People often ask me this and I always have the same answer: I do not remember a time since early childhood when I did not want to be a physician. As a child I read voraciously the series of Cherry Ames nurse adventures, yet never dreamed of being a nurse, but a doctor, despite having no role model except reading about Elizabeth Blackwell, Marie Curie, and other heroines. I am the first-born of nineteen grandchildren of Polish immigrants, and the daughter of a teacher and coal miner-firefighter. Being totally deaf from the age of 2 1/2 years did not deter me, nor did the incredulous and patronizing responses of others when they asked what I wanted to be when I grew up. Others have said that I am the first deaf person in history, male or female, to earn both a Ph.D. and M.D.; and the first profoundly deaf woman physician. In a way this is very sad. It means that there must have been others more intelligent and more qualified who have been denied the opportunity to be who they wanted to be.

As a young student, Judith Pachiarz, M.D., was told that a deaf girl had little chance of becoming a doctor. One high school instructor tried to prevent her from taking chemistry, claiming deafness would somehow cause her to knock over lab chemicals. Yet despite objections from many around her, and after being rejected by many of the schools she applied to, she has built a rewarding and successful career as one of the first profoundly deaf women physicians practicing in the United States.

Judith Pachciarz lost her hearing when she was 2 years old after suffering from encephalomeningitis, an inflammation of the brain which can cause extensive nerve damage. She grew up in Danville, Illinois, always attending schools with hearing students and taking lip reading classes at the same time. She was inspired to pursue a career in medicine after reading about Elizabeth Blackwell and Marie Curie. Shrugging off the low expectations of those around her, Pachiarz sat at the front of the class to lip read and took her studies very seriously. After graduating seventh in her high school class of eighty-four, she majored in microbiology and zoology at University of Illinois, taking the pre-medicine curriculum. She earned a master of science degree at the University of Illinios in 1965 and a Ph.D. in microbiology and immunology at St. Louis University in 1971. New federal legislation prohibiting discrimination against persons with disabilities (section 504 of the Rehabilitation Act of 1973) brought national attention to previous bad practices and promoted equal access, and, teaching veterinary science at the University of Kentucky from 1974 to 1979, Pachiarz was encouraged to pursue her earlier idea of a career in medicine.

In 1979, Pachiarz enrolled in the University of Louisville School of Medicine. The development of telecommunication devices for the deaf (TDD), and the support of her colleagues allowed her to study alongside hearing students. She borrowed class notes from friends, and students in the bioengineering department modified an oscilloscope for her so she could 'see' heart and lung sounds instead of listening for them with a stethescope.

After graduating in 1983, Dr. Pachciarz was chief resident in pathology for five years. She completed a fellowship in transfusion medicine and blood banking, and was laboratory director of a small county laboratory. She has been a hospital pathologist and director of the blood transfusion service at Charles R. Drew University of Medicine and Science in Los Angeles.

Dr. Pachciarz enjoys having a role in patient care as well as teaching medical students, and with her background in microbiology is also keen to keep on with her own research. Her interests include quality assurance in transfusion devices, trauma blood procurement, and the diagnosis of malaria using hemograms. Dr. Pachciarz was medical director of the World Games for the Deaf in the Los Angeles area in 1985, supervising three hundred medical volunteers over ten sites. In all aspects of her work she has made a special effort to mentor people with disabilities and to provide them with the support and enthusiasm that she was often denied as a young student. Her advice to everyone is to never assume that a disabled person can't do what anyone else can do.

What was my biggest obstacle?

My responses to childhood and adolescent experiences were influenced primarily by my deafness, and were focused on simply surviving as a deaf child in a hearing world, rather than on conforming to sex role expectations. While being a deaf girl was more of a handicap than being a deaf boy, the decrement due to sex was small compared to that due to deafness. Attributes such as initiative and assertiveness which I developed to cope with the handicap of deafness conflicted with expected female behavior of that time, but enabled sexist barriers to be ignored or relatively easier to overcome. I enjoyed a relative lack of exposure to sexist attitudes because of the communication barrier and also because I was not considered an eligible female.

It took me seventeen years from my first application to medical school to the time I was accepted, and along the way I earned a master's and a Ph.D. in microbiology and immunology, and had a University academic career. Yet I never lost sight of my goal, better described as singleness of purpose. Once I made my commitment to medicine, there was no looking back, not just to stand on the frontier of the unheard-of, but to build a bridge for others to cross.

The biggest obstacle was in overcoming attitudinal barriers. In 1963 I met all the qualifications for medical school admission as I did in 1979. In 1977 I wrote Health Education and Welfare Secretary [Joseph] Califano, who was considering the provisions of Section 504: "I am a thirty-five year old deaf woman who has wanted to be a doctor of medicine since early childhood. I have encountered resistance and discrimination at every step from grade school through graduate work to a Ph.D...thus the enthusiasm, expertise, and dedication I could provide to health care...is denied...When will our equal educational opportunities be protected under the law? Fifteen years—how much longer do I have to wait?" Secretary Califano signed Section 504 after concerted collective action, and I was accepted into medical school two years later. Other factors involved in becoming a physician include serendipity, technological advances (modification of an oscilloscope for auscultation of heart and lung sounds), mentors, and support services such as interpreters.

How do I make a difference?

As a pathologist and the transfusion service director of a major Los Angeles County medical center with a trauma center, I enjoy the best of both worlds—the practice of transfusion medicine directly benefiting patients, consulting other physicians in their practices, teaching medical residents in transfusion medicine (which impacts most specialties), diagnosing cancer, doing autopsies, serving on committees, and conducting varied research, using my research background. My Ph.D. dissertation in 1971 on the phylogeny [growth and development] of immunity, was dedicated "to my future patients" eight years before I was accepted into medical school.

Who was my mentor?

The support and encouragement of mentors was one of the many factors involved in becoming a scientist and physician. Professional development is as dependent on the actions of colleagues and superiors as on one's own efforts. Some mentors were powerful scientists. There was the assistant professor, the only female faculty member in the department, under whom I studied for my master's. There was the department chairman who invited me to work in his laboratory so I could finish my Ph.D. research. There was the eminent immunologist, on the cover of Time magazine, whose wife told him about my Ph.D. dissertation, who offered me one of his postdoctoral appointments, which were very competitive and highly prized. This smoothed my way for years afterward. Later as assistant professor I came full circle and myself became a mentor, with a young woman obtaining her master's under me, just two weeks before I entered medical school. During medical school, there were three clinicians who took extra time to teach auscultation with the oscilloscope I used, and an internist who trusted me with clinical care of all his in-house patients. There were two women physicians—one an assistant director of a family practice program; the other an obstetrician-gynecologist—who enabled me to gain clinical externship experience. All those mentors were in positions of power, and felt secure enough to feel unthreatened by a deaf woman who dared aspire to the same goals.

How has my career evolved over time?

My career has evolved from Ph.D. biological research in microbiology and immunology with two post-doctorate fellowships to being an university faculty member, then being a student again in medical school with a residency and chief residency of five years in pathology, to a fellowship in transfusion medicine and blood banking, to laboratory director of a small county laboratory, to my present position practicing as an hospital pathologist and transfusion service director and using my scientific and medical background in the practice of medicine, teaching, and research. As we become older and more mature, we pass into a stage where we give more community service, and I was glad to be medical director of the World Games for the Deaf in 1985, with the same venues as the 1984 Olympics, and supervise three hundred medical volunteers over ten sites.