EP183: Breaking Traditions: Dr. Jane Grant-Kels on Family and Career

Career and Family: A Conversation with Dr. Jane Grant-Kels

In this episode of The Girl Doc Survival Guide, Christine interviews Dr. Jane Grant-Kels, a prominent dermatologist and Professor at the University of Connecticut Health Center. Dr. Grant-Kels shares insights from her extensive career in dermatology, including founding the UConn Dermatology residency program and receiving numerous accolades. She offers personal anecdotes about balancing her demanding career and family life, the importance of mutual support in marriage, and lessons on ethical medical practice. The discussion also touches on how societal expectations shape professional and personal roles and the significance of choosing a supportive life partner. The episode is rich with valuable advice for women navigating dual-career marriages and work-life balance.

00:00 Introduction to Dr. Jane Grant-Kels

01:17 Anecdotes from Early Career and Marriage

04:16 Balancing Career and Family Life

10:10 Lessons Learned and Advice for Young Women

13:57 Ethics in Medicine

19:14 Final Thoughts and Reflections

Transcript

Christine Ko: [00:00:00] Welcome back to The Girl Doc Survival Guide. Today I'm very happy to be with Dr. Jane Grant-Kels. Dr. Jane Grant-Kels, MD is Founding Chair Emeritus and now Vice Chair of the Department of Dermatology and Professor of Dermatology, Pathology and Pediatrics at the University of Connecticut Health Center. She founded and initially directed the University of Connecticut's Dermatology residency and is now Associate Residency Director. She attended Smith College and Cornell University Medical College and trained in dermatopathology with Dr. Bernard Ackerman. She currently serves as the Deputy Editor of the Journal of the American Academy of Dermatology. She also served as Vice President of the American Academy of Dermatology and has received numerous awards including the Rose Hirschel Award from the Women's Dermatologic Society, the American Society of Dermatopathology 2022 Elson B Helwig Memorial Lectureship at the 59th ASDP annual meeting, the AAD Professionalism [00:01:00] Award, three AAD Presidential Citations, and the AAD Clarence S Livingood MD Memorial Award. It's an amazing career and still continuing and I'm just so pleased to be with you here today. 

Jane Grant-Kels: Thank you for inviting me. 

Christine Ko: Can you share a personal anecdote to just humanize yourself?

Jane Grant-Kels: Sure. I trained in pediatrics many years ago when we were still on call almost every other night. My husband and I got married two weeks after we graduated medical school. And then that very first weekend after we were married, I was on call. In those days, you went in Saturday morning, like at 7:00 AM, and you didn't come home until Monday about 7:00 PM. And I had a very intense weekend: lots of admissions, a lot of sick children. I had gotten no sleep, hadn't really eaten a meal except for snacking. And I remember going home thinking my husband will have dinner ready for [00:02:00] me, I'll take a shower, he'll rub my back, and I'll go to bed. I got into the house. He wasn't on call, and he was lying in bed, watching TV, waiting for me to make dinner for him. And I didn't get angry. I just sat on the bed, and I cried. I said, If this is marriage, I'm not sure I'm ready for marriage. And I have to say, he never ever did that to me again. He allowed me to shower, ordered in pizza and put me to bed, which is what I had hoped he would do when I first was walking home. But it was a very important lesson because for those of your listeners who are women, I don't mean to sound too much like a female chauvinist, but you have to break your husband in a little bit. It would be wise for a husband to recognize that he might need to take care of you rather than you make dinner for him. I never had to ever ask my husband again. He learned from that one experience. I'm married 51 years. That was within the first two weeks of [00:03:00] marriage.

Christine Ko: Yeah. Both my husband and I grew up in families where our mothers did everything at home and made all the meals. You could call it traditional or you could call it a chauvinistic model, maybe, where there's women's work, and there's men's work. Even to this day, my mom makes the meals. My father can cook, but he doesn't much at all. And so I call it kind of stupidity in quotes, but I didn't realize until actually really recently, like I would say the last five years, how much of an impact that model had on me of what I myself think a proper wife is supposed to be.

