by Whitley Hill
photos by Martin Vloet

For as long as medicine has been taught and learned — even under the sycamore tree on the island of Cos where, legend holds, Hippocrates instructed his students — the value of a mentor to a student-physician’s education has been fundamental and constant. Not limited to medicine alone, mentoring is key to how we all learn.

A century and a half ago, during the early years of the University of Michigan Medical School and medical schools in America, the path to a medical education included just such a relationship. To be admitted, a young man (or, much less frequently, a young woman) had to present evidence of good moral character as well as document an adequate understanding of Greek and Latin for engaging in the language of medicine. Most students had not graduated from a college or university. The critical requirement was a three-year apprenticeship, before medical studies or during periods between terms, to a “respectable” physician (a physician who was not part of a generally spurned medical sect, such as homeopathic or eclectic). The young doctor-to-be would help around the office, prepare prescriptions and even assist the doctor in medical procedures. Often, after medical school, the young doctor would find a specialist to work for and learn from, in exchange for clinical duties and perhaps some small salary.

These relationships — informal, then ungoverned, and reaching back centuries — are still crucial to medical education in the 21st century. A trusted advisor plays a role that can make a tremendous difference in the choices, directions and career success physician-scientists experience, not only during their academic, clinical or research training, but far beyond and throughout their professional lives. Mentors can open doors of opportunity and reveal paths that lead to bold, new, unexpected achievements. It’s as much the rich spirit of willing guidance as a young doctor’s eager quest to know even more that drives medicine forward.

Many mentoring opportunities exist throughout the departments of the Medical School and University-wide. At the heart of each is a unique relationship that keeps the spirit and chain of mentorship strong at Michigan.

Jenny Wong-Sick-Hong, Valerie Castle and Laurence Boxer

Valerie Castle, M.D., chair of the Department of Pediatrics and Communicable Diseases in the U-M Medical School and the Ravitz Foundation Professor of Pediatrics and Communicable Diseases, is an internationally renowned expert in a devastating childhood cancer called neuroblastoma. But 20 years ago, Castle was a newly minted doctor, just finishing a residency at McMaster University in Hamilton, Ontario, near Toronto. With a passion for research, she was casting about for a good place to do a fellowship. Boston Children’s wanted her. Sloan Kettering wanted her. Michigan wanted her. Laurence Boxer, M.D., then, as now, director of Pediatric Hematology/ Oncology at Michigan, while on holiday drove to Toronto to meet her. At brunch in a revolving restaurant overlooking Lake Ontario, he told her what she could expect at the U-M, and came away deeply impressed by the young doctor.

“I knew that Val was a very special kind of person,” recalls Boxer, the Henry and Mala Dorfman Family Professor of Pediatric Hematology/Oncology, a professor of pediatrics and communicable diseases, and associate chair of academic affairs in the Department of Pediatrics and Communicable Diseases. “I’d never met a resident as committed to academic research alongside their clinical duties.”

Castle came to Michigan, and what started as a simple recruitment brunch has grown over the course of two decades into a relationship that beautifully illustrates the power of mentorship. Boxer has steered Castle toward opportunities that have enriched her career and benefited both the University and medical science.

As busy as she is, balancing clinical, research, educational and administrative duties — and a family — Castle possesses a warm and inviting presence as she speaks about the tremendous nurturing effect Boxer has had on her career. “One of the reasons Larry Boxer has been a good mentor is that he recognizes that there are only so many things you can provide for any one individual. As you support that person, you continue to put them in contact with others who will help build their success. Larry knew everyone on campus and at the national level — all the movers and shakers — and he was continually putting my accomplishments out into the local and national communities. He has been a huge advocate for me. What I’ve observed in Larry Boxer — and what I hope I do for others too — is that he recognizes the excellence in those he mentors and gives them opportunities that he could have had himself.”

Castle recalls an earlier mentor, Maureen Andrew, M.D., at McMaster — the first person to encourage her, while still in medical school, to explore pediatric hematology/oncology research. Andrew was a world-renowned specialist in pediatric thrombosis who took a particular interest in the mentorship of women interested in pediatric research; she died in 2001. Castle has never forgotten Andrew’s selfless championing of her work. “Maureen could have presented my work. She could have gone to the meetings and conferences, and she should have! She was the person whose ideas were behind the work. But she insisted I submit my early work for presentation, and then when it was accepted, she insisted I go and present it.” Boxer, she says, pushed her in the same ways. “Through the opportunities he gave me, I could expand my achievements.”

Castle’s first stop at Michigan was the lab of Vishva Dixit, M.D. — another mentor, and today vice president of molecular oncology at Genentech in San Francisco — but after three years there, she changed research directions. Boxer says that was a savvy move. “If you remain at the same institution where your mentor is,” he says, “it’s often difficult to find a niche. She didn’t want to compete with him, so she struck out in a completely different direction, to pursue the biology of neuroblastoma.”

Boxer then gave Castle even more responsibility. “She took over managing our coagulation and hemophilia program,” he says. “And lo and behold, it became a great clinic under her care.” The program grew so quickly that Castle eventually handed it over to Steven Pipe, M.D. — another McMaster alum with whom she’d been working closely — and devoted herself to her neuroblastoma research. With every move, Boxer, like a proud parent, watched his protégé meet every challenge she encountered.

