In this edition, Claire McLintock, MD, discusses her work at the intersection of women’s health and hematology and her experience as president of the International Society on Thrombosis and Haemostasis (ISTH).
Where did you grow up and what was your childhood like?
I grew up in Dundee, a city on the east coast of Scotland. My two brothers and I had a lovely, idyllic childhood. My dad had a PhD in chemistry and worked at the university as an academic, and my mom was a math teacher. I had great relationships with both my parents, but I was especially close with my dad, who was very indulgent with me.
We walked the hills quite often, fishing in the lochs there. I was also fortunate to spend time with my grandparents when I was young; my dad’s parents lived in a little town called Strathpeffer in northern Scotland.
What brought you to medicine? Did you consider any other career?
I have wanted to be a doctor since I was 7 or 8 years old. I couldn’t imagine doing anything else. My mom kept suggesting other careers, like engineering or optometry, but I was set on studying at the University of Edinburgh (probably because that’s where my dad studied) and becoming a medical doctor.
If I couldn’t be a doctor, I think I would be a lawyer. I am interested in the ethics of the law – how the law influences society, how people are generally relatively uneducated about the law even though it’s so important in determining their lives, and how it has the potential to be unjust for many members of society.
What drew you to hematology and specializing in women’s issues?
I went to the University of Edinburgh – just like I said I would when I was a kid – where we did a lot of clinical work from the beginning of our training and, in the third year of the five-year course, students were assigned to hospitals across the city. I enjoyed two specialties the most: hematology and obstetrics. With hematology, I loved the variety of experiences in working with patients with hematologic malignancies or classical hematologic conditions like thrombocytopenia. In obstetrics, I was part of a wonderful team and enjoyed working with women who were having babies.
When I finished university, I practiced as a doctor in the U.K. – punctuated by a yearlong sabbatical when I was deputy president of the Edinburgh University Students’ Association. I worked incredibly long hours, up to 120 per week, which was unsustainable. I started looking at positions in New Zealand and Australia – two countries with better working conditions than the U.K. At the time, Australia seemed more exciting, but I was certain I wanted to do internal medicine and all the jobs were in surgery or pediatrics. Soon, the perfect opportunity became available in New Zealand. So, in 1990, I applied for and accepted a job as a medical specialist in Auckland.
When I arrived in New Zealand, I was deciding which specialty to pursue – obstetrics or hematology.
A few factors influenced my decision. First, I’m not very good at tying knots, so I didn’t think I would have been a good surgeon as an OB-GYN. And, at that time, in the 1990s, it seemed to me that all of the scientific advances were rapidly applicable in the field of hematology. Merging the clinical with the academic was exciting, so I decided to pursue a career in hematology.
I was more interested in the nonmalignant side of hematology, particularly thrombosis and hemostasis, than the malignant side, where I think hematologists can suffer burnout quite easily. Combined with my interest in women’s health, I realized when I was nearing the end of my training that I could develop a specialty in obstetric hematology, which was kind of an untouched field.
Was there a mentor who helped guide you down that path?
When I finished my training, I was pregnant with my younger daughter and thinking about going to the U.K. to work with some other obstetric hematologists. Robyn North, MBChB, PhD, a colleague in obstetric medicine who eventually became my mentor, said that might be tricky. There was no funding for my job in this new specialty.
Instead, she asked me to help her write an article on thrombophilia as an adverse pregnancy outcome. We also discussed preeclampsia and the many hematologic mechanisms behind that disorder. That article was my first big publication. It was in a smaller journal – Current Problems in Obstetrics Gynecology and Fertility – so I didn’t think many people read it. But once, after I gave a talk, an audience member likened the article to a fine bottle of wine you’d find in the very back corner of a wine shop. That made me feel very good about it.
Tell us about your role as an obstetric hematologist.
In my position at National Women’s Health in Auckland City Hospital, I work closely with the maternal fetal medicine (MFM) team. I look after pregnant women, but I don’t deliver babies. My main focus is women who have a medical problem that complicates their pregnancy, or women who develop a complication in pregnancy that is medical rather than obstetric.
