Healthy Woman: Bernadine Healy '65

Show her something that's out of whack — a heart, a policy, an entire institution — and she'll do whatever she can to fix it. If there's anyone who doesn't shy away from challenges, it's Dr. Bernadine Healy.

As former president of the Red Cross and the first woman director of the National Institutes of Health (NIH), this Vassar graduate has taken on some tough tasks. And the forge-ahead agendas she's promoted - including preserving post-9/11 Red Cross donations in a Liberty Fund, for exclusive use in terrorist-related response and readiness; championing the efforts of Israeli's Magen David Adom to be included in the International Red Cross movement; and launching the largest-ever study of women's health issues - haven't always made her popular. But a little opposition rarely stops her.

 

A cardiologist trained at Harvard Med and Johns Hopkins, she's followed a lofty career path that's included (besides her stints at the Red Cross and NIH) being head of the Research Institute at the Cleveland Clinic and the coronary care unit at Johns Hopkins, dean of Ohio State University's College of Medicine and Public Health, and president of the American Heart Association. She's served, in an advisory capacity, three U.S. presidents (Reagan and both Bushes), and followed her own political instincts when she ran for the U.S. Senate from Ohio. She's also written hundreds of peer-review manuscripts and authored A New Prescription for Women's Health: Getting the Best Medical Care in a Man's World (Viking, 1995).

Now a columnist and senior writer for U.S. News and World Report (she writes the "On Health" column), Healy is somewhat relieved to be out of the limelight. In fact, she's pleased to be writing, which still gives her the chance to offer her opinions and weigh in on policy issues, perhaps on a more personal level. "It's really just another version of being a doctor," she says. "It's a way to communicate with people about one of the most important things in their life: their health."

In choosing her topics (recent ones have included teenage depression, the re-importation of prescription drugs from Canada, breast implants, the health risks of air travel, and the dubious claims of "safer" cigarettes), Healy taps her two decades' worth of patient care, experience in public policy, and extensive work as a researcher and scientist. Always, she abides by one simple rule: "Imagine you're the patient."

 

Her work in the media (including six years as a medical consultant and commentator for CBS News, editor of the Journal of Women's Health, and adviser for Prevention magazine) has made clear to her the necessity of talking to the public about complicated issues in understandable ways. And beyond that, she says, "medicine has moved to the realm of being something that must be, should be, driven and dominated by the needs of patients. What do they need to know? There's no question that the biggest variable in health care is education — whether or not you're informed about your health and well-being and use that information in a way to positively affect your life and your family's life."

The swell of magazine, newspaper, and Internet articles — not to mention books — that address health issues has gone a long way in getting people involved in their own well-being. "I don't know any other country that covers health as avidly," Healy says. But that doesn't mean it's easy to sift through all the information. Medicine has become more and more complicated, she says, and that shows no sign of letting up.

One notable change in recent years is the attention that's been given specifically to women's health issues. Even 10 or 15 years ago, Healy says, "it was a struggle to have people take you seriously when you were talking about the fact that differences between men and women weren't being adequately addressed in the health-care environment, and in the research environment. It was sort of seen as 'feminist ranting' or a distorted vision. Now you pick up a journal, and in virtually every area of medicine, you see studies examining fundamental differences between men and women — in the pathophysiology of disease, and how diseases should be treated."

Healy has played a key role in bringing women's health-care issues to the fore and changing the mindset. As head of the NIH in the early 1990s, she launched the Women's Health Initiative (WHI), an effort to study the causes, prevention, and cures of diseases affecting women over 50. "Mystery women," Healy calls them, because there was so little known about their risk factors for heart disease and cancer, or about dietary concerns or hormone replacement therapy (HRT).

"It was a really bold step," Healy says. The WHI — at the time, the largest clinical study ever undertaken in the world — teamed up 40 major women's health centers across the country to examine the health and well-being of women over 50. It came at a time, Healy recalls, when "people were saying it couldn't be done because you couldn't get women to enroll in trials, it was too big, too expensive — which, let's face it, was silly — it was not quite a billion dollars over 14 years. Because it's difficult, does that mean you shouldn't do studies?"

