Throughout her career as a physician and academic leader, Marjorie Sirridge, M.D., became a trailblazer, setting a standard of success for women that is seen today at the UMKC School of Medicine.
A group of the school’s leaders talked about following Sirridge’s path in presenting a tool kit for success on Thursday at the annual Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lectureship.
The panel included Mary Anne Jackson, M.D., interim dean, Rebecca Pauly, M.D., associate dean for faculty development, Brenda Rogers, M.D., associate dean for student affairs, Jill Moormeier, M.D., chair of internal medicine, and Scott Ellison, a local surgeon.
Stefanie Ellison, M.D., associate dean for learning initiatives, served as moderator and opened the discussion with her husband, Scott, discussing the need for a strong support system.
The other panelists followed with brief talks on wellbeing, making strategic choices in career advancement, defining success and self-advocacy.
Jackson drew on her experience as a medical student in Marjorie Sirridge’s docent unit as she spoke on self-advocacy. She shared her own list of lessons learned from Sirridge such as to think boldly, to follow one’s passion, stand with pride and be relevant, and to be a mentor.
“Remember that what you do for yourself as a self-advocate and for each other as other advocates will impact not just your own career but the careers of others as well for generations to come,” Jackson said.
Brian Carter, M.D., serves as the William T. and Marjorie Sirridge Professor in Medical Humanities. Carter began the lectureship by recounting the works the Sirridges accomplished and the high standards they set during their tenure at the School of Medicine.
The Women in Medicine lectureship was established in 1997 in recognition of Sirridge’s dedication, compassion and advancement of patient care and medical education. Sirridge was one of the School of Medicine’s founding docents and later served as dean. She and her husband, William, endowed the Sirridge Office of Medical Humanities, now the Sirridge Office of Medical Humanities and Bioethics, in 1992.
Former UMKC School of Medicine docent and Humanities Department namesake William T. Sirridge, M.D., was a master at connecting with patients, including in their final days.
So it was fitting that this year’s medical humanities lecture endowed in Sirridge’s name was titled “How to Conduct a Good Death.” Gary Salzman, M.D., a 1980 graduate of the School of Medicine, delivered the lecture March 22.
“William Sirridge was my docent and mentor and taught me many things not published in books,” said Salzman, himself a faculty member, docent and Truman Medical Center physician since 1985.
Sharing a half dozen stories about patients at the end of their lives, Salzman told the lessons he had learned from Sirridge and how they had played out in his career. The most important lesson focused on how to connect with patients.
“As we bring more and more technology into medicine, we become less and less able to connect with patients,” said Salzman. “Connecting with patients is as important today as it was 40 years ago when I was in medical school.”
Salzman first told two stories of how, as a student, he had failed miserably in dealing with a patient’s death. In one case, he was ill prepared and “got it all wrong” telling a woman over the phone that her mother had just died at the hospital.
In the other case, he had prepared a case for presentation by examining a woman with a classic case of scleroderma, studying the medical literature on the woman’s dire condition and working up a detailed treatment plan. But he had left out the human element, and was unaware that Sirridge had already tried the recommended treatments – which all failed. Instead, Salzman learned Sirridge was helping the patient and her three daughters take the necessary steps for the woman to die peacefully at home.
“He looked over his glasses and said to me, ‘Salzman, do you know how to conduct a good death?’ ”
After those two instances, Salzman said, he dedicated himself to listening, watching and learning from Sirridge and other veteran physicians. He saw that Sirridge’s skill at connecting with patients had three parts:
Physical touch. A gentle hand on a patient’s arm could be “more powerful than morphine.”
Common interests. Finding and sharing commonalities with some humor mixed in.
Direct and honest conversation.
As Salzman practiced and applied those principals over the years with dying patients and their family members, he began to learn how to conduct a good death, and to pass his lessons on to colleagues, residents and students.
Salzman recounted his education and evolution through cases that took him from trying to do too much for dying patients, to pushing too hard for removing life support. He told of one patient who, after being taken off life support, woke up, looked at him and said, “I need a beer!”
He found equilibrium by listening deeply, respecting patient and family wishes, and then doing his best to find a balanced course of action.
In one case, a hospice patient who recently reunited with his estranged spouse desperately wanted to live and have more time. Salzman, though skeptical, went with the man’s wishes and got him out of hospice and back home with a portable breathing unit. “Eight years later, he still sings my praises as the man who saved his life,” Salzman said. “I just listened to his wishes.”
And for patients “who want you to do everything,” Salzman said, “I tell them, ‘Let’s do everything that will help you, and nothing that will hurt you.’ ” Through that lens, he said, appropriate individual plans can be worked out for each patient.