Jane Grant-Kels: It's interesting because I grew up in a very traditional home as well, where my father did very little except the gardening and barbecuing. My mother was in charge of housework and cooking. I married a classmate of mine. We were both working ridiculously long hours, and it just made sense to me that he would pitch in, and in fact, he [00:04:00] has been an incredible partner and has always pitched in since that night. That was like a turning point. It immediately occurred to him that our relationship was gonna be different. We were both pulling the wagon in regards to bringing in income and had big responsibilities. For some men, women do have to verbalize it and teach them that they need help, that it doesn't have to all fall on us.

The other thing that my husband has taught me over the years is that we, the husband and wife, don't have to do everything. Some things, if you have the money, can be paid. For example, you don't have to wash the floors or cut the lawn. You do have to be with your children and help them with their homework and love them and put them to bed. But there are other things you can have other people do for you. And I think that's a very important lesson that my husband and I found out together. We always advise women who are in these double career marriages, which is most of the people I know, that [00:05:00] anything that can be shifted to someone else that you can pay to do that doesn't involve loving your husband or your children, have someone else do.

Christine Ko: How did you figure out, especially when you were younger with young children and a career, and your husband has a career too. How did you figure out how to have some kind of balance? 

Jane Grant-Kels: It was trial and error. You know, I had no role models. I'm old, so there was no one ahead of me that I could mimic. I didn't know Wilma Bergfeld in those days. And I didn't know how other people were doing it. Around me, I, I was a pariah. I was one of the only working women at my children's school. Women looked at me like I had leprosy. Everybody else was staying in the home. It was a struggle. I happen to have been extraordinarily lucky, and my husband really was a full partner and wanted me to be happy and to succeed and supported my career in an era when men didn't do that. Men looked at him like he was nuts. But he [00:06:00] always helped me. The most important decision of your life is who you marry, a lesson well learned by my grandchildren. One is as young as six. If you ask my 6-year-old grandson, what's the most important, he'll tell you who you marry, not where you go to school, not what kind of car you're gonna buy, not what you're gonna choose as a career, as long as it's legal, but who you marry because that makes or breaks whether you're going to be happy or not.

Christine Ko: You mentioned just now that it was a time when you were a pariah. Other women didn't work. And so I'm sure both of you guys, but him also, he had no sort of precedent for how to support a wife who's working. Do you think you could pinpoint some qualities that he had?

Jane Grant-Kels: No, he was sort of a chauvinist. He went to an all men school, cause in those days that's what people did. Most of the schools was single sex. That's just the way it was. And then we were thrown together in med school, and I was one of very few women. We started out being really good friends, and I don't think he had ever had a [00:07:00] best friend who was a woman, and it evolved over time: another very interesting story. My son, who's incredibly successful and very well spoken, when he was very young, he was on the bus and a kid bullied him, threw him down with his knapsack on. He got off the bus, and out of the blue, he had a stutter. And my heart was in, I mean, here was my delicious little boy and he was so traumatized. We went to the school to talk to them about the event and this kid who bullied him and they blamed me, my working. And my husband said, why are you blaming her? I work, why aren't you blaming me for working? And he said that instinctively. So over the years, he became a women's libber.

Christine Ko: How long did your son have the stutter for? 

Jane Grant-Kels: It was a matter of just a few months. I was the only dermatologist at UCONN, [00:08:00] and for seven years I took no vacation because there was no one to cover me. I worked very long hours. It was very difficult, and I had not spent any significant amount of time at leisure with him because of that. And so we took him to a a speech therapist, and that speech therapist recommended that we bring the tension in the house down. At that time we were a Division of Medicine, and I went to the Chairman of Medicine and I said, I have to take time off. And I arranged for my slides to be sent to Yale. Kurt Stenn was Head of Dermpath then, and I said, Kurt, you gotta cover me. I need to take a few weeks off and just be at home. And I took a few weeks off, and I just hung out with my son. And during those few weeks his stutter just dissolved. It went away. We did take him to speech therapy, but it really just dissolved when the tension and the tone of the house was reduced. I went back to work after that and it never [00:09:00] recurred. In fact, I wrote an article for JAMA, the Piece of My Mind: Equal, Not Really. I published it anonymously. I talked about this, about how I was working and trying my best to be a good mother, a good wife, a good daughter, all of it. Good doctor, and yet the tension that I was carrying and then the bullying on the bus is what tipped it over. I think I contributed to the tension that he felt and just being at home with me that kind of just dissolved and now he speaks publicly, he's fine. People need to know that if you carry a lot of tension, your children pick it up. It's really important to try to leave it at the door, and for the few hours that you are with them to just be a hundred percent mother. And that's what I learned from that.

