I am a physician-scientist with broad interests spanning basic, translational, and clinical aspects of bone biology. I've followed an academic career and devoted significant effort to patient care, education, and research. After training, I joined the Hospital for Special Surgery, an academic orthopedics and rheumatology specialty hospital to study the genetic basis of bone biomechanical performance in mice and develop proficiency in clinical aspects of metabolic bone disease. During that period, I also developed an interest in scoliosis and congenital vertebral malformation genetics. I moved to the University of Wisconsin in 2000, remaining there for 13 years. My research focus expanded there to include bone manifestations of other disorders. I became a leader in UW's MD-PhD program and developed a transitional curriculum for students as they went from the classroom to the lab and from the lab to the clinic. In 2013 I became the chief of endocrinology at the Medical College of Wisconsin. While there, I learned about the challenges of organizing the many activities that go into making a successful division, a successful medical practice, and a successful school. This was my hardest job.
I retired in 2019 and joined the Garvan Institute, where I pursue basic and clinical research and mentor junior colleagues. I'm active in professional societies, advocacy for musculoskeletal disease care and research, and publishing. Thanks to my many mentors and colleagues.
What is your favorite Endocrine Society memory?
My fondest Endocrine Society memories are the meals shared with past and present members of the University of Wisconsin endocrinology division. This was a great opportunity to keep up with former trainees after their graduation from our fellowship, and after I'd left UW, to stay connected with my former colleagues there. Typically, there are 20-30 people present. A partially overlapping group follows the same practice at the American Society for Bone and Mineral Research annual meeting.
How has Endocrine Society supported your professional development/career journey?
The Endocrine Society was most important to me during the 5+ years I spent as division chief at the Medical College of Wisconsin. There is a dinner and evening session at the annual meeting for the chiefs that always provided information and insights I could use. It was a fantastic opportunity to meet peers and learn what challenges were shared. Outside the meeting, the group did important work on expectations, work conditions, and compensation. These efforts were invaluable in supporting my efforts to advocate for the division. Throughout my career, I've benefitted immensely from the society's journals. I've been a contributor, reviewer, editorial board member, associate editor, and of course, reader. I can't measure how much I've learned from the journals, but it's a lot! And last but not least, annual meetings are fantastic.
What experience led you to the study of the endocrine system?
I fell into endocrinology almost by accident, but it's been a great fit. I knew that I was destined for an academic career and wanted a specialty that would allow me to schedule my clinical time while providing a platform that would allow unrestricted choice of research topics. I followed the investigator pathway during residency and fellowship and was fortunate to have supportive mentors. Clinical observation of the variable manifestations and degrees to which patients responded to glucocorticoids launched my interest in the underlying genetics. As I was moving toward independence, I was based at the Hospital for Special Surgery and had great access to experts in bones, joints, and muscles. So, I did a pilot experiment looking at bones' response to glucocorticoids, which I was unable to interpret because the baseline differences were so great. Ever since, I've been trying to understand those differences. It started with and comes back to patients and their needs.
What would you most like to tell yourself at 18?
Smart people are a dime a dozen, but common sense and wisdom are rare nonetheless. The latter come from curiosity, willingness to listen, and perseverance.
What is the best thing about what you are working on right now?
I work in several seemingly disparate domains, all of which share the opportunity to learn new things. I am engaged in epidemiological and healthcare systems research that is remote from what I did earlier in my career. Other current research features single cell RNA-seq approaches that were also new to me. As a visiting scientist, I have the freedom to fail because I'm no longer responsible for figuring out how to pay all the people on the team. I can do projects that were too risky when I was a lab head. I can feed my interests without worrying that study sections will criticize my lack of focus.
My policy and advocacy efforts let me contribute to global health and well-being. It is very satisfying to have a reach that is greater than the patients I cared for myself. I've gained awareness of the variety of medical systems around the world and the challenges colleagues in low and middle income countries face. All of it has given me the opportunity to work with wonderful people.
If Endocrine Society could add one benefit, what would it be?
I would like to see a program that sponsors an exchange between investigators in developed countries and low- and middle-income countries. Ideally, this would cover travel for residential experiences at both sites. Possibly, it would be structured as a 6 month or 1 yearlong project. I think that applications would challenge people to develop some novel and important approaches. I think that reviewing the applications would teach the assessors about topics beyond what's already on their minds.
