In this edition, Clara Bloomfield, MD, talks about being on the right project at the right time and having academia in her blood.
Where did you grow up?
I grew up in Washington, D.C., during World War II. My father was on the National War Labor Board, and after the war ended, he took a faculty position at the University of Illinois, so we moved to Champaign-Urbana.
My father was a professor of labor and industrial relations, and my mother stayed at home with my brother and me until I was in the first grade, when she decided to go to law school. When I graduated from high school, she graduated from law school.
When you were growing up, what career did you see yourself in?
It’s really simple: Nothing other than academia.
Why was that such a clear path for you?
From the beginning, there was a focus on academia in our household. Nearly every weekend, our parents hosted University of Illinois faculty or visiting faculty from around the country for dinner. So, I was exposed to academia and was always learning about how to succeed in academia. Also, when I was 4 years old, my mother put me in elocution lessons to learn how to give talks, so that tells you something about how important academia was to our family.
My brother and I took that message to heart: I remember once, when I was about 9 years old, she told us that she was going to stop going to law school because she felt like she wasn’t spending enough time with us. Well, my brother and I both started to scream and cry. We didn’t want her to leave school because then we wouldn’t be able to boast about it to our friends!
I grew up in a time when the concept of formal mentorship simply did not exist. So, I looked to my parents, and they certainly had a substantial impact on what I ended up doing.
When did medicine enter the equation?
It’s difficult to pinpoint the exact moment. I went to medical school in 1964, after all. Neither of my parents had anything to do with medicine, so I’m not sure where the idea came from. But this is what I do remember: When I was probably 5 years old, I liked to play nurse and pretend to give shots, like most kids do. Of course, I liked to be the one giving shots, not the one receiving them. One day, I came home and told my mother, “I know what I’m gonna be when I grow up.” She said, “That’s nice, dear. What are you going to be?” I said proudly, “I’m gonna be a nurse.” She looked at me and said, matter-of-factly, “You’re gonna be a nurse? You might as well be a doctor.” That’s how it happened!
Certainly, I don’t want to give the impression that there was something wrong about becoming a nurse, but my mother had high ambitions for me. At the time, nursing and teaching were the conventional professions for women; as a mother who went to law school in the 1950s, I think she wanted me to know I could choose my own path – just as she had.
Once I decided to pursue a career in medicine, I initially wanted to focus on public health, but eventually, my interests turned toward cancer. Honestly, I’m not entirely sure why; it’s just been part of my life for so long now, I can’t remember when it wasn’t.
Looking back on your career, what are your proudest accomplishments?
That’s a difficult question, perhaps because of the way I was brought up. In academia, you publish your research and you do things that matter. You don’t necessarily think about being “proud” of them.
There are important accomplishments in my career, though. The first was in 1973, when I published that older patients with acute myeloid leukemia (AML) should be treated. That was the first time it had been proposed; in those days, if a patient was older than 65, the view was that the patient wouldn’t be able to tolerate chemotherapy and therefore shouldn’t be treated intensively. The average age of AML diagnosis is 67, so this left a large portion of the AML population going untreated.
I published an article in JAMA saying that these patients should be intensively treated like other patients with AML.
That paper was important for my career, which was still in its early stages, and for the treatment of older adults with AML. In 1973, no one believed in treating them. Immediately after I published my results, I was invited all over the country to give talks about this topic, and usually by very senior people in the field who vehemently disagreed with my findings. Later, they would come back to me and say I was right.
So, that’s a good thing to have happen early in a career.
That was followed by other research that seemed to oppose the prevailing wisdom at the time, like the discovery of Philadelphia chromosome (Ph)–positive acute lymphocytic leukemia (ALL) in 1978. At that time, everybody thought Philadelphia chromosome only occurred in chronic myeloid leukemia, but I reported that approximately one-third of patients with ALL had Ph-positive disease. This had major consequences for how those patients were treated.
Then, around 1982, I discovered inv(16), an important chromosomal abnormality in AML. Later, in 2004, we found that patients with this abnormality had good outcomes with high-dose cytarabine treatment, rather than standard chemotherapy treatment.
Now, my work focuses on molecular findings with prognostic significance, primarily in AML. This work has contributed significantly to the updated World Health Organization Classification of Hematologic Malignancies, as well as the National Comprehensive Cancer Network and the European LeukemiaNet guidelines for the use of genetics in individualized therapy in leukemias.
Much of my work was made possible through my role as chair of the National Cancer Institute (NCI) Cancer and Leukemia Group B Cooperative Group’s Leukemia Correlative Science Committee, which I held for 17 years. During my tenure, we updated clinical trials protocols to include cytogenetics, molecular genetics, leukemia tissue banking, and other vital information for the future of personalized medicine.
On the flipside, were there any major disappointments or setbacks?
Another simple answer: No.
I’ve been lucky through my career. I became involved in a project early on that turned out to be important. Who could have known that, when I was told to study older patients with AML, I would find what I found? Right from the beginning, I was working on a meaningful project, and one that resulted in a promotion to full professor in seven years. Not everybody is so lucky!
Of course, there is plenty of hard work involved, as well, but that accelerated timeline certainly gave me an advantage throughout my career.
I could also attribute it to my personality: When an unanticipated problem comes along, I’m quick to find a good solution. I think that skill shields me from experiencing any major disappointments, in a way. Making a big to-do about a problem isn’t a useful way to spend my time; I’d rather find a solution and move on.
In that vein, is there any advice that you would share with early-career investigators?
Publish what you find. Don’t worry if it contradicts what others have said, as long as your data are sound. I’ve never believed in ideas separated from data.
Also, get involved. For me, it was important to work with national and international associations, like the NCI, the American Association for Cancer Research, the Association for Patient Oriented Research, and others. My roles within those organizations were essential to my success as an academician.
In a typical day, what is your rose and what is your thorn?
At this point in my career, I’m fortunate that I can choose how to structure my day, so I do exactly what I want. That’s not to say that there aren’t pesky problems that come up, or that every committee is my favorite, but I set my days how I want them.
What you do outside of work, if you have the time?
Oh, I work all the time – seven days a week.
My personal trainer comes twice a week, and, for years, my husband and I did tandem biking, so I guess one could consider that my hobby. My husband is a human geneticist, is 86, and also still works full-time. Our areas of science don’t entirely overlap, but it is nice that we can “talk shop” together.
What is one thing about you that people would be surprised to learn?
My husband is from Finland. So, we have three houses in Finland where we spend our summers. But, it’s not a summer vacation – I still work the same amount, just with different scenery and in a different time zone.
What does a perfect Sunday look like for you?
I’m sure readers can guess my answer by now … working. I have no commitments on the weekends, so I can get caught up with work, which always feels good.