Hannah Valantine: Leading the way in diversifying medicine
Hannah Valantine: Leading the way in diversifying medicine
Hannah Valantine, MD, told her colleagues at London University’s Medical School more than 30 years ago that she was interested in cardiology. In return, she got variations of the same response. “A black cardiologist who’s a woman as well? You must be mad!” Today, Valantine is one of the world’s leading transplant doctors and also the senior associate dean for leadership and diversity at the Stanford School of Medicine.
Eight years ago Valantine was appointed to the senior associate dean post and charged with changing the culture of a medical school that was still reeling from a stinging indictment in the 1990s that its leadership was threaded with an old boy’s network where women and minorities could never advance. Valantine began her task by reviewing a lot of data that spoke to the isolation of women faculty, and it occurred to her that she “had experienced similar feelings” many times too.
Valantine is a realist. She knows that changing any culture around big issues such as making real strides at advancing women and minorities in the workforce doesn’t happen overnight. But she’s an optimist as well and proud of a lot that is underway and says that one of the big questions she was asked in the beginning – “If Stanford paid attention to “this diversity thing,” would it be doing so at the expense of excellence?” – is something that “I don’t hear… so much anymore.”
I talked with Valantine for my latest 1:2:1 podcast. During our conversation she told me, among other things, that for her diversity means:
..bringing together different perspectives to the table that enrich our society, that enrich the way we make decisions, that enrich the decision making processes that lead to better solutions. And I think that diversity as defined by gender and race are mere proxies, mere proxies, for this diversity of perspectives. In fact, I don’t really like the term ‘diversity.’ I think it has implications that are…that really miss the point of this richness of different perspectives and the potential that holds for excellence, innovation, coming up with something that is greater than the sum of the parts.
By Paul Costello
Stanford University Medical Center
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Hannah Valantine, MD
Hannah Valantine, one of five children, was born in Gambia, West Africa. When she was 13 years old, her family moved to London where her father served as Gambia’s ambassador to the United Kingdom. Valantine attended an all girls’ school before enrolling in London University to study biochemistry. “I thought the five-year training for medicine was much too long,” Valantine recalls. However, the young student quickly saw the value her biochemistry studies would have in the field of medicine and changed her course of study.
According to Valantine, her decision to focus her training on the highly competitive field of cardiology was a surprise to those around her. “At the time, there were few women or minorities in academics. People thought I was mad,” she says. Valantine was undaunted, earning the respect of her professors along the way. “I got a lot of positive support, enough to get me from one prestigious program to another,” she says.
Still, it was a lucky break that made all the difference in her career. “I was passed over for a premier cardiology training program,” she explains. “Then the phone rang and I was offered a temporary position because the fellow who had gotten the offer couldn’t start on time.” That single opportunity allowed Valantine to prove herself on the job; she was asked to re-apply for the position, which she won. These early experiences taught Valantine the importance of leadership in enhancing diversity, she says.
Valantine graduated from medical school in 1978 and did her post-graduate work at Brompton and Hammersmith, two top hospitals in London in the field of cardiology. In 1985, Valantine headed for the United States to train as a fellow with top cardiologists, including Norman Shumway, at Stanford University. “I knew from the day I set foot here that it would be hard to leave,” Valantine recalls. After a brief return to the UK, Valantine returned to Stanford in 1987. She was awarded a assistant professorship two years later, and rose to the rank of full professor in 2001.
Since then, Valantine has married and now has two teenage daughters. Her husband, who worked at NASA for many years in information technology, is now a consultant who works from home. The girls enjoy competing in team sports and being regularly cheered on by their parents, Valantine says. The greatest fun is having them on the same team,” she says. Valantine recalls the days when her daughters were younger and the whole family would travel to cardiology conferences all over the world. “I didn’t realize how important that time was. Now they are too busy to travel,” she says.
Valantine says her experience as a working mother has led her to make work/life balance a big part of ODL’s programs for new faculty at Stanford. “I’ve had to find ways to balance work, academia and family life,” she says. “You cannot ignore your family. You have to be downright zealous about your time,” she says. Valantine says one of her secrets for using time wisely is to find a place where she can be undisturbed for hours at a time. Her advice to new faculty, “You can not possibly do it all at the same time, but you can do most of the things that you want to do over time. You have to make choices.”
> Current Research Interests
Prior to my expanded administrative role, my lab focused on understanding the mechanism mediating acute and chronic allograft failure, in particular on the role of microvascular injury in acute allograft failure and the mechanisms of mediating transplant coronary artery disease.
1. Role of microvascular injury in acute allograft failure. We observed decreased cardiac allograft function in patients to be significantly associated with loss of microvascular cell surface markers, consistent with altered biology of the vascular endothelium or injury, and with up-regulation of cytokines such as IL-6, IL-10, TGF-b, and TNF-a. Decreased cardiac allograft function, in particular diastolic dysfunction, was highly predictive of allograft vascular disease and poor outcome in long-term patients. To further characterize cellular and molecular mechanisms we developed quantitative methods to monitor allograft function and correlate it with cytokine expression in a rat heterotopic transplant model. We developed echocardiographic markers of systolic and diastolic function and found decreasing systolic and diastolic function highly correlated with up-regulation of IL-6 expression.
2. Mechanisms mediating allograft dysfunction. We observed the major risk factors for transplant atherosclerosis in patients to be metabolic (hyperglycemia, hypertriglyceridemia, and low HDL). To further study cellular and molecular mechanisms mediating this process, we recapitulated metabolic abnormalities in the rat heart transplant model and confirmed rapid development of transplant atherosclerosis.
My current focus is on clinical and translational research, expanding on my earlier laboratory-based research on the mechanisms of allograft failure and vasculopathy. I study the role of sub-clinical cytomegalovirus infection in the development of cardiac allograft vasculopathy (CAV), and the effect of antiviral agents in preventing CAV, work that has been supported by a program project grant from NIH. Translating my earlier work on gene expression profiling, I conduct clinical trials on the application of this technology for non-invasive diagnosis of transplant rejection. This work, recently published in the New England Journal of Medicine, showed that peripheral blood leukocyte gene expression can be used safely for monitoring rejection in heart transplant recipients, with a substantial decrease in the number of endomyocardial biopsies performed. On going studies in this area will include application of the technology to diagnose CAV; monitor level of immunosuppression in a patient to guide therapy; and individualization of immunosuppression. My current research, in collaboration with bio-X faculty, uses the new technologies of whole genome scans, to detect the appearance of donor DNA in the recipients blood as a novel, non-invasive marker of allograft damage due to acute rejection. Ongoing studies include confirmation studies of the utility, and then external validation in a randomized controlled trial.
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* Stanford University Medical Center integrates research, medical education and patient care at its three institutions – Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital.
** The above story is adapted from materials provided by Stanford University School of Medicine
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