Pulling Back the Curtain: Mary Horowitz, MD, MS

What was your first job?

Being the oldest of seven children, I had a variety of jobs when I was younger, but the first time I actually was paid for my work was as an aide working with children with disabilities. I started when I was 13 and continued through junior high and high school. In fact, when I went to college my plan was to major in special education and to teach children with learning disabilities.

When did you decide to pursue medicine?

I came from a different era: My parents didn’t think that women should work outside the home, and my father actually thought college was a waste of money for women. He also didn’t think women should drive, but my mother was having none of that – with seven kids, someone needed to get them where they needed to go! They weren’t too happy when I decided to go to medical school, but they knew by then that it was futile to talk me out of anything. Eventually, my father came around; I think I was in my 40s when he finally told me, “It seems to have worked out okay.” That was a huge thing for him to say! And, despite their objections, my parents did everything they could to help me throughout my training.

So, it wasn’t until I went to college that I realized there were many other opportunities out there – including science. One of my friends was a graduate student in biology, and I used to hang around his lab, asking him all sorts of questions about what he was doing. At one point he said, “Why are you going into education? You should go to medical school.” I thought that was a good idea, so I enrolled in an independent study program where I had many hands-on opportunities in the lab. The head of the program introduced me to his wife, Miriam Meisler, PhD, who was a molecular biologist at the University of Buffalo at the time. Meeting and working with her opened up a whole new world to me; that’s when I decided to go to medical school.

That experience, and her guidance, was transformative for me in many ways. First, I loved the science. Second, she was also the first woman I knew who had career ambitions and a family. And third, I ended up marrying her brother!

So, it was a lucky meeting all around?

It definitely was. We’ve been married for 42 years. And, actually, he’s a teacher. He’s retired now, but he taught young kids for 45 years.

The one word that describes my life is lucky. I have been incredibly lucky to meet the right people. I was also willing to take chances and to work hard, but I owe a lot to the people who have guided me down my career path.

That also led me to my work with the Center for International Blood and Marrow Transplant Research (CIBMTR), studying outcomes data for transplantations. It wasn’t what I planned to do when I finished my internal medicine training. I was working on my Master’s degree in biostatistics when Al Rimm, PhD, the statistician for what was then the International Bone Marrow Transplant Registry or IBMTR (we became CIBMTR in 2004 when we affiliated with the National Marrow Donor Program), asked if I wanted to work on the registry data for my thesis. That was in 1985, and I’ve been working with CIBMTR ever since. It was totally an accident, but it was the perfect job for me.

That was also when I met the person who was probably my most important mentor, Mortimer Bortin, MD, who was an immunologist and the first director of the IBMTR, which was established in 1972 – before the term outcomes registry was even invented and before there was a computer on everyone’s desk. It was an idea way ahead of its time. But there are many people who helped and guided me – too many for your page limit, I am afraid!

If you hadn’t gone into medicine, what career could you see yourself in?

I could have been happy doing a lot of things, as long as it involved solving problems. Becoming a doctor was undeniably the right choice for me because it combines working with people and solving problems. I truly am always grateful that I get up in the morning, and I am able to go to work.

As a division chief at Medical College of Wisconsin, I don’t do as much clinical work as I used to, but a problem presents itself every day; I love that. Growing up as the oldest daughter in a seven-kid, Irish–Italian household prepared me for my role as division chief, and in a way, I guess my mother is my first mentor. I helped her take care of the younger kids while I was still a kid myself. It was a constant state of controlled chaos, but somehow she made sure that everyone did what they were supposed to and got along – much like a division chief does!

How do you maintain a work-life balance?

Because I started having a family at the same time I started my career – our oldest son was born eight weeks before I started medical school – I integrated them from the start. I didn’t think of it as “work-life balance,” which suggests that work is something different from life. These are all just different aspects of your life, and on any given day, one gets more attention than the other. That equation changes at different times in your life, and it’s different for everyone. It has to feel right to everyone, though – to you and to the people who are depending on you.

We have three children: our oldest son, our daughter who was born after my internship, and our youngest who was born 10 years later. When people hear that I had a baby during medical school, they’re stunned. They think it’s impossible. But having our youngest son after I had established my career was actually more difficult. First of all, with our oldest, I was young and filled with energy. Second, as a trainee, when you walk out the door, someone else takes over; once you’re in charge or have patients, you can’t just hand them off.

It’s not for everybody, but I have a wonderful husband, and we never argued about dividing up jobs or responsibilities or anything – whoever was there did what had to be done. It worked for us.

I always followed one rule, though: We had to eat dinner together. No matter how much work I had to do, I was strident about being home for dinner.

What do you do in your spare time – if you have any?

Our oldest son has two kids now, so I love to be with my grandchildren.

Typically, if I’m given a choice for what to do on a weekend, I’ll get on a plane and go somewhere. I love to travel, and through my work at the CIBMTR, I’ve had the opportunity to go to some fantastic places. Every place is unique, but if you said, “Tomorrow, you can do anything you want to do,” I think I’d walk around Paris.

Traveling for work lets me meet new people in the transplant community, as well. Transplanters are a relatively small, international community. It is a wonderful thing to be able to meet and work with people from all over the world.

What is one thing that most people don’t know about you?

Public speaking is one of my biggest fears. It’s the only thing that nearly drove me out of academic medicine. When I first started, I was petrified of public speaking. If I had to present an abstract or give a talk, I would practice and study for a week before I actually had to speak so I was completely over-prepared. It took me years to get over it. I still get a little nervous before a talk, but nothing like when I was younger. I wasn’t ever terrible at public speaking, but I was convinced that it was going to be awful every time I took the podium.

What was the strangest interview you’ve been on?

The first person I interviewed with before medical school spent the entire time telling me why women did not belong in medical school, including that they would be taking a job away from man. As we finished the interview he said, “Well, I won’t hold it against you.” I was nervous and scared, but anyone who knows me knows that I couldn’t let it go, so I said in a very meek voice, “Well, that would be illegal, wouldn’t it?”

My next interview was with the nicest man in the world, who ended up as my attending when I was pregnant with our second child, during my internship. But on our first interview, he did ask me what my husband thought about me going to medical school and if I – who was eight weeks pregnant at the time – intended to have a family. He didn’t ask me when, so I just said, “Yes, I intend to have a family.”

What advice do you give to mentees or trainees?

There are two things I think all trainees should know: Learn to write and ask for help. Writing is so important in academic medicine, yet, when we complete our fellowship training, while everyone knows how to take care of patients, few know how to write well. I tell young trainees: “Make yourself write something every day, until it becomes second nature.” You could have the best idea in the world, but you have to be able to present your ideas so that other people can understand and appreciate their importance. A well-written grant proposal could mean the difference between your great idea being funded or just remaining a great idea.

I also see that young people don’t ask for help because they are afraid of criticism – criticism of their ideas, their approach, their writing. They spend so much time trying to get everything perfect before they run things by their friends and mentors, that they lose valuable time. All I can say is “Get over it!” Better to get criticism early from friendly advisors than from grant or manuscript reviewers!

At this stage in my career, I enjoy mentoring and helping young faculty. The people I work with have talent and drive and persistence, and it’s amazing to see what they can do with a little push and guidance. The best part of my job is seeing one of my faculty members achieve something they’ve worked so hard for. I just had a young faculty member receive his first R01 grant, and I was so happy I thought my face was going to split from smiling so much.