Christine Ko: I'll try to find your article and link to it. That's amazing that you wrote a piece like that. Maybe because I'm Korean American, I'm only now like really grappling with a [00:10:00] lot of this stuff.

Jane Grant-Kels: Yeah. It's hard. It's very hard, especially for those of us who grew up in very traditional homes. Women look at their mothers as their role model.

Christine Ko: Is there something you wish you had known sooner in terms of having a long and productive academic career and being a mother of two kids and wife?

Jane Grant-Kels: Yes. I have volumes of mistakes I made. I wish I would have been able to enjoy the journey more because I was so intense about trying to be a good mother. One of my grandchildren is in college. I do enjoy the journey of being a grandmother, savor every second, but when you are a mother, and it all falls on you, and I didn't live near family, I was very intense. I worried about everything. I tended to worry a lot and not relax and enjoy the whole process. I can tell you sitting at here at my age that it is a journey. Enjoying every [00:11:00] minute, telling the people that you love them, not losing your temper, not blowing it, is something I wish I had embraced more. I've apologized to my children for mistakes I made that are countless. I've told my husband, just in general, I apologize for the intensity that I had as a younger woman, 'cause I adore him. You can't take words back. I would tell young women, be very careful what you say in anger because even if you say you're sorry, you cannot take words back. If your child is making you upset, you shouldn't say, I hate you. You can say, I hate what you are doing. Now, I never said, I hate you to my kids, but it went through my mind sometimes. You're just human, but you have to be very careful what you say. I'm much better at being a grandma than I ever was at being a mother. My daughter-in-law is a psychiatrist, and she works full time. And she says, and [00:12:00] this is brilliant, she says, women are not kind to themselves. We are not kind to ourselves. We put on expectations that men don't. For example, when you have a baby and you have to go back to work, most men go back to work with no guilt. But we are guilt ridden. And no matter where you put us, we are guilt ridden. If we're home, we are guilty, we're not at work, and if we're at work, we're guilty, we're not at home. We're not kind to ourselves.

I tell my grandson who's in college. Look for somebody whose values are like yours. It doesn't matter what religion they are. It doesn't matter what ethnicity or race or where they came from. You want someone who shares your values, that views marriage as good times and bad times, that raising children is the most important priority. Being good to your children and helping your grandchildren. And when my grandchildren say, Thank you, Grandma, for doing that. My [00:13:00] answer to them is, you don't have to thank me. You have to play it forward. So someday when you are a grandparent, you do this for your grandchildren. My husband and I used to say to our kids, you don't have to thank us. Just do it for your children. Play it forward. And you want someone who agrees with that philosophy, that family is sacrosanct and the children are everything. The rest of it is not that important. So I tell my grandson, they don't have to look like you. They just have to be like you in their soul. Those are the people you wanna hang out with that have good values and value the things you do. That crosses all socioeconomic and ethnic groups. We're Americans, and that's the great thing about our country, the diversity. I teach my children to look for someone who has the same values, and that's the person you can live with the rest of your life. 

Christine Ko: I like how you put that, the values of family, and what marriage really means, and what kids mean. You publish a lot on [00:14:00] ethics. I always thought your husband was a lawyer.

Jane Grant-Kels: He's both. He's a doctor and a lawyer. He had a midlife crisis, and the good news is he didn't give up his aging wife, he went to law school.

Christine Ko: I think you did say at a meeting once that partially your interest in ethics is somewhat related to the fact that your husband's a lawyer. 