Salzman closed with a case in which a sixth-year student got to know a patient with severe pulmonary fibrosis and her daughter. They were having trouble letting go even though the patient’s essential life-support mask, not meant for long-term continuous use, was causing her more and more pain and skin deterioration. Eventually, the student was able to describe what would happen if life support was removed, and what medicines would be used so the woman could die comfortably. Eventually, they agreed to remove the mask, and the mother died in peace.
“The student told me she determined the best way to connect with this family was to sit quietly, to just be present while watching television. So she watched ‘Ellen’ with them, most afternoons for two weeks.” Salzman praised the student on her outstanding work
“I told the student that I had a story that I wanted to tell her. It is about a man she never met but influenced her education. It is a story of my docent, William T. Sirridge, and a question he asked me a long time ago: ‘Do you know how to conduct a good death?’”
The lessons Dr. Sirridge taught on connecting with patients and conducting a good death learned by Salzman are now being passed on to current students. And, according to Salzman, these students will carry on, teaching these skills to their students and continuing the legacy of Dr. Sirridge long after his death.
At the Penn State College of Medicine, Michael Green, M.D., a physician and bioethicist at Penn State University’s Milton S. Hershey Medical Center, uses the medium of comics to help medical students share their experiences of medical school.
Each year, Green, who is also the vice chair of the Department of Humanities, offers a seminar-style class in which students are encouraged to create their own comic book to describe their time in medical school.
Green presented the 23rd William T. Sirridge, M.D., Medical Humanities Lecture on Thursday, March 16, at the UMKC School of Medicine. He described how comics have become mainstream in today’s culture. He said today’s comic strips and entire comic books touch on almost every topic in all genres.
“So it’s not surprising then that there would be some comics that have some relevance to medical education as well,” Green said.
That has led Green to offer a four-week course in Graphic Medicine, an Intersection of Comics and Medicine. And while a large number of his students’ comics describe and depict good experiences as medical students, one serious theme has surfaced: medical students being mistreated by their superiors.
Such experiences are supported by data from the Journal of the America Medical Association, which found that nearly four out of every 10 students surveyed say they have experienced mistreatment in medical school. Only half say they report it, out of fear of retribution.
According to Green, these numbers have remained consistent in surveys taken throughout the past five or six years. And the data is relevant, he said, because it goes on to show that those who experience mistreatment as medical students have twice the rate of burnout as other medical students.
“It is something we should care about and think about,” he said.
Physicians in obstetrics and gynecology continually face complex, evolving ethical questions, and they need thoughtful processes and diverse support to make their best decisions.
That was the message of Susan M. Mou, M.D., an associate professor in the School of Medicine’s Department of Obstetrics and Gynecology, who delivered the Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lecture on Sept. 15 at the school.
Mou started her address, “Ethics in Reproductive Medicine,” by saying she was a general obstetrician/gynecologist and “not a bioethical scholar.” Rather than offering answers, she wanted to share what’s going on “in the trenches” and get students thinking about ever-present ethical issues.
Mou said such issues and questions had existed throughout her career, starting with her residency at the University of Rochester, when steroid use for likely premature deliveries was relatively new. The questions have kept changing, she noted, with advances in many areas, from in vitro fertilization and reproductive endocrinology to HIV treatment.
Such questions often involve weighing possibly competing interests, Mou said, such as fetal health versus maternal health, or a mother’s autonomy and emotional needs versus what appears best for her physical health.
Difficult pregnancies make for difficult questions, such as when a fetal condition makes a live birth unlikely, and interventions to promote live birth might not be in the mother’s long-term health interests. But physicians must consider whether to take those steps, and how far to go with them, Mou said, when the mother has expressed a great desire for the chance to hold her live baby.
According to Mou, the models for evaluating such questions also have evolved, so that a woman’s culture and living conditions and communal network can be considered, along with traditional principals such as autonomy, justice and beneficence.
Treatment and care can be more effective, for example, when they account for barriers such as transportation and work schedules, rather than judging a woman for missing neonatal care appointments. Mou also said approaches that see care for pregnant women as the best way to also care for their developing fetuses can overcome past perceptions of conflict between maternal and fetal well-being.
The growth of bioethics studies and decision committees has resulted in practicing physicians getting more help and support in making the toughest calls, Mou said.
“We need to be aware of ethical principles and practices. We need to utilize ethics committees and other resources. It’s so important to have the Sirridge Office of Medical Humanities & Bioethics” at the School of Medicine.
Though Mou claimed no credentials as a bioethicist, she has been a leader in women’s health teaching and treatment for more than three decades.