“Over the years, Val has continued to engage in neuroblastoma research and she’s had our hematology/oncology fellows in her lab, as well as medical students and undergrads. And as she served on the faculty, I gave her more and more responsibility: directing the clinical program, which she ran with. Then, when Jean Robillard was chair of pediatrics, I was serving as his associate chair for research and thought ‘Val is thriving … Why not give this position to her?’ So I became associate chair for academic affairs and she, in the capacity of associate chair for research, expanded our Research Day and really blossomed. Within the first year of her taking that position, abstract submissions went from 30 to 90. She really got the faculty fired up.”

To Boxer, mentorship is really a kind of leadership. He cites renowned researchers Jim Kouzes and Barry Posner whose theories of the qualities necessary for effective, inspirational leadership have been embraced internationally.

Says Boxer, “Kouzes and Posner express it very well in their Five Practices of Exemplary Leadership: first is ‘model the way,’ then ‘inspire a shared vision,’ ‘challenge the process,’ ‘enable others to act,’ and, finally, ‘encourage the heart.’”

Boxer has found that all five practices easily apply to the world of academic medicine — and are visible in his relationship with Castle, now a cherished colleague. He can see with satisfaction that he has helped to “model the way” for Castle over the years. “I love what I do,” he says, “and I think that’s reflected in the path that Val has followed. And of course we are very fond and supportive of each other — that’s ‘encouraging the heart.’”

But Boxer didn’t just learn how to mentor by reading a book or attending a leadership seminar. “One of my own mentors, David Nathan — my division chair at Boston Children’s — had the uncanny ability to recognize attributes in others that they didn’t know they had,” he says. “He had a giant map of the United States with pins in the places where ‘his people’ were now practicing. Over 100 people trained under him and I don’t know how many chairs and deans and division heads are among them today. David Ginsburg and Jamie Ferrara [both at Michigan] were also trained by Nathan.

“Part of the fun of mentorship with Val is that she is one of the warmest and most engaging people I’ve known — but as warm and engaging as she is, she has the skills and the spine to make tough decisions. I’ve been very fortunate to have Val around and, in turn, Val is now mentoring the next generation.”

Valerie Castle and Jenny Wong-Sick-Hong

Jenny Wong-Sick-Hong is a self-described “Okie from Muskogee” — but one with a brand-new U-M degree in cell and molecular biology. Raised in Muskogee, Oklahoma, Wong-Sick-Hong was a senior in high school when she won a scholarship to participate in two months of hands-on cancer biology and immunology research at the Oklahoma Medical Research Foundation. Then, at Michigan, she took advantage of the Undergraduate Research Opportunity Program and found herself in the lab of Valerie Castle. To say it’s been a formative experience would scarcely begin to describe its impact, she says, and the high point has been having Castle as a mentor.

“She’s the chair of the department and has so much going on, but she takes an active interest in my life,” says Wong-Sick-Hong. “I remember having lunch together and, being an undergraduate and still quite young, I was trying to figure out who I am and what I want out of life. It was nice to have her there discussing my goals and all the ways I could go about accomplishing them. Sometimes it’s hard not to get discouraged and confused, but it helps to have someone to support you and help you find the way that’s right for you — over something so simple as lunch.”

On Castle’s part, the benefits have run both ways. “Jenny came to us in her first year at Michigan, interested in working in a lab for credit. She quickly became a fixture in our lab throughout her undergraduate training. She spent summers with us. She is an outstanding young scientist, just remarkable, and I think when you can give people some opportunity and advantage, they, in turn, give so much to the group. She’s become the heart of the lab, organizing soccer excursions, a trip to Cedar Point and floor parties to celebrate holidays in different cultures.” Wong-Sick-Hong’s work these days focuses on a protein called Bcl-6. “I’ve come up with a new theory of how it works,” she says. “That, for me, is kind of rewarding. It may or may not pan out, but for the moment, it could be possible …”

Castle adds that her protégé’s thirst for knowledge is matched by her desire to give back to people in need. During school breaks, Wong-Sick-Hong traveled to Belize and Mongolia to volunteer in medical clinics. The experiences, she says, have nurtured concurrent interests in political science and international health.

“Jenny’s going to do huge things in her life,” says Castle.

She adds, “I think the success of academic medicine is very much dependent on good mentorship at virtually every level. The model of medicine has always been one of mentorship — before there were medical schools, practitioners in small communities took individuals under their wings and trained them in the art of medicine, as meager as that training was in those days. Today many major discoveries are made with a senior person and a junior person working together; this reflects the reality of how medicine always has been. The most successful medical schools nurture opportunities to be a mentor — but also nurture the philosophy of strong mentorship by rewarding and encouraging it.”

Castle says that a singular pleasure for her today is watching faculty that she once mentored now doing the same for others. “The chain does go on,” she says. “That’s what’s so dynamic and important about an academic medical center. We give opportunities to others and recognize their ability to shine and be successful. This is one of Michigan’s great strengths.”

If you have fond memories of a mentor relationship at Michigan, we’d love to hear from you. Send your stories to rkrup@umich.edu or mail them to Mentor Stories, Medicine at Michigan, 301 E. Liberty St., Ste. 400, Ann Arbor, MI, 48104. Your story may appear in an upcoming issue of Medicine at Michigan or on this Web site.