Heart to Heart

Training to become a cardiologist is a long and grueling process — four years of medical school, three years of internal medicine residency, and up to five years of a fellowship that cuts across young adulthood. Work hours extend beyond a typical 9-5 schedule, and it can be profoundly challenging to balance personal, family, and professional life. As a cardiologist with several decades of experience, I know firsthand the ups and downs that come with the job. But I am so thankful for my decision: I get to teach students and medical trainees, conduct research, and most of all, help and take care of my patients. 

When I was at Barnard in the late 1970s, I remember hearing that of all the women’s colleges, Barnard produced the most doctorates of any. At the time, I did not anticipate that I would be one of them, but I went on to earn two doctorates: one in exercise physiology and the other in medicine. But during my training, I soon learned there were areas of medicine that still had very few women doctors — and it wasn’t until then that I fully realized how this gender gap might present obstacles as I moved along on my own professional trajectory. Cardiology remains a male-dominated field; only 15% of cardiologists are women. I’ve personally faced gender issues in the workplace, often through implicit bias.

Looking back at my undergraduate experience, I am appreciative of the role that Barnard played in fostering my desire and resilience to go after whatever it is I wanted to do. It is not surprising that a number of cardiologists who’ve graduated from Barnard share this very sentiment. I spoke with three cardiologists spanning five decades — Nora Goldshlager ’61, Annabelle Santos Volgman ’80, and Lauren Cooper ’03 — about their paths into medicine and how Barnard influenced their lives and careers.

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Nora Goldschlager ’61

Professor emeritus, University of California San Francisco School of Medicine; former president of the Heart Rhythm Society

What made you decide to go into medicine?

My father was a cardiologist who had escaped from Russia and came to the United States. I knew I wanted to be a doctor at age 6 — not exactly sure where it came from at the time. When I was in the 7th or 8th grade, I used to help my father put together manuscripts and cut up his EKG tracings. And I got to be good at this. So, early on, I was fascinated by EKGs and heart rhythm and then knew I wanted to be a cardiologist.

How do you feel a women’s college helped you navigate your professional life? 

“Mentor” was not a word at the time, and I did not seek out or need mentorship. But I have to say, looking back: the excellence of the faculty, the student discussion, the stimulation. If you wanted a group to talk with in your classroom, I was never intimidated. There was no shyness or no embarrassment, no fear. I think that Barnard gave this to me; it was part of the journey. The freedom to be — that was part of what Barnard did for me. We could do [or] say anything and not pay a negative price. The freedom to think, talk, argue, and be wrong was there.

With the long years of training and long and unpredictable hours at work, how have you navigated family and job? 

I did not feel that there were “sacrifices” in order to be a woman in cardiology in terms of personal life. One of the things that was operative then but not now was the expectation that you had to have a family. My feeling is “you can do it all,” but you can’t do it all at the same time, and you can’t do it all well.

Cardiology remains predominantly male. Did you take this into consideration when deciding to pursue your career? 

I did not recognize gender issues — I would not have known this if they hit me in the face in New York. I attribute that to my parents and the appreciation of New York City. 

We all remember the 2016 presidential campaign when Hillary Clinton’s “likability” was called into question. Have you even felt that you had to purposely make an effort to be seen as “likable”?

In my case, those [colleagues and trainees] I worked with liked me because they see they can do their best. How are you not going to be liked? I think if you show people what they are capable of doing, they will integrate that into their persona. It is a construct that you have to have. It is also very important to admit when you are not correct, it makes you human. It’s not about you.

Annabelle Santos Volgman ’80

Professor of medicine and senior attending physician at Rush Medical College and Rush University Medical Center; medical director of the Rush Heart Center for Women; Madeleine and James McMullan-Carl E. Eybel, MD Chair of Excellence in Clinical Cardiology

Could you tell me about your Barnard experience? 

Barnard was great for me. We got this feeling that we could do anything we wanted. It was a woman’s world. It was shocking when I went to Columbia College of Physicians and Surgeons, as this was a man’s world. Barnard was so empowering; there were no men to tell you it is your position to do this or that. 

What made you decide to go into medicine?

