Dr. Rita Meek, MD: Determined, focused, and intuitive trailblazer in pediatric hematology/oncology
Dr. Rita Meek, MD
Determined, focused, and intuitive trailblazer in pediatric hematology/oncology
You are originally from the east coast.
I was born in Washington D.C. and grew up in Silver Spring, Maryland, a suburb of Washington. As a child growing up I had amazing experiences, from standing in line all night to get into the Capitol to file past John F. Kennedy’s casket as he was lying in state, to doing my research as a high school student in the Library of Congress. When you grow up in a suburb of D.C., the capitol city and all its history is part of your daily life.
Did your parents work in D.C.?
My mother worked at The Washington Post for many years in classified advertising, back when people use to read the printed paper, and the Sunday paper came in two sections because it was so big. I remember how exciting it was visiting my mother at work because of the noise of all the typewriters, so many people talking on the phone at the same time, people walking rapidly to get from one place to another, so much energy in the air – a big city newspaper is a really busy place! My father worked for the U.S. government from the time he was 17 until he retired.
Did your parents have a strong influence on you?
I remember in high school, when I was taking accelerated classes my dad would say “whatever else you’re studying you better know how to type and take shorthand because then you will always be able to get a job. Knowing calculus won’t help you very much.” I was the only person in the academic track taking typing and shorthand!
The connection to journalism and government must have been quite formative as you were growing up.
I grew up reading The Washington Post. I remember in the early 1960s the story of thalidomide broke, about Dr. Frances Oldham Kelsey, a medical officer at the Food and Drug Administration who had refused to certify thalidomide in the United States. Now, it is clear what that drug did to the infants of women who had taken thalidomide during their pregnancies. Just think about how many children at that time in the United States were spared these physical abnormalities because this one scientist said “I’m not signing off on this drug. I’m not comfortable.”
You also held summer jobs in the government.
Every year I would take tests to see if I could score high enough to get a summer job working for the government. With those great typing and shorthand skills, I always got a job and even worked one summer at the Pentagon.
How did you go from government work into medicine?
I was a biology major in college which was the same as being pre-med. At that time, I did not realize that you could take out loans to go to medical school. I had gone to college on a scholarship and my parents did not have money to send me to medical school, so I didn’t even consider that as an option.
This took you from New York, and then back down to Pennsylvania.
After I completed my undergraduate degree in Biology from New York University, I applied to several PhD programs and decided to go to the University of Pennsylvania in Philadelphia.
It was in this program at PENN that you had your first “aha” moment that changed the trajectory of your career.
As part of the program, they sent us to the Children’s Hospital of Philadelphia (CHOP) for one class. I cannot tell you why we were there, but I remember sitting in the lobby of the old Children’s Hospital of Philadelphia and I heard a voice in my head say “You belong here. This is what you are supposed to do.” I went home, discussed this with my fiancé and we decided that we would find a way to pay for medical school tuition. I went back to the lab and quit my PhD program. Although I was offered a master’s degree if I stayed for one more semester, I decided to just leave the program.
This then led you back to Washington, D.C.
My fiancé and I moved back to Washington, D.C where he got a job in the Patent Office and, thanks to my dad’s advice to learn typing and shorthand, I got a job as a secretary and saved all my money to put towards my medical school expenses. I give my first husband a lot of credit, because on his salary at the Patent Office, we managed to pay the tuition for medical school at George Washington University, as well as his tuition for law school at night so he could become a patent attorney.
After my four years of medical school, I completed a three-year Pediatric residency at the Children’s Hospital National Medical Center (CHNMC) in Washington. D.C. I did my three-year fellowship in Pediatric Hematology/Oncology there as well.
It was during medical school that you experienced your second “aha” moment.
At that time there were relatively few women physicians in medicine and most became psychiatrists, internists, obstetricians/gynecologists, family medicine practitioners or pediatricians. Only ten percent of my medical school class were women. Now, women are more than 50% of the students in most medical schools. I knew I wanted to keep my options open and not necessarily do what was expected. In the third year of my medical school curriculum, we did thirteen rotations, such as surgery, psychiatry, internal medicine, pediatrics, etc. One day halfway through the year as I headed off to a new rotation, I thought “30 lucky medical students are starting at Children’s today…and I wish I was one of them.” I remember thinking “That’s it, Rita. You are going into Pediatrics.” It was the right decision for me. I have never looked back.
How did you decide to focus on pediatric hematology oncology?
I am a pediatric cancer doctor and people would frequently ask why – how could you do that, isn’t it depressing? And the short answer is that my mother got treated very poorly when she was diagnosed with cancer. She was having a procedure in the same hospital where I was a resident taking care of pediatric patients. When her physician received my mother’s pathology report, he called me to tell me she had cancer. He was going to tell her everything was fine. This was medicine in the 70s. And before HIPAA. Then he said, “when she comes back for her follow-up visit in six weeks, I’m going to tell her she just needs a little radiation so that everything stays fine.”
I said “No, we are not going to do it that way. You are essentially asking me to collude with you because my parents will know that I have gone to the lab to see the pathology for myself.” Here was this 60+ yr. old doctor, with a 25 yr. old pediatric resident telling him “NO!”. I said “Doctor, let me remind you that YOU are the DOCTOR. I am the DAUGHTER. I will go with you to tell them, or I will go after you tell them to be with them, but I am not going to do YOUR job for you.” I remember hanging up the phone and thinking to myself, “If this is the way that people who have cancer are treated, I can do a better job.” Once again, that was it – I never looked back.
From there I did a pediatric hematology oncology fellowship at Children’s Hospital in D.C., and I was an attending physician there for the next five years. Then we moved to Delaware.
