This is the first part of a monthlong series in honor of Women’s History Month.
In celebration of Women’s History Month, we’re sharing the stories of women in medicine caring for other women and children across Stanford Medicine Children’s Health, from the operating room to research labs to advocacy in the community. We’re honored to spotlight these clinicians who are making a world of difference in the lives of patients, their families, and colleagues, and in their community—and to share the insights they’ve gained in pursuing their callings, experiencing the power of female mentors, and articulating advice for other women.
One of the family
As a pediatric gastroenterologist and Medical Director of Intestinal Transplant, Yoyo Zhang, MD, gets to spend a lot of quality time with her patients. She takes care of kids on the wait-list for intestinal and multiorgan transplants, which may include transplants of the intestines, liver, pancreas, or stomach. She partners with the transplant surgeons and then cares for the child “the minute they’re out of surgery, through their hospital stay, and, well, evermore,” she says.
Dr. Zhang’s devotion to this patient population started during her fellowship and residency at Stanford Medicine Children’s Health. Seeing two female mentors’ work with fragile, chronically ill children inspired her to think about how she could be part of longer-term care for a group that didn’t have a lot of options. “Through my training, I realized that I wanted to work with patients in a way where I could become part of the family and live alongside the kids and be more than just a doctor who they saw once,” she says.
As a medical student, Dr. Zhang learned about the niche population of kids with intestinal failure. “There aren’t a lot of resources for these kids, and they’re really impacted,” she says. “Most of them spend their lives in a limited state because their health condition impacts everything—school, activity, their ability to be with friends,” she says. “Most of them are completely dependent on IV nutrition. I wanted to make an impact on their lives.”
Dr. Zhang savors the time she spends with patients after their transplants, during the long hospital stay and at regular follow-ups. “I get to see them eating, sometimes for the first time,” she says. She recently asked an 8-year-old patient what he wanted to eat after his transplant. “He said, ‘Octopus!’ And he got it.” She lives for moments like that one and for seeing patients transform from being so sick that they’re often hospitalized for months to being an active child able to go home eating normally and living a completely different life. “When I meet families, I tell them that they’ll be able to go on vacation together, that their child will be able to swim in the ocean, go to college, have children, have a full-time job—things that haven’t been a part of what they thought their futures looked like,” she says. “To see that brightness come out of the children and their parents, when they understand their futures will be so different, is so gratifying.”
Changing maternal and child health
Many people hear the sobering statistics about the disparities in U.S. infant and maternal mortality rates, but few are so affected by these numbers that they devote their lives to changing them. “Maternal and infant mortality rates are a sign of the health and well-being of a country and of a state, and it just says so much about how much a society values mothers and babies,” says Leslie Kowalewski, Executive Director, California Maternal Quality Care Collaborative (CMQCC) and California Perinatal Quality Care Collaborative (CPQCC).
In this role, Kowalewski works to unite efforts within Stanford, hospitals, the state, and the community to improve maternal and infant health outcomes. She’s made it her mission for decades to end preventable morbidity, mortality, and racial disparities in maternity care, having spent 20 years at the March of Dimes Foundation and serving as the State of California Maternal, Child and Adolescent Health Director before joining Stanford.
Kowalewski’s many accomplishments include launching a statewide prematurity campaign to increase the understanding of the root causes of preterm birth and implementing interventions known to reduce preterm birth. As part of the prematurity campaign, a Big 5 State initiative to eliminate non-medically indicated deliveries before 39 weeks’ gestation was established. The campaign united the five largest states, which represent nearly 40% of the births in the country, in changing clinical practice across hospitals and improving patients’ understanding of full-term deliveries.
Most recently, at Stanford, and together with her team, Kowalewski was instrumental in creating a low-dose aspirin campaign to educate pregnant women at risk for preeclampsia (which can cause preterm birth) about talking to their provider about the benefits of low-dose aspirin. She also helped secure a Centers for Disease Control and Prevention grant to strengthen CMQCC efforts to reduce disparities in cesarean births in low-risk pregnancies and a large Health Resources and Services Administration grant to improve maternal risk assessment and triage before, during, and through a year after giving birth to reduce maternal morbidity and mortality.
Kowalewski is most passionate about opportunities to unite hospitals, clinics, community, and public health programs. “There’s a divide between the medical model and public health systems, and we need to do a better job investing in and establishing integrated systems of care to improve perinatal outcomes,” she says. “I believe that when a community, health care providers, and public health systems are knitted together, we have the potential for deeper impact. My favorite saying is that we’re stronger together.”
Her devotion to maternal, infant, child, and adolescent well-being goes beyond the 40-hour workweek, but Kowalewski would want it no other way. “For me, it’s not about a paycheck, it’s about helping ensure that all moms and birthing persons everywhere have healthy, happy infants.”
The many ways to work toward child safety
Stephanie Chao, MD, a pediatric general surgeon and Trauma Medical Director at Stanford Children’s, knew she wanted to go into medicine as a teenager—much to her parents’ disappointment. “They were small business owners and wanted me to take over the business,” she says. Her parents tried to cajole her to change her mind all the way through medical school and into her first two years of medical residency. “All in a loving way, of course,” she laughs.
