In my final year of high school, my high school guidance counselor suggested that I apply to McGill University's seven-year med program.

Well, at first I didn't want to become a doctor. When I was 15...13, 14, 15, I was interested in all kinds of aspects of biology. So for example, in junior high I read a three-volume book on worms. I was into worms. And I liked paleontology, I liked dinosaurs, I liked, archeology, but I didn't think I wanted to become a doctor.

In my final year of high school.... my guidance counselor suggested that I apply to McGill University's seven-year med program. That is, we applied out of high school, and would be accepted into medicine—we had to do an undergraduate degree in three years, and then go onto medicine—and I didn't want to apply. And my guidance counselor convinced me to apply, with the following logic—which in fact, I've followed the rest of my life

That is: Since you don't necessarily want to be a doctor, if you apply and don't get in, you won't be disappointed; and if you do get in, you have three years to make a decision, because you don't have to start medicine until you've finished your undergraduate degree. So I thought: Well, that's a good... way of making a decision; it gives me three years to think about it. So I applied, and I got into the seven-year med program.

At the end of the three years of undergraduate, where I had taken biochemistry, and anatomy, and so on, I had begun to identify myself with the medical profession. And I found that I did want to be a doctor. And that whatever preconceptions that I had about what being a doctor meant, I was beginning to think that I really do not only like biology, but I like working with people. And that being a physician would allow me to do both biology, and work with people.

And then something really important happened in the middle of all that that at the time I didn't realize influenced my decision to be a doctor, but I am sure now, thinking back on, it that it did—and that is that my grandfather had a very bad stroke. And my grandmother and my mother spent, really, all their waking hours taking care of my grandfather—first at the hospital and then at home—and I then became very familiar with what it meant to have a family member deathly ill.

And I think what that did, is it made me decide, at some very deep emotional level, that I needed to learn as much as I possibly could about illness, in order to have as much control over life and death. And the only way to do that was to become a physician. And I wasn't really aware of that motivation until much, much later; but I'm sure that it influenced me at a very critical point in time.

Dr. Sternberg is internationally recognized for her groundbreaking work on the interaction between the central nervous system and the immune system. Her research concerns the brain's stress response and whether it makes people susceptible to rheumatoid arthritis and other inflammatory diseases. She has been credited with helping illuminate the possible underlying mechanisms for connections between stress, depression and autoimmune disease.

Esther Sternberg was born in Montreal in 1951. Although her father was a prominent physician, she did not plan on following him into a career in medicine. It was not until the age of 15 that she found her thoughts turning to medicine. At the urging of a guidance counselor, she began to consider applying for a grueling, seven year degree program at McGill University. At the same time, her grandfather became severely ill. As she watched her mother and grandmother care for her grandfather, Sternberg found herself drawn closer to the study of medicine. "I distinctly remember coming home from the hospital one evening and thinking that I am going to learn enough so that I will never feel helpless again when someone is ill," she remembers.

Dr. Sternberg graduated McGill University's Faculty of Medicine in 1974, and after her residency was appointed an associate of the Howard Hughes Medical Institute and an instructor in medicine at Washington University and Barnes Hospital. She entered general practice, and from 1984 to 1986, she was an attending physician at Barnes Hospital. Her daily interactions with patients and their families were rewarding for her, and she remembers seeing clearly how she could make a difference in improving their health.

As she migrated from practice into a research career, Dr. Sternberg's feeling of making a difference evolved from dramatic intervention to a more abstract—but in many ways larger—arena. She began her career at the National Institutes of Health (NIH) in 1986. Since then, much of her work has focused on interactions between the central nervous system and the immune system.

In 1989, when the L-Tryptophan Eosinophilia Myalgia Syndrome swept the nation in epidemic proportions amongst people taking the amino acid food supplement L-tryptophan, Dr. Sternberg led the NIH response and coordinated the interagency research that followed. But it was a difficult period for her. "I had been working in the lab as a scientist, not realizing that sometimes your findings can have huge economic implications. For example, for this drug company. They were being sued for over two billion dollars. I started to experience a lot of retaliation from this company, where they tried discredit me, and harass me, and I and my colleagues at the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), who had done the work together." Sternberg "stuck to the truth," knowing that it would help many thousands of people, and adds that if she had it to do over again, she would do it the exact same way.

In 2000, Dr. Sternberg became the director of the Integrative Neural Immune Program at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH). She remains a tenured senior scientist at NIMH/NIH, as she has since 1991. She is a research full professor at American University in Washington, DC, and a medical officer, chief, Section on Neuroendocrine Immunology and Behavior at NIMH/NIH.

Dr. Sternberg has acted as advisor to several U.S. and international organizations, including the National Academy of Sciences Institute of Medicine, Pan American Health Organization and the World Health Organization. For her outstanding contributions in the study of the L-tryptophan epidemic, she was awarded the FDA Commissioner's Special Citation in 1991 and the Public Health Service Superior Service Award in 1994. She earned the Public Health Special Service Award, in Recognition and Appreciation of Special Achievement from the U.S. Department of Health and Human Services in 2001. She Co-chairs the new multi-Institute NIH Program on Research in Women's Health, designed to foster research across all NIH Institutes in sex and gender differences in women's health.

What was my biggest obstacle?