Our team consists of hematologists, obstetric physicians trained in internal medicine, the OB-GYN MFM specialist, and midwives. We are women-centered and women-focused. This approach has given us good outcomes with quite difficult and complicated medical conditions.
You never know what you’re going to see. We take care of women with blood clots, cancer, cystic fibrosis, diabetes, heart disease, kidney disease – any medical problem that a woman comes into pregnancy with, we assess how it will impact the pregnancy and how pregnancy will impact the medical disorder and provide care for these women throughout their pregnancy.
Do you enjoy working in a team environment?
Sometimes it’s a little bit challenging, with different personalities and different opinions, but it’s best for the patient to have more than one mind thinking about her treatment. We function well as a team, so it’s exciting. If we do have differences of opinion, we seem to be able to resolve them and focus on the patients.
I was the team’s clinical director up until a few years ago, when I was elected president of ISTH.
Tell us about your time as ISTH president.
I was elected to ISTH Council by international members of ISTH, and then was ultimately elected by my ISTH Council colleagues to be president. It was a huge honor to be selected by luminaries in my field, and to be the first New Zealander to not only serve on ISTH Council, but to have been its president.
I truly enjoyed my term as president. We accomplished some cool things under my watch, including developing a diversity, equity, and inclusion task force and an early career committee. I also led the development of the international curriculum on clinical and laboratory thrombosis and hemostasis.
What would you say is the greatest accomplishment of your career?
In 2019, I received the award of Officer of the New Zealand Order of Merit in the Queen’s Birthday Honours, awarded on behalf of Queen Elizabeth, for my contributions to the field of obstetrics and hematology. It was a huge honor and the medal is beautiful.
I’m also really proud of my ongoing work with my colleagues here in Auckland, developing protocols and guidelines that make pregnancy safer.
In addition, I’ve managed to get lots of early career professionals interested in obstetric hematology and obstetric medicine. We have established a training program for fellows in New Zealand and around the world to come train with us. In my opinion, you can be the best hematologist in the world, but unless you bring on the next generation, your achievements won’t have a long-term impact. It is critical to foster and support the next generation of specialists, giving them all the help, time, and encouragement that they need.
Tell us about your children. Are they interested in medicine?
I have two daughters: Hart is 25 and Vita is 21.
Hart decided early on to be a lawyer and she’s just finished her joint degree in law and arts. Vita is more artistic, and enjoys shooting and editing films. She takes after my husband, John, who is a painter. Some people think that makes us an odd couple, but our professional strengths are complementary most of the time.
For a while, my younger daughter was unsure about what she wanted to do, which was quite interesting to wrap my head around, having been absolutely sure about medicine from such a young age myself. I’ve been careful not to push my kids into doing something they don’t want to do or aren’t sure about.
What do you do when you’re not working?
Art plays a big role in my non-medical life. I really enjoy going to art galleries and events with John. Even though I’m not very good at it, I find it relaxing to paint watercolors. John always gives me positive feedback on my paintings, even though he’s much better than me. He would say, “No one can tell you the right thing to do and the wrong thing to do in art. You just have to do what you want to do.”
I also like cooking and hanging out with friends and socializing, going out to restaurants and concerts. I love being in nature, and we’ve got beautiful countryside around here. We’re near the wild West Coast of New Zealand so I go to the beaches and go for bike rides. It’s a bit hilly, so my electric bike is great for that.
I’ve also got a new puppy called Silvio. He’s a Brussels Griffon, a little short-haired guy, and he keeps us busy.
What’s something that most people don’t know about you?
Many people don’t know that I speak Spanish fluently. I did my medical elective at the Red Cross hospital in Puebla, Mexico, and was immersed in Spanish for four months – it was sink or swim. In the years since, I’ve had opportunities to visit the area and have made very good friends and colleagues in Mexico and other parts of Latin America. When I teach and lecture there for the regional hematology societies, I sometimes try to do it in Spanish. People don’t seem to mind my imperfect Spanish and are very encouraging.
Disclaimer: This interview has been edited for length and clarity.