What was my biggest obstacle?
The biggest obstacle was the lack of a role model. There was no one in my family or close to me that had ever gone beyond high school. I came from Puerto Rico at age 5 with my uncle while my mother was already in New York and planning to return after making some money as a seamstress. My arrival put an end to her plans to return and soon my father and other brother followed. We never knew we were poor because we had food and clothes and very hard-working parents. They encouraged us to do well in school, but as the oldest, I felt that I could not take eight years of financial support from my parents, and I did not know how to go about getting loans or scholarships. I also did not feel that I was smart enough. So there were lots of obstacles which were probably self-created, although there was still a bit of a societal bias against women entering medicine at that time.
How do I make a difference?
The greatest difference that I feel that I make is in being an advocate for health care and education for women, especially women of color. I am now in a position where I can make changes in both the delivery of care to women and in the education of future physicians. As a faculty member of a medical school and of a residency program, I am able to teach about cultural and linguistic competency and as chief of the department I am able to set standards for care and to review the care given with an eye to improvement in the quality and to adherence to the standards.
As a hands-on physician I get the greatest joy and satisfaction out of being able to be part of a family's life and death decisions. It is a real privilege to be able to be with women as they are having their babies and to make a difference in how they are treated. I can be there to greet the baby and welcome him or her to life, and I can help the parents to prepare for the new arrival. When my patients are sick or require surgery I am there to provide counseling and to actually provide the care needed.
As I have become more involved in organized medicine and the state and local governmental agencies, I have become more aware of the impact that involvement makes in the availability of services to the poor. Issues such as access to care and the impact of poverty and race on health care are a fact of life in our country and it is important that those of us who are aware of the issues to be part of the leadership making the decisions for health care. I am a member of the board of the union at the health center where my parents still receive care, and at the state level I am on the board of the New York State Academy of Family Physicians. In those groups I am often the one to bring up the issues related to cultural competency and to the problems of the underserved. Sometimes it creates an environment of change when one raises the issues and finds a voice to say the things that need to be said.
Who was my mentor?
My most influential mentors are my parents. They have always been outspoken about the issues and fought really hard for me to do the right things in my life. At times when I have deviated they have pointed this out, sometimes not so gently, and it has kept me on the path. They have been there to support me when I needed help with my two children as a medical student and as a physician in training, and they are still my best fans and worst critics.
Family has been very important to me by enabling me to do the things that I have done. My children are supportive and have tolerated my absence and lack of involvement during very difficult times for all of us. They say that they are not interested in medicine as a career because of how hard they see us working. My husband, who is a pediatrician, still holds on to a hope that Adrian, one of our youngest, will decide that he will do it after all.
Others that have been important include Herbert Kohl who was my cousin's teacher in the 1960s and took time out to gather all of us kids on the Upper West Side and take us on outings and teach us the rules for chess. He was a sounding board for some of my goals and ideas as a teenager and helped me to make career decisions when the time came.
I have been fortunate that in every stage of my life there have been friends and colleagues who have been able to serve as my counsel and my listeners. In my early career days I worked with a very creative and innovative group led by a strong and goal-directed physician, Arnold Lewis. He served as my mentor during that time and encouraged me to continue my education and to begin work towards my Bachelor's Degree. I listened and learned from him and he gave me the opportunity and flexibility in my schedule to attend school and still fulfill my work responsibilities. By the time I was ready to leave that position I had completed most of the work towards my master's degree.
At Medgar Evans College as a new assistant professor of nursing, I met a strong group of professional women including Bertie Gilmore and Norma Johnson who encouraged me to dream big and to go after my dream of becoming a doctor.
In medical school my friend and mentor was a fellow student with three kids instead of my two, Norma Villanueva. It is hard to imagine that I would have made it through without the strength and support that we gave each other. A bond grew from those years that made us more like sisters than friends.
There were not too many Hispanic women role models, but we were privileged to have two at Albert Einstein in the Bronx, Helen Rodriguez-Trias and Sylvia Ramos, both on the faculty and both advocates for the inclusion of Blacks and Hispanics in Medicine. I learned to be outspoken about those needs and about the needs of patients in our community from listening to them teach and give local and national lectures on the issues.