Ties can bind many things. Family ties can bind you to a place, stitches can bind wounds, and yarn binds knitting
Most of those who have known Margaret Dunn over the years have seen her knit. During her more than 30 years with the medical school, she would often sit quietly during meetings silently working yarn and needle as she knitted row upon row. Knitting is the thread that has looped back and forth through her life since her earliest days.
The oldest of four children, Dunn grew up in a large, extended Irish Catholic family that included 46 first cousins. She was raised on Long Island, as were her parents. They moved from New York City to Oakdale on the south shore when Dunn was four.
“I spent a lot of my time growing up with my family,” she says. “You could spend every weekend doing a christening or a shower or a birthday with my extended family.” Summers were spent at the beach. “My mother’s strategy to deal with four children was to just take us all to the beach.”
Because her maternal grandfather was unable to work, her grandmother supported her five children by working in hospitals, which led to Dunn’s interest in medicine. Although her grandmother’s formal education had ended before high school, “She was a really smart woman,” said Dunn. “She never let the lack of formal education make her think she wasn’t a bright person. Which of course, she was. She had five kids to raise.”
Candy striper at 12
Although there were no physicians in her family, Dunn remembers getting interested in the idea of becoming a physician at the young age of 10 or 11, and she soon became a candy striper. “Once I worked through being the nun thing, it just seemed like a way to help people, and it was intellectually interesting.”
In her teens, she applied to an accelerated medical school program at Jefferson Medical College in Philadelphia that combined an undergraduate and medical education into six years. She was accepted and began medical school at the age of 18.
She developed an interest in anesthesia early in medical school because of a pediatric anesthesia elective she did in Montreal, Canada. She pursued a surgery clerkship thinking it would expose her to anesthesiology and soon found that the third-year students in the program functioned more like interns. “You could write orders for everything except Coumadin because some student had anti-coagulated a patient to a bad place once,” she said. “But everything else you could write orders without them being signed.”
Surgery over anesthesiology
She had signed up for the surgery clerkship thinking she was interested in anesthesia, but instead developed an interest in surgery.
In the middle of the clerkship, a third-year resident sent her to take stitches out of a patient with a large incision. “The incision just didn’t look right,” she recalls. She went back to the resident and told him he needed to look at the incision because it didn’t look right. Instead he sent another student who removed the stitches. Dunn’s concern was justified—the wound had not healed correctly and the patient eviscerated. “That’s when I decided, yeah, I can do this,” she said.
When she made the decision to pursue a career in surgery, she had never met a woman surgeon. “I was 21 and I didn’t know any better,” she recalls. “It’s like why not do it? Why shouldn’t I do it?”
She met her future husband, Bill Spohn, when he was an intern doing a pediatric residency in Delaware. He was her classmate’s resident.
After graduation from Jefferson in 1977, Dunn did her residency at Einstein-Montefiore in the Bronx, where she served as chief surgical resident.
After finishing his residency in pediatrics in Delaware, Spohn followed her to New York. He joined the Public Health Service and worked in the Lower East Side of Manhattan for two years. “And then he did his pediatric pulmonary fellowship at Mt. Sinai, so we ended up finishing up at the same time,” she said. They were married in 1982.
Staying awake with knitting
Knitting helped her throughout her medical training. Dunn’s mother taught her to knit when she was nine, and she taught herself to crochet when she was 10. She crocheted as a medical student to stay awake in lectures and decided to pick up knitting again as a fourth year. “It helped tremendously during my residency,” she said. “Without knitting, I was asleep as soon as the lights went down at grand rounds.”
After completing her residency, Dunn was offered a faculty position at Einstein Montefiore. She would have stayed, but her husband couldn’t find a position he liked because there were so many pediatric pulmonologists in New York. Since many positions were open in other parts of the United States, he landed an interview for a Wright State position at Children Medical Center of Dayton. Although he considered it a practice interview, after interviewing he decided he really liked the position and Dayton. “I told him he could decide where we moved next,” she said. “So we did.
“I thought Ohio was one of those rectangular states in the middle,” she recalls. “I really had no idea where I was going.”
First pregnant woman on the surgery faculty
She soon landed a faculty position in the Department of Surgery at the Wright State School of Medicine, starting in 1982. “The founding chair of the department was pretty sure he didn’t want to hire a woman,” she said. “He was a lovely man, and he turned into a mentor, but at the time he met me, he didn’t believe women ought to be in surgery.” But because the job had been open for a year, and no one else had applied, he was left with little choice. Dunn became the first woman on the surgery faculty and one of the very few women faculty members in the medical school.
Dunn recalls that there were a few women surgeons in the Dayton area then, but she was the only woman working in the allopathic community. “For most people, I was the first woman surgeon they had seen,” she said. “Without a doubt, I was the first pregnant surgeon anybody had seen.”
At that time, the surgery department was located at Kettering Hospital, but Dunn spent most of her time at the Dayton Veterans Affairs Medical Center. She went on to serve as surgery clerkship director for 13 years.
Since Dunn was so young when she started at Wright State, she attributed any possible disrespect she experienced to her youth as much as her gender.
