Mentoring and Service Across a Career: A Q&A with Dr. Vivian Pinn

Vivian Pinn, MD, didn’t grow up wanting to be a pathologist. But after taking a semester off of college to attend to her mother who was dying of cancer, Dr. Pinn got her first exposure to pathology when she took a job in the summer of 1962, as a research assistant with Dr. Benjamin Barnes, a transplant surgeon at Massachusetts General Hospital (MGH), who worked with Dr. Martin Flax, an immunopathologist.

Over the next few summers, Dr. Pinn transitioned to working and learning predominantly from Dr. Flax. At the conclusion of medical school in 1967, she received a research fellowship in pathology. From there, her career in pathology and health care steadily climbed. Even in retirement, Dr. Pinn is a force within pathology and laboratory medicine. Critical Values recently talked with her about her substantial career and the challenges she’s faced.

This interview has been edited for clarity and length.

Critical Values (CV): When you first started in medicine, there weren’t a lot of women, and certainly not a lot of Black women in the field. Tell us about that experience.

Vivian Pinn (VP): I’d often go to national pathology meetings, and there would only be one or two other women in the audience. Many times, they were not American women. I had experienced, having been the only woman and the only person of color in my medical school class at UVA, a number of challenges, but the pathology department at MGH was very welcoming. There was one fellow resident who used to always tell me I was taking the place a man should have, but I realized by that time I didn’t need to defend myself because my co-residents would always speak up. After four years of medical school, I was immune to it. I really found the MGH was a very welcoming place, and I was very fortunate because that was not the experience that many women were having in other specialties, or at other institutions.

CV: You were the first Black woman to chair an academic pathology department in the U.S. How did that opportunity unfold?

VP: I remember talking to a pathologist colleague who had become a medical school dean, at an AAMC (Association of American Medical Colleges) meeting. I told him I was really trying to decide whether to leave my position in the Dean’s office at Tufts, as well as running a kidney biopsy lab, and practicing pathology at Tufts. I had this opportunity to chair the Pathology department at Howard University, and I wasn’t sure if I should do it. The deciding moment was when my colleague looked at me and said, “You know, if you’ve got the opportunity and you’re going to stay a pathologist, then you need to go run your own department.”

Getting advice and talking to other people who had been active in pathology helped me make up my mind. For people who are developing their careers, it’s important to get that advice. Dr. Flax, who had been my mentor since I started working with at MGH when I was finishing college, and through medical school, was a wonderful mentor. When he went to Tufts as the new Chair of the department there, he took me with him, and I was with him as he built up the department at Tufts. When I decided to take the job at Howard, I was on the phone with him all the time asking for advice. He supported me and vouched for me with other pathology chairs, and I developed a real relationship with many of them. That was fortunate because I could call on them and find out what others were doing with their curriculum or services or residency programs, because I wanted to make changes in my department.

And, as for acceptance by my department, I can remember the hospital and the environment there were good. But I was, for many years, the only woman chair of a department at Howard. But other department chairs and the administration were very supportive and mostly understanding of my perhaps different approaches for the pathology department.

CV: Did you encounter any resistance as the Department Chair?

VP: I did have some instances where faculty were not used to taking orders from women. And, of course, I was making changes. So, there was some resentment, which I think many new department chairs in general may find when they go to a new department and want to make changes. I was advised ‘evolution not revolution’ but looking back, I am not sure that was the best advice!

I remember one of my faculty members saying that he had been practicing pathology longer than I had been alive, and how dare I tell him what to do differently. There were days when it would really get me down, but I was able to get through that because I had excellent training and had the support of my former boss and mentor, and support knowing what other departments were doing so I felt that the changes I was making were ones that were needed. I don’t know that we called them mentors back then. But it essentially was mentoring in that there was always someone I could call on for advice or encouragement, when I had questions, both about chairing the department or about things in general related to pathology and new techniques and procedures that I needed to put into place.

CV: You eventually left Howard to take a position with NIH. How did that differ from what you’d been doing throughout your career until that point?