Jane Grant-Kels: Our son is an attorney as well. Both he and my husband are interested in healthcare law and we had used to have, when everybody got together, very interesting conversations. Even though the law and ethics are not the same because something can be unethical but still be legal. It sparked an interest for me in ethics. So that's how it started. 

Christine Ko: I appreciate how you put it that something ethical isn't always legal and vice versa. Not being trained in ethics myself, is there, in your opinion, the minimal amount of ethics we should know as doctors? 

Jane Grant-Kels: Yeah. In fact, it's mandated that residents be exposed to ethics and have lectures on ethics, and very few [00:15:00] programs have that. We happen to have it at UConn, but one of the most common things I get invited to speak on is ethics. I do not have a Master's in ethics. It's self-taught. I hang out with smart people, read a lot and think a lot. It's just like you can become a melanoma expert by seeing a lot of melanoma patients. You don't have to do a pigmented lesion fellowship.

There are pillars of ethics everyone should be aware of. One is autonomy. So the patient has a right to either accept what you want them to do or refuse it. You cannot force a patient to have a treatment that you think is right. It's our job to educate them why we're recommending a certain treatment, but we can't force them. In the 1950s, doctors were very paternalistic. They took care of you, and you did what they said, and you weren't allowed to have an opinion. You need to take the patient's perspective into consideration. Paternalism and patient [00:16:00] autonomy are in direct conflict. Another is beneficence and beneficence is basically that the patient's interests are above all. So you never make a decision that's going to enrich yourself and hurt the patient. You would never do an inappropriate procedure or put them on a medication that you have stock in. The patient, they come first. Above all else is the patient, which then leads into nonmalificence, which means that you don't do any harm on purpose. On purpose is important because we do harm by mistake, and you have to live with that. You put a patient on a medication and they get TEN. You didn't plan that, but it happens. That's the hardest thing to live with. Other things like truthfulness, which is to be totally transparent and honest with your patients, I think is very important. The final one is respect. Respect for the patient, but I [00:17:00] also think we need to be treated with respect. So I don't go to work to be treated disrespectfully by the manager of the clinic or the CEO of UConn or the Dean. I expect to be treated respectfully. Sometimes patients can be very disrespectful. When that happens to me, I simply say very quietly to the patient, do you realize that you're being rude or being very disrespectful to me? A normal patient will catch themselves and apologize. If they don't, there's something wrong, and you should leave the room and let them calm down. As a young woman, I wasn't aware of that and allowed patients to rant and rave, but now I don't. If a patient isn't being inappropriate with me, I tend to very quietly and very respectfully address it with them. Most patients don't mean it. They don't wanna alienate their doctor. The big problem is when they're rude to your staff, but nice to you. That's another whole issue.

Christine Ko: I really appreciate what you just said about respect, that the [00:18:00] patient should respect us, the doctor. You made a comment that you couldn't do it as a young woman, but you're able to do it now. Do you have tips on that?

Jane Grant-Kels: It comes with maturity. When I'm in the room, the only person that exists for me is that patient. I have good body language, and I think it comes with maturity. Being able to speak up for yourself. You have to educate them lovingly that you are not their enemy, and you are there to help them. That comes with maturity. By the time I die, I'll be a great doctor. That's the problem. You learn these lessons, and then, you're old. As a young woman, I was not mature enough and not secure enough in my own self to be able to stay calm and talk to the patient and try to address that they were being rude to me. I think you need to work. People need to just try to work on it. And get better at it with time. 

Christine Ko: These things are skills and someone can tell you what to do, but just like a sport or music, just because [00:19:00] someone tells you how to shoot a basketball doesn't mean you can do it until you practice it.

Jane Grant-Kels: Internalize it, practice it. A lot of people believe in play acting, if that helps, doing it with someone you trust, like a colleague or your spouse might help.

Christine Ko: I've enjoyed talking to you. Do you have any final thoughts? 

Jane Grant-Kels: It's been fun chatting with you. I hope whoever listens in finds it helpful. If anybody has good ethical dilemmas, let me know. People contact me, and that's how we write these different scenarios.

Christine Ko: Yeah. Thank you so much.

Jane Grant-Kels: Thank you. I hope it records well and my New York accent isn't too terrible.