A.B., Haverford
College, 1966
M.D., Duke University, 1970
M.P.H. (T.P.H.), Harvard School of Public Health. 1977
Pediatric Training at Massachusetts General Hospital and Boston
Children's Hospital Medical Center
Board Certified in Pediatrics
We are pleased
to welcome Dr. Campbell as our keynote speaker. Dr. Campbell's prior
job titles at the Centers for Disease Control include Chief of the
Malaria Branch in the Division of Parasitic Diseases, Medical Officer
of the Vector Biology and Control Division of the Bureau of Tropical
Diseases, Medical Officer of the Central America Research Station
in El Salvador, and Epidemiology Intelligence Officer in the Immunization
Division. In addition, he has had short-term assignments in developing
countries such as Guatemala, Nigeria, Kenya, Tanzania, and Malawi.
An expert on malaria, he has served as a consultant to the World
Health Organization since 1982 and has over 115 publications.
The
following is a transcript of Dr. Campbell's presentation at Biology
Career Day 1995:
I grew up in
Knoxville, Tennessee, and I went to a high school that graduated
200 people. Ten of those people were going to go to college. I was
one of them. I was the only one who went out of the state of Tennessee.
I went up in Haverford College in Philadelphia, a small liberal
arts college. It really turned my life around. It was the late to
mid 1960's, the Vietnam, anti-war era. I had actually never thought
about what I wanted to be because people always presumed I was going
to be a doctor. I don't know where that came from. I don't recall
any thought that went into it. So I went to medical school, and
I became extremely interested in pediatrics. I went on to Boston
to get my pediatrics degree.
As a result of something I thought I was going to be able to avoid,
I was the last to come out of medical school and still have military
obligations. This was the early 1970's. I had been constantly subjected
throughout all my career, and it became clear that I was about to
have to do something about my military obligation right in the middle
of my residency.
Eventually, I wound up at the Centers for Disease Control, which
opened up an interest in me in public health and a population-based
approach to things. I went back and got a master's degree in public
health.
My background has been one that I have been overly trained. One
of the great challenges is how to keep your options open with the
perspective of not being afraid to make a commitment. How do you
keep that balance? For one, there isn't any one thing you can or
should be, and, secondly, there's lots of things you could be. Sometimes
it seems like you really need to be in a hurry to get it to happen,
but, on the other hand, there's a lot of strategy making sure you
look around and see what you're all about.
Questions
and Answers
How
have your career choices affected your family?
I shouldn't be answering this question - my wife should be. I've
been married for 29 years, and I guess we've survived through it
all! Most of the credit is to my wife, not me. I was on call every
other night all night and every other weekend all weekend. So I
was home basically twelve hours every third day, and that went on
for almost three years. That's changed. I have traveled in my career
in and out of the United States for three or four months a year.
You can not underestimate the importance of trying to understand
the balance. You will never at some point in your life establish
that the balance is set. It has to be renegotiated for yourself
and your family.
One thing I've had colleagues complain about is that they feel that
their job is demanding them to do something. This is, in fact, totally
a misunderstanding of the situation. You have some understanding
of your major and what you're going to do. If you're not making
those decisions about your career, then you are really assuming
the victim's stance.
I'll tell you one other thing that I highly recommend. I have a
lot of people who work for me who are about ten or fifteen years
younger than I am, who have, in fact, postponed commitment/marriage/family
until their biologic clocks are sort of running out. All these things
get compressed in your mid to late 30's in terms of decision making,
particularly for women. I can tell you that postponing isn't the
only or best solution to the problem because you approach family
and children very differently in your mid 30's than in your 20's.
I'm not suggesting you should have children in your 20's, but what
I'm saying is that thinking all these things can be postponed for
a better time may or may not be true because you're a different
person later on in your 30's. The decision is going to be just as
hard when you find that you're at the mid-point in your career and
having children isn't any easier - it's just different than being
in graduate school or in your 20's.
What
kind of resume or CV should a person applying for a job in industry
send?
I encourage a CV. A resume isn't really used that much. Interviews
will bring out all that information. I think that CV's convey what
you're looking for or what your job skills are.
Paul
Johnson, Instructor, Pima Community College:
When I was an undergraduate, it was kind of a hot time for oil exploration.
The oil companies used to come and recruit. We were encouraged to
go talk to them and see what they were looking for. I used to go
talk to all of them. And I'm glad I did. It's best if you don't
want to work for them because psychologically you can relax and
get an idea of what it is they're looking for, and you start to
get a feel for it. It's like anything else - it takes experience.
So don't look too narrowly. Broaden your experiences to include
the interview even if you're not sure that you want the job.
Would
you describe a typical day?
I've always tried not to have a typical day, and I've been very
successful at it! The range of things that I'm involved in at this
point in time are developing ideas, which is usually done in small
group settings. I spend a lot of time writing. I spend a fair amount
of time teaching. I'm not a teacher in a classroom setting, but
I have a lot of junior staff working with me. I spend a great deal
of time with them developing ideas and going through their work
in terms of analyzing data. I spend some time overseas in a very
different setting. I spend way too much time on the telephone, and
we're all discovering ways to keep that from just consuming us.
Time management is really a problem.
Have
you had any experience in the field?
The CDC experience is an interesting one because we're involved
in public health. We're involved in epidemiology. It tends to be
a very practical, applied type of perspective of problem solving.
