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MT: Today, I'm here with Dr. MT: Dina Mody, who's the medical director of the Cytopathology Laboratory at Houston's MT: Methodist Hospital, as well as a professor of pathology and laboratory medicine at the MT: Medical College of Cornell University.

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MT: Dr. Mody, thank you so much for this opportunity to speak with you. DM: Thank you. Pleasure. MT: So, we'll start kind of from the beginning and just go from there. MT: You're originally from Dahanu, India.

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MT: Could you speak a little bit about when and where you were born? DM: So, I was in Bombay. DM: I was born in what was then Bombay, India. DM: My parents actually lived in a village called Dahanu, and it was about 100 miles

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DM: north of Bombay, along the western shores of India. DM: And as soon as I was born, they took me back to my village and I spent my first five DM: years on the farm over there. DM: And then, since there were no English medium schools in the village,

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DM: the—everybody sent their kids either to boarding schools or to stay with a DM: relative in a bigger city where there were English medium schools. DM: And so, at the age of five, with much fanfare, I boarded my bullock DM: cart and off to the railway station I went.

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DM: And then from there on a steam engine to Bombay where I DM: went and stayed with an aunt, my dad's sister, and went to a Catholic DM: school. And from kindergarten through high school DM: it was right across the street from my house and think they gave me a very good education.

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DM: And then college and medical school was all in Bombay at GS. MT: Wow. Okay. So, do you have any, like, specific vivid memories or stories that you MT: have from that time or any difficulties, like, especially moving away for MT: school?

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DM: Well, yeah, I cried every time, and so did my sisters. DM: My older sisters were in boarding school, but they were much older than I am. DM: And so, every time we—the holidays ended, you know, we had six DM: weeks in summer, three weeks in October for Diwali, and then a week in December for

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DM: Christmas. And then every time we had to get back on the DM: train, there was an uncle who took us to our destination. DM: We would cry and try to postpone it by a day, but hey, you know, it is what it is. DM: As a kid, it's hard.

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DM: But, you know, you cry for a couple of days once you get back DM: to your destination and then you get over it. DM: You wait for the next holiday. MT: Wow, yeah.

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MT: So, what were your parents like? MT: What were their occupations? DM: So, my parents, you know, they were farmers and DM: horticulturists. They had orchards.

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DM: They grew a fruit called chikoo. DM: And of course, back then in India, if you had land, you also had to grow rice and wheat DM: and sell it to the government. DM: So, that's what they did,

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DM: they–they–they lived there, DM: and it was a simple little village life. DM: Now the village is the last stop on the commuter rail from Mumbai. DM: So it's no longer this village.

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DM: Last time I was there, it was like a Bombay suburb, DM: and it's lost its charm. DM: But I have some very happy memories of all the kids getting in the DM: bullock cart and going to the beach.

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DM: And the only instruction we got was don't touch the DM: jellyfish. And there were like 15 of us in the bullock cart, okay? DM: And one person supervising—all he did was a head count. DM: And guess what we did?

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DM: We touched the jellyfish.[laughs] MT: I imagine it would be hard— DM: Don't touch the crab! DM: Guess what the boys did?

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DM: They got the crab. So those are happy memories. DM: We're all dispersed all over the world. DM: Some are still there, some are in Australia, and I'm here in the DM: US. So is my sister, and one sister is still there on the

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DM: farm, but it's no longer a farm. MT: Those sound like wonderful memories. MT: Can I ask what kind of values your parents emphasized to you, religious or MT: otherwise, and how did those values sort of shape your current philosophies and maybe

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MT: your approach to work? DM: So, you know, I'm one of those ancient Zoroastrians, the world's DM: oldest religion, and it was very simple. DM: It's more a philosophy on how you live your life.

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DM: So, it's good thoughts, good words, good deeds and DM: respect—There's one God and we are all God's creations, and you have to DM: respect all of God's creation, living and the non-living. DM: So, in other words, you got to respect the animal kingdom, the fish kingdom, the bird

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DM: kingdom. You got to respect the water, the fire, the whatever. DM: They're known as fire worshippers, but that's just a symbol of showing appreciation DM: to God. But these are all God's creation. DM: And now, when you think about it in the current context of climate change and

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DM: what is going on—this is an ancient religion like 4000, 3000 DM: years old—and back then, they were talking about respecting all of God's DM: creations. There's no–there is no DM: prophet or gods or goddesses that we worship.

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DM: But when my ancestors came DM: to India as refugees, they were given refuge on the condition DM: that they followed—they blended into the Indian customs. DM: So, they adopted many of the Indian customs, but it's not like we worshiped

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DM: them, but if there's a Hindu festival and it involves eating, hey, we're there. DM: [laughs] MT: That's amazing. DM: Yeah, if it involves food, my community, we're all in.

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MT: I'm going to skip a little bit and we'll come back to family, but I'd like to talk MT: about—So, from your CV, I understand that you did a residency at a hospital in MT: Bombay before coming to the Baylor College of Medicine in Houston in 1981. MT: [DM: Mhm.] Was that the first time that you came to the US, and why did you come to

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MT: Houston specifically? DM: Well, so I—yeah, it was my husband. DM: So, my husband got recruited when he finished his master's in engineering DM: at the University of Oklahoma.

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DM: He was recruited by the recruiters that go to the campus. DM: And of course, he didn't really have any major opportunities in DM: India. So, when this company, which is part of Schlumberger now, offered him a DM: position in Houston, he took it and they sponsored him.

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DM: They got him to Houston. And that's how he ended up in Houston. DM: And although the families knew each other, our meeting was more like a blind date. DM: I was already doing my residency and he was visiting and the DM: two sisters schemed to introduce us

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DM: or—I didn't know. DM: But anyway, the long and short of it is he proposed to me after DM: a week, and a week later we got married. DM: And then I was like, okay, we applied and oh, the papers will take 2 or 3 years.

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DM: So, I said, “Great, I'll finish my residency, take my boards and then come and DM: do my subspecialty here.” Well, there was a new DM: president in the US and they had changed—whatever—anyway, my papers DM: came in seven weeks and I had to literally drop everything

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DM: because, you know, you don't have the option of saying, "Oh no, can you wait for three DM: years?" Oh no, no, no, that doesn't work. DM: It's now or done. DM: And so, I had no choice, I came here and when I got here,

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DM: it was May. DM: And of course the–the residency match had already DM: ended in March and the next one was not till next match. And so, I thought, well, I was studying—I'd already taken the

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other exam, the TOEFL and the ECFMG but I was working on the Texas board exam which you could do in those days, right after you got here. So, I was working on that and I said, "Well, time to pick up the applications for the residency," and this was pre-computer—remember, this is 1981,

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it's pre-computers and all, so you actually ask for the form or you went and picked up. So, my husband dropped me off in the medical center barely three weeks after I got here, so it was, like, the first week of June. And I went to UT, picked up the form, went to Baylor and picked up the form.

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And as I was picking up the application form, I heard these two admins talking about an opening. I said, ”Hey, there's an opening?” And they said, "No, no, no, it's not in internal medicine, it's in pathology." And I thought to myself, Well,

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I'm going to be sitting at home for a year, probably getting pregnant, might as well do something and learn something. So, I said, "Hey, you know, I'm going to be sitting at home for a year, can I apply? I'd rather do something rather than be bored at home." And they said,

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"Oh, no, you got to go to Methodist. That's where the program director is." So, I huffed and puffed my way to Methodist. The program director had just left. It was 5:05 when I got here.

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And the admin was leaving and she said—so, I gave her my phone number, I said, "Well, I'm available, I've got my—" She said, "Sure, sure, sure, sure." And then I waited. My husband picked me up at 7:00. I thought, "This is a nice hospital.

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This is really nice compared to King Edward Memorial," where I was training in those days King Edward Memorial in Bombay, we call it KEM, which was the main hospital for my medical school, it was a 2500 bed Bombay Municipal Hospital. And they had a 24/7 autopsy service

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because of the religious laws there at the medic—you know, the medical examiner's office. But anyway, I thought, “Hm, this is a really nice place.” And of course, I didn't know at the time that this is where Michael DeBakey and Earl Stanley Crawford basically revolutionized and invented cardiovascular

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surgery. Had no clue. Clueless as a clam. Anyway, I went home. Next, I told my husband what happened, and great.

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Next day I got a call from the program director and he kind of talked to me on the phone and I was honest with him. I said, "Look, I was a medicine resident, I'd like to do medicine, but I realize what —" "Sure, well, let me talk to my—we have an opening, but we understand your situation."

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I said okay. "And I'll call you back, depending on what we decide." Calls me back two days later and says, "We've decided to interview you." I said, "Okay." I didn't own a suit, I didn't have a driver's license [laughs]. So, I wore whatever dress I had and showed up for the interview.

