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February 02, 2005

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Publication Date: Wednesday, February 02, 2005

Cover story: Dr. Hannah Valantine's journey through diversity Cover story: Dr. Hannah Valantine's journey through diversity (February 02, 2005)

Ladera resident comes from mainland Africa's smallest country. Now she's professor of cardiology at Stanford's medical school, and its newest dean, promoting diversity and leadership on the faculty.

By Marion Softky

Almanac Staff Writer

Think diversity? Dr. Hannah Valantine has been there.

Born in Gambia, educated as a cardiologist in London when women were expected to stay home and have babies, now a medical star at Stanford, Dr. Valantine has conquered minority status all along her path.

Now she's a professor of cardiology at the Stanford University School of Medicine and heads clinical research in its post-heart transplant program. Yet she still takes time to help other women, minority, even non-minority, faculty members to forge the same kind of success she has achieved.

As if she didn't already have enough to do, Dr. Valantine has accepted a newly created post as senior associate dean for diversity and leadership in the medical school. She will work half-time toward the goals of attracting more women and minorities to the faculty, and ensuring that all junior faculty members become able to succeed in their careers.

"At the very least, our faculty should represent the proportion of minorities and women in the general population," says Dr. Valantine.

Dr. Philip Pizzo, the medical school dean who appointed Dr. Valantine, says he created the post because he wanted the school to have a "focused effort on this very significant challenge."

Dr. Frances Conley, who went public in the 1990s about sexism in the Stanford medical school, hailed Dr. Valantine's appointment.

"She's absolutely fabulous," says Dr. Conley, who moved from Woodside to Sea Ranch after retiring from Stanford and the Palo Alto Veterans Affairs hospital. "This position won't be just a feather in her cap. She'll take it and run with it -- which is great."

The need is obvious. At Stanford, 55 percent of medical students are now women, Dr. Valantine says. But only 25 percent of faculty members, and 8 percent of senior faculty, are women. "We are not catching up," she says.

The situation with minorities is more complicated. While 22 percent of current medical students are under-represented minorities, Hispanics and blacks make up just 10 percent, according to Dr. Valantine. On the junior faculty, a number of Asians and Asian-Americas are coming up through the ranks of assistant and associate professors, but the number of Hispanics and blacks remains low.

The 308 senior faculty members at the medical school include 18 Asians or Asian-Americans, six Hispanics, and one black -- Dr. Valantine. "Stanford is really committed to improve diversity on the faculty," she says. "It's a real challenge."


Banjul to London

Thirteen is not an easy age.

Thirteen was particularly hard for Hannah Valantine. In 1964, she moved from Gambia, mainland Africa's smallest country, to London with her parents and five brothers and sisters. Her father, a retired government administrator, was tapped to become ambassador from the newly independent country.

"I had a sense of being different," Dr. Valantine reflects 40 years later. "At 13, you don't want to be different."

London was different, too, from Banjul, the capital of Gambia, where Hannah grew up in a family compound full of jostling kids playing games and sports and contests. She was also a top student and leader at school.

"I have very good memories of my family home," she recalls. "That completely disappeared in London. It was a difficult transition."

In confronting her new sense of isolation, and of being different, Hannah learned important things that helped her then, and now help her help others.

She was a top student, even in England, and soon qualified for a first-class girls school affiliated with Westminster Abbey. But she was lonely there, too; out of 600 girls, there were two minority students: one from India, and one from West Africa -- Hannah Valantine.

Later, Hannah attended Chelsea College at the University of London, and graduated with a degree in biochemistry.

At first, she wanted to be an airline pilot, but that career wasn't open to women. So she turned toward medicine. "I loved anything to do with circulation; I wanted to do research," she says.


  Black and female, in med school

Medicine in England was still pretty much a man's world when Hannah Valantine entered medical school at London University. She was a leader and did well -- until she told colleagues she wanted to become a cardiologist.

They scoffed at the idea of a black woman becoming a cardiologist, she says with a chuckle. "They said, 'Are you crazy?'"

Dr. Valantine recalls that at that time, the overriding feeling was: "What was the point of training women? They get married and have babies."

Nevertheless, Dr. Valantine persisted. She trained in cardiology at Royal Bronton Hospital, which specialized in hearts and lungs. Later, she spent two years at Royal Postgraduate Hospital at Hammersmith, and two years doing research.

A major key to Dr. Valantine's success -- mentors -- is something she wants to strengthen at Stanford. "I found some great mentors, white men who believed in what I could do," she says.

Dr. Valantine recalls vividly how she got her first residency by a stroke of luck, a fluke. She had made the short list for a residency, but was not picked. Then the successful applicant went away for a couple of weeks, and she was offered the job temporarily.

She was such a success in those two weeks, the hospital administration arranged for her to stay. "I got in and never looked back," she says. "Once there, they support you; it's one of the best."

