Maria E. Schnmidt, M.D., (left), assistant professor of radiology at the School of Medicine's Mallinckrodt Institute of Radiology, discusses a breast biopsy with Lori Kunzelman, M.D., clinical fellow in radiology, using the new breast diagnostic and treatment flip chart. |
By Darrell E. Ward
Almost daily, Maria E. Schmidt, M.D., must tell frightened women they may have breast cancer. It's an unavoidable part of her job as a radiologist at the School of Medicine and a breast-imaging specialist at Barnes-Jewish Hospital's Breast Health Center.
"Emotionally, this is a stressful area in which to work," Schmidt said. "But it's also rewarding because we have a good staff, people who are empathetic and caring."
In addition, Schmidt and her co-workers share in the joy when a suspicious shadow on the first mammogram proves harmless on the second one.
"We often get hugs and kisses when we tell a woman everything is fine," she said. "Some women are so relieved they start to cry."
Schmidt, assistant professor of radiology at the School of Medicine's Mallinckrodt Institute of Radiology, chose breast imaging for its mix of technology, clinical care and interaction with patients. She enjoys the challenge of making a diagnosis: correlating clues from radiological images, physical exams and biopsies.
Whereas some people enter radiology to tweak and improve machines, Schmidt is more interested in working with people.
"Any problem related to the breast provokes great anxiety in a woman," she said. "Our work requires a lot of empathy. It's challenging to tell people they have a serious problem in a way that is honest and straightforward but not terrifying."
Schmidt is particularly interested in helping patients deal with the pain that comes with a breast-cancer diagnosis, focusing on minority and low-literacy patients.
Last year, Schmidt and colleagues Dione Farria, M.D., and registered nurse Jill Bokern obtained funding from the Susan B. Komen Breast Cancer Foundation to produce a booklet and video that translate the implications and treatment of breast cancer into readily understood language.
(From left) Alex, Carmelo Romano and Max |
"My mother was a maverick and a groundbreaker," Schmidt recalled. "She was the only woman in her medical school class. When she came to California, she was the first board-certified female otolaryngologist in the state and the first female surgeon in her hospital."
Her parents, now deceased, divorced when Schmidt was a child. She lived with her mother, who loved to travel.
"She took me around the world in a very adventurous style," Schmidt said. They often visited her grandparents in Germany and traveled widely through Europe, Asia and Egypt.
At age 6, Schmidt lived in Panama and learned Spanish while her mother was a physician in the Canal Zone. As a child and teen, she lived in southern California and spent many weekends in Mexico. In high school, she traveled with her mother and a friend through Central and South America, visiting village health clinics along the way.
"I learned what health care means in the Third World," she said. "Some of those clinics had dirt floors, but they were clean and full of pride." This experience marked the beginning of her interest in medicine.
After high school, Schmidt attended Stanford University as a biology major. Through a work-study job she met Carmelo Romano, Ph.D., then a graduate student in pharmacology. Today, Romano is associate professor of ophthalmology at Washington University and studies how neurons communicate.
"We met in the worm room," Schmidt recalled. "I was working under a sterile hood beside a Bunsen burner with stacks of petri dishes in front of me."
Like any good investigator, Romano recognized a first-rate discovery.
"Maria not only was pretty and smart," Romano said, "she was well-traveled, with interesting stories about her adventures. I saw her as one cool, brave, sophisticated gal."
Schmidt graduated from Stanford in 1979 and entered medical school at Albany Medical College. Then Romano entered a post-doctoral program at Yale University. They married a year-and-a-half later, and Schmidt transferred to Yale. While in the naval reserves, she attended medical school through a military scholarship from the Health Professions Scholarship Program.
"I spent my whole career in the Navy without being stationed on a boat," she said, laughing. She served her internship at the Naval Hospital in San Diego, then returned to Philadelphia to fulfill her scholarship obligation, working from 1984-88 as a general medical officer in Philadelphia at the naval hospital, shipyard and air station.
She also rejoined her husband, who was working at the University of Pennsylvania in Philadelphia. Their two children, Alexandra and Max, were born during this time.
"The Navy was good to me," Schmidt said. "People criticize military medicine, but I saw the benefits of a single-payer system. No one had to worry about whether a patient could afford care; everyone was treated equally."
She had begun her residency training at a Jefferson University affiliate hospital when, in 1990, Romano was recruited by Washington University's Department of Ophthalmology as a research assistant professor. Schmidt transferred to the renowned Mallinckrodt Institute of Radiology residency program at the School of Medicine and then continued with a fellowship in the subspecialty of breast imaging.
Schmidt finished her fellowship in 1994 and was hired by Saint Louis University to help develop its mammography program. There she founded and co-directed the Breast Center of Saint Louis University. The center served many minority women, and Schmidt's work included community speaking and outreach.
Four years later, she was recruited back to Washington University for her present position.
"My experience with a mini-universal health-care system in the military made me a bit of a socialist," she said. "I'm not happy about managed care and how insurance companies control medicine. I'm also disappointed by the lack of concern shown within my own profession for the uninsured."
She joined "Physicians for a National Health Program" in 1998 and chaired a local committee of "Call to Action" to help address those problems.
Among friends and co-workers, Schmidt is known for her almost boundless energy, range of interests and dedication to family.
"She's a good scientist and a good doctor, and she's doing the kind of outreach activity that makes you proud to work for Washington University," said Lori Fox, associate general counsel for the University and a close friend of Schmidt's.
Barbara S. Monsees, M.D., professor of radiology and chief of the Breast Imaging Section, said, "Maria does a remarkable job balancing her personal and professional life. Too many doctors are so immersed in what they do that they give short shrift to their home life. Maria's kids genuinely like her; she is an active participant in their lives, and they embrace that."
Schmidt's foremost hobby remains travel, and her daughter, Alex, 16, and son, Max, 15, spent time this year in Germany as exchange students. Schmidt also enjoys gardening, bicycling and scuba diving.
But working with the Ethical Society of St. Louis is her main extracurricular activity. For the last four years, she has led the society's high school youth group, spending Sunday mornings and other times during the week exploring topical issues and helping develop social responsibility among the 27 teen-agers.
At the Breast Health Center, Schmidt teaches residents and fellows about breast imaging and issues in patient care. She stresses the importance of the "little things" --being polite, showing compassion, easing anxiety.
"When I meet with a patient whose mammogram looked fine, I tell her the result immediately after introducing myself," Schmidt said.
"Touch also is critical to support a patient when giving bad news," she explained. "Radiologists get extensive training in interpreting images and data, but we usually receive little training in how to speak to patients in a way that is kind, compassionate and reassuring. We shouldn't send them away saying they'll get a letter in three days. Most patients today are very astute. They want you to get right to the point, and they want the straight story. It's only humane --and that's what my job is all about."
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