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And there were 13 different people who interviewed me, and everyone asked me the same question, "Why do you want to be a pathologist?" I said, "Well, actually, I want to do internal medicine, but here's my situation. I'm going to be stuck at home doing—studying for this exam, maybe getting pregnant." I'd

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rather work and learn something different. It was never on my radar. And I said, "I'll apply in the meantime." And I told everyone the same thing. It didn't even occur to me that I should lie or, you know, sugarcoat it and—oh, how

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wonderful pathology is. And they said, "Okay, we'll let you know. And then three days later, they called me and said, "You can start July 1." I still don't have a suit.

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I still didn't have a driver's license, but I got here. My husband would drop me off early morning and then I used to take the bus because we used to live in Spring. It took me an hour and a half each way, so I would start at like 5:30 in the morning

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on the bus and then I would change the bus in downtown, and make it to the medical center on the other bus, to be here by 7:00. But I did that, and we did that for nine months and applied to medicine, got my interviews. Then, in December, I got a call from the program director of

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medicine saying, "Hey, you know, we have an unexpected opening. You can transfer into medicine and you don't have to go to the match." And by then, I was beginning to like pathology because I actually had a life, and it was very different from what it was in India.

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And I said, "Well, let me talk to my husband." So, we talked and I said, "Really I'm torn, I don't know what to do." And so he –he said, "Tell them no, just not. Tell them you'll just go to the match and we'll think about it." And so, I said,

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"I don't think I'm going to take this. I'm beginning to like cyto—pathology," and–and the rest is history. I–I was used to working like a dog as an internal medicine resident.

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So, when the residents here complain that, "Oh, we were working till 6:30 doing this," I was like, "What are you complaining about?" I was used to working till 10:00 at night. I had to live in the RMOs quarters, which is the resident medical officer's quarters. And then you're up at four in the morning drawing blood because we didn't have

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phlebotomists back at King Edward Memorial back then. So, needless to say, I was quite productive in my spare time. I did projects with the professors and they were quite amused—amazed

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that within three months of getting there, I had an abstract at the United States Canadian Academy of Pathology meeting, which, you know—so, I didn't know all that, I just did my thing.

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And I, as a pathology resident, I had to go on rounds and, you know, 6:30 in the morning, pediatric rounds at Ben Taub and some kid with diarrhea, and every day the kid still had diarrhea, and they were thinking of Crohn's and all the

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illnesses and said, "How about amoebiasis?" And they looked at me and they said, "We don't have amoebiasis here." I said, "Well, sure looks like it." Two days later, the kid ruptured the colon, they took to surgery. Guess what it was? Amoebiasis.

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They all thought I was so smart. I was like, "well, I saw a lot of that. I had amoebiasis. I know what amoebiasis looks like."

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So, it was just, you know, I just put what I learnt over there and—and I have to say people were very accepting. They–they kind of saw me and they were like, This is a strange bird, where is she from?

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And then they would ask me, "Where are you from?" And I would say, "I'm from India." And they said—well, then they'd say, "Oh, well, you don't look Indian." I'm like, "Well, India has all kinds and I'm one of them." So, you know, we already had, like, four, five generations in India, so we were

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refugees to India. MT: That sort of leads into my next question, which is, was there any significant like MT: culture shock or discrimination or unfair treatment that you felt when you first moved MT: here?

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DM: Well, add—well, actually, having spent DM: most of my life in Bombay, not in the village after I was five, except for the DM: holidays. I was pretty Westernized because, you know, I went to DM: a Catholic school and, you know, the Catholics were pretty progressive there.

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DM: And, so, I was quite Westernized, so I didn't have problems fitting in. DM: The only problem was I couldn't understand all the American idioms and, you know, and I DM: had some very kind co-residents who would say, "Well, let me tell you DM: about this one at 5:00, after all the day is ended." And he says,

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DM: "Well, you know, when they say this in Texas, it means actually it means that." I'm DM: like, "oh, I didn't know that." [laughs] And I was DM: like, "whatever." But at the DM: time I was asked—everybody asked me, "Where are you from?" Like, everybody,

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DM: like, "who is this strange bird?" And I remember there was one time DM: I spoke at a meeting and everybody, as they were leaving, shook hands and said—they DM: would say something nice and then they would say, "Doc, where are you from?" And my DM: colleague with me, finally, after the eighth one, she couldn't take it anymore.

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DM: And she said, "Now, where do you think I'm from?" She got so mad, and I was DM: like, Mary—it's just—People are curious, I don't get offended DM: by it. Yeah, there were some jokes made. DM: I—you just–you just shrug yourself off.

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DM: Our community in India was a little unique, so we were always the butt of many jokes. DM: So, I was like, okay, a few more bad jokes, whatever. DM: You just move on. DM: I didn't take it very seriously or get too offended by it.

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DM: And sometimes I—if there was a sarcastic remark made, I probably DM: didn't understand it. DM: So. You just you just fumble along. MT: So, you've talked a little bit about your education, but

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MT: —I'm sure you've been through many, many years. MT: Could you just sort of describe what the process of going through medical training and MT: everything looked like? DM: So, India Medical School was very competitive at the time.

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DM: It still is. But they only had four medical colleges in Bombay. DM: And so, there were something DM: like–something like, I think, less than DM: 500 slots between the four schools.

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DM: And a third were reserved for the scheduled–class scheduled tribes. DM: And so, you're really competing for some 300 and something spots. DM: And there were 21,000 people—students applying. DM: And it was strictly on your ranking on that inter science exam.

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DM: And I think in Bombay University that year I ranked DM: something like 20th. DM: And, so, you get invited and then your—during DM: your meeting with the, you know, the–the deans of the four medical schools

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DM: , you know, they pick where you go, but they give you a choice. DM: Where would you like to be. DM: And of course GS was the best. DM: It was always—for years and years and years it was number one or number two in the

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DM: country. The other one was all India Institute in Delhi, which is where all the DM: politicians went. So, they were the privileged one, but we were the always 1 DM: or 2, 2 or 1, big competition. DM: So, of course, I picked GS.

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DM: And that's how I—so, GS is Seth Gordhandas Sunderdas Medical DM: School, so we just called it GS. DM: And the hospital was King Edward Memorial, which was the 2500 bed hospital. DM: And that was medical school for me.

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I—when I went to medical school, the whole idea was that I would do my medical schooling, do my internal medicine, and then go back to my village and open up a—in fact, my dad had even purchased a little office space in the—near the railway station that I could help the locals.

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And so, I worked very hard because in India they–they control the number of slots you have for subspecialty training. They want most people to do just primary care. So, the people who could take the boards for the internal medicine or

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surgery or, you know, all the subspecialties were controlled. So internal medicine only had eight slots. And again, it's strictly on your grades. And so, I made it into—I was number seven.

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There were eight slots and I made it. And it was the first time in like nine years that a woman actually qualified for that slot. So, I was very happy.

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And the–and the chief of medicine, who was the first female chief of medicine, was really excited. And, unfortunately, I had to leave and I gave up that slot.

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So she was very disappointed and was really apologetic. But my life took a totally different trajectory and I told her I'll make her proud. I meant to go meet her last time I was in India.

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But she had already passed, so. Yeah. MT: I'm sorry. DM: Yeah, that's okay. Well, I told them, Look, I did something with my life,

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DM: so. Yeah. MT: Yeah, you're very, very successful. MT: So, were there any—I guess, maybe she MT: was—but important role models or mentors that sort of developed your interest or set

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MT: your path on your current career? DM: Well, there were a—in India, she was probably the DM: one, but, having—I mean, I DM: just had one focus on India.

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DM: Get–get into med school so work your butt off, and then get into internal DM: medicine, And so, that was my focus. DM: I had my little clique of friends from medical school. DM: We still communicate on WhatsApp, we have a group.

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DM: Over here, I have to say there was a chief resident at the time, her name DM: was Mary Schwartz, she's still there. DM: She's my—the vice chair now. DM: And really, when I was doing my residency, she

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DM: was very helpful and she really was sort of the role model. DM: She grew up in Hawaii, went to Stanford. DM: Medical School, Wash. DM: U., Undergrad, Stanford, Medical School, Wash.

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DM: U, and then Baylor for residency. DM: So, when I started, she was my chief resident who would show me around. DM: She even rescued my car when it was getting towed away from outside the library. DM: We chased the tow truck and then paid and really

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DM: got the car released. DM: But sharp as a whistle, still is, and she really in DM: some ways, her work ethics kind of rubbed off on me. DM: Back in the days, really, there weren't that many women

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DM: and—in pathology and it was pretty DM: male dominated. And then the few that were there DM: usually never—many of them didn't stay in academia they went into DM: some private practice in a smaller town.

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I, as a resident I was, I think I was the first chief resident with a foreign accent and a woman for Baylor Pathology. So I have to say they were pretty open minded. The program director, Dr.

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Malcolm McGavran, his–his father was a-one of those missionaries and he had spent some time in India. He spoke better Hindi than I do. So I have to—I had to keep my conversations with him down to monosyllables because

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mine was pretty bad. Catholic school Hindi is not very good. But he was tough, and he didn't shy away from criticizing you.

