Sometimes when we see an average looking person, we are overlooking the unique characteristics that mark them as exceptional. In 2011 I had the privilege of meeting Dr. Janet Rowley when she spoke to SELAM (the Society for Executive Leadership in Academic Medicine) about the challenges of being a woman in medicine and science. Quiet and unassuming, Dr. Rowley was revolutionary. She was smart, tenacious and modest. She achieved her Bachelor’s degree at the age of 19 and was one of a very limited number of women admitted to medical school, graduating at age 23 in 1948. Dr. Rowley died December 18, 2013 at the age of 88.
Dr. Rowley was fascinated by familial and genetic disorders. She worked part time treating “mongoloid” children with Down’s syndrome. Along the way, she bore and raised 4 sons with her husband and former classmate. Her intellect could not be denied, and she eventually was able to negotiate part time work in a leukemia research laboratory. She described her salary negotiations as “weak” – saying that she was able to obtain funding sufficient to cover the cost of baby sitters for her children, a microscope and supplies.
In this laboratory she studied and applied herself to learning the emerging techniques to study the blood and bone marrow specimens of leukemia patients. She stained chromosomes, and used a literal cut and paste technique to compare those of leukemic marrow with those of normal patients. (She described her children calling the cutouts her paper dolls). Dr. Rowley identified a consistent abnormality in several leukemia patients – pieces of chromosomes 8 and 21 had changed places; they had “translocated”. She went on to clarify that the Philadelphia Chromosome was a translocation of chromosomes 9 and 22. Initially identified in 1960, the Philadelphia Chromosome was felt to be an artifact of the leukemia and possibly due to the deletion of chromosome 21.
“CELLS from nine consecutive patients with chronic myelogenous leukaemia (CML) have been analysed with quinacrine fluorescence and various Giemsa staining techniques. The Philadelphia (Ph1) chromosome in all nine patients represents a deletion of the long arm of chromosome 22 (22q−)1,2. An unsuspected abnormality in all cells from the nine patients has been detected with these new staining techniques. It consists of the addition of dully fluorescing material to the end of the long arm of one chromosome 9 (9q+). In Giemsa-stained preparations, this material appears as an additional faint terminal band in one chromosome 9. The amount of additional material is approximately equal to the amount missing from the Ph1 (22q−) chromosome, suggesting that there may be a hitherto undetected translocation between the long arm of 22 and the long arm of 9, producing the 9q+ chromosome.” – A New Consistent Chromosomal Abnormality in Chronic Myelogenous Leukaemia identified by Quinacrine Fluorescence and Giemsa Staining, Janet D.Rowley – Nature 243, 290 – 293 (01 June 1973)
Dr. Rowley also identified the translocation of chromosomes 15 and 17 that has become the sine qua non characteristic of acute promyelocytic leukemia. Her landmark paper was published in the New England Journal of Medicine in 1973 – “Chromosomal patterns in myelocytic leukemia.” Rowley JD. N Engl J Med. 1973 Jul 26;289(4):220-1. More recently, Dr. Rowley authored a Perspective in Science – “Genetics – A Story of Swapped Ends” Science 21 June 2013.
Dr. Rowley’s accomplishments have been marked by receipt of the Presidential Medal of Freedom, The National Medal of Science, a Lifetime Achievement Award from the American Association for Cancer Research and the Lasker Award. She did note that her five grandchildren were among her greatest prizes.
Dr. Rowley looked at chromosomal abnormalities in a way that others had not – she looked beyond the ordinary and used emerging staining techniques to see patterns not previously recognized. She founded a method of investigation in medicine that is integral to the way I treat cancer patients today. She helped us along the path that led to treatments like Imatinib (aka Gleevec), and ATRA (all trans retinoic acid), and that has led to the classification and treatment of leukemias on the basis of their chromosomal abnormalities.
It makes me wonder what our students will accomplish in the future. Which of them will identify a new way of looking at things that transforms medicine? With the passage of time, which one will emerge as the next giant? Odds are good that greatness is lurking within our students. Let’s share our passion, and nurture their intellectual curiosity – who knows what the next chapter will hold!