I wish that someone had told me I could be a cardiologist earlier on. But there were no role models. When I was doing my medicine rotation, I interviewed one of the cardiology patients. I saw how a patient with chest pain went to the ER and [was treated for] STEMI [a serious type of heart attack]. I wanted to do that! In my residency at UC and Northwestern, the most fun people were the EP [electrophysiology] attendings. We were going to the operating room to perform ablations and other procedures! 

For several of us, medicine in general was still predominantly male, and cardiology even more so. Was this taken into consideration?

It is still an old boys’ network, and women feel discouraged. There are a lot of men who don’t want to relinquish control of this field to women. Electrophysiology is still 91% men. I did not consider my gender when I considered going into cardiology. [But] if a woman wants to go into cardiology — do it! I just wrote an editorial about the lack of risk of radiation to women [if] mitigated by wearing lead protection. A lot of electrophysiology procedures can be done without fluoroscopy and radiation. So women don’t really need to worry about that.

We need to know that we are in a powerful position, and if what we are doing is right, step up to the plate to be assertive. You do not have to excuse your leadership as something you don’t deserve. We have to empower more women to be assertive and stand their ground. I have three brothers that helped me in the way I conduct my life. Maybe this is where I get my assertiveness from. 

I am 4 feet, 10 inches, and I need a step stool to do procedures. My residents and fellows were always bigger than me. I may have been mistaken for not being the senior physician/cardiologist, but when I opened my mouth — they knew! This is resilience — it is their problem and not ours. 

Lauren Cooper ’03

Director of heart failure, North Shore University Hospital; associate professor in the department of cardiology at Zucker School of Medicine at Hofstra/Northwell 

What made you decide to go into medicine?

I was originally interested in politics and worked on a campaign while at Barnard. But, at the end of the day, only one person wins an election. It was very disheartening for me, and I could not change the world in politics, whereas in medicine I could make a change — even if it was one person at a time. I picked internal medicine as it was pretty broad, but at the end of my residency I did a rotation in heart transplant and decided to become a cardiologist. 

How do you feel a women’s college helped you navigate your professional life? 

[At Barnard] there were women in every position — professors, deans; it was female driven. This is huge, but reflecting back on this, there is no reason that women cannot be in every position. This piece has gone with me every phase of my career: female mentorship.

Cardiology remains predominantly male. Did you take this into consideration when deciding to pursue your career? 

It had not been a consideration; my residency had a lot of women. When I did my rotation in heart transplant, there were also a lot of women. There were many prominent women in the field as well. I think times are changing. 

With the years of training and long and unpredictable hours at work, how have you navigated family and job? 

I think there have been times in my career where I have been passed over due to gender. It is the man with the stay-at-home wife who has been picked. When I had my first child and maternity leave, it took me a full year to get back to where I left off, with both clinical and research work. I wish someone had told me how this would be but that it will be okay when you [are] back at it. I now try to be that person to my colleagues.

For myself, I met my husband in fellowship, so this was the package he was getting, and I was going to move where the job took me. This is a matter of fact. As we had kids, he knew that I worked a lot of nights and weekends — it was part of the deal. This has always been our life together. We can make [the field] more friendly though, in terms of accommodating family and personal life. For my generation, work-life balance is being talked about more. 

Have you ever felt that you had to purposely make an effort to be seen as “likable”?

Women in leadership positions have to do this — be leaders and likable. People perceive women differently than men. People think that women are kinder and gentler — from a patient-care perspective, especially when women walk into the room. So it makes people connect to women on a different level. We should not strive to be who [men] are — women don’t have to be like men to be leaders.

Much has been written about the glass ceiling, fewer academic promotions, and salary discrepancy for women in medicine, but what is the impact of implicit bias and microaggressions in the workplace? 

Male doctors are generally referred to as “Dr. X” and women by their first names. We always joke that people thought I was a nurse. I am over it by now. At the end of the day, I am not a nurse. When it comes to hiring practices, there are places that have a lot of men in leadership, and when they interview someone for entry level, it might not be conscious but they see themselves in the male candidate, unless they are actively trying to recruit a diverse group.

What do you feel can be done to change or improve these experiences women have in their work environments?

For future generations, it is having that mentorship to help navigate the field. I have had wonderful mentors, and this helped in making the most critical decisions. We have to seek out women mentors and also be those mentors.