| 
 Dr.
Kathie-Ann Joseph has a difficult job. Not only must she tell her
patients when they have breast cancer, but she must also perform
surgery on them to try to take the cancer away. Her approach—be
sympathetic, direct and give them hope.
She says that she frequently uses the words, “We are going
to get through this.” It is easy to imagine. Dr. Joseph’s
voice is eager without being rushed. It is humble and down to earth,
but you can feel her mind working quickly, maybe faster than your
own. She is the total package—energetic, compassionate and
driven beyond belief.
Dr. Joseph is the Director of Breast Cancer Surgical Research
at NewYork-Presbyterian Hospital/Columbia. She said it is her relationships
with her patients and her desire to help them that motivates her. “It
sounds cliché,” she said, “but that is simply
what drives me. I have a lot of friends that went the Wall Street
route, but I would have been terrible at it. I like coming home
and knowing I helped someone. When my kids ask me what I did at
work, I tell them I tried to help someone who is sick feel better.”
She was always interested in medicine, but it wasn’t until
after her residency when she did her oncology research that she
knew what direction she wanted to head in. She chose breast cancer
surgery because she wanted to have relationships with her patients. “It’s
not like taking out someone’s appendix and then never seeing
that person again. You really get to know your patients.” She
added that there is often a strong familial component with breast
cancer, “sometimes I see entire families when one member
is sick.”
Another motivating factor for Dr. Joseph was that her own mother
died of cervical cancer at the end of her freshman year of college.
She says that her mother was sick for 5 years and she is always
in the back of her mind.
Dr. Joseph was born in Jamaica and grew up in Brooklyn, the youngest
of three children. She recalls, “Education was extremely
important in my house. My parents wouldn’t always buy me
toys, but they rarely denied me a book to read.”
A graduate of Harvard University and Columbia Medical School,
she said she occasionally met people who weren’t encouraging,
but always had someone else around to keep her going.
Aware that people with her background were not expected to go
to college, much less Harvard. Joseph remembers calling her mother
from school when she heard that her classmates had gotten their
acceptance letters. She said “My mother wouldn’t tell
me over the phone. But when I saw the big envelope, I knew.” She
felt guilty about leaving home when her mother was sick, but she
told her that she had to go. “She died during my last week
of exams my first year of college, but I am glad she knew I was
on the right track.”
Being the child of immigrants has also helped shape her work ethic. “When
you know that your parents gave so much to come to a new country
for a better life for their children, it’s not something
you take for granted.” She watched her father, who was a
manager at Pan American, go back to school in his thirties for
his business degree while working, and her mother work nights as
a nurse so she could be around during the day. “Somehow,” she
said, “they found a way to send money back home to help our
family in Jamaica while raising three children in New York.”
Joseph is now the mother of two sons of her own, ages eight and
four. “I love my work but my family is really foremost in
my life,” she said. However, to be a mom and surgeon is very
challenging and she must be organized. “All my appointments
are on palm pilot,” she said. She acknowledged that her husband,
who is also a surgeon, is supportive. “We are truly partners,” she
said. She added that their families are also a great help.
She had both of her children during her residency. “At the
time,” she said “It was one of the hardest periods
of my life, being a surgery resident and mother in a male dominated
field. ” She feels lucky that someone suggested that she
contact Dr. Freya Schnabel, Chief of the Breast Service at Columbia,
who trained in the same hospital she did. “Working with her
and another female breast surgeon, both mothers, helped me realize
that I could have a career and a family.”
 Joseph’s day begins at 5:00 with exercise and getting her
kids ready for school. Once she gets to the hospital, every day
is different. On a day that she sees patients or is in the OR,
she goes non-stop. “If I am lucky, I’ll grab five minutes
to eat. I may go from one patient who is ten years out from breast
cancer to spending an hour with a woman who I just had to tell
that she has cancer and needs surgery.” She says that this
is especially difficult when the patient is young or when it is
a very serious case. She recently diagnosed a 29-year old who fit
both bills. Joseph didn’t want her to be in denial, but she
also didn’t want her to lose hope. She recalls telling her, “We
have to be very aggressive.”
On her academic day, she catches up with paperwork, phone calls,
meetings and also teaches medical students and residents. Dr. Joseph
spends a half-day per week in a clinic treating women with no insurance
or Medicaid patients.
Joseph, who is 36, would like to continue to help her department
build a stronger clinical research program. She said that one day
she would like to travel to developing countries to see how health
care is delivered. “I feel that I am making a contribution
here, but I would also like to go other places, talk to doctors
and find out how they handle things.”
She acknowledged that there is a lot of great research being done
at Columbia and nationally, but she pointed out the high mortality
rates of breast cancer in the Caribbean and Africa. “We’re
spoiled here,” she said, “we need to realize what
is going on elsewhere and try to make things a little better.”
However, she pointed out that many challenges exist including
finding a better screening tool for high risk and young patients
and obtaining funding for research. “While there are a lot
of organizations out there that raise money for research, they
are generally for small projects. Major federal funding continues
to get cut by the government.”
On the bright side, Joseph says there is a lot of progress being
made in the field, specifically, the research being done on targeted
therapies, that is, looking at the different proteins that tumors
express and targeting specific treatments. “As we get better
at identifying these proteins, we can better target and treat patients.” Another
strong positive is the work being done to develop alternatives
to chemotherapy that patients will hopefully be able to tolerate
better.
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