving in a direct, hands-on way.”

While, as a woman, she is still among a minority in the predominantly male surgical world, she has always “felt very well accepted by other surgeons,” she says. “Surgery is a big equalizer once you show that you can do your job, take responsibility for your work and care for your patients.”

Despite the demands of research, teaching and administration, about 65 percent of Rice’s time is still devoted to clinical duties—everything from diagnosis and surgery, to chemotherapy and long-term follow-up.

“ Dr. Rice is right on top of everything,” says one of her patients, Marilyn Epstein, of Charlottesville. “She doesn’t leave anything to chance. I had two breast cancers, and afterwards, she watched me like a hawk, and it’s because of her that I’m making it. I did develop endometrial cancer after my breast cancers,and she discovered it early because of her persistence in seeing me so often. I got the report about my endometrial cancer on a Thursday, and she had me in the operating room the next Monday for a hysterectomy, which was the cure. That kind of response time is rare. I’m sure that’s why she was included in the [NLM] exhibit. She absolutely deserves it.”

Another patient, Diana Smith, assistant headmaster for academics at the St.Anne’s-Belfield School in Charlottesville, was so impressed with Rice that, following surgery, she wrote a letter to Thomas Massaro, chief of staff of the Uva Health System. “Throughout my stay in the hospital and during my period ofrecuperation, [Dr. Rice] could not have been more thoughtful, genuine, and plain-old competent,” Smith wrote. “She saw me in the hospital daily, sometimes even twice. She has worried about my health way beyond what I deserved.…Above all, she has modeled what must be the highest goal in your profession:
a remembrance that patients have bodies and spirits, both of which need a healing hand.”

They need that hand even when healing is no longer possible. “Laurel is really a phenomenal person and consistently receives outstanding marks for patientsatisfaction,” Hostler says. “She insists that her students demonstrate compassion for her patients by actually sitting down and talking to them when they make their rounds. And when you realize that so many of her patients die, it is remarkable to see how she’s always filled with such optimism and such determination for finding a cure.”

Rice is also “fearless about asking for what she needs,” says Hostler, even if that means standing up before a room of businessmen, as she has done during Cancer Center fundraising events, and educating them about endometrial cancers—a process that requires in-depth description of the female reproductive system and inevitably produces awkward silences from among her audience members.
An exceptional public speaker, Rice has given 100 lectures at regional, national and international conferences. She is a fellow of the American College of Surgeons and is a member of various prominent medical societies.

In addition to the awards already mentioned, Rice has made Good Housekeeping’s “Best Doctors” list, serves as an oral examiner for the American Board of Obstetrics & Gynecology (“a testament to how highly she is regarded in her field,” Hostler says), and last year received the National Faculty Award from the American College of Obstetricians and Gynecologists Council on Resident Education in Obstetrics and Gynecology. What makes these and other accomplishments more remarkable is that Rice, with so many daily responsibilities, remains steadfastly committed to her family, her surgeon husband, Eugene F. Foley, M.D., and their two children, Olivia and Conor Foley. “To make it work with children, every decision about how I spend my time has to be analyzed,” she says. “My philosophy has been to run as hard as I can for 14 hours a day and see what I can get done.”

“Laurel is the best that medicine has to offer,” says Leigh Grossman. “She is a brilliant physician, a successful investigator, a respected administrator, a wonderful teacher, and yet, with all this, brings the perspective of warmth andhumanness that a woman can bring to the practice of medicine and the medical care of other women.… She is able to put herself in your shoes; she is open, honest and straightforward; and makes you feel, regardless of whether the situation be personal, medical, academic or administrative, that you are not alone.

“The University of Virginia, and particularly the medical professions, have had very few senior women—women who are being promoted to department chair positions and who have gained important leadership within this institution. Dr. Laurel Rice is one of those women. We are very fortunate to haveher here.”

KAREN SCHULDER RHEUBAN

Karen Rheuban, a native of Jamaica, New York, earned a bachelor of arts degree from the University of Rochester and her M.D. from the Ohio State University College of Medicine & Public Health.

