The Epidemiologist Who Crushed The Glass Ceiling And Media Stupidity | KUOW News and Information

The Epidemiologist Who Crushed The Glass Ceiling And Media Stupidity

Apr 17, 2016
Originally published on April 19, 2016 12:58 pm

When they wouldn't hire her because she was a woman, she threatened her superiors. When the media asked her a stupid question, she gave them an earful. And when she thought she had contracted HIV/AIDS, she said, "if that's what happened, that's what happened."

Don't mess with the tenacious Dr. Mary Guinan. A 40-year veteran of epidemiology, she was one of the first female physicians to work on smallpox eradication at the Centers for Disease Control and Prevention and one of the first doctors to work on the AIDS epidemic. She did all of this during a time that did not favor women in the medical field.

In a new memoir, Adventures of a Female Medical Detective, Guinan tells stories of her experiences in controlling outbreaks, researching new diseases and caring for patients with untreatable infections around the world.

Guinan, based in Reno, Nev., is a professor of epidemiology and community health at the University of Las Vegas' School of Community Health Sciences. This interview with NPR's Michel Martin has been edited for length and clarity.

You started your career at a time when only 10 percent of medical graduates were women. What attracted you to this?

I really wasn't attracted to epidemiology. I was an internal medicine resident, and I thought I was going to be a hematologist. But I started to get worried that I didn't want to do that. I read about a wonderful new program to eliminate smallpox in the world. This would be the first time in history that a disease would be eradicated [by] the design of people. I wanted to be part of that.

The Centers for Disease Control was the agency liaison with the World Health Organization in the U.S., so the people volunteering for the smallpox eradication program were at the CDC, and most of them were coming out of this program called the Epidemic Intelligence Service.

I applied to be an EIS officer and I was accepted in the class of 1974. I was the only woman physician in a class of 39 physicians, then volunteered for the smallpox eradication program and eventually got accepted and went to India.

In fact, you had applied many, many times and they wouldn't take you.

They told me first that the WHO wasn't taking women, and then I said, "Well, can I appeal?" They said, "It's a done deal. Women aren't being taken by the WHO."

They kept asking volunteers to go to India — "It's really important, we need to wipe out smallpox in India." I applied again and they said, "It's really not the WHO that's keeping women out, it's India. India says no women in the smallpox program." I said, "Can I speak with the director of the EIS program?"

I asked him, "You know the prime minister of India is a woman. Does she know you're banning women American physicians from entering the smallpox eradication program?" And he said nothing. I said, "Well, should I write to Indira Gandhi directly, or should I write to the embassy of the United States and ask them to rescind this ban?" He said, "I'll get back to you."

The next week, without any explanation, I was accepted into the smallpox eradication program.

Would you talk a little bit about your time there? What stands out?

It was unbelievable. Where we were was a remote area with a 99 percent illiteracy rate, up near Nepal and Uttar Pradesh. The women had never seen a foreign woman before.

People would come out and stare at me. The women always wanted me to come out to their mud huts and talk to them. Unfortunately, I had a male interpreter with me all the time, and they wouldn't allow him in the hut. They insisted I come in anyway, and they would pat my stomach and ask me where my babies were. It was so sweet. I always knew the women would be cooperative with me [about smallpox vaccinations] because they found me interesting.

You were working with the sexually transmitted disease unit in the early days of the AIDS outbreak. Did you feel that there was a stigma to that work back then?

I can tell you it was unusual for a woman to be working in the area of sexually transmitted diseases. People would say to me, why would you do that? Why would you be in such a specialty? Do you have this interest in looking at people's genitals? Well, is that what you would say to OB/GYNs? To urologists? Why would you think they were perverted?

What did your mother think of your line of work?

My mother was very proud of me at the CDC. She didn't know I was working in sexually transmitted diseases.

I was asked to be interviewed by 60 Minutes, and I refused to go on there because I thought it would be another crazy interview where people would accuse me of doing something unusual or something that perhaps was a little off-base for a physician. They called the White House and asked, "Why is Mary Guinan not going on our program? [Is she] covering up the herpes epidemic?" — which is what I was working on at the time.

