Physician at Work: Advancing care from the virology lab

New therapies in the ’80s changed a doctor’s career path

alt textMarie-Louise Landry, MD 
Marie-Louise Landry, MD

Marie-Louise Landry, MD, the director of the Clinical Virology Laboratory at Yale, originally intended to care for patients in the developing world. Instead she ended up in the lab, diagnosing viral diseases.

As part of her training in infectious diseases, Dr. Landry worked with the late Edith Hsiung, PhD, a world-renowned Yale virologist who was testing new antiviral agents against herpes viruses. The advent of these therapies in the 1980s introduced a need for rapid diagnoses and the ability to monitor a patient’s viral load. “I meant only to learn about viruses to inform my infectious disease training, not make virology the focus of my career, but the need and opportunity presented themselves,” Dr. Landry said.

At that time, she was seeing immunosuppressed patients who suffered terribly and often died of herpes infections. It wasn’t uncommon, for example, for kidney transplant and lymphoma patients in their teens and twenties to die from herpes simplex and varicella-zoster, or chickenpox, virus infections.

She saw a man with chronic lymphocytic leukemia who had painful, deforming, progressively enlarging lesions on his face, nose and mouth for months. He had seen multiple specialists, none of whom were able to provide a diagnosis, and had become suicidal. Dr. Landry, as a fellow in the lab, isolated herpes simplex virus and enrolled him in an early clinical trial for acyclovir, an antiviral drug that is now used widely to treat herpes and shingles. “It was like a miracle. I still have a photograph of him after therapy, his lesions healed, with such a smile on his face,” she said.

Diagnostic virology at Yale has since come a long way. It used to be a Monday-through-Friday, eight-hour-a-day operation that offered only a handful of tests; today it operates seven days a week, 18 hours a day, and offers more than 80 tests. Most results are available within 30 hours and often in as little as one to two hours.

“When I started in virology, tests could take weeks to complete, there were no treatments, and the laboratory phone never rang. Now we have clinicians calling all day and even in the middle of the night wanting virology tests,” Dr. Landry said. “The current test menu is very extensive, and there are some key tests that we were either the first or one of the first clinical labs in the country to offer.” When pandemic H1N1 appeared in 2009, she and her team were able to implement molecular testing very quickly. “It’s been very gratifying to see the tremendous advances that have been made in the treatment and diagnosis of viral infections, and to have been part of the transition.”

Name: Marie-Louise Landry, MD

Title: Director, Clinical Virology Laboratory at Yale, professor and vice chair of laboratory medicine; professor of internal medicine (infectious disease)

Area of expertise: Diagnosis of viral infections

Place of birth: Urbana, Illinois

Age: 64

College: University of Massachusetts, Amherst

Medical School: Georgetown University

Training: Residency in internal medicine at Yale-New Haven Hospital; fellowships in infectious diseases and clinical virology, Yale School of Medicine

Family: Husband, Peter Aronson, MD, professor of internal medicine (nephrology) and physiology at Yale; son Paul Landry Aronson, MD, assistant professor of pediatrics (emergency medicine) at Yale, and his wife Jenny Shieh, middle school teacher; and son Will Aronson, musical theater composer in Brooklyn, New York.

What is the most important thing you’ve learned from your patients? The importance of making a rapid and accurate diagnosis

What was the biggest challenge you ever faced as a physician? While I was in medical school and residency, we watched people die of viral diseases that we can now treat.

How have your experiences with patients changed your approach to care? I am acutely aware of the amount of misinformation out there, and of the need to foster communication. Virology test selection and result interpretation are complex and ever-changing, so I try to make myself available by phone or e-mail to answer questions as they arise.

Personal interests or pastimes? Theater, opera, cycling, cross-country skiing and gardening. For 13 years I have been on the board of directors for “Guilford A Better Chance,” a college-bound program in which community volunteers raise funds to provide housing, supervision, enrichment activities and academic support to six young women of color so they can attend Guilford High School and subsequently thrive in college.

Last book read: Master of the Senate: The Years of Lyndon Johnson, by Robert Caro