60 Years in Medicine, from Psychiatry to Blogging

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"If you want to fly high you have to expect to be buffeted by high winds."

Monica Starkman entered medical school in 1959, when a scant eight percent of students were women.

Although her European-born parents revered physicians and professors, she might not have taken the first step toward what blossomed into a distinguished career in psychiatry and research if not for a quick word of encouragement.

“In college, I worked as a technician in a radio isotropic lab. Part of my job was to gather the charts and I was fascinated by them. I kept reading and reading,” she recalls.

An internist at Mount Sinai was intrigued by her dedication and curiosity. He took her aside and suggested she go to medical school.

Sixty years later, Dr. Starkman is Active Emerita in the Psychiatry Department at the University of Michigan and its Depression Center. She is an accomplished blogger and expert for Psychology Today. Her novel about psychiatric patients and psychiatrists, The End of Miracles, is recommended by the American Library Association’s Booklist, and was an International Book Awards 2016 finalist for literary fiction.

Back in 1959, Dr. Starkman describes herself as “a quiet, non-politicized student.” She quickly learned that she could not be a shrinking violet if she were to succeed in what was then a man’s world. 

“During my medical school interview, the man who was interviewing me asked: ‘Don’t you want to have children?’” she remembers. “Somehow, from the depth of my being, I said: ‘well, I don’t expect to have puppies.’”


Taking on the Pay Gap

Dr. Starkman, who has three children, continued to take an assertive approach, addressing the pay gap between men and women physicians early in her career.

“When I was on faculty at University of Michigan Medical School, we women would talk one to another about our salaries being less than men for doing the same work,” she recalls. “We wrote to the dean of the medical school. To his credit, he responded and set up a way for us to investigate this. The next time salary allotments were sent around, some women received large increases in their salaries.”

In going after funds for research, she showed perseverance when one of her first applications to the National Institutes of Health was not funded.

 “I took note of the critiques, bolstered my application and improved my score,” says. “I have a very persistent personality in going after my goals.”

Dr. Starkman was turned down again. So, she did more research, gathered more evidence from the literature and tried again.

On her third try, she was awarded a $1 million grant from the NIH to study the impact of Cushing disease on stress hormones and the brain that result in depression. She became an NIH Established Investigator, receiving several large grants.


"Make Your Voice Heard"

She encourages physicians who want to lead to make their feelings known.

 “Make your voice heard. If you want to get to leadership, you have to start speaking out at meetings and other places that will get you noticed. You have to be seen as involved and active. You have to make it known that you would like to be considered for committees,” she says.

And don’t be surprised or deterred by pushback.

“If you want to fly high you have to expect to be buffeted by high winds,” she says. “There’s a lot of competition out there and women tend to compete more subtly.”

She also urges women physicians to embrace studies and publish their findings.

“Scientific and clinical publications enhance your clout,” she says. “Research doesn’t require a laboratory or a large team. You can find small series of people in the hospital or your practice.”

As an example, Dr. Starkman teamed with endocrinologists to write a paper on two patients with false pregnancy, an extremely rare condition. She says women physicians should not hold back and wait for ideal circumstances.

“Studies have shown that women write fewer papers because they wait until every ‘i’ is dotted and completely understood,” she says. “That is not the way a lot of guys publish. They don’t wait until they have every last section.”

Dr. Starkman also noticed that male doctors socialized and networked differently than their female counterparts and worked to create settings that are gender neutral.

“Poker games and golf can have a powerful impact among men,” she says. “I thought one way to counter that is to suggest activities that both genders can enjoy, such as rotating international dinners at various homes.” 


Self Examination

Dr. Starkman did not have mentors who championed her at school or in her academic career. Looking back, she thinks she did not position herself as a young doctor seeking a mentor.

“I’ve thought over why that is and I think there are a couple of reasons,” she says. “First, I presented myself as someone who wanted to be autonomous. And maybe the guys felt uncomfortable about it, and were concerned about interacting with women even before the Me Too movement.”

She believes her success in medicine benefited her children as they were growing up and beyond. 

“I thought that being a happy professional person was something that would be beneficial to them,” she says.

In her 80s, she embraces social media for its power to connect with a larger audience, blogging regularly for Psychology Today.

“I know my articles there have been downloaded by well over 100,000 people, and it is gratifying to know I am helping bring important information to the public,” she says. “I could reach many more people than I could in my professional career.” 


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Alicia Lazzaro