The head of CDC called me and said, "Mary, you know, I understand that you have refused to go on 60 Minutes, but I think you should think that over again," so I said I would go on.

I told my mother I was going to be on 60 Minutes, and she told everyone at her church, our relatives in Ireland. I started worrying and sweating about not what 60 Minutes might do to me but what my mother would think!

The opening question was, "Dr. Guinan, what venereal disease would you least like to have?" It went downhill from there. I talked about syphilis and gonorrhea and oral-genital sex and a number of other things. After the show, I got a phone call from my mother and she said, "Congratulations, dear, your hair looked very nice."

Well, that's wonderful!

She said, "[You] go girl," as far as I was concerned. So if my 70-year-old mother could deal with me as an STD expert, I didn't care what anyone else really thought after that.

Were you ever afraid?

I received an AIDS needle stick at one point in my life and thought I had AIDS. But fortunately, I did not.

Weren't you terrified? This was at a time when doctors weren't sure about how AIDS was spread. Two years later, you found a lesion in your arm where you were stuck by the needle. You had just given birth. When your assistant heard you had HIV, she quit on the spot. How did you deal with all of that?

It was a very difficult time. In the early days, when I spoke to anyone about AIDS, people might take two steps backward.

At the CDC, the STD division was unusual in that we had clinical practice, so I saw patients on a regular basis. I saw what everyone was going through. I said to myself, "If that's what happened, that's what happened." But my greatest fear was that my child might be infected, and fortunately, he wasn't.

One of the interesting things about the book is your low opinion of the news media, at least in the early days of the AIDS epidemic. You talk about the price of misinformation.

For example, CNN called to ask your opinion on the controversy of women workers at an insurance company in Chicago. They were picketing the company because they had to use a bathroom with only one toilet, and the women believed that one of their co-workers had AIDS. They were convinced that they were at risk of contracting AIDS from using the bathroom.

CNN persisted and the CDC wanted you to talk to them even though you didn't want to. Do you remember what you said when the reporter asked if you were sure you couldn't catch AIDS from a toilet seat?

Yes, I do: "The only way that I know you can get AIDS is if you sit on it before someone else gets up."

You said you never saw the news clip, but you've often seen that quote in a slide in medical meetings. Someone said that line would be your epitaph. But if you could pick, what would you want your epitaph to be?

"She was right about public health."

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

MICHEL MARTIN, HOST:

Now let's hear from someone at the other end of a career in science. Dr. Mary Guinan spent decades traveling around on the world trying to track the source of disease outbreaks working for the Centers for Disease Control. She called herself a medical detective, and she explains what that is.

MARY GUINAN: A medical detective is an epidemiologist. An epidemiologist is someone who studies the health of populations and tries to use the data collected to prevent and control diseases.

MARTIN: Dr. Guinan investigated the illnesses of some of the first AIDS patients during her 20-year career at the CDC. Dr. Guinan's new memoir showed up in the mail just as the world was turning its attention to another disease outbreak. We called her in Reno, Nev., where she lives now. Her memoir is called "Adventures Of A Female Medical Detective." And I started by asking her what attracted her to the field.

GUINAN: I read about this wonderful new program to eliminate smallpox in the world. This would be the first time in history that a disease would be eradicated from the world by the design of people. I want to be part of that.

So the people volunteering for the smallpox eradication program were at CDC and most of them came out of this program called the Epidemic Intelligence Service. So I applied to be an EIS officer, and I was accepted into the class of 1974. I was the only woman physician in a class of 39 physicians and then volunteered for the smallpox eradication program and eventually got accepted and went to India.

MARTIN: Some of the pages that I think Americans will recognize was from those early days of the AIDS outbreak. I mean, one of the things that I found fascinating was you were working with the sexually-transmitted diseases unit. And do you feel that there was still kind of a stigma to that work because it was hard to talk to people about it?