As Dunn recalls, the founding chair, Dan W. Elliott, M.D., didn’t have a mean bone in his body. “He really couldn’t figure out anything to say to me other than what he would say to another faculty member,” she recalls. “He was really at a loss. So he pretty much gave me the advice he would have given anybody.”
Because the department was so small, he often sent her to meetings where everyone else was a department chair. “I really had an incredible opportunity that I never would have gotten in a bigger department,” she said.
VA patients accepting
Surprisingly, the one place she found no resistance to a woman surgeon was among the patients at the Dayton VA Medical Center. “The patients there were so lovely and accepting,” she said. After the birth of her second child, “There was no going to clinic without baby pictures, because all the guys wanted to see the baby.”
She became one of the early leaders of the fledgling Association of Women Surgeons (AWS), serving as its second secretary. She was elected as its president in 1994 and has served as the AWS Foundation treasurer. In 2011, she was awarded the organization’s highest honor, the Nina Starr Braunwald Award in recognition of her contributions to the advancement of women in surgery.
It was through AWS that she met Dr. Mary McCarthy, now chair of the Department of Surgery. “I knew Mary because Bill and Charles (McCarthy’s husband) met fighting over the last high chair in the dining room at the Grand Hotel in Mackinaw at the Midwest Surgical,” she said. Dunn recruited McCarthy to the medical school faculty in 1991.
For the most part, Dunn found tremendous support from the male surgeons in the area. Longtime surgeon Dr. Robert Finley was very supportive and nominated her as a regent of the American College of Surgeons. The second chair of the Department of Surgery, Dr. Jim Peoples, was a close friend and mentor. “Because Jim was so open, early on we ended up having a department that had a lot of women in it,” she said. “Disproportionately so.”
Midwestern culture shock
Dunn was attracted to academic medicine because she has always enjoyed teaching and was good at it. “That I ended up at a medical school whose mission was primarily education was really fortunate,” she said, “Because it was exactly the type of medical school I wanted to be at.”
She admits to a bit of culture shock when she moved to the Midwest. “I went from being perceived as one of the nicest people in the place I trained to being perceived as not being nice,’ she said. “And it took me awhile to understand that I was living in a place with different cultural norms and ways of communicating. Just because we’re speaking English here doesn’t mean it’s the same.”
She found Midwesterners more reticent in offering their thoughts and opinions. “You have to actively elicit opinions in a safe space, or you’re not going to get them,” she said. She found that frustrating when she was younger. “But at the age I’m at now, I think it’s wonderful,” she said. “It’s just less stressful.”
Named dean in 2015
Dunn has had a long and successful career during her 33 years at the Boonshoft School of Medicine. She served as associate dean for faculty and clinical affairs from 1999-2007. After earning an M.B.A. in 2005, she was appointed president and CEO of Wright State Physicians and executive associate dean of the medical school in 2007. In February 2015, she was named dean of the medical school.
Despite her busy schedule, Dunn still sets aside a day each week to practice breast surgery. She also stays active with national professional organizations, including serving on the Board of Regents of the American College of Surgeons since 2010.
Dunn found herself dean during a time of enormous change in American health care, including its accessibility, how it’s delivered, and how it’s paid for. “Guiding our school through this transitional period in American medicine is a big responsibility that I take very seriously,” she said.
“Everything is changing about medicine. The funding of it, how physicians get paid is changing,” she said. “We recognize that we’re not getting value in this country for the money we spend on health care for what we get in terms of the health of our population.
“I think physicians, particularly our faculty, are energized to obtain better health outcomes in our patients, and we know that’s generally associated with lower costs of care. Everyone wants to do better; we will do better.” she said.
To help respond to those changes, the medical school is transforming its medical student education to better prepare physicians to deliver safe, evidence-based, quality care to a diverse population. “We are committed to providing our students with a curriculum that is forward-thinking and a learning environment that nourishes their professional and personal growth,” Dunn said.
Faculty members are collaborating to create the WrightCurriculum, an innovative program of study that will evolve with new information and best practices. “The new curriculum is being designed to not only meet today’s challenges in health care delivery,” she said. “It will emphasize a spirit of inquiry and discovery that will also prepare our graduates to meet the health care challenges of the future.”
Dunn says she is also committed to raising funds for scholarships to reduce student debt and to reinvigorating and deepening the medical school’s relationships with its clinical partners as well as finding new institutions to work with. She is especially excited about expanding the new rural health track in the counties surrounding WSU’s Lake Campus.
She also plans to grow the research enterprise, particularly in population health and health systems research, as well as biomedical and translational research.
In her spare time Dunn has started running, although by her own admission, not very fast. “Even though for years I told patients what a good thing exercise was, I really only started to personally appreciate it,” she said. “As I get older, I’m trying to be more focused on getting it, and I’ve really come to enjoy it.”
And she still finds knitting very soothing.
Even though she never intended to pursue a career in academic medicine in Dayton, Ohio, or expected to become dean at this stage of her life, she says it all worked out. “Most of my life, things have just worked out.”