What was your biggest obstacle?
My biggest obstacle was also the biggest opportunitynamely, that the areas I was interested in developing were outside mainstream medicinevacuum areas in terms of competition for resources or power. They were ideas ahead of their times in many cases. Therefore, my role was to articulate why these areas were important (such as prison health or HIV/AIDS in adolescence) and make the case for why resources (for example, grants) or effort (for example, time during medical school or residency training) should be allocated. Developing model programs and documenting their effectiveness was both harder and easier to do in these cases because there were often no prototypes and we were shaping areas that hadn't previously been tackled. Having made the case successfully meant creating the opportunity for "scientific migration" to occur, such as drawing smart, energetic, talented people into these fields and areas as they became better defined and resources began to flow.
How do you make a difference?
My thirty-five-year career as a medical doctor and administrator has focused my creative energies in areas ripe for new ways of thinking. My role has been to connect people of differing views, disciplines and perspectives to create programs addressing pressing, but unmet, societal needs. This intersection of societal needs and new areas led me to work with young people in the new field of adolescent medicine and resulted in my working in diverse settings, including New York City's detention center for young people in the 1970s, founding the nation's first program focusing on HIV in adolescence from the 1980s to the early 1990s, and writing and speaking in medical and public settings about public health and health policy (particularly HIV/AIDS, vulnerable populations, and improving the health care system). First based in academic health centers in New York City at Columbia and Albert Einstein College of Medicine, I developed programs, worked with educators, policy makers, and politicians, and co-authored a book on AIDS to educate young people which has sold over 103,000 copies. It has been translated into three languages and has been reprinted three times.
Grappling with national issues at a time when comprehensive health care reform was contemplated in the early 1990s, I had a Washington D.C., chapter of my career involving shaping Congressional health care reform legislation in the Senate Finance Committee and at the National Academy of Sciences as the executive officer of The Institute of Medicine. As president of The William T. Grant Foundation, my role has been to inspire and enable the Foundation Board, staff and grantees to embrace and implement our mission to "create a society that values young people and helps them reach their potential." During my five years as president, we have aligned our grant making and convening activities to try to bring about intentional social change and launched a major, new Prize in Youth Development in collaboration with the National Academy of Sciences and the Institute of Medicine. Together, we have forged a new chapter in the history of this august institution, now in its sixty-eighth year of philanthropy to be true to William T. Grant's notion of "increasing knowledge to better understand human potential" in ways that are consonant with our times.
Who was your mentor?
I have had many mentors and co-learners. Mentors (those more senior in years and experience) include Martin Cherkasky, M.D., who headed Montefiore Medical Center for forty years. His philosophy was that one's role was to use resources (in this case a hospital affiliated with an academic health center and medical school) to bring about social change. Other mentors included Michael Cohen and Iris Litt, leaders in adolescent medicine who helped shape the field in the 1970s and therefore shaped me as a trainee (pediatric resident and fellow in adolescent medicine). David Hamburg, whose brilliance as an academic and later as president of the Institute of Medicine and the Carnegie Corporation had a particularly powerful effect on my worldview, as he so magnificently outlined views and approaches to conflict, both interpersonal and worldwide. Drs. David and Betty Hamburg, my predecessor as president of this Foundation, have been my professional parents over the past 4 decades. They have crystallized their latest thinking and writing as it has evolved from understanding deadly conflict to educating for peace...incredibly timely, important contributions to everyone in the world beyond those of us lucky enough to have known them personally.
How has your career evolved over time?
My career began and has evolved full circle. My original reason for becoming a physician was to be an agent of change in society by helping to improve the system related to health of the people in this country and around the world. My journey began by being part of a new way of defining health/medicine, by age, rather than by disease, namely by focusing on young people, rather than adults, newborns or the elderly. Adolescent medicine, a new discipline, combined a focus on individuals with understanding and ameliorating the conditions in the family, community and society that made or prevented young people from thriving, not just preventing illness or disability. My career lead me to work in places where young people gathered, rather than exclusively focusing on bringing them to health care settings like hospitals. Therefore I worked in a juvenile detention center in NYC, bringing comprehensive health care to an incarcerated population in great need of full services; in Africa in a rural hospital with full services including serving people with leprosy and TB; in the NYC public schools bringing a full HIV/AIDS curriculum with condom availability to 450,000 high school students (1 million students K-12); and later switching to government (Senate Finance Committee) and an intermediary organization/policy "think tank" advising the government and the people about matters related to health and science. Finally, as president of William T. Grant Foundation, I have had the opportunity to bring these previous experiences in health, health policy, politics, and communications to bear on the well-being of the nation and the world's youth-the country and the world's most precious resource. As I begin the next chapter in the fall of 2003, I will enlarge my lens to once again be part of the evolving world situation well beyond the
boundaries of this country. In the fall I will continue my public service in a different way. First by traveling the eastern-most section of the Silk Road and by volunteering in Mongolia, as part of a project to exchange thoughts on the development of the health care system in this emerging democracy. I hope to celebrate my 60th birthday with my husband and 2 children trekking through the Sacred Valley of Bhutan as I transition to a life that has more time for contemplation and integration of the evolving world situation. I hope to create a time in which, as Ghandi said, "My life is my message."