Rheuban’s talent for medicine was evident early, when she received the Nu Sigma Nu Outstanding 1st-Year Medical Student Prize. Before graduating with her M.D. in 1974, she also was awarded the Department of Pediatrics Prize, the Department of Surgery Prize, membership in the Alpha Omega Alpha medical society, and the Janet Glasgow Outstanding Student Award of the American Medical Women’s Association.

Rheuban next came to the University of Virginia to pursue her residency in pediatrics. During her internship, she made history as the first pediatric resident to serve with UVa’s then-new Neonatal Emergency Transport Service. From 1977-1978, she served as chief resident.

The next two years, Rheuban conducted a fellowship in pediatric cardiology under the direction of U.Va.’s Martha Carpenter, M.D., whom she views as one of her most treasured mentors.“No one surpasses her skills as a pediatric cardiologist,” Rheuban says of Carpenter.

After completing her fellowship, Rheuban joined the UVa faculty as assistant professor of pediatrics and assistant professor of surgery. In 1986 she was promoted to associate professor, and then, in 1990, became associate dean for the Office of Continuing Medical Education at the encouragement of another mentor, Robert Carey, M.D., who was then dean of the School of Medicine. Last year, her administrative duties as associate dean were expanded yet again to include external affairs. This was done at the request of Rheuban’s long-admired pediatric cardiologist colleague, Arthur Garson Jr., M.D., who succeeded Dr. Carey as dean in June 2002.

As associate dean for CME, Rheuban expanded the program’s outreach within Virginia, and also, with the assistance of colleagues, extended its offerings to include educational services deliverable through videoconferencing, computerassisted instructional materials and Webbased online activities. These efforts resulted in the highest possible accreditation status from the Accreditation Council for Continuing Medical Education— a designation that fewer than five percent of all CME providers, nationwide, have obtained.

While attending a meeting in Washington, D.C., Rheuban heard about telemedicine, a new technology that was being used to deliver CME to health professionals in rural areas. She recognized telemedicine’s potential for providing clinical services to rural Virginians.

Rheuban had, for years, been driving to clinics throughout Virginia to provide on-site pediatric specialty care. Unfortunately, when patients needed care between those clinic appointments, they had to travel long distances to Charlottesville. “I realized that telemedicine could help us bring timely care to patients in their local communities when they needed us, not just when we were physically present,” she says.

Rheuban consulted with Eugene Sullivan, a retired U.S. Army lieutenant colonel and technology expert who was investigating telemedicine’s potential through research-and-development studies for UVa neurosurgeon Neal Kassell, M.D. In 1995, Sullivan’s efforts and Rheuban’s interests combined to form the UVa Telemedicine Program, with Rheuban as medical director, a position she continues to hold.

A year later, the Office of Telemedicine was created—a move that was one of Rheuban’s “really big coups,” says Sullivan, who became the office’s director at that time. “She was able to convince the new vice president, Dr. Bob Cantrell, that the entire UVa Health System should participate in the program. That decision now makes us unique in the Commonwealth, and it is one reason that we are so successful. Other institutions do telemedicine in Virginia, but only with one or two specialties. Here, we currently have 26 specialties and subspecialties providing patient care via telemedicine.… To be able to go out with the logo of the Health System and really mean ‘the system’ is super for us.”

Today, the Office of Telemedicine coordinates three initiatives over a 48-site network. The first, the Southwest Virginia Alliance for Telemedicine, delivers specialized medical care to rural patients and education to rural health professionals in partnership with network healthcare facilities. The second, the Virginia Department of Corrections Telemedicine Project, provides specialized medical care to inmates at eight state correctional facilities and the regional county jail. The third is an outreach program with the Craig County School System, which provides clinical consultative services and health and science education to the students, teachers and citizens of the county.

Telemedicine literally saves lives. On New Year’s Day 2000, for example, Rheuban helped save a two-day-old baby, thanks to the telemedicine link between UVa and the Winchester Medical Center. Rheuban was able to decipher, from Charlottesville, a lifethreatening congenital heart defect after reviewing the baby’s chocardiogram. That diagnosis had not been apparent to the doctors in Winchester. She advised the use of a medication to stabilize his condition, then arranged for his transport to UVa Hospital for successful open-heart surgery.