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But it was done in a positive way, like, believe in yourself, you know? And I remember I—but he was very good about giving you feedback. So my–my first weekend call as a resident at Ben Taub and I started out there, my first rotation was at Ben Taub, Mary Schwartz was

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my chief resident. So she made sure we all did our stuff. And I remember at Ben Taub in those days, all the labor and delivery was at LBJ Hospital, which doesn't exist anymore. Now there's a high rise there.

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Not LBJ, Jefferson Davis. And you know, DeBakey was the chief of surgery and–and all the stillborn babies and whatever the babies who died during birth and whatever, they would hold the bodies there and bring them every Friday

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evening to Ben Taub for the person who was on call on Saturday to do the autopsies. And of course, the person on call on Saturday, the resident and the faculty would do that, and I had this really strange case and things weren't adding up

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why this kid had what it had. So, I told my chief and my–my attending at the time, Dr. Hansoo (?) Kim, and he said, "Yeah, I think we better consult

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the Texas Children's people." So, I took my slides and went to Texas Children's and consulting them and they said, Yeah, this is really strange. Let's present it at the conference. Well, the conference was at Jefferson Davis and didn't have a car to drive at the time.

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So, I went to Dr. Langston. We drove to Jefferson Davis and we presented, and at that time, the Texas Children's people would also go to Jefferson Davis. And they also thought that this was unusual.

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And they said, talk to the fellow and said, "Let's find out if they still have the body. We would like to do a biopsy of the skin because the skin fibroblasts live for a month after death." And so, the fellow found the

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body and did a biopsy, grew the fibroblast and it turned out it was the first time they found that this particular deficiency would cause hydrops fetalis in a baby. And so,

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that–that fellow at Texas Children's who went and got the biopsy and, anyway, we wrote it up and it was written in Lancet, it was published in Annals of Internal Medicine. And then I was like, "Great.

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I got a paper, I wrote a paper." And then, two weeks after the paper came out, I had a knock on my—in the residence room and said, "Hey, congratulations." I said, "What?

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Oh, the paper is out." She says, "No, you got mentioned in Lancet in the editorial that how sometimes, you know, you make these strange discoveries and sometimes all it takes is an astute pathology resident." And–and I was like, "Oh, wow, that's great." I had no clue what The Lancet was at the time.

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I was like, "Whatever. Oh, that's nice. Thank you." Well, the resident—the fellow at pedi–in pediatric genetics at Texas Children's, her name was Huda El-Hibri.

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She's now Huda Zoghbi and—the famous Huda Zoghbi. So, that was my first paper. It was the autopsy the first weekend I was on call [laughs]. So, crazy things happen.

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You just–just go along with the flow and just be yourself and—So I have to say, I was a resident at Baylor and on the blood bank they would often get us to, you

00:27:24.350 - 00:27:40.240

know, we would have to help out on these cardiovascular cases that were bleeding and, you know, talk to you on the blood banker was in charge. And I guess they got so used to seeing me around that they–if they couldn't find Dr.

00:27:40.240 - 00:27:56.210

John(?), they'd call me. So, I'd come out of whatever hole was in, go and—and then would find Dr. John(?) and then we'd take care of the patients and and that's how Earl Stanley Crawford and DeBakey got to know about me. And I believe it was Stanley Crawford who was—him and

00:27:56.210 - 00:28:11.610

DeBakey were tight. They were like the ones who modern—invented cardiovascular surgery, modern cardiovascular surgery. So he was the one who I think mentioned to the chairman that you need to hire this gal. And–and I remember,

00:28:11.610 - 00:28:27.350

when I was–I had an offer from MD Anderson to do a fellowship there and I was so excited I told my program director and he said, "Oh, that's great. Have you accepted it?" I said, "No, I want to talk to my husband first and tell him if

00:28:27.350 - 00:28:45.830

that's a good idea." And–and 20 minutes later, the chairman called me in his office and offered me a position at Baylor. And he said, "I don't know which hospital I'll put you at, but you have three choices -VA, Methodist, or Conroe."

00:28:46.310 - 00:28:58.080

And so, I did a one month rotation at Conroe. I would get there at nine in the morning, I would be done by three and I was bored to tears. I went back and told him. I said, "No, I don't think I can survive that.

00:28:58.190 - 00:29:11.610

This is too slow for me." And as—I was chief resident so I had to supervise the VA residents and I told him, "I don't think VA is for me. Again, you know, it's a 10 to 3 job.

00:29:11.660 - 00:29:21.750

I need to be busier. I think I'll stay at Methodist." He said, "You know, it's busy." I said, "Yeah, it's busy. That's fine. I like it." I came from the internal medicine side, I'm used to working

00:29:21.750 - 00:29:35.960

like a dog. This is the place for me. And I've never looked back. And I had some people like Dr. Harlan Spjut who was like, you know, one of the best surgical

00:29:35.960 - 00:29:48.770

pathologist, he mentored me. My program director, Dr. Malcolm McGavran. And then in 1986, Dr. Ramsey, who was a very famous cytopathologist and–and was in San Antonio,

00:29:48.770 - 00:30:04.820

moved to Houston and joined our department. And that's when he sparked my interest in cytopathology. Till then I was—in those days you could only take three boards. So, I already had my anatomic and clinical path both so I could take one more.

00:30:05.240 - 00:30:15.800

And the choice was blood bank or cyto. And Dr. Ramsey said, "No, no, you got to do cyto, you got to do cyto." And Dr. Yawn was saying, "You got to do blood bank. You got to do"—and, of course, it was Crawford and DeBakey.

00:30:16.100 - 00:30:29.220

And then, by then I had had my second child—by the way, in those days there was no maternity leave. You only got three weeks and that was your vacation time. If you took a fourth week off, that was without pay.

00:30:30.180 - 00:30:46.490

So, two–two young kids, I was on a call for blood bank, 22 calls in one night. My husband said, "I think I'm going to decide. You're doing—you're taking the cytopath boards and giving up the blood bank." Dr.

00:30:46.490 - 00:30:57.860

Ramsey was very happy. Dr. Yawn hasn't forgiven him for it still. But yeah, it was really interesting. As residents, we got three weeks off, and as faculty,

00:30:58.640 - 00:31:11.720

the previous chair was like, he didn't want anybody getting pregnant. Well, there were only two young women who could potentially get pregnant. Otherwise it was all old guys. And when I heard he was retiring, I

00:31:11.720 - 00:31:26.900

said, time to get pregnant because by the time they find the next one, it'll be another 6 to 9 months. And so, I got pregnant with my second child and I called my administrator to find out, "Hey, what's the maternity leave policy for attendings at

00:31:27.470 - 00:31:45.680

Baylor?" There was dead silence. And I said, "Wesley, you want the line?" He said, "Yeah, I'm on the line, I'm thinking." I'm like, "Thinking what?" He says, "Well, I'm trying to think who was the last person who was pregnant." [laughs] Turns out, the last

00:31:45.680 - 00:31:56.630

woman who had a kid, her kids were in her 30s and she had had them in New York before she moved. So, he said, I don't know, I'll have to go and check. So, after two weeks, he calls me.

00:31:56.630 - 00:32:13.560

He says, "Well, as a matter of fact, we don't have a maternity policy at Baylor." He said, "It's whatever you've saved from your vacation time." So, that was four weeks then. So, I took my four weeks off and while I was on maternity, they picked the new chairman

00:32:13.590 - 00:32:28.350

of Baylor, Dr. Michael Lieberman, who really, I would say, he was very open minded about women and, you know, and work-life issues, and very supportive of his faculty.

00:32:28.350 - 00:32:45.550

And it was very different when he got here. He came from Fox Chase in Philadelphia. And although Ramsey and Spjut and McGavran were my mentors, Mary Schwartz is my chief, I would consider her my peer

00:32:45.550 - 00:33:00.550

mentor. I think the chairman sort of changed the whole tone. And that was–that was–that was a breath of fresh air. In retrospect.

00:33:00.550 - 00:33:14.890

At that time, I didn't realize it because there was so much going on. Little kids, you know, trying to juggle. I remember my—there was a time when my husband worked in Dallas for six—nine months and I was here with my son, I hadn't had the second one yet.

00:33:15.670 - 00:33:35.380

And if the school called or the–the daycare called and said he's saying had to take him home and I had to literally sneak out and leave the slides on my scope and leave the the dictaphone on and go out with the door open lights on and then I would take him home.

00:33:35.410 - 00:33:48.230

My mother would—was—I had to bring her from India. So, that—she couldn't drive. You know, she was a village person and—but she would keep the baby, and then I would sneak back in and then I would work till late till I got done with my cases.

