my most significant mentor

[[{"fid":"3256","view_mode":"default","type":"media","attributes":{"height":355,"width":445,"style":"width: 313px; height: 250px;","class":"media-element file-default"}}]]I was delighted to be flipping through the pages of "Rochester Medicine" a publication of the University of Rochester School of Medicine (where I did my pediatrics residency), not really expecting to find anything of interest, when, near the end of the magazine my eye caught the visage of a man who had a significant positive impact in my life, and the lives of countless children throughout the world.

Dr. David H. Smith, described in the publication link, and pictured in this post, was chair of the department of pediatrics when I began my residency. He was a giant in the field of pediatric infectious disease, a superb teacher,  an outspoken child advocate, an exemplary role model, a conscientious and compassionate physician, a wonderful husband and father to his wife and children, and my mentor. You can read more about his life here.

Of course I consider "my mentor" to be the most important facet of his life, although I suppose his wife Joan may have taken issue with that assessment.

Many of us have mentors, and I have been lucky enough to have had more than a handful of folks in my life take me by the hand, offer me assistance, introduce me to key people in my field, and take a personal interest in my success. But there was something so very special about David, that causes me to label him as my most significant mentor, for the role he played in my life.

He was the person who, more so than anyone else I have ever known, taught me to believe in myself and to know that I could do anything I set my mind to doing. To this day, whenever I am faced with what might seem an unsurmountable task, I think of David, smile, and get going attacking that obstacle. Dr. Smith was not only a brilliant scientist (and all the other things I listed) but he was an entrepreneur and what we would today call a futurist. He knew the scientific discoveries made by his team would change the practice of pediatrics forever. He knew that the discovery of a new method to produce a vaccine that would enable young infants to become immune to certain bacteria much earlier than had ever been dreamed of would save thousands of lives world wide. [Not just those due to Hib (which at the time I was in my residency was THE most common cause of bacterial meningitis in children the world over, and now occurs only rarely) but with other significant pathogens as well, such as pneumococcus (a common cause of bacterial pneumonia as well as meningits) and meningococcus (another cause of meningitis and sepsis).]

And he was eager to take the discovery to the public so that the new vaccine could be approved by the FDA, then mass produced, so it could be made available to real children, not just research subjects. The article describes how he tried to interest major pharmaceutical firms in manufacturing and distributing the vaccine, but no one was interested.

Why? Because there is not much money in vaccines.

So what did he do? He struck out on his own and started his own vaccine company called Praxis Biologics.

After I finished the required three years of the pediatric residency,  I spent a fourth year as the senior chief resident for the program and needed to stay in Rochester for a fifth year waiting for my husband to complete his surgical residency before leaving for Baltimore where I was going to do my fellowship in pediatric critical care. That happened to coincide with the time frame during which Dr. Smith was developing Praxis.

He decided to hire me to be "director of clinical research" even though I had never done any research previously.

Everything would be riding on my ability to conduct clinical trials and prepare the results of these trials to submit to the FDA for approval (this was the predecessor of the current Hib vaccine, but a necessary step in the process). I was honored to be asked; I was frightened at what might happen if my inexperience got in the way of accomplishing the task at hand. Eventually I said yes and became one of the first four employees of the company.

To prepare me for my job, he handed me a book: "Getting to Yes" by  Roger Fisher and William Ury, of the Harvard Negotiation Project.

Huh? you might say. How would a business book on negotiations prepare you for doing research properly?  You see, that was how David was. Remarkably subtle, he was also inculcating in me a love for business methods that eventually led to pursuing the MBA degree (but that is another story). He told me he knew I would learn what I needed to know to conduct the vaccine trials, do the statistical analysis (without benefit of a computer or a stats program) and prepare the data for submission, But he wasn't sure I would always be able to move a group of people to an endpoint, solve seemingly impossible conflicts, and have all sides see themselves as winners. And because he was committed to seeing to my future success, not just my short-term productivity, he wanted me to learn lessons that were universal and important.

David told me it didn't matter what I did, or where my path in life led. He told me whatever happened he was certain I would always "land on my feet" and he let me know that the qualities of the iindividual, he believed, are much more important than the specific knowledge or skills the person possesses. I have remembered that when recruiting others. Attitude is everything. Knowledge and skills can be taught. To this day I have a tendency to believe that I can do anything I put my mind to, anything that is truly important. I am convinced I have that confidence (or what psychologists now term self-efficacy) in great part because of David H. Smith.

From David I learned the value of believing in your protegees, the importance of providing both professional and personal support to your mentees (I remember him pacing outside my hospital door when I had to have emergency surgery, and I remember that he gave me the book "Goodnight Moon" on the birth of my first child), and the necessity of an open and trusting mentor-mentee relationship. I have tried to emulate, in my own inadequate way, that approach to mentoring and leadership. Not always successful, I still believe I can do anything I put my mind to.

Does this story have anything to do with you, my readers, or my current life and work?  Yes, I think it does. One of the reasons I moved to Roanoke, and accepted the position of chair of pediatrics was because of the challenges inherent in the position.  Although the Carilion Clinic Children's Hospital (CCCH) existed (under a different name) when I arrived four years ago, its future was not necessarily secure. We had no identity in the community. The care we provided to infants, children and adolescents was excellent but not always coordinated. We were involved in teaching students and residents, but they were not our own. We thought we were providing "patient centered care" but we didn't  families present on morning bedside rounds.

The fact that I am 100% convinced that CCCH can move forward over the next decade and beyond, providing state-of-the-art care for all children, teaching medical students from our own school (VTCSOMRI) as well as from others (UVA), starting a pediatric residency program that will rival ANY pediatric training available in the US, and becoming a valued and valuable part of our community in Roanoke and Soutwesth Virginia, is, in large part due to David H Smith, my mentor.

Dr. Smith died in 1999,  from a malignant melanoma, that claimed his life in a matter of months (NY Times obituary and more about Hib here). I will always miss him.


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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

Close to home links

Carilion Clinic Children’s Hospital
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Pediatric Residency Facebook Page
The AAP website for parents
Just the Vax
Moms Who Vax blog
Parents Who Protect
Roanoke Times Medical blog
Running a hospital blog


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