That experience speaks to another need Dr. Valantine sees at Stanford. "We should teach women and men to seize the opportunities that come up," she says. "That's part of the equation."

By the early 1980s, Dr. Valantine was ready for her "BTA" (been to America) degree, which was considered crucial training in the field of cardiology.

In 1985, Dr. Valantine came to Stanford, already a Mecca in the field of heart transplants, for a year as a research fellow. Twenty years later, she's a full professor.

"I really felt my career path would be more supported here than it would have been in England," she says.


Probing the heart

In the cardiovascular clinics at Stanford, the atmosphere seems to brighten whenever Dr. Valantine stops by.

Lynn Milteer, a retired flight attendant whose transplanted heart is being rejected after 10 good years, chats warmly with her; you can feel the bonding. "I love her," says Ms. Milteer, who hopes to benefit from treatments Dr. Valantine has developed at Stanford.

In another treatment room, a computer monitor shows Ms. Milteer's heart pulsing sinuously. This is an echo-cardiogram, a technique that Dr. Valantine has developed at Stanford. "The beauty of an echo-cardiogram is it's non-invasive," she says.

The flexing image on the screen is an ultrasound map of the heart. It allows Dr. Valantine to detect specific spots where the transplanted heart is being rejected by the patient's body. "It tells how well the heart is functioning," she says. "You can tell it's not working well. A month ago it was much more vigorous."

The echo-cardiogram is followed up with a biopsy to confirm the diagnosis. "We can predict the early stages of rejection so we can increase the dose of immune suppression drugs," Dr. Valantine explains. "Transplant patients take immuno-suppression drugs for the rest of their lives."

Dr. Valantine's research focuses on why the arteries of a transplanted heart tend to block up after a transplant. She is in the fourth year of the research, funded by a grant from the National Institutes of Health.

Dr. Valantine has been pursuing the hypothesis that a virus could be causing the early rejection of transplanted hearts. "Our preliminary results suggest the virus becomes activated in the blood after a transplant, so the patient's risk of acute rejection is increased," she explains. "So five years after a transplant, you can end up with blocked arteries in a young heart."

During her 20 years at Stanford, Dr. Valantine has also been active outside the clinics and laboratories. In 1990 she married a Frenchman, Denis Von Kaeppler, who works as a consultant in information technology. They live in Ladera with two daughters, Ericka and Natasha, and a series of cocker spaniels.


  Why diversity?

Dr. Valantine knows from her own experience how women need greater flexibility to succeed in medicine, and also care for children. "They need more clarity about what they need to do to be promoted," she says.

Dr. Valantine hopes to bring this sensitivity not only to women and minorities but to all junior faculty, who often feel lonely, isolated, and unsure of their future careers.

"One of the big problem areas is to make sure that all faculty have an opportunity for success within the medical school," she says. "They need career development, leadership training, opportunities for promotion. We can do a lot better."

Dr. Valantine is focusing on building institutional support in three areas:

** Education in managing diseases that may affect different races and genders differently.

** Treatment that recognizes these differences and also respects cultural differences.

** Research, where it is important to include these differences.

"In clinical treatment, you need to enroll people from different ethnic groups, so you can see if treatment works across racial and ethnic lines," she says.

Mentors are high on Dr. Valantine's to-do list. Her own mentors -- including heart transplant legend Dr. Norman Shumway -- were crucial to her success.

"You need more than one mentor," she says. "We want to look specifically at training mentors to be more effective, and being sure everyone has mentors, and coming up with a method of evaluating mentors."

Well-organized and to the point, Dr. Valantine is overflowing with ideas about how to improve career paths in the medical school. Every faculty member should have an individual career development plan for the next seven years.

"It's not that difficult," she says. "Once it's clear, you have a road map. That helps take out the stress."

There is also a need for more social programs to address isolation, so that junior faculty can share experiences, network, develop bonds, and engage with senior faculty. The alumni can help. "Simply getting together is the first phase," she says.

One topic not on Dr. Valantine's agenda is the sexism and sexual harassment that plagued Dr. Conley during her decades in the Stanford medical school. That has already been addressed through a variety of mandatory training programs, she says. "Sexual harassment has become a non-issue."

Dr. Conley, who left Stanford in 1997 and wrote a scathing book, "Walking Out on the Boys," tends to agree. "Stanford has improved a great deal since my day," she says in a phone interview from her new home in Sea Ranch.

Dr. Conley admires Dr. Valantine and believes she will be able to improve the environment for recruiting new faculty members and improving their success at Stanford.

"She is unique -- intelligent and outspoken," Dr. Conley says. "She is very beloved by students, and by patients also."

Dr. Conley stresses, "I hope they will continue to increase the number of women faculty and minority faculty.

"Medicine is such a touchy occupation," Dr. Conley says. "It's very inhibiting not to have a role model who can show you it's OK to touch across skin-color differences, and across gender differences."

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