00:33:48.230 - 00:34:06.380

And there was a little back door you could sneak in through the underground, like where—like, you were going to the morgue, and then take the tunnel and get out. So, that's what I used to do, because really, I mean, Dr. Schwartz at that time had not had babies, so she didn't understand what I was

00:34:06.380 - 00:34:22.970

going through. And we couldn't afford a nanny, so we –we got mom, but Mom couldn't drive. And it was—but, you know, you–you just juggle many balls and you move on. That's the life I chose, and I was happy.

00:34:24.930 - 00:34:37.910

It didn't even occur to me to, you know, that this is wrong and only got four weeks off at that time. In retrospect, it makes sense. But at the time, you're just so caught up in your world that

00:34:37.910 - 00:34:54.440

you didn't realize that, "gee, I shouldn't be doing this sneaking out with my lights on, and the microscope on," and like I was looking at slides and I just went off to the toilet or something. But now, yeah, that would be

00:34:54.440 - 00:35:05.380

horrible. In retrospect, it was, but it's okay. Whatever. MT: Wow, that's really interesting. MT: Going to a bit of a different topic.

00:35:05.410 - 00:35:19.990

MT: You mentioned earlier your first paper, and I know that you've written many, many things MT: since then, and you published a textbook. DM: Yeah. MT: Could you talk a little bit about the process of–of that, getting a book published?

00:35:22.360 - 00:35:36.240

DM: [Holds up textbook] This is the third edition, actually. DM: So, there's a first and a second. DM: So, in DM: 1995. I got appoint—By then, I was already my

00:35:37.020 - 00:35:53.490

DM: —Dr. Ramsey, who was in charge at Methodist of the Cytology Lab DM: —I'd taken my boards and passed them. DM: He made me the associate director of the lab, so I was in charge of all the quality DM: assurance and the—you might want to look up , there was CLIA '88 back in '88

00:35:53.490 - 00:36:08.760

DM: because '87 what Bogdanovich did the story on–on the bad practices DM: in cytology and how people died because their cervical cancers were missed. DM: And so, Congress got into the act. DM: There were congressional hearings and they got the Clinical Laboratory Improvement

00:36:08.760 - 00:36:26.100

DM: Amendments of 1988, which came down heavily on cytology. DM: And so, there was a lot of—there were a lot of mandates that had to be implemented. DM: And Dr. Ramsey put me in charge and said, "Well, Dina, you're going to do it for our DM: lab. I'm like, okay." So, I was the associate director and

00:36:27.240 - 00:36:38.860

DM: the College of American Pathologists inspects us. DM: So, we were in our inspection cycle. DM: They came and one of the famous cytopathologists DM: from Virginia, VCU, Dr.

00:36:38.860 - 00:36:54.490

DM: Frable, was the inspector, and he did a very thorough inspectio–inspection, and he DM: didn't find anything wrong with the lab. So, he actually told—I didn't know there was a committee at the College of American Pathologists that was dealing specifically with good practices and trying to set up

00:36:54.490 - 00:37:07.180

a quality assurance and proficiency testing program, et cetera. So, he said this gal would be good. So, I got invited to be on the Cytopathology Committee of the College of American Pathologists.

00:37:07.830 - 00:37:16.390

So, I said "Yeah, Sounds like a good idea." Dr. Ramsay said, "Yeah, yeah, do it." Dr. Lieberman said, "Of course. Do it. Do it." So, four times a year had to go to Chicago

00:37:17.110 - 00:37:30.740

and attended the meetings, and it was my second meeting where there was some discussion. So, cytology has the screening part which everybody knew as a pap smear. And then there's the diagnostic part, which is the fine needle aspiration, where we do

00:37:30.740 - 00:37:40.120

the biopsies and all. We have a clinic here where we do it. And, college had nothing on the non-gynae part and they said, "Why don't we have anything on this?

00:37:40.130 - 00:37:53.780

We're all concentrating on gyn—that's because Congress has told us—what about this?" And they said, "Oh, it's a lot of work. Why don't you put together something for us?" I said, "Okay, I'll write you a proposal." So, within a couple of weeks, I went back and I wrote my proposal,

00:37:54.440 - 00:38:03.620

send it, emailed it to them. At that time, the emails were just coming about. I sent it to them and then presented it and the board approved it.

00:38:03.620 - 00:38:21.450

DM: They said, "Yeah, this is a very good idea." So, I actually started the non-GYN program DM: for the College of American Pathologists, and now it's like one of the largest DM: programs we have. So, I became the vice chair of the committee in charge of the non DM: GYN while they were also—we were also doing the gynecologic stuff.

00:38:21.450 - 00:38:35.730

DM: So, two days before the regular meeting, the non gynae group would DM: go and we would do our thing. DM: And then, so, I got the program started in like nine months from concept to DM: implementation. It's the fastest program they've had.

00:38:35.820 - 00:38:54.750

DM: And everybody was like, "Oh, this is interesting. DM: This woman did it." And I did have help, Doctor Frable was there, I had my friend DM: Diane Davie and, and then after vice chair when DM: Diane, who was chair, she said, "Hey, you know," basically I was the

00:38:54.750 - 00:39:10.330

DM: next chair, and by then the College of American Pathologists started DM: getting awards and all that. DM: I was a chair of the committee, and that's when the proficiency testing for GYN hit DM: nationally. So I had to get the program through Medicare.

00:39:10.330 - 00:39:20.550

DM: And they approved it. DM: I was also invited to be on CLIAC, so I had to go to Atlanta DM: twice a year. So, I did that for four years in between everything else I was doing.

00:39:20.550 - 00:39:37.640

By then the kids were already in high school and all that. And then–and then while I was there, there was this group of radiologists who had started a, you know, they had a unique software whereby you could—really a different way of publishing.

00:39:37.640 - 00:39:55.870

And none of the big famous guys wanted to deal with it, like, "Oh, it's too much work, too much computer." So, one of them asked me and I said, "Well, hey, I've done this, I'll try this." So, it was—I had to go and it was –it's a different way of

00:39:55.870 - 00:40:10.750

doing, but you can see your—what your paper is going to look like and all that. And, it was a company owned by radiologists called Amaurosis (?). And, I did the first edition of my book and it did quite well.

00:40:11.530 - 00:40:29.350

I told them I will do the book—By then I was already a full professor at Baylor, so I told them, "I'll do the book only if you let me include my young people because it's really important for—" By then, I realized the importance of the promotion system and how you need it to have papers, chapters, this, that and the other.

00:40:29.350 - 00:40:44.590

So, I said, "I have a whole bunch of young people and I would like to include them." I also told them that all the pathology and cytology textbooks are from the Northeast, and there was one guy in Chicago. I said, "I would like to make it a uniquely Texas Medical Center thing."

00:40:44.590 - 00:41:00.320

DM: So, I will include the the famous and not so famous people from the Texas DM: Medical Center. So, that's how I did. DM: And I contacted my friends at MD Anderson and I said, "Hey, you know, here's an DM: opportunity." And so we—I got together a team.

00:41:01.160 - 00:41:18.800

DM: I had to get one or—one from Emory, so—George Birdsong. DM: But we–we got–we got the book out, and the first edition, actually, nobody knew how DM: this would fly in pathology, but it turned out it was doing—it did quite well. DM: So, immediately they booked us for the second edition and then the second edition

00:41:18.800 - 00:41:27.860

DM: did even better than the first. DM: And typically the first ones do better. DM: The second did even better than the first, and then they booked us for the third. DM: So, that's the third edition came out last September.

00:41:28.850 - 00:41:46.580

DM: The second edition was on the British Medical Association, you know, they have a DM: book award, so it was chosen as a top five in my DM: specialty category and then the finalist award—so, I went to DM: London to the BMA for the awards in 2019.

00:41:46.580 - 00:41:58.310

DM: But the award, the overall best book award, went to some—a DM: book in travel medicine. DM: I can't compete with that. DM: It's—And, you know, it's travel.

00:41:58.310 - 00:42:13.610

DM: It's fun. You know all the stuff you get when you travel. DM: And then the–the book that won for pathology was a book that was in its DM: 28th edition. So, for me to be in my second edition to make it to the final five, I thought was quite

00:42:13.610 - 00:42:31.940

good. And–and of course, with all the chapters and everything that I had helped my young people, they all got promoted. I had to write a lot of promotion letters about what a wonderful job they did with the chapters, but, it worked out.

00:42:32.240 - 00:42:47.540

So, my feeling is, you know, by then I had made it and it was my time to open doors for my young people. I mean, as a mentor, all you can do is open doors for them. What they do with the door once it's open, that's up to them.

00:42:47.720 - 00:43:05.840

But I felt it was my moral obligation, just like my mentor, you know, opened doors for me, then I did my thing. I think it's my—and some of them ran with it, and I have some very famous cytopathologists who are doing very well.