VP: Once I went to NIH I was totally enveloped in women’s health. The best I could do for connections to pathology was try to always make sure I had someone representing the field of pathology on our advisory committee. I would also invite those I knew from pathology for meetings and for committees, and for contributing to our strategic planning. I tried to make sure that pathology was represented, but I was not formally involved in pathology, because I had too much else on my plate dealing with what was then the new field of women’s health research.

CV: But once a pathologist, always a pathologist.

VP: Yes! I used to say, during my first years at the NIH, “I really miss my microscope.” Being a pathologist really helped to influence how we eventually developed, or implemented, the NIH women’s health research agenda for the nation, with its strategic plan and its priorities. I believe if I had not been a pathologist, that might have been shaped differently. It might have had a more reproductive bent. But the fact that I came from pathology, where we know a little bit about almost everything, bringing that broad perspective helped me implement that women’s health encompasses the entire body. It is not just the reproductive system; it goes from head to toe, and you have to consider all the systems, and across the life span of girls and women.

CV: You’ve had a very illustrious career. Throughout it, you chose to really foster your own voice and raise awareness on health disparities and women’s issues, and give back. How has service shaped your career, and your objectives throughout the years?

VP: When I was in medical school, there was only one woman who was a full professor at the school. So few women were in medicine, and very few held leadership positions. As the lone woman in my medical school class, I was looking for someone I could go to who would appreciate the things I was dealing with. But that one woman professor was downright nasty to me and the nurses. I didn’t have that support.

When I got to Boston and even in my first junior faculty position, many students started coming to me. I was not much older than they were. But students started to talk to me, first women students, and then some minority students, then other students. I just always felt I needed to be available for them; I knew how much I had missed having someone I could talk to. That was how I got into mentoring and advising.

In terms of women’s health, I remember in medical school being the only woman. When a topic would come up that I would see as related to women’s health, I did not see where it was being discussed as I thought it should be. I remember thinking, “Research is important,” although I wasn’t sure I really knew what research was. I knew we needed to get the answers to gaps in knowledge. On the other hand, we needed doctors who were going to listen to their women patients, because women know their bodies better than anyone else. I have maintained that all the way through my career.

We know that part of the change in medicine as it related to women’s health was listening to women, as well as including men who appreciated differences in approaches to women’s health than the traditional focus on reproductive health. I focused on women and hearing what they have to say about issues of importance to them and their health and well being. I gave them a chance to talk about their bodies and their concerns because those will be the clues you need to make the right diagnosis or to explore through research studies. I had always been a bit of an ‘activist’, speaking up more than some would have liked. I felt that I needed to again leave the still segregated South to be able to further my career without the stresses of residual racism as well as some sexism—not to condemn everyone, as I had some very supportive classmates who to this day I still am in touch with as colleagues and friends.

CV: There has been a push for more diversity in pathology. How would you like to see that change happen?

VP: I’d love to see more diversity. I can’t tell you how many meetings, or how many departments, and how many times I have been, in my early years, where I would be the only woman. If there were a few other women, I would barely see anybody else of color. It is nice to see that is increasing, but there is still a need for more progress in addressing and improving diversity.

You often hear people say we need Blacks and other underrepresented in medicine minorities to go back to their communities to serve—where they came from. I agree that primary medical practice is important. We need more community doctors. But I’ve always said what gets lost is that our communities are everywhere. It’s not just going back to practice in the barrio or the ghetto, or underserved areas. It is also in terms of hospital administration, taking care of labs, doing the research, being involved in conducting and interpreting research, and in educational pursuits and teaching.

So many of our young pre-med and medical students have the passion for wanting to serve. [Yet] they can serve the underserved in fields like pathology, where we have an important role in managing and monitoring how health care is practiced. [We need to] impress on young, potential pathologists that these are valuable roles. They are not deserting their communities by going into a field like pathology where they’re more hospital-based, and not out seeing patients in a private office.