She is the director of the Breast Clinic and OB Simulation for Truman Medical Centers, and has special interests in general obstetrics and gynecology, pediatric and adolescent gynecology, peri-menopausal issues, vaginitis, and infection disease in obstetrics and gynecology.
Her Sirridge lecture followed more than 90 presentations she has given from coast to coast, including Milestones and STI Lectures at UMKC. Mou’s more than 60 publications include research studies, book chapters and abstracts. She provides peer review for the Journal of Maternal-Fetal & Neonatal Medicine and for abstracts for the American College of Obstetrics and Gynecology.
Mou began teaching at the School of Medicine in 1984. She was director of the school’s residency program in obstetrics and gynecology with Truman Medical Centers and Children’s Mercy Hospital from July 2012 to September 2014. Mou was section chief for gynecology surgery at Children’s Mercy in the 1990s.
Several members of the Sirridge family attended the lecture this year. The Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lectureship was established in 1997 to recognize Dr. Sirridge’s dedication, compassion and advancement of patient care and medical education in Kansas City.
When Julie Freischlag, M.D., was only 6 years old, she skipped first grade … and got a few words of advice from her grandfather.
“He told me at that time that people are going to say you can’t do this, and you’re going to tell then that you can,” Freischlag said.
As the keynote speaker for the 18th annual Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lecture on Thursday, Sept. 10, Freischlag talked about resilience and how she has spent a lifetime rising above the stacked odds to become a surgeon and role model for women in medicine.
She currently serves as dean of the school of medicine and vice chancellor for human health sciences at the University of California-Davis.
While in college, Freischlag opted to go to medical school rather than become a high school biology teacher when the college closed its education program, believing it was producing too many teachers. She entered Rush Medical School with the idea of becoming a pediatrician. During her clinical rotations, Freischlag discovered her passion for surgery and decided to become a surgeon instead — a rarity for women at the time.
When she attended her surgery residency interview at the UCLA medical school in 1979, she was the only woman in the audience.
“Today, there are many women,” Freischlag said. “About half of our candidates for surgery are women, now.”
Throughout her career, Freischlag continued to smash through the glass ceiling for women, becoming just the second female vascular surgery fellow at UCLA and only the sixth woman in the country certified for vascular surgery. She became the first woman in the vascular surgery division at University of California-San Diego; the first woman chief of vascular surgery at UCLA; the first woman to achieve the rank of professor of surgery at the Medical College of Wisconsin; and, eventually, the first woman chair of surgery and the first woman William Stewart Halsted Professor of Surgery at Johns Hopkins. She is also the first woman to chair the Board of Regents of the American College of Surgeons and the first woman president of the Society for Vascular Surgeons.
During her 11-year stay at Johns Hopkins, Freischlag was the only woman to chair a clinical department.
“It really was a concrete ceiling,” she said. “There were a lot of chances that I took with that job and getting there. And a lot of people took chances on me.”
Freischlag currently oversees academic, research and clinical programs in the UC-Davis Health System that include the schools of medicine and nursing, a 1,000-member physician practice group, and the UC Davis Medical Center.
She said that women in medicine should no longer be invisible, and that more women need to be encouraged to enter the arenas of medicine and science.
“The key ingredient is resilience, that ability to bounce back,” Freischlag said. “Resiliency transforms us.”
Julie A. Freischlag, M.D., dean of the school of medicine and vice chancellor for human health sciences at the University of California-Davis, has been selected to present the annual Marjorie S. Sirridge, M.D., Outstanding Women in Medicine lecture. Her presentation will take place at noon on Sept. 10 in Theater C at the School of Medicine.
Freischlag, whose lecture topic will focus on “Resilience,” is recognized as a prominent leader among academic health centers in the United States, having led education and training programs at top medical schools for the past 15 years. In her current role at UC Davis, Freischlag oversees academic, research and clinical programs that include the school of medicine, the Betty Irene Moore School of Nursing, a 1,000-member physician practice group, and the university’s medical center.
Prior to joining the UC Davis Health System, Freischlag was chair of surgery and surgeon-in-chief at Johns Hopkins Medical Institutions. In those roles, she spearheaded initiatives to expand research, add specialty clinical services, and improve patient care and safety.
On a national level, Freischlag has served as a former governor, secretary of the Board of Governors, regent, and immediate past chair of the Board of Regents of the American College of Surgeons. She is also the immediate past president of the Society for Vascular Surgery and a past president of the Society for Vascular Surgery Foundation.