GUINAN: Well, I can tell you that it was very unusual for a woman to be working in the area of sexually-transmitted diseases. People would say to me why are you doing that? Why would you do that? But I told you about my mother and how in the book about my mother and how she found out what I was doing. She knew I was working at CDC. But she didn't know I was working in sexually-transmitted diseases.

And so I was asked to be interviewed by "60 Minutes," and I refused to go on there because I just thought it would be another sort of crazy interview where people would be accusing me of doing something that perhaps was a little off-base for a physician. And so the head of CDC called me, and he said well, I think you should think that over again. So I said I would go on, and then I told my mother I was going to be on "60 Minutes." I knew the date - you know, it was six weeks ahead.

And I started really worrying and started sweating about - not what "60 Minutes" might do to me but what my mother would think. And I didn't know if they were going to say well, the opening question is Dr. Guinan, what venereal disease would you least like to have - and went downhill from there.

MARTIN: Oh...

GUINAN: And after the show, I got a phone call from my mother. And she says congratulations dear, your hair looked very nice.

MARTIN: (Laughter) Well, that's wonderful...

GUINAN: It was wonderful.

MARTIN: ...'Cause...

GUINAN: She said go girl, as far as I was concerned. And so after that, if my 70-something-year-old mother could deal with my working as a sexually-transmitted disease expert, I didn't really care what anyone else thought.

MARTIN: Well, I'm glad you brought that up because one of the interesting things about the book is your low opinion of the news media. You talk about, for example, the day that one of the cable networks called to ask your opinion about the controversy involving the women workers at - an insurance company in Chicago were picketing the company because they had to use a bathroom with only one toilet and the women believed that one of their co-workers had AIDs. And they were convinced that they were at risk of contracting AIDS from using this bathroom. Do you remember what you said?

GUINAN: Yes, I do. I said - Dr. Guinan, Dr. Guinan, are you sure that you can't get AIDS from a toilet seat? And I said the only way that I know of you can get AIDS from a toilet seat is if you sit down on it before someone else gets up.

MARTIN: And you said that you never saw the news clip but a lot of people did. A colleague once said that that line would be your epitaph. You think that's true? I remember it.

GUINAN: Yes.

MARTIN: I confess...

GUINAN: Yes.

MARTIN: ...That I do remember it, so...

GUINAN: (Laughter).

MARTIN: When it was all said and done though, I mean, did you see some similarities between your work overseas and the way sometimes people would react in this country to word of an epidemic?

GUINAN: Yes, I think that there's a great misunderstanding of how epidemics occur and how they're controlled. The - public health is a specialty that deals with this. And I think the public really doesn't understand it our value it very well, which is why I wrote the book and why I geared to the general public because I hoped that people would understand better our public health system in the United States and how it works to prevent disease and promote health.

I loved working at CDC. It was just such a wonderful place to be. There were people there that you just would not believe. They were so dedicated. And they didn't - had no fear and going to all parts of the world and investigating terrible outbreaks and trying to get them under control.

MARTIN: Were you ever afraid?

GUINAN: I wrote about it in the book. I received an AIDS needle stick at one point in my life, and then eventually I thought I had AIDS. But fortunately, I did not. I used to be afraid of talking about being a sexually-transmitted disease expert. Can you imagine?

I used to say I can clear a room by saying I'm from the venereal disease control division and people would just run away. When I spoke to anyone about - that I worked in AIDS, people would take - in the early days might take two steps backwards. You know, when I said to myself if that's what's happened, that's what's happened. You know, that's the choice I made.

MARTIN: Well, before we let you go, I want to mention that you have a long career at the Center for Disease Control. And then you went to become a state health officer and a professor. What would you want your career - your epitaph to be?

GUINAN: I'm not sure. Let's see - maybe she was right about public health.

MARTIN: That'll work.

(LAUGHTER)

MARTIN: Dr. Mary Guinan's new memoir is called "Adventures Of A Female Medical Detective: In Pursuit Of Smallpox And AIDS." She was with us from Reno, Nev., where she's also professor emerita from UNLV. Dr. Guinan, thanks so much for speaking with us.

GUINAN: You're welcome. Transcript provided by NPR, Copyright NPR.