 

More than 160,000 women have participated in the WHI, and in its first decade, it has only begun to raise questions and disperse information, Healy suggests. A WHI report in summer 2002, for example, revealed that HRT — in regular use for decades — wasn't all it was cracked up to be. In fact, it was determined in the randomized clinical trial that HRT could be quite harmful. The side effects among women on combined estrogen-progestin therapy included breast cancer, heart attacks, strokes, and blood clots. The news was "a big shocker around the world," Healy says.

While the findings came as a surprise to her, too, she says she'd had "an intuitive sense that if you take women who are in their 70s who have not been on hormone replacement therapy — who have gone through menopause feeling well — and then you suddenly put them on hormones — we have no idea what that's about. That was just one big question mark, yet it was being done at the time. The world seemed ready to put hormone replacement therapy in drinking water [as if it was] good for everybody."

Healy's work at the NIH was cut short when the Clinton administration took office. (She'd been appointed to the directorship by George H. W. Bush in 1991.) While her tenure in the post did allow her to oversee the WHI, time ran out before she could fully launch a similar initiative focused on nutrition. In terms of medical science, she says, "I think nutrition has really fallen through the cracks at every level. It's time, as it was 10 years ago, to look at it, in part because we now have more insights into genetics. Everyone doesn't have the same risks. People have different diets; there are reasons for that. A particular diet might be good for some people and not for others."

Nutrition "is the ultimate biochemical interaction — the human organism reacting with the environment, daily, in a very intimate sense. And it's been starved for research funding," Healy says. "If you don't invest in research in a particular area, you're not going to have any scientists working there. They might have all the ability and attention to doing it, but if there's no money, there's no ability to set up laboratories and train new scientists."

Nutrition studies, no matter how simplistic they might seem, need to capture funders' attention, Healy says. "Again, if you focus on who you're serving — the public, the patient — then it seems obvious that you need to do those studies. Like it was obvious there needed to be more emphasis on women's health research."

 

In her commencement address at Vassar in 1994, Healy reminded her audience that no matter who we are or what we do in life, every one of us has a stake in health. She spoke about the huge advancements being made in medicine, calling the trend "a measure of the greatness of this country and its priorities, especially how we value the individual." She urged everyone to acknowledge that ethics and public interest are necessary companions of science. And, in trademark Healy fashion (she ends all her addresses this way), she concluded with the maxim, "At the end, what really matters is who you loved and who loved you." It's a sentiment she holds near and dear.

"I've been with many people in the last moments of their lives," the cardiologist says. "I've sat at their bedside and held their hand in the last moments of their life. They've shared with me where they are, what's burdening them, what's giving them any kind of solace. You never hear anyone talk about the money they did or didn't make, the jobs they had or didn't get, the vacations they went on...it's only about who they love and who loves them. Because in a way, that's a measure of your life — your family, your friends. That's the most important thing, and you have to keep it in your heart at all times. It doesn't mean you don't enjoy your life and what you're doing. But ultimately, we all will face that time."

When Healy had a brain tumor a few years back, she had a life-assessing moment of her own, which only reinforced her view. "You're there in a very lonely time in your life, and your relationships are the things that define who you are and how you get through that period of time, whether it's for good or bad."

In becoming a doctor, Healy "approached medicine as both an intellectual and a spiritual, humanitarian, endeavor. I still feel that way, absolutely," she says. "I think the moment medicine ceases to be [both those things], it'll break with what should be an immutable quality in medicine, which is helping a fellow human being in distress." Throughout her career, Healy says, whatever she's taken on — "even if it seemed a little off the beaten path" — she's done it as a doctor. "There are different ways to practice medicine," she says. "But I've never ceased having the heart of a doctor, the mind of a doctor, the perspective of a doctor."

Maryann Teale Snell is a freelance writer and editor in Saratoga Springs, NY.

 

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