00:43:05.840 - 00:43:24.760

And when people see me, they ask me, "how was my mentor doing?" He's retired in California. When people see him, they ask, "how's Dina doing?" So thought, "Hey, that's good." So, there's a whole bunch of young people here that we're mentoring and it's a—I think the Texas Medical Center and the Methodist

00:43:24.760 - 00:43:38.620

and Baylor, they're all—it's a very resource rich environment in terms of the breadth and depth of cases. You see so much here that —it's this thing.

00:43:38.620 - 00:43:55.200

And although the split with Baylor was very, it was rough, let's put it that way. We had nothing to do with it. I had to decide whether I want to stay at Baylor or Methodist—They were in a fight over me and Mary. And I decided—I looked at what was

00:43:55.440 - 00:44:09.840

best for my residents and the teaching programs and all, and I stayed at Methodist. They promised me that they would let us continue with the teaching and all that, and they kept their word. We started out we were one of the first residencies in

00:44:09.840 - 00:44:21.710

Pathology and the Fellowship mind. Back when we were Baylor, we couldn't collaborate with Anderson because they were the competition or the enemy. Methodist said, we don't care, you can collaborate with them.

00:44:21.720 - 00:44:39.240

So, Anderson had a need for gynecologic cytology. I said, "Sure, send your fellows here." I said, "The only problem is I'm landlocked here." If you remember, the old Methodist building had a mural of Jesus, you know, with his arms.

00:44:40.180 - 00:44:55.900

And whenever people asked me where is cytology, I would say between Jesus and radiology because radiology is on the other side. Now Jesus is in the main lobby of the new building. But–but we were landlocked, I said, Look, I'll take your fellows, but I

00:44:55.900 - 00:45:10.690

have to keep my fellows somewhere, so why don't I–when your fellows come here, you got to park my fellows there because I don't have a place to park them. Literally, there's no desk for me, that I can put them in. So, they said, "Okay, that's the thing, we signed the contract."

00:45:10.690 - 00:45:28.150

The Methodist lawyers and the Anderson lawyers did their thing and, Dr. Ayala, who was the chief at Anderson, came here as vice chair, you know, so he kind of helped facilitate. So, he had actually told the program director there that, look, "Methodist

00:45:28.150 - 00:45:45.250

has a lot of these cases, you need to collaborate with them." And the boundary, once the split with Baylor occurs, they are free to do whatever. And sure enough, the day the split occurred, September 8th, 2004, I hadn't even–I was on call the night before, hadn't even yet

00:45:45.280 - 00:45:59.680

turned in my beeper, because, you know, we had a Baylor beeper, and gotten the Methodist pager. He was in my office to talk about this and I said, "Absolutely." And we were talking about how we could do this.

00:45:59.680 - 00:46:15.710

And the pager people came and they took my BlackBerry and my pager, and gave me a new BlackBerry and a new pager and all that. So, yeah, that was—so, that's how our collaboration with MD Anderson begun–began. And it's happened now.

00:46:15.710 - 00:46:32.240

So, I kind of feel like, yeah, I just—you just do your thing as it happens. I have to say, when I started out and, I–you know, I won many

00:46:32.240 - 00:46:49.520

awards. But the thing that—the one that really–the one that really–the ones that really matter are the ones you get from your local people, because they know you the best. And the Spjut Award, that's the local Houston Society of Clinical

00:46:49.520 - 00:47:06.740

Pathologists, and Dr. Harland Spjut mentored me in surgical pathology. You know, he was–he was the first attending I worked with at Ben Taub. And, he was the protege of Lauren Ackerman, who's considered the father of surgical pathology. Of course, I had no clue when I got here about all that.

00:47:06.740 - 00:47:19.850

I kind of learned that years later. So, I basically just landed in the right place. I had no clue. It turned out that the guy who was supposed to be starting as a resident at Baylor

00:47:19.850 - 00:47:37.940

in Pathology, he was in the military and something happened, I forget whether it was Korea or where, and the military didn't just let him go. They–they put—Reagan put a hold on anybody leaving, you know. And so he couldn't start July 1st.

00:47:38.770 - 00:47:56.530

And that's why the spot fell open. And I bumbled on to it while I was picking up my application for internal medicine. So, it's just—it just happened. I'm–I'm very grateful for it.

00:47:58.090 - 00:48:15.340

MT: That's amazing. It seems like a series of sort of happy accidents that led to. DM: So, when the Department of Pathology at Baylor turned 50 years old, Dr. DM: Lieberman, the then chair, he commissioned a writer to write the history DM: of the department.

00:48:15.340 - 00:48:27.670

DM: And the first chapter was The Accidental Pathologist. DM: And she interviewed me and I told her the story. DM: I told you well I'm actually doing medicine, but yeah I would sit at home for a DM: year and get pregnant, might as well do something else.

00:48:27.970 - 00:48:41.440

DM: And then when the book came out, of course, I was busy doing whatever. DM: And everybody says, "Dina, that's you, that's you!" I'm like, "That's me, what?" DM: "Didn't you read the book? DM: It starts with you, that's you!

00:48:41.440 - 00:48:58.150

DM: We could tell from the way, you know—" Sure enough, the story I had told her it was there DM: verbatim. It's called The Doctor's Doctor, the book, and it was DM: commissioned. And–and–and turns out DM: Dr. Spjut, the great

00:48:58.180 - 00:49:13.790

DM: pathologist, he actually started out as a surgeon, went to DM: World War Two. DM: Came back. And decided, "You know what? DM: I don't like surgery, I'm going to do pathology." So,

00:49:14.330 - 00:49:27.830

DM: he discovered it later. DM: And there were–there were 3 or 4 others who were like that. DM: And she kind of started out—she started the book with The Accidental Pathologist, and DM: that was us, I said, "oh, gee, I'm in such good company." I had no clue.

00:49:31.310 - 00:49:43.730

MT: That's amazing. MT: It's amazing. I guess next, could you talk about your MT: current research a little bit? MT: And then also maybe sorry, just a little bit about

00:49:44.090 - 00:50:04.660

MT: how COVID affected your work and stuff like that. DM: So, my work is clinical, so, you know, DM: we do case series and what we learn from that and I've DM: published, I don't know, 130 or 40 papers total

00:50:05.020 - 00:50:17.070

DM: now, but it's mostly clinical work. DM: I was involved in some hard core research with Dr. DM: Michael Hegness (?) from Orthopedics, so Dr. DM: Spjut got me inspired into orthopedic.

00:50:17.080 - 00:50:32.530

DM: He was retiring and he trained me to become an orthopedic bone and soft tissue DM: pathologist. So, this Dr. DM: Higgins came to Baylor as the chairman of orthopedics, DM: and he was—he had these mouse models, and then he had–he had other research

00:50:32.530 - 00:50:42.790

DM: he was doing, and he needed a pathologist. DM: So, everybody said, "go to Dr. DM: Spjut." Dr. Spjut said, "look, I'm winding down, but I have this young lady I'm DM: training, she can be your pathologist." Okay.

00:50:43.600 - 00:50:59.110

DM: So, I didn't have a choice. DM: Okay. And so we would study the reactions DM: to the steel rods and whatever in humans. DM: And then he had a mouse model and then his fellows would do like

00:50:59.110 - 00:51:16.420

DM: the–the nerve ending research, like can the nerve—In those days they DM: thought that the nerve endings would not be able to regenerate. DM: But, well, we showed that if there was a certain substance, maybe things will happen DM: and all that. So this was early—we were publishing in the early 90s,

00:51:16.450 - 00:51:33.880

DM: late 80s, early 90s, '91, '92, '93, '94. And, if you remember all the breast implant stuff and the lawsuits, of course we—I didn't do anything on breast implants. I would see the resected specimens and I thought they looked awfully similar to what

00:51:33.880 - 00:51:46.960

we were seeing in the mouse models and in the human–in the humans when they took off the rods and whatever. It's more of a local reaction, you know, and and whether it's the rod or the implant, you know, there was a certain reaction.

00:51:47.690 - 00:52:02.860

The body can only react in so many ways, and it was reacting. And there was all this stuff that it was causing autoimmune disease and this and that. And we weren't seeing that in humans. It was—But anyway, the lawsuits were going on and the

00:52:03.020 - 00:52:15.220

plaintiffs were winning. And the stuff that they made that the plastic or the silicone they used in that implant was also used to make ommaya reservoirs for kids.

00:52:15.230 - 00:52:30.860

These are kids who have hydrocephalus. So, they put this reservoir, and then there's a tube that drains into the abdomen, so that they don't collect fluid on their brain, you know. And the company had lost the lawsuit, so they were getting ready to shut

00:52:30.860 - 00:52:45.540

down making that silicone. And that would have affected the making of ommaya reservoirs for kids. And Dr. Ralph Feigin—by then, DeBakey had stepped down as the chief at Baylor,

00:52:45.550 - 00:53:03.010

and Dr. Ralph Feigin, the chief at Texas Children's, came. Ironically, one of the people who was for the plaintiff and claiming that it caused all these diseases—where as we thought it was just a localized reaction—was a neurologist at Baylor

00:53:03.010 - 00:53:16.230

and at Methodist. So, of course, he had a cast—he made a lot of money and had a castle in France. So, Ralph Feigin, when they heard about the ommaya reservoir, and those days, they had no alternate supply for the Ommaya reservoir silicone.