And that's probably in contrast to something more academic that
would be more rigorous and use more direct methods in chronic disease.
The CDC is a federal agency and, because of the way our government
is set up, we do not have responsibility or even direct access to
state and local health problems. We only get legally involved when
there are state issues, and then we still have to be invited in.
So that's sort of the state's rights.
The other thing that actually works well is that over the past 30
years, CDC has trained a large number of people, like myself, who
instead of staying with CDC are actually moving into the state health
departments. So a lot of the state epidemiologists have come through
CDC training.
The way in which we get involved in the field is myriad. I think
the Four Corners outbreak is a good example of a radically new situation
in which something happened, some health problem, that was recognized
as something different than what people have seen before, and it
wasn't clear what it was. That's a classic situation in which the
CDC is a national resource in terms of strange, unusual, and unknown
phenomenon. The CDC can work with state and local health departments
and bring a fairly multidisciplinary approach to the situation.
Lab people, some of the best biologists, physicians, and epidemiologists
come in and work together to try and sort out the who, what, where,
and when of the phenomenon. And that's a partnership that works.
In the case of the Four Corners area, it took them a period of six
months to figure out exactly what it was, how it was transmitted,
what the risk factors were, and other issues like that.
We do, basically, either descriptive or analytical epidemiology,
which means that we are attempting to describe the events that are
called "cases." The case, in a statistical way, would
be your numerator. And then you're trying to understand what the
denominator is. You're basically going through and trying to define
and describe the problem and form a hypothesis and begin to test
it. What were the major factors that led to the exposure? That is
a very heavily biostatistical process.
A fair amount of the people, like myself, are going to be in the
clinical line - visiting with physicians, interacting with doctors
and people like that. On the other hand, I spend a huge amount of
my time working with people who are sociologists, biologists, etc.
I guess, whether it's right or wrong, it's true that physicians
in my business tend to be the ones who are "in charge."
That's one of the onerous realities in the business that I'm in.
This is true in many academic settings, too. Most disciplinary persons
work very well and provide a lot of strength. The Food and Drug
Administration and the CDC are large agencies in the federal government.
We're actually under the Department of Health and Human Services.
What's interesting is that there are many different disciplines
in the health professions, but the medical side has historically
had much of the lead in terms of where things are going. I said
"onerous" in the sense that, in fact, there are many situations
in which it isn't logical to have the physician in charge. If someone
has to call the shots, it might not be logical, but you've got the
medical person calling the shots.
That's particularly become true as there is more and more dependency
and utilization of basic science technology. An example of that
is actually the Four Corners area. If you really ask who gave the
most important input in figuring out what was causing the epidemic,
it was the people who clearly knew what the issue was. Once they
identified what people needed to do to keep that from happening,
the virologists and the molecular biologists, the physicians, and
epidemiologists really got close to figuring it out, but actually
the clinician had already figured out what the issue was before
the CDC epidemiologist came in. The local health providers here
knew something was happening, knew sort of what it was; the epidemiologist
came in, applied some rigorous common sense to the situation; and
then the high tech people came in, and the whole process began quickly.
Is it a virus? What is it? It was a wildlife engineered disease.
There was a phenomenon about 20 years ago in Philadelphia, which
was a rare situation.
The same is true with HIV - the early days of HIV. Epidemiologists
were running around the country describing everything and still
didn't know anything. And then it was only the work of a few virologists
and molecular biologists with specimens who actually turned it around
and figured out what it was. So, historically, prevention and public
health has been a medical issue, and I think that we're seeing a
growing diversity of people involved. This is good news for people
like yourself because the question that I get asked frequently is,
"Is there something I can get involved in that I don't have
to be a doctor?" It's different to be a doctor. It's harder
and harder to get into medical school.
In
terms of bureaucracy in administration, how hard is it to deal with
that?
I thing bureaucracy and administration are a lot like institutional
food. I don't really know of any place that thinks they have good
institutional food! People seem to need to worry about it and complain
about it. But if you think about it, it's just a continuum of involvement,
and that the decision to work totally by yourself, and to be totally
isolated, would be sort of at one end of the spectrum of trying
to isolate yourself from the hassles. Administration politics are
merely words we use to describe ways in which we interact with each
other as professionals. We have committed that there will not be
chaos with everybody doing whatever they want to do. It's kind of
like society. Somehow those norms of how we interact and where the
resources go are what we call administrative bureaucracy. Most people
will opt to not work totally by themselves because they understand
that unless they're a genius or an Einstein or something, working
with other people is more efficient. You're going to have a certain
degree of administrative politics. My job has a lot of that. I spend
a great deal of my extra time trying to work with people to understand
what we're going to do. So by some process, some decision is going
to be made. We're going to either decide to do something or not
to do something. That's going to be defined by the resources we
have to work with. Inevitably, there are tensions around the discussions
because, basically, people are not all alike. I don't want to say
that this is not an issue, but I want to say that you will, at almost
every stage of your career, be involved in that. One good skill
is knowing how to work in groups, how to understand points of difference,
not avoiding conflict but being able to deal with conflict, and
move past it constructively. It's an extremely important coping
skill. Too few people really have the understanding of how important
it is not to avoid conflict, but to move past it constructively.
Many people dwell on these things, and it becomes too much a part
of their career as opposed to a natural process of people working
together.
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