Delaware was another pivotal moment in your career.
At the time, Delaware didn’t have a medical school or a children’s hospital or any pediatric hematologists/oncologists, so if I wanted a job my choices were to do general pediatrics in Delaware or do Pediatric Hematology/Oncology in Philadelphia. At that time, children in Delaware with serious blood diseases or cancer were treated at CHOP or at Johns Hopkins Hospital in Baltimore. I thought it was wrong that a family should have to drive two or three hours with a very sick child for medical care.
Once again, that voice came into my head and I thought, “This is ridiculous. I can do this.” Looking back, I realize how naïve I was thinking that I could establish a practice treating incredibly sick children with me as the only doctor, in a specialty that nobody in the state had done before -- while trying to help raise a 3 yr. old and a 5 yr. old at home. Many male doctors were pushing back hard, telling me that I wasn’t going to be successful. Mostly though, I think they felt threatened by an assertive woman who might be impacting on their practice in some way or another.
How was your practice different?
My approach was more holistic. My team and I treated the whole family, the patient, the parents, the siblings – it was a family centered approach. We addressed psychosocial issues, economic issues, educational issues and tried to make the whole horrible experience as tolerable as possible for the child and the family. That’s not what was happening in the world of adult medicine at the time. Pediatric hematology/oncology is almost always done at a children’s hospital but there was no children’s hospital in Delaware at the time.
My husband Jim, who I met in 1977 and married in 1978, and I agreed that we would give it five years. If in five years I couldn’t make this practice work, I would instead be a general pediatrician or I would try to find a job doing pediatric hematology/oncology in Philadelphia. It was incredibly difficult. I knew nothing about how to run a practice, how to bill, hire nurses and administrative staff, etc. For the first five years I was on call 24 hours a day/7 days a week, 365 days a year. I had to create a pediatric hematology/oncology program model where I could safely treat these children with state-of-the art therapy in an adult community hospital.
What led you to begin working at the Alfred I. Dupont Institute in Delaware?
I had a successful practice for ten years, and then the hospital in Delaware, the Alfred I. Dupont Institute, which had been a children’s orthopedic hospital, began to expand and develop a full-service program. Ultimately, I closed my practice, and my entire staff began working at what is now called Nemours Children’s Hospital, Delaware which is the Department of Pediatrics at Thomas Jefferson University Medical School. The pediatric hematology/oncology program I started is now huge.
You held several positions during your time at Nemours Children’s Hospital, Delaware.
I served as the Division Chief of Pediatric Hematology/Oncology for 15 years and then in 2001, was appointed the Hospital Medical Director. In 1998, with almost 30 people working for me, I went back to school and received my Masters in Organization Development from American University in D.C., traveling back and forth one weekend a month. Then, for the last five years before I retired, I focused on creating a Division of Transition of Care.
Can you talk more about this division for Transition of Care?
As a hospital medical director, I was very concerned that we took care of kids until their 21st birthday, and then on their 21st birthday they and their families were on their own to manage their health care. I felt that we had done little or nothing to prepare families for what was going to happen, and many of the kids were very impaired and really were going to need very complicated adult medical care.
We were deeply involved with our families and routinely helped them navigate through all their appointments and procedures, and our various medical and surgical teams actively communicated with each other, so the children really did have a multispecialty team coordinating their care. In my experience, this was a very different model than the way adult subspecialty care was delivered. I thought that we, as the patient’s pediatric caregivers, weren’t doing much of anything to prepare families and the teenagers for all the changes and challenges they were going to face when the child was over 21.
No one was talking to them about whether the parents needed to obtain guardianship, possible changes in medical benefits, the differences in the role of the family in the adult world, the need for the family to assume more responsibility for organizing and overseeing the care their child would be receiving, etc. It was clear that we needed to be taking a more comprehensive approach as children who had been followed for years in our medical system were getting ready to be adults. So, for the next five years, I focused on creating a Division for Transition of Care.
How did the decision to retire come about?
I retired in 2014. It was time to focus on my family. I didn’t have the chance to be as much a part of our children’s lives as I would have wanted, and now grandchildren were starting to arrive. It was my opportunity to be a grandmother.
Why Oregon – why Portland?
Our house, in historic New Castle, Delaware, was built in 1826. Thomas Jefferson stayed on our property when it was a tavern. The house was wonderful, but it required a lot of upkeep and had four flights of stairs -- and our two sons are here in Oregon, one in Portland and one in Eugene.
Jim and I looked at many places to live in Wilmington, DE and in Portland and Eugene. We wanted to be close to our sons in case we needed them, and we wanted to be part of our grandchildren’s lives. When we were trying to decide where to live, it was very sweet that each of our sons wanted us to move where they were, versus hoping we would move to where the other one lived. We were lucky. Eventually we decided upon Portland because of the quality of the medical care available in the city.
Why Terwilliger Plaza?
When we walked into Terwilliger Plaza we looked at each other and said, “this is where we need to be.” There was an energy about the place. The people we met were interesting, welcoming, and engaged in the community. We are very active and love travelling. Terwilliger is in a part of the city that we could see ourselves aging and leading full lives.
How has your experience been so far?
We can easily find people to talk to, and everyone has been so helpful. What we found so fascinating is that the people here have such varied backgrounds. It can be very difficult to retire, and then move to a completely different city and culture 3000 miles away. It’s a big undertaking at our age to reinvent ourselves. We feel that we are blessed every day with family, new friends, and exciting intellectual pursuits.
We feel grateful that we are here. We’re in a good place – it’s a new chapter. It’s exciting.