Well, there's no question that there were lots of obstacles along the way. The word "stress" carries with it a lot of baggage. So, at the beginning, when I started to talk about stress and the immune system to scientific audiences, I was actually afraid to use the word "stress." And I began to get up some courage, probably in 1996 and 1997, to ask the question to a scientific audience, "How many of you believe that stress can make you sick?" I would say most of the scientists in the audience kind of looked to one side and other, and...raised their hands very slowly, and then hid them, just in case their colleagues might notice that they had raised their hands. So \they were afraid to admit that they actually believed that stress could make you sick. Even using the word "stress" in a scientific workshop or meeting would cause great consternation. I mean, the scientists became very stressed when they heard the word "stress," but they didn't want to admit that they believed that there was such a thing as stress; so that was the culture.

The reason for it was, I think, that for so many thousands of years, the popular culture believed that stress could make you sick; that believing could make you well. And people believe what they feel. But scientists need evidence. And there really wasn't any good, solid scientific evidence to prove these connections; nor was they're a good way to measure them. And scientists only believe what they can actually measure.

So it took another 50 years to develop those scientific tools, to really be able to prove these concepts to hard-core scientists. And so I would say that there was a real sea change in acceptance of these concepts, probably around ... somewhere between, 1996 and 2000. It was in that short window.

Even though the research was being done for the previous ten to fifteen years, more and more in neuroscience and immunology—it took a critical mass of really hard, solid, molecular and nueroanatomical studies, immunological cellular studies, to really prove to both of these disciplines—to the neuroscientists and the immunologists—that a) these connections existed; and b) that if you break the connections, disease results.

And once those two facts were established, the dam burst, and everyone accepted the notion. But there was a lot of resistance at first. And this field was kind of marginalized, and I think all of us felt it. Everybody doing research in this area felt marginalized, and, really rejected. We were not just ignored by our colleagues; we were laughed at, and rejected. And that hurt, actually.

How do I make a difference?

Well, I guess the thing that gives me the most passion is knowing that what I do makes a difference. That it makes a difference to people's lives in many different ways.

It's hard, you know, when you make a discovery—and I have made in my career three discoveries that I know have changed the way disease is viewed, or treated. But that's a very, very, abstract thing. It's really hard to say: "Okay, I've a discovery, and I know I've helped thousands of people, or millions of people." It's when you see the one patient that really has benefited from that discovery that you really know that you've helped.

You know, when the family can come up to you and say, "Thank you." You know, "You helped ... save my mother." That really makes a difference. And I think that's what motivated me from the beginning when I started seeing patients on a one-on-one basis, when you know that you've saved a life. And then if you make a discovery in the lab, in a rat, that you know can be applied to saving many lives—that really is tremendously rewarding.

So there are many different aspects of medicine that are wonderful and that I loved. One is interacting with people; one is seeing that you can really help them. There's nothing more gratifying than knowing that you saved a life. It doesn't happen very often in a medical career. I can count the number of times that I know I saved a person's life...I can count them on one hand. But when it happens, it is THE greatest feeling that you can ever have.

But there are other kinds of rewards that you get from different aspects of a medical career, and the research career, the day-to-day... what is involved in day-to-day research, involves really, detective work. Figuring out: How do I find the answer to this mystery, in a systematic way.

Who was my mentor?

My father was a doctor; he was a physician and a research scientist. My aunt is a professor of physiology at McGill University in Montreal. I grew up in Montreal. And so scientists and a physician surrounded me. I guess my father was my physician role model. And I took for granted the lifestyle of a physician-researcher-scientist, but I didn't explicitly think I wanted to go into medicine.

I remember the doctor's show at the time on TV was "Ben Casey," or you could also watch "Dr. Kildare." It sort of was the equivalent of "E.R." And I remember when I would think of myself as graduating from medical school, I kind of visualized myself turning into Dr. Kildare. So I think without realizing it, didn't have a female physician role model.

How has my career evolved over time?

I was trained originally as a rheumatologist. I actually started, when I finished my medical training, going into general practice, in Montreal. So I did all my medical training at McGill in Montreal, and then I went into general practice. I loved it. I loved seeing patients; I loved taking care of families, and children, and grandmothers, and seeing the whole family together, and helping them get through rough times.

But after about two year in general practice, I realized that I needed to know more about the diseases that I was seeing in most of my patients—and most of my patients had some sort of joint problem. Some arthritis, some aches and pains. So I went back and I trained as a rheumatologist; that is a specialist in different forms of arthritis.

And I was intending to go back and be the rheumatologist in the family practice clinic where I had worked; but in the last year of my residency I saw a patient who had developed a horrible scarring, very painful rheumatologic disease, where his arms were flexed, he couldn't extend them fully, and his skin was very painful—he had to have the bed sheets tented up over his legs, and he was really in extreme pain. And he had developed this rheumatologic disease while being given an experimental drug for a very severe form of epilepsy that he had.

Now, this patient was between a rock and a hard place, because he needed the drug to live, because his epilepsy was so severe, but he developed this arthritis kind of disease; and the question that was asked to me when I saw the patient was: Is this drug that's changing brain serotonin—that was what the drug did— is it causing this autoimmune inflammatory disease?

And so at that time, which was 1978 to 1979, I didn't know the answer to the question. There was no answer actually in the literature; and I realized that in order to answer the question, I had to do the research my self.

So it was in the course of doing that research, trying to figure out: how it is that changing brain serotonin can lead to, or be associated with an arthritis-like disease, an inflammatory disease, that I stumbled on the finding that then really changed the course of my research career.

So first of all, seeing that patient changed the course of my career. Because I was originally going to go into clinical practice seeing that patient completely shifted me onto a research career. Because in studying that patient, I began to realize that I loved the detective work that's involved in research.