00:53:17.260 - 00:53:34.810

So, he said, "Hey, if any one of you is doing any research on this implants and stuff, please let us know, because it's going to affect the Ommaya reservoir." So, there I was, tooling around with my little mice and–and then looking at the removed specimens,

00:53:36.340 - 00:53:51.860

you know, in humans. So, my—I told my chairman, and I guess he passed on the word, and they said, "Well, would you be willing to talk about your findings to these lawyers, you know, the Baylor lawyers?"

00:53:52.290 - 00:54:05.080

"Yeah." So, I talked about what I was seeing, and they said, "Oh, this is very interesting. It might be useful." Next thing I knew, there was a law firm called Beck Red—And, I don't do lawsuits, okay.

00:54:05.090 - 00:54:19.460

So, Beck, Redden and Seacrest. And they were the defense lawyers for McGahn Medical, which was the maker of the silicone that was used for ommaya reservoirs, for breast implants, and a whole bunch of other things.

00:54:20.030 - 00:54:30.090

DM: But they were going to shut it down because they didn't want a legal liability, because DM: it was costing them too much money. DM: So, they came and took my deposition. DM: And I explained the findings.

00:54:30.090 - 00:54:41.840

DM: He said, "Would you be willing to test?" And I said, "Of course," you know, I mean, it's a DM: good cause. So, then the plaintiff lawyers came and DM: the plaintiff lawyers was John O'Quinn. DM: I had no clue who he was.

00:54:41.990 - 00:54:55.430

DM: So, I remember, until 9:00 at night, they had these video depositions of me in my DM: office—In those days, I was in the smaller office across the hall—and he was kind DM: of nasty. But I told him, "this is what we saw. DM: It's a localized reaction.

00:54:55.430 - 00:55:15.050

DM: It looks just like the whatever." Well, anyway, the case went to DM: court and I remember I was one of the DM: last or the second last witnesses for the defense. DM: So, they put me up there and there were these ladies claiming they got this

00:55:15.080 - 00:55:28.970

DM: arthritis and that and that and whatever. DM: And I got put up on the thing and I said, "Well, you know, what I have seen is it's DM: a localized reaction. DM: And whether you put in this plastic or you put that rod over there, you know the

00:55:28.970 - 00:55:42.110

DM: metal rod, well, the histiocytes eat up the metal in the rod. DM: So—and then they sit there fat and happy. DM: At the most they'll drain to the lymph node, but they're not doing anything. DM: If you put silicone there, they'll eat up the silicone, they'll get fat and happy,

00:55:42.140 - 00:55:57.940

DM: drain to the lymph node. So, we've not seen that." And they said, "Oh, but these ladies have fatty liver disease." I said, "Look, fatty liver—now we all know that—" I said, "Look, anybody who's fat will have fat in the liver, too." I said, "I'm sure I have some." Boy,

00:55:57.950 - 00:56:10.420

John O'Quinn was nasty. He was threatening me. And, you know, I mean, at that time, I think my daughter was like three years old and –and the judge finally had to admonish him for intimidating me.

00:56:10.780 - 00:56:22.660

And then there was another one. Then, after my testimony, one of the pathologists testified, and then—he was a regular for the defense, I was the newbie. But I was quite shaken up.

00:56:23.140 - 00:56:37.570

And—but they were very nice afterwards. And the judge apologized and said, "you don't have to worry." And it was the first lawsuit that came out for the defense, and that McGann Medical didn't pull the plug on the silicone.

00:56:38.650 - 00:56:53.380

And then the whole tide turned and people realized that it causes the localized reaction, but it doesn't give you all these other diseases they were claiming it was creating, like fatty liver. Nothing to do, if you're fat you're going to have a fatty liver, we all know that now.

00:56:53.380 - 00:57:12.110

But at that time they didn't know that, and, it was—so, and then when they asked the jury foreman, the main guy, you know, the chief juror, and he said, "yeah, actually it was that that lady pathologist who really made sense, and that made us realize that she had nothing to do with this." She was

00:57:12.110 - 00:57:27.040

doing her own little thing in her own little world with her rats and her rods. And she realized that the two looked similar. And so my little claim to fame—after that, I never did another lawsuit or anything, but that turned the tide.

00:57:27.050 - 00:57:41.420

And then the whole thing died. And if I—I'm sure there are other substitutes now for the ommaya reservoir, but I feel like contributed in a teeny tiny way of the, with all those kids with water on their brain.

00:57:42.230 - 00:57:57.830

And—but it was basically, Dr. Ralph Feigin send-sending a memo to all the, like, if you have something that can help us defend otherwise we are going to lose the ommaya reservoir and we don't have an immediate replacement for that type of silicone.

00:57:58.660 - 00:58:09.910

And, because it was doing great for kids, the kids—Nothing was happening. It was all these fake claims. And now we all know, you know, you don't get fatty liver from having a breast implant. You get fatty liver because you're fat.

00:58:10.000 - 00:58:30.300

Or you drinking too much, whatever. MT: And then how—what was your work like during COVID? DM: So when COVID happened, that was quite a shock. DM: And, you know, Methodist, ironically, the hospital came into

00:58:30.330 - 00:58:45.270

DM: being during the Spanish flu because there weren't enough beds. DM: And this doctor decided to build this hospital in a house in near downtown that DM: he had. Fast forward 100 years and Methodist really DM: stepped up to the plate during COVID.

00:58:45.270 - 00:58:55.230

DM: And it was my department, my–my chairman, Dr. DM: Musser, the current chairman, he's Mr. DM: Whole genome sequencing. DM: He was sequencing things back in 2002 when he was at Baylor.

00:58:55.260 - 00:59:07.350

DM: All the bugs and the viruses and whatever else. DM: So, when Covid hit, he got his clinical—I don't do DM: clinical pathology anymore. DM: I'm subspecialized.

00:59:07.950 - 00:59:27.130

DM: But he got his team together and we really got the testing up and running. DM: Of course, while all this was happening and the place was shut down, I had a DM: observer from Thailand I had to ship back on the very last flight out of the US to DM: Thailand. And she was like, "No, no, I don't want to go." I said, "No, you have to go

00:59:27.130 - 00:59:41.440

DM: because you won't be able to go." Literally had to put her on the last flight out of DM: Houston to Japan, Tokyo and then to Bangkok, but DM: I got her out in time. DM: And then, of course, everything shut down.

00:59:41.440 - 00:59:56.050

DM: But you see, the work still goes on. DM: I mean, people with cancer still get cancer. DM: The problem was, that people were so terrified of coming to the hospital because DM: they thought they'll get COVID, that they would sit on whatever they had and this

00:59:56.050 - 01:00:07.880

DM: thing— So, on Mother's Day, I'm on call. It's a night call and I get called at, I forget, midnight, two in the morning. Some guy got flighted in from Tomball or

01:00:07.880 - 01:00:21.190

somewhere. And what it was was that it turns out that... he couldn't swallow. But he didn't wanna go to the hospital. So finally ruptures his esophagus.

01:00:21.190 - 01:00:32.800

So, they get him in here. He's on the operating table at two in the morning, they go in and they say, well, gee, is this cancer or is this an abscess that has ruptured? Well, yours truly is on call.

01:00:33.430 - 01:00:51.130

So, there's Mother's Day, I'm here 2:00 in the morning doing a frozen and it's cancer. And, basically, we have patients—this is just an example I'm giving you, without giving you any confidential information. But basically there were patients who would not come into the hospital

01:00:51.730 - 01:01:06.700

or come until it was really bad. And, after post—So post Covid I came to work pretty much every day because there were—we let the younger people stay at home with the kids and all but the old dogs, you know, we didn't have a kid at home or anything.

01:01:06.700 - 01:01:18.290

We just had a husband. So, we–we came in and we tried to do whatever cases, emergency cases. And because, you know, the cancers are cancers, they're going to grow and the–the

01:01:18.320 - 01:01:33.890

bugs are bugs and they're going to grow. So, while the clinical part did all the testing and, you know, they set up the little thing for the Texas Medical Center and all that, we at our end, we were doing the cancer diagnosis, the-there were transplants still going on and stuff like that.

01:01:33.890 - 01:01:47.780

So, we still had to take care of those. So, if you get called in the 1:00 in the morning to tell them if the liver is good or no good to transplant the donor liver, all that went on. So, we–we still went on with that.

01:01:47.930 - 01:02:04.580

So, in that sense, we didn't miss a heartbeat. The kind of work I do I can't do from home. I have to be physically here to, you know, and I get the specimen. I can't sit and look at it on a camera.

