ASTCT asked Kirsten Williams, MD questions about what it is like to be a woman in the transplantation and cellular therapy field in celebration of Women's History Month, March 2023.
What inspired you to enter the BMT and Cellular Therapy field?
I’ve wanted to be a pediatric oncologist since I was 8, when my best friend’s brother was diagnosed with cancer of his pitching arm. Soon after, our adventures of solving mysteries and speeding along on bikes moved to antics in the living room, filled with a hospital bed and her now-bald brother. We really believed we could contribute to his cure. Later, my neighbor, a college senior, was diagnosed with AML and never even made it home from school. By age 12, I decided that I wanted to try to improve cancer outcomes through research, prompting me to swim to raise money for the Leukemia Lymphoma Society. Before I was 17 years of age, I would have known 7 people I loved who died of cancer and I had decided this was the problem I wanted to tackle for my future.
With my first pediatric patient in medical school, I further differentiated to BMT and cellular therapy. She was a toddler with M0 AML and diffuse leukemia cutis who had visibly failed every chemotherapy attempt. After a cord blood transplant, she achieved her first-ever remission with a marrow filled with natural killer cells—lauded as the mediators of her remission. Sadly, her remission lasted just 20 days; she died the next. Were there insufficient numbers or activity or focus of these cells to conquer her AML? In her short life, she inspired my lifelong passion, to understand how the immune system recovers and how we can imprint the threats of tumor and infection while averting the misdirected assault on healthy organs.
How do you inspire others?
For me, those who inspired me the most were the ones who took a nontraditional path but succeeded while unifying their peers. Some pursued patient reported outcomes instead of a laboratory project, or sought a new mechanism when the current dogma was established but unproven. I have tried to follow in their footsteps by following my passion in unconventional ways. While I started my career interrogating how to reinvigorate the thymus in mice, I somehow ended up writing a lung chronic graft versus host disease interventional trial based on data from lung transplant bronchoalveolar lavage. (In my defense, I had 6 patients with this disease and realized 5 would die before I finished my NIH-protracted-6-year fellowship). I hope that I can echo the inspiration of my predecessors—that there is no single outline that we must follow to elucidate disease and improve outcomes. Further, I strive to promote collaborations and connections between diverse individuals, and hope that I am continuing the work of others who first developed small and large consortia to address urgent needs. This combination of unique approaches and diverse team science has been shown to elevate publications, and I suspect, ultimately contributes to our happiness in our work, and our ability to continue to be collectively inspired in our field.
Which living person do you most admire?
My mother. She was the child of German immigrants and grew up on a farm in rural Missouri without running water. Her mother had abandoned her bank account in Germany and boarded one of the last boats to the U.S. in 1937, lacking a college education nor proficiency in English. Despite this, her daughter, my mother, entered college, supporting herself by washing dishes in a laboratory. Undaunted by the myriad of medical schools who would not even grant her an application nor an interview (“we have filled the women slots” and “why she should steal the spot from a more-deserving man”), she joined just 5 other women in a medical school class of 111. Years later, as I stood to take my Hippocratic oath with those in the audience who were physicians, my mother was the only one, the only woman of her vintage, in a sea of men.
My mother, Dr. Margarethe Hagemann, spent her career fighting for equitable care, from the city hospital where she started her career, to her final position in the Veterans Administration as a Chief of Staff. She practiced evidence-based medicine long before this was coined, and fought for equitable care of her patients. She implemented algorithms in the emergency room for rapid diagnosis and treatment of common conditions and expanded options for psychiatric and other benefits that were an urgent need in the VA. In the midst of this, she became a single parent of 4, a hectic world she made look facile. She worked 47 years in medicine, transforming care for many of our most vulnerable, striving to make rapid but enduring change, and was a trailblazer for women in medicine in so many ways. She did all this without recognition until today. And notably, she isn’t done—she still consults with aplomb on pediatric BMT patients as well as friends, family, and of course, those of her handyman, lawn mower, pest control expert, and community center receptionist.
What does it mean to you to be a woman in this field?
Although I am a pediatric transplanter, a field filled with women, most of my experience has been as a gender minority. In fellowship and my early career, I was often the only woman at the table, and a very short slight one at that. I remember looking around at my first tandem meetings seeking my role models. There were so few women on the podium then, or in leadership positions, to guide me. However, I sought out some of these wonderful women over the intervening years, and feel deep gratitude for the ways they taught me to overcome adversity, including Drs. Mary Horwitz, Stephanie Lee, Stefanie Sarantopoulos, Sophie Paczesny, and Mary Flowers, to name a few. My fervent hope is that I am paying these gifts forward, helping the next generation, regardless of gender.
I do feel that as a woman, I—we—have an onus to improve things for the next generation. I was told many times that I should give up on a career in medicine, research, and should stay in my lane. I know from friends and colleagues that these are constant refrains for women. The first woman’s medical school opened in 1848 and was absorbed in Boston University in 1874. A century later women like my mother were still fighting to get a seat in the classroom. We know the story of Rosalind Franklin who lost credit for the discovery of the structure of DNA to a man, and it still goes on today. I think we need to bolster women, and even more so, non-white women, to foster a culture of learning and patient care excellence, devoid of marginalization, misogyny, and misappropriation of credit.
What do you consider your greatest achievement?
I think my greatest achievement so far is being in our field at this moment, to have the good fortune to work with amazing colleagues inside my program (CHOA), and collaborators, mentors, and friends from Oklahoma to Michigan and NC to Seattle; to have treated amazing children and watch them graduate high school; to be afforded the opportunity to answer research questions to increase our understanding a mere pixel at a time—in lung chronic GVHD, or graft failure, or immunotherapy; to be fortunate to mentor such incredible rising stars—our most important achievements, our legacy.
Who are your heroes in real life?
Desmond Tutu for shaping how I look at the world: if you are neutral in situations of injustice, you have chosen the side of the oppressor. Ruth Bader Ginsburg for inspiring me: the freedom to think, speak, and write are so precious but vulnerable. The unsung heroes- our patients, those who rescue us in our darkest hours—family, friends, and confidents—you know who you are!
Tags: Womens History Month, Women, Women's History Month