Telemedicine also improves the delivery of health care. Alexandra Bartley of Honaker, Virginia, was born with a ushaped cleft palate and a benign facial tumor known as a hemangioma. Both of these conditions required regular visits to UVa plastic surgeon Kant Lin, M.D., for treatment. “We’d have to leave the house at 6 a.m. in order to make our 11 o’clock appointment,” says Lisa Hubbard, Alex’s mother. “We did that every couple of months for a couple of years.”

Once UVa’s Southwest Virginia Alliance for Telemedicine extended into the Honaker region, Hubbard and her daughter began to consult with Lin over the telemedicine link. It was through the use of telemedicine that Hubbard got to know Rheuban. “Dr. Rheuban is one of the most wonderful people I’ve ever worked with in my life,” Hubbard says. “A lot of doctors are so impersonal, but she’s not like that. She cares about people, no matter where they live.”

As evidence, Hubbard cites Rheuban’s efforts to bring telemedicine to communities like hers. “She fights for that program constantly,” Hubbard says. “She truly believes in it, and sees it as a way to reach out to people she has never even met. I can hardly put my feelings about her into words.”

One of Rheuban’s most recent “fights” on behalf of telemedicine involved the Federal Communications Commission. “Five years ago, Congress authorized that $400 million a year be set aside to underwrite the high costs of broadband telecommunications services which facilitate the delivery of telemedicine to rural areas; but rules the FCC devised for disbursing this money were so onerous that in five years’ time, less than 5 percent of the authorized funds had been used for this purpose,” Rheuban says. “With the assistance of Congressman Rick Boucher, D-Va., of the 9th Congressional District, we encouraged them to change those rules.”

Last fall, Rheuban arranged a telemedicine demonstration for FCC officials involving health care providers and patients at the Saltville Medical Center. The effort paid off. In an FCC meeting held November 13, 2003, the rules were modified to improve the effectiveness of rural health care support mechanisms.
FCC chairman Michael Powell publicly recognized Rheuban for her championship. “The work she is doing is not only heartwarming and spectacular, but it’s saving lives and making a difference in lives,” he said.

Furthermore, the Saltville Medical Center telemedicine demonstration he had watched, at Rheuban’s invitation, not only impressed him with its use of technology, he said, but “it was one of those events that I walked away from proud to be a human being.”

Congressman Rick Boucher is equally appreciative of Rheuban and her efforts on behalf of his constituents. On February 11, 2004, at a kickoff event for the Congressional Internet Caucus Advisory Committee, Boucher acknowledged Rheuban’s role in bringing about much-needed federal regulatory change, calling her “the foremost advocate for telemedicine.”

Rheuban, who was promoted to full professor in 1996 and has twice testified before Congress, has won awards and commendations, and regularly appears in The Best Doctors in America directory. She is a member of the American College of Cardiology, the American Academy of Pediatrics, the Medical Society of Virginia, and the Society of Medical College Directors of Continuing Medical Education. She also is a trustee of the American Telemedicine Association.

In addition, Dr. Rheuban continues her clinical practice of pediatric cardiology, conducts research on outcomes in telemedicine, and is devoted to her family, which includes husband William Rheuban, M.D., a Charlottesville psychiatrist, and their three children.

“Here at the office, we affectionately call her Dr. Mom,” says Sullivan. “It’s hard to put into words, but there is no facet of her life that takes second place. She is just as involved in her work as she is with her family. No one ever comes up short.”

DIANE GAIL SNUSTAD

Diane Snustad, the Claude Moore Professor of Geriatric Medicine, is one of only four women in the UVa School of Medicine to hold currently a chaired professorship. The idea of it still surprises her.

“I never would have conceived of this life when I first went to college,” says Snustad, who was born in Fargo, North Dakota, and grew up in Minnesota. “I thought I’d be a teacher.”