A prolific author, Freischlag has more than 225 publications and is recognized internationally as an expert in thoracic outlet syndrome. She has received numerous teaching and achievement awards, has been named a “Top Doctor” by Baltimore Magazine, and was selected as one of the “10 most powerful moms in health care” by Working Mother Magazine.
Freischlag’s research activities include a prospective trial tracking more than 800 patients from 34 Veterans Affairs Medical Centers throughout the country to compare outcomes among open and endovascular repairs for abdominal aortic aneurysm.
The Marjorie S. Sirridge, M.D., Outstanding Women in Medicine lecture is open to students, faculty, alumni and staff.
Daniel Hall-Flavin, M.D. ’79, associate professor of psychiatry at the Mayo Clinic College of Medicine, will present the William T. Sirridge Medical Humanities Lecture at the School of Medicine at noon Thursday, March 26.
Reached by phone at the Mayo Clinic, Hall-Flavin said he planned to speak about the search for and meaning of mercy. He titled his lecture The Quality of Mercy, a nod to Shakespeare’s The Merchant of Venice. Hall-Flavin said he vividly recalls being a candidate for the B.A./M.D. program and seeing the famous passage from the play (“The quality of mercy is not strain’d/It droppeth as the gentle rain from heaven”) inscribed above the entrance to General Hospital No. 1.
“I remember at 17 looking at that and just stopping,” he said. “It just grabbed me. It was something that I’ve thought about frequently since then.”
Preserved when the hospital was torn down, the frieze stands outside Truman Medical Center. Hall-Flavin said the marker is more than a vestige to a building that that no longer exists. “I think it’s really kind of a daily reminder to everybody who walks through those portals of what a critical role mercy and all that it carries with it plays in our daily practice,” he says.
After graduating from UMKC, Hall-Flavin interned in internal medicine and trained in adult psychiatry at the Mayo Clinic. He completed a fellowship in chemical dependency at Cornell University. Board-certified in addiction psychiatry, he is involved in research that seeks to identify factors, including genetic factors, which render an individual susceptible to addiction and relapse. He also studies responsivity to antidepressant medication.
Hall-Flavin said he is at a point in his career where he is able to begin to cut back on his duties at the Mayo Clinic. He hopes to use the extra time to pursue his interests in the medical humanities and bioethics. He recently applied to a master’s program in the medical humanities at King’s College in London. A frequent traveler to England, Hall-Flavin has been a visitor at a center for neuroethics at the University of Oxford and is a member of the Oxford Round Table, an American-led educational organization.
Hall-Flavin said his interests in the medical humanities and bioethics are “a natural extension of how I was trained.” His docent was the late Marjorie Sirridge, M.D. Sirridge and her husband, William Sirridge, M.D., who died in 2007, worked to increase the opportunities for UMKC students to study humanities and bioethics and eventually established the Sirridge Office of Medical Humanities and Bioethics. The William T. Sirridge, M.D., Medical Humanities Lectureship was established in 1994.
Hall-Flavin said he met with Marjorie Sirridge in early 2014, a few months before she died. “She asked me to consider doing the lecture,” Hall-Flavin said. “I said it would be an honor.”
From the beginning more than 40 years ago, women have played major role in the history of the UMKC School of Medicine, said the School’s Dean, Betty Drees, M.D., on Sept. 18 as the speaker at the annual Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lecture.
Drees shared a quick review of how women from Sirridge, who served as a founding docent and as dean, to many of today’s graduates have had a hand in shaping the School into the successful academic medical institution it has become today during her lecture, “Women of the UMKC School of Medicine over four decades.”
“They were connectors. They were mavens. They were sales women,” Drees said. “And I think they are part of who we are today, and it’s not by accident that we are here today as we are today.”
Drees joined the School of Medicine as Associate Dean for Academic Affairs and was appointed interim dean of the medical school in 2001. She was named the permanent dean in 2003 and will step down from that role on Oct. 1.
“I owe the opportunity I had here to Marjorie Sirridge,” Drees said.
Drees said she drew the inspiration for her lecture from Sirridge’s passion for story telling and for championing women in medicine.
Throughout her talk, Drees recognized many of the women who have made a notable impact on the School since its inception in 1971, such as Virginia Calkins, who served as the School’s first assistant dean for students and who played a large part in increasing the number of women students who enter the School to nearly 50 percent by 1979. Today, just less than half of the School’s 3,241 alumni are women.
“I believe women were very important in moving us from where were to where we are now,” Drees said.
She also shared how the number of women among the School’s faculty has grown to 47 percent of the current faculty and how many have taken on leadership roles including five current academic department chairs as well as women leading a number of School’s academic programs.
“We have women who are continuing to bring on new programs and be leaders in those programs,” Drees said.