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ss triple helix - summer 2011,  I never thought...

I never thought...

Margaret E Hodson reflects on the path which led her into a career in academic medicine.

Key points

Looking back over the key decision points in her life the author shows how God clearly guided her into an unexpected field.

Overcoming the obstacles of ill health and a culture of discrimination against women wasn't easy but God enabled and blessed each step of the journey.

The author reminds us to continue looking for God's guidance, trusting him for the future and giving thanks for the past.

When I was at medical school, I fully expected God to call me to overseas mission. Yet that call never came. I had wanted to specialise in respiratory medicine since I decided to become a doctor, but it had never occurred to me that I would be called to an academic career. However, as I look back, I am very grateful for the way that God has so clearly guided me.

Childhood

At the age of two I developed asthma, which I have had ever since. Treatment at the time was poor and consequently I missed a lot of school. I enjoyed lessons, but was often too breathless to play games and spent a lot of time busy with my books.

I grew up in a Christian home and attended Sunday school, and I am also grateful for the influence of several Christian teachers. At the local village school a lovely Christian lady taught us how to love and serve the Lord, together with reading, writing, and arithmetic. At secondary school, we had two Christian teachers, one of whom took me to a Billy Graham rally at the local Baptist church, where I rededicated my life to Jesus.

I began to wonder and pray about what I would do with my life. When I was about 14, it became increasingly clear to me that God wanted me to study medicine. Nobody from my school had ever gone to medical school before. At the time, the entry requirements included O-level Latin and A-level Zoology. My school had no classes in either subject. However, the headmaster arranged special tuition for me, so I got the qualifications I needed.

Medical school

At that time there was a quota system so only a few girls could study medicine each year and initially I was not allocated a place. I prayed hard and wrote to the Dean of every medical school in the UK asking that they consider me if anyone dropped out. After five or six weeks, Leeds offered me a place. However, shortly after I arrived, they discovered that the girl who had failed her exam, leading to the spare place, had in fact been given the wrong examination paper. They had to reinstate her, but fortunately they decided to keep me as well!

At medical school one of the GPs at the university health centre taught me to treat my asthma. Consequently, I missed very little time from classes. I worked hard, and valued the support of the Christian Union and local church. A CMF group also invited the students round for meals and helpful talks at least once a month.

I prayed a lot about what I should do when I qualified. However, in the summer when I should have taken my finals, I became very ill with viral pneumonia and asthma. I spent many weeks in hospital and the staff wondered if I would ever be able to work because my lungs were so bad. However, six months later I was able to go back to Leeds to take my final exams, which I passed with honours and distinctions.

Life as a junior doctor

During my house jobs, the consultants made it clear to me that it was not a suitable for a lady, to want to become a consultant physician.Various people tried to talk me into taking a laboratory job or doing anaesthetics, which they thought would be less demanding. Indeed, on one occasion I was seriously considering accepting an anaesthetic post, but the Spirit gave me no peace for 48 hours. I realised it was not part of God's plan and turned it down: one week later I was offered a general medical registrar post at the local teaching hospital.

Still keen to pursue to a career in respiratory medicine, I felt led to apply for a post at the Royal Brompton Hospital in London, a specialist centre for the treatment of heart and lung diseases. I was told by my consultants, that I would be unlikely to get the job as I had no medical relatives, I was a woman, and I had not been trained in London. They must have given me a good reference, however, as I was appointed.

Royal Brompton Hospital

On my arrival I was allocated to work on the cystic fibrosis (CF) firm. I did not know that adults with CF even existed. I soon realised the tremendous challenges involved in caring for these young people, many of whom were preparing for death with peace and dignity. During these years, I worked with the Free Church chaplain to set up informal Sunday services in the hospital, making them suitable for young adults and others with life-threatening illnesses, but very little knowledge of the Christian faith.

I felt called to continue working with CF patients, but I was told that it was not easy for a woman to get a consultant post at the Royal Brompton and I would need to have more qualifications than my male colleagues! So I set about getting an MSc in immunology, a new science at that time, as well as my MD and anaesthetic exams.

I was subsequently appointed as a senior lecturer with honorary consultant status to the adult cystic fibrosis unit. I was certainly not very interested in academic medicine at the time and patient care remained my main interest, but I had to take this route. At that time, the University was more prepared to appoint women than the hospital, and an academic appointment automatically led to honorary status with the hospital.

I was given laboratory space and I raised money for a research team to work with me, and it soon became clear to me that this too was part of God's plan. Over the years, I have gone on to have the privilege of working on some of the big developments in CF care, including new methods of physiotherapy, inhaled antibiotics, Pulmozyme and transplantation. I have also been able to develop new methods of care delivery, such as nurse specialists and home care services, many of which are now standard around the world. In 2002, I was awarded the first Rossi Medal by an international committee for the greatest contribution to improving treatment for patients with cystic fibrosis in the past 25 years. This however was a reflection of the work of a dedicated team, not of me as an individual.

One of the hardest things about being a clinical academic is money. My research group has never received any funding from the university, so I have had to find every penny myself. God has, however, been very faithful and whenever we have needed money, we have managed to raise it.

During these exciting years God gave me a wonderful gift without which much would not have been possible. In my first year as a senior lecturer, a new secretary was appointed to the department. She was a Christian and wanted to work with a Christian consultant. I have been privileged to work with her for over 30 years. She made it her life's work to help me improve care for cystic fibrosis patients and maintaining Christian witness within our hospital.

The future

I do not intend to retire until I reach heaven. However, the work I do will change as the years go by and I am confident God will find something useful for me to do. I hope to serve more in the church as gradually I reduce my clinical work. I have been a lay minister for many years and recently was made a lay chaplain to the hospital. I am still an asthmatic, but during the last 35 years I cannot remember a day off work because of my chest.

I am very grateful that God has so clearly guided me in all the big decisions of my life and I now know why my call was not to work overseas. I have been privileged to serve in academic medicine and I have been given many exciting challenges. Although the discrimination against women has now gone, I would say to any young doctor called to academic medicine, this is hard work but a very exciting journey. It never occurred to me that I would be called to an academic career – I never even thought it would be possible. But with God's call and blessing it was.

Margaret E Hodson, MD MSc FRCP DA Dip Med Ed Professor of Respiratory Medicine, NHLI/Imperial College Honorary Consultant Physician, Director of Medical Education, Royal Brompton Hospital, London

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