Snustad attended Macalester College for one year as a National Merit Scholar, then transferred to the University of Minnesota in Minneapolis, where, in 1974, she graduated with a bachelor of arts degree in philosophy. While at Minnesota, she had opted to take premed classes for a broad exposure to many subjects—not because she had any thought of becoming a doctor. “I had no role models,” she says. “The only doctor I had ever known, growing up, was an old man,” she says.
But over time, the idea of becoming a doctor seeped into her life. Two years after completing her undergraduate education, Snustad entered medical school at the University of Minnesota. She graduated with her M.D. in 1979 and headed east to conduct her internal medicine residency at West Virginia University in
Morgantown.

In 1982 Snustad moved to Pittsburgh, where she first served as an instructor in medicine, and then as an assistant professor of medicine at the University of Pittsburgh. She also served as an attending physician at four medical facilities, including Presbyterian University Hospital and the Pittsburgh Veterans Administration Hospital, as well as a consultant to the Western Psychiatric Institute and Clinic.

While in clinical practice, Snustad worked with David Martin, M.D., a geriatrician. She discovered that she had a real affinity for working with elderly patients, and he nurtured her interest. “Geriatric medicine appealed to me,” she says. “I found the field to be more inclusive of other health areas of care— that it tends to employ a more holistic approach in treating the patient.” She also liked its potential for serving people whose special needs were only beginning to be appreciated. In Pittsburgh, Snustad also met and married Paul Humphreys, an assistant professor of philosophy from the University of Virginia (now full professor and chairman of UVa’s philosophy department), who was then on sabbatical and conducting a fellowship at the University of Pittsburgh. In 1985,they moved to Richmond, where Snustad taught at the Medical College of Virginia and served as an attending physician at Hunter Holmes McGuire Veterans Administration Medical Center, while her husband commuted to his academic post in Charlottesville.

At the VA hospital, Snustad worked with gerontologist Holly Stanley, M.D. The two women shared a research interest in osteoporosis and forged a lasting friendship.
“ I hold Diane in the highest regard,” says Stanley, now owner of Coordinated Care for Seniors medical practice in Richmond. “When you take care of someone with lots of medical problems, who is maybe a little demented, has limited finances and maybe no family, you’ve got to be intelligent and creative in pulling a lot of things together.”

Stanley punctuates her respect for Snustad by proclaiming: “She can take care of any member of my family at any time.”

In 1986, Snustad was hired for a new position in geriatrics at UVa. The position involved a joint appointment in psychiatric medicine and internal medicine in recognition of the fact that elderly patients often experience mental impairments such as dementia in addition to physical infirmities.

“Soon after arriving here, I became pregnant,” Snustad says. She asked about the School of Medicine’s maternity leave policy, and found that none existed. Since she was the first woman on the faculty to have a baby, the school had never needed such a policy. So, with the support of her boss, Richard Lindsay, M.D., she created one. “I just told them I would take six weeks off, and that was it,” she says.
After a few years as medical director of UVa’s geriatric clinic, in 1991 Snustad became medical director of UVa’s Colonnades Medical Associates and Health Care Center in Charlottesville, a position she holds today.

“From the beginning, it has always been a team effort,” says Sharon Smith, one of the first nurses Snustad hired to assist her at the Colonnades and the nurse who has now been with her the longest. “It was just the two of us for a while, and the doctor would do anything—bring patients in, check vital signs, do filing, whatever was necessary. And the people who have been hired to work here since get the same message from her: ‘Everyone helps everyone.’”

“I think it’s natural for women to work as a cooperative,” Snustad says of her managerial style. “I still know nurses who used to have to stand up whenever a doctor entered the room.

The doctor was king. Here, there are no queens.”

Smith agrees. “I have never seen her become impatient or lose her temper,” she says. Rather, what Smith often sees is the doctor laughing with her patients.

“She has a great sense of humor, and we have several patients who enjoy that and like to tell her their little jokes,” Smith says. “It’s wonderful to see them smiling together and enjoying a happy time. For many of these patients, their lives are now very complicated, so it’s really precious to watch her make a connection with them.”

