The mystery of medicine

As a college chemistry student in the 1970s, Michele H. Johnson, M.D., found herself intrigued by the television show “Quincy, M.E.,” about a crime-solving forensic pathologist. In one episode “they found a femur, and in a television hour, they came up with the drawing of the person. This is so hokey,” Johnson says, but the show led her to an idea: “Could I use chemistry to solve medical problems?”

Since then, problem-solving has formed the backbone of Johnson’s own narrative. She has also followed in the footsteps of her mother, a chemist, and her father, a neurochemist and the first African-American to receive a Ph.D. in chemistry from the University of Delaware. After earning her B.A. in chemistry at the same institution, she entered medical school at Temple University, where a medical “mystery” on a rotation struck a familiar chord.

At St. Christopher’s Hospital for Children in Philadelphia, Johnson watched Marie Capitanio, M.D., chief of radiology, use a single chest X-ray to diagnose both cystic fibrosis and sickle-cell disease in a teenager. She immediately saw the value in pairing X-ray clues with clinical knowledge to diagnose patients: “I learned very early that the more clinical information you know and can apply, the stronger diagnostician you are,” she says.

After her internship and residency in diagnostic radiology at Temple University and fellowship in neuroradiology at the University of Pennsylvania, Johnson returned to Temple to join the diagnostic radiology faculty. It was an exciting time to be in radiology, she says. Bolstered by the appearance of non-invasive technologies like computerized tomography (CT) and magnetic resonance imaging (MRI), the field blossomed in the late 1970s and 1980s.

In 1999 Johnson came to Yale School of Medicine (YSM), where today she confronts medical mysteries routinely. As professor of diagnostic radiology, neurosurgery, and surgery, like any good detective, she throws herself into every case. “We’re not just sitting in a dark room looking at films,” says Johnson. “We’re part of the patient care team, and I’m very proud that that’s an important part of what I do.”

Johnson shows off photos on her ever-buzzing phone of one of the latest advances in neuroradiology, a clot retrieval tool no wider than a blood vessel that resembles a Chinese finger trap. To restore blood flow in the brain after an acute stroke, she uses the contraption to snake through vessels, latch onto blood clots, and pull them out the same way she went in.

One of the field’s biggest challenges, Johnson says, is training new radiologists to apply established fundamentals in using newer, non-invasive technologies. Trainees need to develop the ability to take two-dimensional images and make them three-dimensional in their heads. “Our challenge as faculty is to teach that effectively,” she says.

In 2012 Johnson completed a fellowship in medical education through the medical school’s Teaching and Learning Center, to stay abreast of pedagogical trends. She challenges students and residents to think creatively and cooperatively when faced with novel situations. “I try to teach trainees that it’s more effective to be collaborative than confrontational,” says Johnson. “You might even have fun in the process.”

In 2014, Johnson became the first African-American woman named a full professor at YSM, but she doesn’t dwell on the subject. “I can teach technique and anatomy,” she says. “Can I teach students to work together successfully for the patient’s benefit? That would be the real legacy I’d aspire to.”