Medicine offers satisfying careers in both science and patient care, and at the School of Medicine, students and faculty are encouraged to creatively combine these two vocations as physician–scientists. But Marie-Louise T. Johnson, M.D., Ph.D., has forged a career path that is “utterly unique in our field, and an exceptionally lofty model,” says Richard L. Edelson, M.D., chair of the Department of Dermatology, who calls Johnson “a physician, scientist, humanist.”
At age 83, Johnson maintains a busy dermatology practice in Kingston, N.Y., a city of 23,000 on the Hudson River about 100 miles north of New York City, which draws patients from a wide swath of the surrounding Hudson Valley and Catskills region. But she also boasts a curriculum vitae that bristles with honors, including the Master Dermatologist Award from the American Academy of Dermatology and membership in the National Academy of Sciences’ Institute of Medicine. What makes Johnson special, says Edelson, Aaron B. and Marguerite Lerner Professor of Dermatology, is that she blends clinical care with biomedical insight and inspirational teaching. “She sees every medical problem as a mystery inviting a solution, a teaching opportunity, and a very personal challenge.”
The rarity of the particular constellation of qualities possessed by Johnson is a testament to the challenges faced by physicians who are as dedicated to advancing medicine as they are to the well-being of their patients. To help others attain this uncommon balance, Johnson has recently made a gift of $1 million to the School of Medicine, creating an endowment to support “clinical scholars” at Yale.
“As a role model, she presents a very high bar,” Edelson says of Johnson, who on many Wednesday mornings drives over 90 miles from her home to attend Dermatology Grand Rounds at Yale, often transporting a patient with an unusual or difficult illness. “Though she will be quite hard for anyone to emulate, this gift will help future generations of potential Marie-Louise Johnsons reach for that bar.”
Johnson graduated from the medical school in 1956, having already earned her Ph.D. in microbiology at Yale in 1954. Since her medical school training preceded the arrival of Yale’s first chair of dermatology, she became troubled during her internship at Grace-New Haven Community Hospital (now Yale-New Haven Hospital) by her lack of comprehension of the many skin lesions and rashes she saw in patients admitted through the emergency room. And she was struck by the myriad cutaneous ways in which a disease could manifest itself in different patients. Skin problems, she says, “looked different, even when they were the ‘same diagnosis.’ ”
At that time, the medical school offered electives in microbiology and electrocardiology to interns. Having already earned a doctorate in the former, “I could find my way around a microbiology lab,” Johnson says, and the cardiology elective held little interest. She petitioned the medical school to allow her to pursue her budding interest in dermatology as an elective, and got a green light.
As it happens, Aaron B. Lerner, M.D., Ph.D., had joined the Yale faculty in 1955 to head the Department of Internal Medicine’s Section of Dermatology. Lerner, who would go on to make medical history as discoverer of the hormones α-MSH and melatonin, was an ideal mentor to immerse Johnson in the scientific life; she still recalls him tinkering with the chemical models he kept on the ledge of his office blackboard, deciphering the structure of α-MSH “click-by-click.”
Before long, Johnson was directing the Section of Dermatology’s inpatient and outpatient services. She held that post until 1964, when she and her husband, cardiologist Kenneth G. Johnson, M.D., were dispatched to Hiroshima, Japan, where Marie-Louise served as chief of dermatology on the Atomic Bomb Casualty Commission (ABCC), which was conducting rigorous long-term studies of the medical effects of radiation released by the atomic bombs dropped on Japan at the close of World War II. Her experiences there led Johnson to become an active member of International Physicians for the Prevention of Nuclear War.
She vividly remembers the polio epidemic and “life before penicillin,” when people routinely died of what would now be considered minor infections, and she believes that physicians, and dermatologists in particular, have a vital role to play in ensuring the continuation of the advances in medicine she has witnessed since her youth.
“The skin is the body’s largest organ, and it gives protection to the body in its interactions with everything that’s outside,” Johnson says. “It’s pretty important!” Nonetheless, she adds, medical dermatology is being absorbed into other specialties, as in the case of lupus, which is generally treated by rheumatologists despite the disease’s significant effects on the skin. “This is a disservice to dermatology,” Johnson says, “because there is something to knowing the skin and to knowing what these serious diagnoses do in the skin.”
Her gift, she says, is “to encourage the young, able, innovative dermatologist to pursue new avenues opened by his or her inquisitive mind and give funding so he or she not be compelled to work in the clinic at the expense of time to think. You have to have support to do that.”
Edelson says he can think of no better person than Johnson to inspire young physicians in the field. “She is precisely the physician any of us would want for ourselves, and she is precisely the teacher any of us would want to have—or to be.”