Increasing Knowledge About Disease Processes
By Barbara Spector
Ellen C. Riemer '85
Ellen C. Riemer '85, an assistant professor of pathology at Wake Forest University School of Medicine in Winston-Salem, N.C., loves being a pathologist. "Pathology offers some of the greatest intellectual rewards in all of medicine," she says. "Pathologists are called 'the doctor's doctors' because they have a significant role in educating other physicians. Rather than focusing on one organ system in isolation, you can see how disease in one organ affects another."
Yet pathology was not her initial career choice. After graduating from Bryn Mawr College as a philosophy major, Riemer attended law school at the University of Wisconsin–Madison. "I decided to go to law school straight out of Bryn Mawr in large part because I hadn't really decided what I wanted to do," she says. Law school, she reflects, "was a way of becoming better educated about a lot of things in which I was interested."
Riemer served as a law clerk on the Wisconsin Supreme Court in 1988-89 and in the early 1990s worked as an associate at two high-profile New York law firms. "It was my job, and I was good at it," she says, "but it didn't come from my gut." Over the years, she gradually realized her true calling lay elsewhere.
"When I was in my late 20s, someone I cared about a great deal got very ill," Riemer recalls. "Through that experience, I was introduced to medicine. As I was learning more and reading more about medicine, I realized that it was where I wanted to put my energy."
A New Direction
Yet there were complications. As an undergraduate, "I took a minimal number of science courses," Riemer says. "I always knew that I was good in science, but I still grew up with a lot of the stereotypes — that math and science were the masculine realm." To change careers, she needed to take the premedical courses she had avoided as an undergraduate. Riemer left a big law firm to take a less-demanding position in the litigation department of an insurance company, which enabled her to devote time and energy to her studies. She completed the additional coursework in two summers plus the intervening academic year and took the MCAT exam in the spring of 1993.
During this time, Riemer learned about a program for American medical students at Tel Aviv University in Israel . The four-year curriculum, chartered by the state of New York and conducted in English, is patterned after U.S. medical schools. Enrolling there enabled her to begin her studies in August 1993, at age 30, rather than waiting another year. In addition, "I always wanted to live abroad," she says, "and that added an extra dimension to medical school."
Riemer found medical school "very challenging and very exciting." While law school involved considering issues from different angles, in medical school "there's a massive amount of information that you just have to internalize."
Riemer says her Bryn Mawr experience gave her the confidence to succeed in her career change. "Somehow I never doubted that I could change careers. Bryn Mawr women don't doubt their ability to do something. You're told from the day you arrive, 'You're a Bryn Mawr woman; you are extraordinary.' You're not told, 'You're a college kid.' Bryn Mawr instills the confidence in you to pursue your ideas and not be embarrassed by them."
Riemer was drawn to pathology because "I was asking a lot of questions, the answers to which could be found in pathology books. I wanted to help patients, but I didn't like to see patients suffering."
She did a residency in anatomic pathology at Columbia University, followed by a fellowship in forensic pathology at the Office of the Chief Medical Examiner of the State of Maryland and then a fellowship in cardiovascular and pulmonary pathology at Johns Hopkins University.
Riemer says she loves doing autopsies. "They serve an incredible purpose — they're the patient's final consult. Autopsies improve patient care and lead to a better understanding of disease processes."
Autopsies offer valuable societal benefits, she notes. "Whenever there is an unexpected or sudden death, it's in the public-health interest to do a forensic autopsy. Forensic pathologists are often the first ones to become aware of fatal manufacturing defects or hazardous products." She adds, "Autopsies serve an important role in helping family members come to closure. The fact that knowledge gained from an autopsy may improve the care of a patient in the future actually helps to ease their profound sense of loss." If a child died of a genetic disease, Riemer points out, "an autopsy can help guide the family to genetic counseling and family planning. My job entails delivering this information in a factual yet sensitive and compassionate manner."
At Wake Forest, Riemer teaches several courses, including a seminar titled "When a Patient Dies," which deals with the determination of when death occurs and a physician's responsibilities upon the death of a patient. "I love teaching," she says. "When you're taught something the proper way, it forms the basis of your understanding. I take that responsibility very seriously. It's just an incredible privilege for me to do this kind of work."
Barbara Spector writes on science and technology as well as business topics. She is the editor-in-chief of Family Business magazine and former editor of The Scientist.