Budget balancing easier
with a variegated life

In high school Jonathan S. Berek decided he had to “get out of Dodge” — literally — and since then he has skirted with a career as a professional actor, a Harvard faculty member and an academic dean before landing as chair of Stanford’s Department of Obstetrics and Gynecology. His interests range from his subspecialty of gynecologic oncology to authorship of both the gold standard textbook in general gynecology, Berek & Novak’s Gynecology, and in gynecology oncology, Berek & Hacker’s Practical Gynecologic Oncology.

Since his arrival from UCLA a year ago, Berek has created a new Division of Gynecologic Specialties, completed nearly half his goal of adding about 10 to 12 new faculty members — all “without being fired as a dad.”

We talked with Berek in his office, where he sat behind a glass-topped desk nearly empty except for the Dell laptop he unplugs and takes home each night to his new home on the Stanford campus. His wife, Deborah, a painter, recently moved north, thus ending Berek’s eight-month stretch of every weekend and occasional midweek commutes via airplane to the family’s old home in Santa Monica — where his youngest of three children, Jessica, had remained to finish high school. (He also has two adult sons and a 2-year-old-granddaughter):

Q: Okay, you said it, a dream cliché come true: “get out of Dodge.” Where did you come from originally?

BEREK: Fremont in Dodge County, Nebraska, which actually was a great place to be a kid. I was raised in a blue collar family — my dad was a junk dealer — but his business collapsed and my mother, a junior high school teacher, supported us. Although we stayed happy, our difficult financial situation created a very healthy perspective on money. I don’t take anything for granted, and I think that I — better than some people — understand the value of a dollar. In order to help support my activities and my education, I had many different “odd jobs” as a child and young man — most of them rather menial. I never thought that I would be able to have the kind of career I have now, but when I was very little, my father made it clear to me that I was going to get a university education. My horizons opened when I spent part of my high school years as an exchange student in Brussels, Belgium. Then shortly afterward, a family friend suggested that I apply to Brown [University] because someone he knew had once gone there. I took the bait and wound up with the rich liberal arts education I so needed at the time. At college I became a voracious reader and majored in English and American literature with an emphasis on dramatic literature and theater arts. I contemplated a professional career in the theatre [You can still find a reference on Brown’s website to Berek’s role as Enoch Snow in Carousel], but I didn’t think I could do that fulltime for the rest of my life. I had taken the requisite science courses and in the end opted for medical school. That way I could aim to be a “do gooder,” as my parents had taught me, and also help my wife and kids avoid worry about whether dad was going to get another paycheck.

Q: So how did that choice lead to coming to Stanford?

BEREK: Circuitously, obviously, and weather played a part. After medical school at Johns Hopkins, I was on track to stay at Harvard after a residency at the Brigham, but my wife really wanted to get back to her home state of California. And the acceptance letter for my fellowship at UCLA came at the time of the [New England] blizzard of ’78.

Q: UCLA is a pretty good place, yet you chose to come here at the height of a successful career — chief of gynecology, executive vice chair of obstetrics
and gynecology, chair of the College of Applied Anatomy, “best selling” textbook author, among other things?

BEREK: Well, I was recruited to Stanford, and I was attracted to [Dean] Phil Pizzo’s vision of excellence for this department. In that process I realized I had been looking for a new opportunity. At UCLA I was on track to become senior associate dean for academic affairs, but in the end I chose to take the challenge here.

Q: What did you find here?

BEREK: Some great faculty members and a good but small department that needed some restructuring and building to fill out the solid foundation built by the likes of my colleagues, Maury Druzin, chief of Maternal-Fetal Medicine and Obstetrics, Nelson Teng, who leads the Division of Gynecologic Oncology, and my predecessor Mary Lake Polan.

Q: So what are you doing?

