Listen To What Makes You Happy

From a young age, I knew what it felt like to be labeled as a handicapped kid or a kid with a birth defect, so I was very sensitive to it. I was born with bilateral club feet, which is a birth defect where your feet are twisted backward. Right away I was put into casts and had to have surgery twice to correct it and was put in a wheelchair for a while. Coming from a family where both parents were in education, they put in everything to help me feel like there were no obstacles for what I wanted to do.

The experience of being a patient as a young kid and, as I got older, the opportunity to work in a clinic in a developing country and see the impact of poverty in a community with limited resources really inspired my direction. I worked with children who didn't get a chance to have corrective surgery or casting when they were younger, and having uncorrected club feet leaves you unable to walk properly. Knowing how fortunate I was to have the resources and access to have it treated put things in perspective; there are orphanages full of kids that don't have this option. I remember being a patient and getting the strength to be able to walk normally, and eventually run the Marine Corps Marathon at the age of 39 with my husband and two daughters cheering for me. 

My grandmother had diabetes, and I remember helping her with her insulin injections when I was younger. She passed away from pancreatic cancer, which is an endocrine-related cancer, and so I think that experience has certainly probably affected me in many ways. Even as a kid, my friends and family looked to me to help and to be a support. I am the first person to be a doctor in my immediate family. I had incredible science teachers growing up, and honestly having science introduced to you as a young child can really open different opportunities for you. I grew up in Bethesda near the NIH, where I used to ride my bike in the summer when I was in high school working as an unpaid intern. I was doing a project where I would take blood from the blood bank, and I worked in the lab to try to isolate stem cells and studied different compounds to analyze their effect on fetal hemoglobin levels — one of these drugs, hydroxyurea, is now a treatment for sickle cell anemia. When I was 16 I was exposed to physician-scientists and research and I could see that what we did in the lab mattered. It translated into being able to see that what we did helped people's lives directly, and that sparked an excitement in me. I still have my ID from my time as a student volunteer at the NIH in the '90s on the bulletin board in my office now. One of the things that gives me so much joy is that I have had the opportunity to mentor students at different levels of their career. That old ID is a constant reminder that I was a student too, and to just pay it forward.

I am now a pediatric endocrinologist. I completed four years of medical school and then did a pediatric residency, followed by a fellowship in pediatric endocrinology, after which I became board certified in pediatrics and pediatric endocrinology. I am a staff clinician at the NIH in the National Institute of Child Health and Human Development. Within my field my subspecialty is endocrine cancer. At NIH, primarily I take care of children who have tumors of the endocrine system. These types of tumors include those of the pituitary gland, which is the master endocrine gland in the brain, as well as thyroid and adrenal tumors in children.

I was drawn to oncology early on. When I applied to my residency in Pediatrics at Johns Hopkins, I wrote my personal statement about how I was going to become a pediatric oncologist. When I did my rotations in pediatric oncology, I was very depressed and my husband said I couldn't do this because I was too miserable to be around, I was so sad. I think that it was a skewed exposure to pediatric oncology because the kids I was caring for were the sickest of the sick. There is a lot of pediatric oncology that is positive and kids do well for the most part. When I did my endocrinology electives, a physician who motivated me was Dr. Leslie Plotnick. She focused her clinical research on diabetes, and I remember seeing a newly diagnosed child with her and the dad had been her patient as well, and he basically started crying and said, "You can't retire until my child is at least 20." This experience drew me to the field of pediatric endocrinology where you can have continuity in someone's life and see them grow up. I also like endocrinology because I majored in biochemistry and I enjoy understanding complex pathways, and in this field a lot of the treatments require understanding where there is a block in making a particular hormone and then replacing the hormone. Or if you have too much of a particular hormone you try to remove the tumor or use a medication to block the effect of the hormone. It is very science driven and evidence based, so that attracted me to it. So, thinking forward to what I do now, I have the best of both worlds because I get to take care of kids with endocrine cancer, so it is oncology and endocrinology together.

There are two areas that I focus my time on. One is pituitary tumors — I get to take care of children that have different pituitary tumors that make too much of certain hormones, like cortisol (leading to Cushing Syndrome) or growth hormone (leading to gigantism). What I'm trying to do is better understand how to treat these kids and make sure that they have the best possible quality of life and low mortality rates. At the NIH Clinical Center, we are constantly striving to increase our knowledge about these conditions. For each child with a pituitary tumor that we see, we get a sample of their DNA and the sample of the tumor DNA and try to understand what genes are the driving factors for these kids' tumors. The goal is to potentially have directed therapy that could be individualized for different types of tumors and different genetic causes. This helps us to understand why certain kids are more at risk of certain types of tumors, and understanding the genetic etiology that drives the tumor growth.

Another area of research that I do collaboratively with the National Cancer Institute is on children who have thyroid cancer, but not run-of-the-mill thyroid cancer; it's a special kind of thyroid cancer called medullary thyroid cancer. It's much more aggressive and has a much higher mortality rate, and we're doing clinical trials of medications to treat metastatic medullary thyroid cancer and hopefully improve outcomes for these kids. One of the most rewarding parts of my job is serving as director of our fellowship training program in pediatric endocrinology, so I get to help choose the new trainees and mentor them through their three years at the NIH.

I must say along my journey my husband has been incredibly supportive and such a team player. I have two daughters, one is 5 and the other is 9, and they both are very involved in my life as a doctor and scientist. They come to "take your child to work" days with me. My youngest was in a daycare that was on the NIH campus, so we did a lot of STEM activities with them even they were little. It is fun to get kids excited about science very early.

My advice for women or girls heading on their own path is, don't beat yourself up about trying to be perfect about something. There are going to be times when you must give yourself a break. Make sure that you find mentors who are people who believe in you and are going to help you. A good mentor is someone who wants the people working with them to rise. Listen to what makes you happy.

At some point, you need to get off the train of what is to be expected of you and do something that you truly believe in. Have a real-life experience? Go work with refugees, go to an inner-city clinic and help, and get out of this mode of it being all about yourself and being stressed out and anxious and get inspired about something.

Maya Lodish, M.D MHSc., received her bachelor's degree from Dartmouth College in 1998, and earned her medical degree in 2003 at Yale University School of Medicine. Dr. Lodish completed her internship and residency in pediatrics at Johns Hopkins Children’s Center in 2006. She then joined the NIH Fellowship Program in Pediatric Endocrinology, which she completed in 2009. Following fellowship, she was appointed an Assistant Clinical Investigator under the mentorship of Dr. Constantine Stratakis, and she earned a Master of Health Sciences in Clinical Research in the Combined NIH-Duke University Clinical Research Training Program in 2013. Dr. Lodish became program director of the NIH pediatric endocrine training program in 2015, and is an active member of the Pediatric Endocrine Society's clinical education committee. Dr. Lodish is a fellow in the American Academy of Pediatrics, a member of the Children’s Oncology Group, and a member of the society for pediatric research. Her clinical research on endocrine tumors bridges collaborative endeavors between the National Cancer Institute and the National Institute of Child Health and Human Development. She is currently a primary investigator on two protocols, “Genetic Investigation of Pediatric Tumors of the Pituitary” and “Detection and Treatment of Endocrine Abnormalities in Childhood Cancer Survivors.” She is a co- investigator on a clinical and genetic study of adrenal tumors in children and on a clinical trial of tyrosine kinase inhibitor therapy for pediatric medullary thyroid cancer. Dr. Lodish has published over 90 papers in peer-reviewed manuscripts incorporating data from clinical studies at the NIH.

Words: Dr. Maya Lodish