At one point, Dr. Chao toyed with the idea of going into public health, after working with a mentor on a campaign to eradicate hepatitis B, the leading cause of liver cancer. “I always wanted to have an impact on a large scale. But it’s also meaningful to me to have a personal experience with a patient at the bedside,” she says. She found her calling as a pediatric trauma surgeon, where she could make an enormous impact in a hands-on way. “What kills the most children is injury, and this is where I knew I could make a difference,” she says. “Our impact with children—whether it is through surgery or prevention—can save a lifetime … over 80-plus years. And we get to offer that every day.”
Dr. Chao also works to lessen the impact of traumatic injuries on children on a wider scale. When she isn’t at a patient’s bedside or in the operating room, she’s working on a project to reduce gun-related deaths and firearm injuries. “Guns are the leading cause of death for kids—more than any disease,” she says. “Nationally, the dialogue has been about gun control and Second Amendment rights, but we also need to think about it differently when it comes to children.” She’s creating the P.L.E.D.G.E. Campaign, a school-based curriculum for K–12 children focused on firearm safety, storage, and mental health awareness to reduce firearm-related injury and death among children. Because of this work, she’s been selected to be a part of the 2024 Presidential Leadership Scholars Program, during which she’ll meet with former presidents and their advisers to advance her work.
For Dr. Chao, it’s fulfilling to wear many different hats. “I get to live three or four lives at my job,” she says. She wears another hat as a mother to a 5-year-old and a 7-year-old. “The best part of my day is when I get home, walk through the door, and say, ‘Hey girls, I’m home!’ and they come running down the hall. I get the ‘Hi Mommy!’ and that transition is the best.”
Using natural curiosity to help others find answers
“If you told the 16-year-old me, who grew up in a poor area with little means, that I’d be a faculty member at Stanford, she wouldn’t have believed it,” says pediatric pulmonologist MyMy Buu, MD. In addition to being a faculty member, Dr. Buu is the Associate Director of the Aerodigestive Program at Stanford Medicine Children’s Health and the lead pulmonologist taking care of patients with neuromuscular diseases. “This was never on my radar,” she says. Her parents were immigrants, and her family lived in a Vietnamese and Mexican enclave in one of the poorest neighborhoods in Orange County. “I can’t say that being here at Stanford is a dream because I didn’t even think it was attainable.”
Growing up, Dr. Buu was a curious student who liked science and asked a lot of questions about the world, always wanting to understand more. Later, at college, she appreciated the opportunity to ask questions and to try to answer them in science labs. “At the same time, I’m very practical and like to apply that inquisitiveness to life,” she says. “Over the years, this evolved into helping people in the most need—children with the most potentially complicated conditions—or helping find answers to medical problems that other people haven’t figured out.”
Dr. Buu appreciates that women have inspired her along her career pathway. Some helped her become adept at legislative advocacy to give voice to underserved or marginalized patients and to help families in fragile situations. And a female mentor during her fellowship “taught me everything I know about neuromuscular diseases,” she says. Dr. Buu ended up taking over her mentor’s position, and she’s proud to build on the foundation that her mentor laid.
Now in a leadership role, Dr. Buu says, she’s glad to be a mentor to women exploring their careers. “Women have multiple roles in their careers and at home, and it’s all important. Many people think they have to balance their lives. But I think of it as a juggle with balls of different sizes and shapes,” she says. “I often remind female colleagues, and other physician mothers in particular, that it’s OK to drop a ball. You just have to pick it up and keep going. You learn to juggle, and you do it better over time. Then the balls change, and you have to learn again.”
Covering the full spectrum of medicine
As a pediatric otolaryngologist and head and neck surgeon, Kara Meister, MD, covers the full spectrum of medicine in her work. She takes care of kids who are otherwise healthy, and also very sick kids. She cares for patients on both an inpatient and an outpatient basis. She sometimes treats children medically; other times, surgically. “I joke that this specialty is a procrastinator’s dream because you don’t need to decide to do just one thing—you can keep your options open,” she says.
Dr. Meister was first inspired to become a physician as a child, growing up with her pediatrician being her close friend’s mother. “That made it tangible for me, and I really didn’t think too much about becoming anything else,” she says. She thought about going into pediatric oncology at one point, but her career trajectory changed course when she met a pediatric otolaryngologist. “There’s a shared quirkiness of the kind of people who go into the field,” she says. “You find that we have similar senses of humor and work ethics. We all like to do things with our hands but also like to think a lot about the medical part and about the disease processes—while still being very patient-focused.”
The goal of Dr. Meister’s career, she says, is to better treat children with thyroid problems, including cancer and autoimmune disorders. Her research looks at ways to understand thyroid diseases and to advance therapies. “Treatment options haven’t really advanced in decades, and we don’t understand why more kids are getting diagnosed with these conditions,” she says. She’s investigating possible factors, such as the environment, endocrine disruptors, and the immune system, to understand how to drive better outcomes. “Overall, my goal is to move the science field forward while doing well for our patients now.”
Even though advancing the field by developing the treatments of tomorrow may seem like a daunting undertaking, Dr. Meister is able to appreciate and take satisfaction in where she is today. “I feel proud that I’ve stayed true to what motivated me, and every day I go to work I want to give it my best,” she says. She’s able to do the same with her home life. “Right now, I think I’d define success as being able to leave behind something greater than myself—both in my career, contributing to the science of a pathology I’m passionate about, and with my family, setting my kids up to be good people who can go into the world and define success for themselves.”
Authors
- Erin Graham
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Fortunate to work with Leslie Kowalewski and thrilled to call her a friend. I am grateful she joined the quality collaboratives and is our executive director. To the future!