BEREK: I created a Division of Gynecological Specialties, which contains existing General Gynecology programs but which also includes specialty services — Minimally Invasive Surgery and Endo-scopy, Urogynecology and Pelvic Reconstructive Surgery, Contraceptive Research and Programs, Pediatric and Adolescent Gynecology, Female Sexual Health, and Infectious Diseases. We’ve recruited some outstanding people to develop these new programs, including Paul Blumenthal from Johns Hopkins. He directs ambulatory gynecology and will be running our family planning and contraception research program as well as some additional women’s health research programs. He will join Mary Jacobson, also an expert in endoscopy and minimally invasive surgery. We’ve recruited Judy Lacy, an outstanding pediatric/adolescent gynecologist. We’ve also brought in Lisa Rahangdale as a Women’s Reproductive Health Research Scholar in infectious diseases, who joins our other WRHR Scholar, Leah Millheiser in female sexual health. Both Leah’s and Lisa’s positions are made possible by the NIH-sponsored WRHR Career Development Program, a young scholar’s initiative that allows us to find outstanding talent early in their careers. Urogynecologist Bertha Chen was joined by Eric Sokol who was recruited just before I arrived, and he’s a strong component of an outstanding team. By the way, we’re also recruiting a new chief of the Gynecologic Specialties division, a role I’ve been filling temporarily. We have been working hard on improving the efficiency of the Gynecology Clinic — to make it more patient-friendly and accessible.

Q: Is your program building primarily a clinical endeavor?

BEREK: We’re putting together a comprehensive package that will include the entire range of clinical, education and research services. That’s what we’re going to wind up with in a few years with many new people on the faculty. Recruitments are also ongoing in gynecologic oncology, reproductive endocrinology and infertility [REI], and research positions in reproductive biology, stem cell biology and immunology. I think as our people move forward in their careers, our colleagues, including referring physicians, as well as patients, will begin to see us increasingly as a world class center for women’s healthcare at Stanford.

Q: Does an ambitious effort like this leave you time for your own research and clinical activities?

BEREK: When you come to a job like this, you have to understand that during the first year you are going to spend a disproportionate amount of time on administration. Recruiting as we’re doing could be a full-time job! Until now I’ve spent the vast majority of my time running my department. But next month [January], I’ll double the time I spend in clinical activities, doing surgery and seeing patients in the cancer center, and I will soon get back into the lab to provide hands-on support for my continuing research studies in translational immunology, immunotherapy, and cancer vaccine development. I’ve retained my hat as group chair of COGI, the Cooperative Ovarian Cancer Group for Immunotherapy.

Q: Obviously you wear a lot of hats. How did you get to that point?

BEREK: As I got into science and medicine and realized the potential for a career, I realized that I wanted to do more than clinical care, as valuable as that is. I enjoy a variegated life. I love to deal with issues that are the full range of activities within the department.

Q: Even the administrative aspects?

BEREK: The business aspects which are an important part of my job are more, well, pleasant, to me than they might otherwise be because I have a lot on my plate and I see administration in a fairly wide context. That being said, the finances and the personnel issues are difficult. We try to navigate the healthcare system, we try and pay our physicians a decent wage, and still we encourage a strong academic program, which faces tremendous challenges, including competition for research funding.

Q: Can you be more specific about the challenges?

BEREK: Look at it this way. As chair I work for my faculty and my trainees, not the other way around. You bring in the best and the brightest. They’ve spent their whole lives getting As and doing the right thing, and we all expect them to succeed. Then they turn in a grant to the NIH that looks brilliant to everyone, and they are told that they cannot receive funding. My challenge is to find ways to bridge that gap so we don’t lose several generations of scholars. Running the department as fiscally efficient as possible is certainly a key part of that. On the research side I see a challenge to become increasingly involved in nurturing philanthropy, such as obtaining endowed chairs and research endowments, to fill in the gaps left by tighter grant funding. Clinically, we face a particularly strong challenge in reproductive health, because, quite frankly, it doesn’t provide the positive cash flow to the hospital that some other services do. If we are the best, I think that we can survive by capturing the attention of those who can help us.

Q: Any final thoughts?

BEREK: It’s a very rich professional life to be a physician, surgeon, professor, scholar, writer, editor. The things I get to do in my job are really a tremendous blessing. It’s a very good career for someone from my background. I love to come to work every day and deal with the issues that are the full range of activities within a department. I am truly fortunate to have so many outstanding new colleagues in our department, in the medical school and in the hospitals at Stanford. This is a remarkable place!