An encompassing view of the world

Pediatrician Joan C. Downey's rich experiences inspire students and physicians

From a small petroleum camp nestled deep in the Amazon jungle, young Joan C. Downey and her family traveled up the windy Magdalena River to receive immunization shots at a nearby village.

The Colombian village was about an hour by canoe from the Texaco base where her father produced oil. The nearest city — Bogotà, Colombia — was 24 hours away by car.

Downey still recalls the corridors of the clinic, lined with children at different stages of starvation, injury and death.

Joan Downey, M.D. (right), assistant professor of pediatrics, and nurse Judy Compton care for Jayla Gibbs, who was born weighing just 14 ounces but now weighs 4 pounds, in the neonatal intensive care unit at St. Louis Children’s Hospital. – Photo by Bob Boston

“Just seeing these children — who were my size and age — made it very clear to me that I wanted to be a pediatrician,” says Downey, M.D. “I knew that I needed to do something to make a difference.”

The desire to make a difference in a child’s life began years ago at that destitute clinic. But Downey was drawn to neonatology during postgraduate work at a hospital in Bogotà.

In the pediatric intensive-care unit, she often ventilated babies by hand to keep them alive through the night. “We were the equipment,” she says.

Intensive care is so exceptionally good in the United States, Downey explains, that you can make an immediate difference in the life or death of a newborn.

“I love the whole arena of a new life, which can also be a new death,” she says. “The whole arena, which usually brings out the best but sometimes the worst in people, has always fascinated me.”

Downey is now an assistant professor of pediatrics, director of the Labor and Delivery Service at Barnes-Jewish Hospital and director of the Antenatal Consult Service at St. Louis Children’s Hospital, which cares for women with pregnancies involving abnormal fetuses. In these roles, she has the opportunity to positively affect a child’s life every day.

“She is scrupulously attentive to the details of care for critically ill newborns and their families,” says F. Sessions Cole, M.D., the Park J. White M.D. Professor of Pediatrics and head of the neonatal intensive care unit at Children’s Hospital. “She is also adept at anticipating the needs of families and addressing them in a proactive fashion, a strategy that significantly reduces their stress.

“She is passionate about ensuring that all babies and their families have the best possible care.”

That combination of empathy and insight are what makes Downey an excellent fit for pediatrics.

“You have to be connected to your patients — it doesn’t require a M.D. or Ph.D. to figure that out,” she explains. “If you don’t give your patients and their families a piece of your heart, they can see right through you.”

Family matters

Even as a small child, Downey’s mother, Graciela Chaves de Downey, stressed to her daughter the importance of helping others. Every year, Graciela organized charity missions that delivered desperately needed food, clothing and supplies to the impoverished villages along the Magdalena River.

Poverty was an anathema that Downey’s father knew all too well. Growing up in the 1920s as an Irish immigrant in the ghettos of Hell’s Kitchen in New York City with only an elementary-school education, John Downey knew there were few opportunities to escape ghetto life.

Downey and family enjoy Parrot Jungle during a vacation in Miami.
(Front, from left) Brett, Jaelithe and Whitt; (back) Joan Downey and Skip Virgin enjoy Parrot Jungle during a vacation in Miami. — Courtesy Photo
The day after his mother died, he boarded a barge with 30 other American men and headed to Colombia to “make his fortune.” Not long after he arrived at the petroleum camp, John fell in love and married Graciela.

Seventeen years later, Texaco transferred the Downeys to Miami. As a high-school student, Joan Downey worked in a city hospital from 4 p.m. to midnight, moving up the ranks from escort to finance clerk in an effort to understand all the occupations that make the medical enterprise work.

But medicine wasn’t the only thing that sparked Downey’s interest. A young man from a sailing family named Herbert W. “Skip” Virgin caught her eye at a National Honor Society induction ceremony when, as president, he placed the society’s pin on her.

The following summer the couple met again at a Bohemian restaurant. With a calypso band playing in the background, they had a fantastic conversation about E. coli.

“I realized then that this could really be something great,” she recalls.

Virgin, M.D., Ph.D., professor of pathology and immunology and of molecular microbiology, delayed his applications to M.D./Ph.D. programs and worked in a lab for a year so he and Downey could apply to medical school together. A year later, both were admitted to Harvard Medical School.

After a year at Harvard, the couple married and took 18 members of Downey’s extended family on a monthlong Colombian honeymoon. While they traveled, the couple was escorted by 40 armed guards to protect them from kidnappings and drug-related violence.

The first night of their honeymoon, marching soldiers and passing tanks awoke her husband in the middle of the night.

“I thought I was witnessing a coup attempt,” Virgin says, “but it was a practice parade — an unusual reason for not sleeping during your honeymoon!”

“Skipper is very ‘gringo,'” Downey adds, laughing.

While her new husband finished his Ph.D. training, Downey pursued a master’s degree at Harvard’s School of Public Health and spent a year working on related projects.

In addition to working at the pediatric hospital in Bogotà, Downey went to Cali, Colombia, and Santiago, Chile, to work with a mobile surgery team, (as the only female) performing trauma surgeries in mobile army surgical hospital tents.

Joan C. Downey, M.D.Native language: SpanishHusband: Herbert W. “Skip” Virgin, M.D., Ph.D., professor of pathology and immunology and of molecular microbiologyYears married: 23; they’ve been together for 28Children: Whitt, 13; Brett, 10; Jaelithe, 5. “Our children need to be No. 1 – we limit our commitments if it doesn’t include them.”Favorite pastimes: Sailing, reading historical novels and going to Miami to meet extended family members, who travel annually from Bogota; for reunionsShe also lived in a trailer across from the Indian Health Service while she worked at a 30-bed hospital on the Zuni Reservation near Gallop, N.M.

After Virgin finished his Ph.D., the couple was back “in sync” and accepted positions at the School of Medicine in 1990, partly because “the University is very welcoming to husband-and-wife teams,” Downey says.

A great role model

At Harvard, Downey and Virgin were very involved with advising undergraduate students about careers in medicine and science and even lived above them in university housing as head resident tutors.

Those experiences primed Downey for her current position as assistant dean and coordinator of undergraduate research programs in the College of Arts & Sciences.

“Helping students as they mature in their careers is such a rich experience,” Downey says. “I love passing the torch.”

James E. McLeod, vice chancellor for students and dean of the College of Arts & Sciences, explains that Downey’s unique set of life experiences make her an ideal student adviser.

“Not only is Joan very caring, but she’s also accomplished a lot of different things, which is very inspiring for young people to see,” McLeod says.

One of Downey’s more recent accomplishments was serving as the 2001 president of the Academic Women’s Network, which promotes interactions among female faculty and assists junior faculty and trainees. In 2002, the group received the Women in Medicine Leadership Development Award from the Association of American Medical Colleges.

And junior faculty and students are the ones who truly benefit from Downey’s wisdom and guidance.

“Joan is an incredible mentor because she’s a good listener, and she has a unique, encompassing view of the world,” says former medical student Amy McBee, M.D., who met Downey during her pediatric clerkship. “I wouldn’t describe many people as wise, but I think that word suits Joan well.”

Downey recently spent hours advising McBee on the career and lifestyle issues surrounding the neonatology fellowship McBee just accepted at Children’s Hospital.

McBee sought advice in the right person — Downey juggles career and family with grace and ease.

The focus on family is deeply rooted in Downey’s Latin Ameri-can heritage and was stressed to her growing up both in the United States and South America.

“St. Louis is a fabulous place for us to live because Midwestern values prioritize the family, which is consistent with Latin values,” she says. “We all work hard for our achievements but never at the expense of family.”