01:02:04.590 - 01:02:19.440

I have to touch and feel it and decide what needs to be frozen so that I can get to the correct diagnosis. And so—and that you can't do on a camera. So, a lot of people, people who we didn't need to come in,

01:02:19.440 - 01:02:34.890

didn't come in, but there were there was always a small crew that was here and I was one of them. And we did our part. And once the–the hospital opened up, there was this huge rush of

01:02:35.880 - 01:02:54.390

people who had sat at home and now they came in worse off with more advanced disease. And I would say for a year or two, we were picking up cancers that were much more advanced than what we were before. So, on the–on the breast biopsy service, we would originally find these

01:02:54.390 - 01:03:05.610

millimeter cancers. Now suddenly we're finding one and two centimeter cancers because these women sat at home, they didn't want to come into the hospital, they didn't want to go. They missed their mammograms, they missed their colonoscopies.

01:03:05.610 - 01:03:24.040

So, we were finding bigger and higher stage ones for some time. I think things are now settling down. So, that's kind of what we observed in our –in our practice. And Methodist is a huge—and the lab at the mothership is a system wide

01:03:24.040 - 01:03:38.320

laboratory, and that's–that's one of the labs I direct. And, but we sort of noticed that. It's—so there were many more things that happen during COVID, not just COVID.

01:03:38.530 - 01:03:51.580

It's all the other things that got affected. I mean, I know the kids are messed—who got messed up sitting at home and, you know, and fell back in their studies. But there were a lot of cancers that didn't get diagnosed or got

01:03:51.580 - 01:04:08.410

diagnosed when they ruptured something; an organ, and had to be helicoptered in, or they sat on it till they were bigger. So, instead of catching in that stage one, we would catch it at stage three. And so, that sort of stuff, you know.

01:04:09.580 - 01:04:24.600

MT: That's a side effect of the whole situation that I had never thought about before. MT: Man. I guess we're going to move away from your work now, and I'd like to MT: ask a little bit about your family. MT: You mentioned you had two kids?

01:04:24.930 - 01:04:39.140

DM: Yeah. The grown ups. MT: What kind of values do you emphasize in their upbringing MT: and have you kept them, like connected to your heritage? MT: And do you ever visit your family in India?

01:04:39.150 - 01:04:49.740

MT: Stuff like that. DM: I've tried, but you know what? DM: Where I come, you know, the—When we got here and DM: my kids were little, we had a very small community.

01:04:50.670 - 01:05:04.980

DM: So, once or twice a year we would meet at someone's house. DM: We never had a center, a community center or anything. DM: That didn't happen until '97. DM: By then, my kids were already—my son was already in high school.

01:05:05.250 - 01:05:18.850

DM: My daughter was in middle school. DM: So, we kep-we keep in touch with the community. DM: But, you know, if they are here in town, when my daughter is in town, we take her. DM: But at that time, you would usually meet at someone's house.

01:05:18.850 - 01:05:31.240

DM: So, that's how we did things. DM: I always told them, you know, "good thoughts, good words, good deeds, respect everything. DM: , respect all of God's creations, animate and DM: inanimate objects.

01:05:32.050 - 01:05:41.540

DM: And–and live your life. DM: Live a clean life. DM: Don't harm anyone. DM: Don't do anything illegal and

01:05:41.990 - 01:05:58.550

DM: just very simple." We kept it simple. DM: This–There's no temple or idol or DM: anything. We have to worship because we're such an ancient culture. DM: We just–we just respect all of God's creations

01:05:59.240 - 01:06:11.730

DM: and–and live a clean life with good thoughts, good words, good deeds, DM: help other people out. DM: Whenever you can. My son's a cardiovascular anesthesiologist. DM: He practices in Houston.

01:06:11.760 - 01:06:26.250

DM: My daughter is an OBGYN. DM: She practices in central Denver. DM: So, I think we did okay with both careers, raising two kids DM: who—I have a little grandbaby.

01:06:26.250 - 01:06:38.300

DM: He's two–two years old. DM: And he's a joy of our life. DM: Keeps us in stitches. MT: I guess, are there any ways that you sort of adapted

01:06:40.310 - 01:06:52.040

MT: new traditions or, like, continued old traditions MT: after moving here or like when raising your kids and stuff? MT: I don't know if that makes sense. DM: Yeah. So, like, we celebrate Spring:

01:06:52.400 - 01:07:06.830

DM: Nowruz. So we–we have—we set a little table with DM: all the fruits and vegetables. DM: You know, it's the beginning of the new year plants, animals, everyone. DM: So, we set up a little table with that and we say a

01:07:07.340 - 01:07:22.760

DM: small, you know, thank you, God, for all of your creations. DM: And then we eat. DM: And then now that we have a community center, we do the same thing at the center. DM: We have an event, the kids have little dances and whatever.

01:07:22.790 - 01:07:31.970

DM: You put up a little—see, we didn't have anything like that, so my kids couldn't DM: participate in that. DM: They would have sports event in which my kids participated. DM: They were reasonably good at it.

01:07:31.970 - 01:07:43.220

DM: I didn't have an athletic bone in me. DM: But, now it's a much bigger—there's like, I don't know, DM: 500 people showing up. DM: Even the ones from San Antonio and Austin come in.

01:07:43.220 - 01:08:01.040

DM: And, you know, so the new year, we'll celebrate and we'll—they'll set up a DM: big table and explain the significance of all the things, you know, the egg, which is DM: new life, ovum, you know, things like that. DM: And we–we–we eat and have a good time

01:08:01.070 - 01:08:19.910

DM: after the kids are done dancing and the music, and then we eat and then we dance. DM: And my kids will, if they're here or they're not on call, DM: they'll–they'll come and they'll catch up with their old friends from the community. But, my son has stayed more in touch being in Houston.

01:08:19.910 - 01:08:35.360

My daughter in Denver, there's a ver—Denver's doesn't have too many of us. So—but my kids are totally integrated into the American way of life. So, we-we've had no issues.

01:08:35.540 - 01:08:53.380

In some ways, it's been a blessing that the religion we follow is really a philosophy on life, and it's so ancient that it doesn't tell us that I have to fast or I have to do certain things, thank God [laughs].

01:08:53.380 - 01:09:00.020

It doesn't stop us from eating. And we celebrate everything. We celebrate Christmas. We have Santa Claus, we have the gifts.

01:09:00.020 - 01:09:12.170

We do everything. If the Hindus have their Diwali and there's an event, we'll be happy to go and eat all the sweets. If the Muslims have Eid and they bring some a tray of something, we'll happily eat it.

01:09:12.470 - 01:09:29.240

So, we have no problem. We–we–we follow all—Having grown up in India. We–we followed all the cultures, you know. So, the Hindus on the on the other saying they always give out sweets, hey, we

01:09:29.240 - 01:09:46.450

were there to eat them. And so–so yeah, the kids are the same way. We–we follow all cultures, and it's a good thing. I've never been to—Like I said, it's it's more

01:09:46.450 - 01:09:58.010

of a philosophy on how you live your life. So, it's been easier for me in that sense that we're not so tied into anything. MT: That sounds wonderful.

01:09:58.040 - 01:10:17.300

MT: The next question is kind of a pretty broad one, but how would you describe your MT: identity? DM: ... I think my work defines me. DM: I think that's what I identify with.

01:10:17.320 - 01:10:29.840

DM: My work defines me. DM: And that's the other thing DM: I–I–I DM: haven't figured out—I mean, I could retire now if I want to, but I

01:10:29.860 - 01:10:47.400

DM: haven't figured out that–that thing I want to do in my DM: retirement. I know I can't sit at home. DM: I have to do something that will help the greater good, and I haven't DM: figured that out. The day I figure that out–The day I figure that out, I will

01:10:47.400 - 01:10:58.950

DM: retire and do that. DM: But so far I haven't. DM: So, I enjoy working with the young residents, encouraging them, my young DM: faculty, encouraging them to move up and opening

01:10:59.700 - 01:11:08.810

DM: doors for them. DM: And so I kind of have more of DM: this... DM: Motherly attitude.

01:11:08.820 - 01:11:27.990

DM: But again, it's all tied into my work. DM: So, I think in some ways my work defines me. MT: And then I guess a little bit about, MT: just the US's treatment of Asians and

01:11:27.990 - 01:11:38.390

MT: Asian Americans. MT: Recently, since there's been a sort of rise in hate and discrimination against all. DM: Yeah, that is a shame. DM: It shouldn't be that way.

01:11:38.400 - 01:11:54.360

DM: I never felt—I mean, yeah, I was the butt of a few bad jokes, DM: but—partly because I didn't understand some of the stuff. DM: But yeah, it's sad that we're so DM: —It's come to that.

01:11:55.110 - 01:12:07.860

DM: And, I didn't feel that way. DM: I mean, when I was—when I started at Baylor and Methodist, there were all kinds DM: . I mean, DeBakey was there. DM: He was a Lebanese Christian.

