Women in science and medicine

1 INTRODUCTION

Science and medicine know no barriers, no country, and no language. They are universal tools for the benefit of humankind meant to be accessible to everyone, both men and women. As women physician-scientists, we all have had our own journeys wanting to be part of science and medicine. We were curious and enthusiastic but did not see the glass ceiling as we grew up but have witnessed it in our and others' careers. Our role models were women who tackled difficult questions and broke glass ceilings: Marie Curie, Rita Levi-Montalcini, Golda Meir, and Indira Gandhi.

1.1 Journey of Mariana Castells

Born in Barcelona, Spain, I received a privileged education in a co-ed, multicultural school. Inspired by my biology teacher, I fell in love with anatomy and physiology and took up medicine. When I read the K. Frank Austen's chapter on allergy in the Harrison's textbook, I was fascinated by the immune system. Wanting to explore the world, I moved to the US and did my PhD under Larry Schwartz at Richmond, Virginia and defined tryptase as the major protease of mast cells as my dissertation, while a mother of a 9-month boy. I became a mast cell biologist, moved to Boston in 1990 and cloned the first mast cell inhibitory receptor, mouse gp49B1 in K. Frank Austen's laboratory, the year my daughter was born. My work on the ligand avb3 led me to publish in Nature Immunology with my confocal microscopy figures on the cover, in 2001. Translating the functionality of inhibitory receptors in humans, I generated the first desensitization protocol for chemotherapy, standardized protocols for antibiotics, monoclonal antibodies and all medications now being used globally. K. Frank Austen taught me that excellence is not a choice but an obligation and that following one's passion can lead to discovery. Albert Sheffer, my clinical mentor, taught me that no patient is too complex and that a good physician is one who is available, listens, and heals. Along my journey, I had no female mentors and I looked at my mother, grandmothers, and great grandmothers for strength and comfort. It takes more than a village to get a woman to this height, and the journey was neither short nor easy but filled with excitement at each step, which provided impetus to continue and never give up.

1.2 Journey of Mübeccel Akdis

Born in Turkey as the third daughter of a strong mother with four girls, I was fortunate that my parents supported our university education despite the conservative society. I witnessed the struggles of my eldest sister at university and as a teacher in a remote town. I was relatively in safe heavens with the experience that she had brought to our family and the era of rapid modernizations of 1970s. I wanted to become a doctor since the beginning, as I was very eager to learn, especially biology, and became a physician in 1985. I feel myself lucky to have moved to the Swiss Institute of Allergy and Asthma Research in Davos to pursue my keen interest in immunology and I did my PhD on skin immunology. Just as Carl Sagan said, "something incredible was waiting to be discovered somewhere." I started researching the mechanisms of allergic diseases under my first mentor, Kurt Blaser, and continued investigating the mechanisms of allergen tolerance in human allergen-specific T and B cells. I established the immune dermatology group in 2003, habilitated in 2005, and became professor at the University of Zurich in 2015. Using single-cell sequencing technologies, we continue to investigate the mechanisms of immune tolerance to allergens, and in-depth characterization of regulatory and effector B cells. Even though in Switzerland there is a huge gender imbalance in universities, our institute has an over 50:50 gender ratio. My husband and I also did our best in parenting our daughter who is now a young physician-scientist. Science is not a job, it is a life style for all three of us. Scientists can create miracles with effective time management and creatively improve our capabilities to meet our needs. The most important thing is to believe in yourself and continue with your endeavors.

1.3 Journey of Kari C. Nadeau

Born in New England (USA) to a family of farmers and immigrants, I was taught that hard work and perseverance are key qualities in life. In high school, I loved math, science and volunteering to take care of people and the Earth. Fortunate to have had many mentors, I remember some saying “women don't become doctors” (and at 14 years my inner voice knew they were wrong) and others teaching “the sky is the limit.” As my family could not afford supporting my college or graduate education, I won scholarships to follow my dream to become a doctor. My PhD was in Biochemistry under Dr. Chris Walsh who strongly encouraged women and people of color to become leaders. My training in allergy, asthma, and immunology was with Dr. Dale Umetsu who said to me “Let patients inspire your science.” I felt my work in immunology was an opportunity of a lifetime for me to study science to help improve the lives of patients. From parasites to proteins, food allergies to food safety, from wildfires to world health, my curiosity and my scientific approach have driven many collaborations with rigor and excellence. I have invented new procedures and drugs, and started biotech companies and I now lead a Center dedicated to allergy and immunology research. I viewed every hurdle as an opportunity to learn. I chose friends and mentors who supported me to get through the toughest of times. I now enjoy mentoring and teaching other women to excel in their careers while juggling life and family. I feel fortunate to have a supportive family and to have a career as a physician-scientist, to be among other women and men scientists who are making transformative impacts in the world.

1.4 Journey of Ruby Pawankar

Born in Kolkata, India, into a family of many women firsts, I was brought up to believe in gender parity and the value of excellence. Keenly interested in biology and driven by a passion to heal the sick, medicine became my sole dream. Privileged to receive my medical education at the Armed Forces Medical College, Pune, India, I developed a keen interest in allergy and destiny brought me to Japan. While pursuing clinical expertise in allergy at Nippon Medical School, I also started laboratory work in allergy and immunology, researching on airways T cells and mast cells. I was fortunate to have the opportunity to work in Tomio Tada's and Ko Okumura's research laboratories. Science became my passion and my clinical mentors taught me that patients are our best teachers. My PhD dissertation was on phenotyping airway gamma delta T cells. Subsequently, I defined the role of mast cells in allergic airways disease exhibiting increased expression of the FcεRI, as a major source of IL-4 and IL-13, and in driving local IgE synthesis. This formed one of the basis of successful biological therapeutics. While I had supportive mentors, friends and a supportive husband, I faced many challenges as a woman. I feel honored to be one among many women physician-scientists and to have mentored many young women. In 2012, when I became the first woman President of the World Allergy Organization, I was still dealing with the untimely passing of my husband. Converting grief into positive energy, and believing in my inner strength, I focused on serving the global community. As President of APAAACI, I continue to be motivated to serve the region. As the saying goes, “We make a living by what we get, but make a life by what we give.”

2 THOUGHTS FROM PROFESSIONAL WOMEN WHO HAVE BEEN THERE

Stories can be empowering, and we hope that ours will encourage many young women into science and medicine (Figures 1 and  2). In our journeys we have had motivating mentors but often heard “You cannot have it all.” It's a man's job, said in different ways and many times. Our experience tells us that one should not be discouraged by the “Nay Sayers.” They do not bring solutions, see or recognize problems and do not inspire you. Follow your passion, stay focused, stay positive, and stay strong. Be inspired by good mentors, mentor those younger, integrate with and motivate them. Be open to other's perspectives and divergent views. Be curious, consistent, patient and perseverant. Where there is no path, create one. Engage, participate, and prioritize. Do not be disillusioned by failure, it is the first step to success. Just do it.

image Panelists Professors Mariana Castells, Kari Nadeau, Mübeccel Akdis, and Ruby Pawankar. The APAAACI International Women's Day Special panel on “Women in Science” with moderator Dr. Agnes Leung https://youtu.be/hFx8rwjbHLQ image

A word cloud including words that women in science are often exposed to

CONFLICT OF INTEREST

The authors declare that they have no conflict of interest in relation to this article.

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