“My feeling is that you have to use humor—not at the expense of patients, but to make patients feel good,” Snustad says. “I am a firm believer in the value of the therapeutic relationship. When sick people know you’re there for them, they feel better. In geriatrics, the doctor is a big part of the patient’s life. I see around 350 patients, and some of them come back every two weeks; it’s very labor intensive. We become their surrogate family.”

“From my point of view, the greatest thing about Diane is that she is very personable,” says patient Amma Kidd, of Earlysville, Virginia. “In today’s world, you feel like a number in most doctors’ offices, and you almost feel as if you were disturbing them by being there.

With Diane, it’s totally the opposite.When you go to her, she listens, answers, never gives you the impression she’s pressed for time. To me, part of the healing comes from the relationship the patient feels with the doctor. The healing is in the trust you feel that this person cares for you.”

Over the years, Snustad has trained close to a dozen geriatric fellows, and she has taught in all six of UVa’s “Mini-Med Schools” for community members. A fellow of the American College of Physicians, she is also a member of, and reviewer for, the American Geriatrics Society and the Gerontological Society of America.

Snustad enjoys working with students. “The fact that I didn’t have role models and had to find my own way makes me want to teach them things I didn’t know, such as how to have good relationships with your patients,” she says. “I hope I serve as a role model of a doctor who is also a person, and a mother, as they see me with my kids.”

“Basically, she’s a superb doctor, and the people who work for her are absolutely devoted to her,” says Jonathan Evans, M.D., chief of the Section of Geriatric Medicine at UVa. “In addition to that, she really—more than anyone I know—has figured out the work-life balance. She is a very proud and devoted parent who takes great pride in her children’s activities. I think she’s a caring person, and that’s evident in everything that she does.”

Evans sees Snustad as working in the “frontier” of women’s health. “The overwhelming majority of older people are women,” he says, “yet when you read about women’s health, there tends to be a big focus on younger women. But the needs of older women are unique and under-recognized by most physicians, including women’s health experts. Diane is a pioneer in many respects. I think the field of women’s health needs to take a longer look at geriatrics, and the expertise physicians such as Diane Snustad can provide.”

Despite her “accidental” entry into medicine, Snustad can see clearly, in hindsight, that she was cut out for the profession. “I’m thankful to be part of it, to be taking care of people,” she says. “The other stuff ”—the yearly inclusion in America’s Top Doctors, the chaired professorship, the NLM exhibition—“are all whims of fate, of being in the right place at the right time.”

Vivian W. Pinn, M.D.

In addition to three members of the UVa clinical faculty, the National Library of Medicine exhibit, “Changing the Face of Medicine,” also includes UVa alumna Dr. Vivian Pinn, director of the Office of Research on Women’s Health at the National Institutes of Health.

In examining Pinn’s career, the NLM exhibition identifies three “milestones”:
In 1967, Pinn became the first African American woman to graduate from the School of Medicine. She was also the only woman in her class.

In 1982, at Howard University College of Medicine, she became the first African American woman in the United States to chair an academic pathology department.
And in 1991, she accepted her current position, becoming the first director of the Office of Research on Women’s Health.

The exhibition also includes Pinn’s own words about how she and her NIH colleagues have helped change the face of medicine. One way, she says, has been by convincing “individuals in both the scientific and the lay community that pursuing issues of women’s health is a scientifically directed effort—not something to be held with disdain, but to be applauded, because it’s helping us to get at the truth in terms of knowledge,scientific knowledge.”

She also says, “We have, I think, played a major role in helping to define women’s health as beyond the reproductive system, which traditionally was how their health was viewed.” As an example, she cites the recognition of heart disease as the leading killer of women in this country, “something that was not fully recognized until recently,” she says. “And for that reason, we have more research looking at heart disease in women, which, we hope, can guide our young medical students, our young nursing students and our young physicians, as well as more mature physicians, to know that we must counsel women about risk of heart disease...so that they become more aware of this as a threat to themselves—not just to their husbads and fathers.”

Through the years, Dr. Pinn has received numerous awards and honors, including induction as a fellow of the American Academy of Arts and Sciences in 1994, and receipt of the Elizabeth Blackwell Award from the American Medical Women’s Association in 1995, the same year she was elected to the Institute of Medicine.