01:12:09.500 - 01:12:28.870

DM: Earl Stanley Crawford was a white guy, from Boston. DM: They didn't treat us any differently. DM: In fact, I almost feel like it's gotten worse DM: now. There's too much of you're this group and I'm

01:12:28.870 - 01:12:46.530

DM: that group. And, you know, I never felt it that DM: way. I've just felt like you give it your best and let the DM: chips fall where they may. DM: I never considered myself like I'm this or I should be,

01:12:46.530 - 01:12:56.590

DM: you know, you just do your thing and let the chips fall where they may. DM: And, if you got recognition, great. DM: If you didn't get recognition, great. DM: I wasn't looking for anything.

01:12:56.590 - 01:13:03.850

DM: But now it's become so divisive. DM: It shouldn't be that way. DM: There's too much. DM: It needs to stop.

01:13:04.540 - 01:13:19.280

DM: It needs to stop. And, I realize this country has a history. Of course, my–my ancestors were being slaughtered elsewhere and they sought refuge in India.

01:13:20.780 - 01:13:37.620

But that doesn't mean I hate every one who was slaughtering my ancestors. You move on, you know, eight, nine generations, just move on. Think of the now and what you're doing now and what you can contribute

01:13:37.620 - 01:13:50.150

to society now. And don't be so stuck and so—you know, I mean, what's the current generation have to do with what happened in the past?

01:13:50.150 - 01:14:04.830

And I certainly don't have anything to do what happened in the past in this country and —But, so I'm an outsider looking in and I'm like, why? This is so unnecessary. Why are we doing this to ourselves?

01:14:04.840 - 01:14:22.300

Why? It's so unnecessary. When my—both my kids were delivered by a black OB/GYN. I love Wandermart (?). My first pediatrician was black, Dr.

01:14:22.300 - 01:14:38.380

Roosevelt. I followed him to Chelsea also after he closed his practice. But then they kept on shuttling me around, so I went to another one. But it's just gotten so divisive and it was—shouldn't be that way.

01:14:38.890 - 01:14:53.260

It's just wrong. And trying to make some poor kid feel guilty about what his ancestors did 150 years ago. Stop it. It's enough.

01:14:53.280 - 01:15:10.200

Enough. And I'm just an outsider looking in. And like I said, I don't bear any ill will towards the people who slaughtered my ancestors, because I know the people now don't do that. It's-It doesn't mean it was right.

01:15:10.210 - 01:15:21.180

It's just. Times have changed. Move on. There are so many opportunities in this country. Don't get stuck in the past.

01:15:21.210 - 01:15:39.690

Move on. MT: The next question is a bit of a tone shift, but do you have any MT: advice for young people who might want to go down a similar path to you? MT: Or just advice for anyone who's unsure what they want to do in life or how to go about

01:15:39.690 - 01:15:54.600

MT: it? DM: Sometimes you may be sure what you want to do, but life takes a different turn. DM: And so, make the DM: best of the opportunities that come your way.

01:15:54.810 - 01:16:07.400

DM: Give it your all. DM: And you'll find something there that–that works. DM: I mean, I thought I was going to be an internist until I discovered pathology. DM: So, keep an open mind.

01:16:07.490 - 01:16:19.130

DM: Don't be that, "Oh, I have to do this, and if I can't do this, then I'm no good." Or, DM: you know, it's not the end of the world. DM: Embrace new opportunities. DM: Keep an open mind.

01:16:19.160 - 01:16:35.290

DM: Give it your best. DM: And if you're really good at what you do, the opportunities will come. DM: Give it your best. MT: Thank you. And then you mentioned you love to keep busy.

01:16:35.300 - 01:16:47.990

MT: So, what about any lessons on like time management and stuff like that, that you've MT: learned? DM: Well, so, here's the thing. DM: My husband has an equally busy career, so we —but one thing we always did was

01:16:48.020 - 01:17:01.950

DM: we decided that one of us was always going to be around with the kids. DM: And when the other one was traveling DM: or was busy with dinners and meetings and all that. DM: So, that was the rule.

01:17:01.980 - 01:17:20.790

DM: We never left our kids with—Well, we couldn't afford nannies then, but even DM: then, even when my mother was there, one of us was always there. DM: We never left them. And—and, you know, I've said DM: no to major opportunities to speak or be in committees because

01:17:21.000 - 01:17:37.860

DM: we had decided that my husband had his meeting to be somewhere else. And one of—one such thing was a very important meeting in Baltimore, that I could have been in on September 10th, twenty-2001. But I said no and I found a replacement, so

01:17:37.860 - 01:17:54.360

another pathologist went in my place, because my husband had to be in London for a very important meeting. Well, his meeting got over, and, on the 10th. I was with the kids, so I didn't—I gave up my slot and let somebody

01:17:54.360 - 01:18:09.270

else do it. And, you know, he–he–he got some publications out of it, but that's okay. And my—it turns out—No, they were flying via London I forget. Anyway, they missed–they–they missed their connection

01:18:10.380 - 01:18:27.240

and they had the airline said you can stay here, we'll pay for—Yeah they missed the connection in Amsterdam. So, the airline said "you can stay here, we'll pay you." Or my husband said, "no, I have to be back in Houston, get me on a flight to North America and

01:18:27.240 - 01:18:41.310

I'll figure out a way to get into Texas." DM: So, he got on the last flight out to Vancouver and then DM: from Vancouver, he took a late flight into Houston, got in at 2 a.m.. DM: That was 9/11.

01:18:41.910 - 01:18:57.690

DM: His friends, who had a great time in Amsterdam that night on the DM: airline's dime, got stuck in Gander. DM: Remember, they landed all the planes? DM: Ended up in Gander for like weeks.

01:18:58.890 - 01:19:13.500

DM: But we always—my husband, 2:00 in the morning, he made it because he DM: said, we're going to be here—we had no idea about 9/11 or any of that. DM: It just happened. So, he got in at two in the morning and then 9/11 happened. DM: Those guys sat in Gander.

01:19:16.210 - 01:19:37.660

DM: So, stay focused, you know, keep your word. DM: And keep your end of the bargain. DM: You know? So, you kind of have to have your priorities. DM: Even though it's-it was giving up a great opportunity and not being in Baltimore

01:19:37.660 - 01:19:52.300

DM: for that very important meeting with pathologist, gynecologist, all kinds of DM: people from NIH, I opted to be with my DM: kids. My husband said, I'll be here. DM: He got here on time no matter what.

01:19:52.630 - 01:20:08.190

DM: And 9/11 happened and we were here intact as a family. DM: But because it would have been horrible if he was stuck in Gander with the rest of them. DM: And I was here. DM: So, it all, you know, stay–stay–

01:20:08.400 - 01:20:26.560

DM: stay true to what you want to do for your family. DM: And, wherever life takes you. MT: Thank you. And then I think we're going to start wrapping up now since it's... DM: Yeah, I might get called.

01:20:27.400 - 01:20:41.520

MT: Do you have any, like, final messages or closing remarks that you'd like to share? DM: Make the–make the most of opportunities that come your way. DM: Be kind. DM: It doesn't cost you anything to be nice to people.

01:20:44.610 - 01:21:03.170

DM: Don't worry so much about yourself, think of the greater good. DM: And, once you've reached a certain point in your career, DM: consider it your moral obligation to help others out and open doors for DM: others. A rising tide floats all boats,

01:21:03.320 - 01:21:17.880

DM: you know, and do what you think is the best for your DM: patients, your colleagues, your profession and DM: , all good will come out of that. DM: Don't think about what's in it for me.

01:21:17.910 - 01:21:34.080

DM: Think about what's in it for the greater good, and it all works out. DM: And be intellectually curious rather than DM: —and you know, like, why is this not working? DM: Or why is this different, or.

01:21:34.620 - 01:21:52.080

DM: And, I was the butt of many jokes you just shrug DM: off, you know. DM: It's—the people who treat you that way DM: , that's–that's them, that's their loss if they are stuck in their ways.

01:21:52.080 - 01:22:06.610

DM: Don't let yourself be—don't DM: wallow in that mud of self-pity. DM: Get out of that. Just. DM: Just. Move on.

01:22:10.420 - 01:22:20.620

MT: Thank you. Thank you so much for talking with me today and for taking the time out of your MT: schedule to do it. MT: I'm really honored that I got to interview you. DM: That was nice. I'm happy to talk.

01:22:20.650 - 01:22:31.640

DM: It's just that things get crazy. DM: So, I was here at 6:30 in the morning, I already started my day. DM: I have a new faculty starting next door, so I already told my techs, you know, she's DM: coming. Please do this, this, this, this, that.

01:22:32.170 - 01:22:41.500

DM: So, I kind of took care of that. DM: I had my coffee, so I'm ready for the day. DM: I'm on call tonight, so I'm going to be here till late. DM: So, this was a good day.

01:22:43.000 - 01:22:43.540

DM: Thank you.