Grace under pressure

Diana L. Gray offers compassionate care when diagnosing and treating fetal malformations and genetic disorders

Not long ago, Diana L. Gray, M.D., gently told a young teacher expecting her first child that without fetal interventive surgery, her unborn baby boy most likely would not survive.

Gray was faced with the most difficult aspect of being an obstetrical geneticist. She had to explain that an expanding cyst was compressing the baby’s fragile lungs and impeding their normal development. There were also signs of heart failure. If Gray and her team didn’t surgically intervene to drain the cyst, the baby would likely die.

Through ultrasound guidance, Gray and her team placed a shunt into the chest wall of the 24-week-old fetus to drain the cyst so his lungs could develop normally.

Diana L. Gray, M.D., professor of obstetrics and gynecology and of radiology and associate dean for faculty affairs, administers an ultrasound to patient Patricia Wells, who is pregnant with a baby boy.
Diana L. Gray, M.D., professor of obstetrics and gynecology and of radiology and associate dean for faculty affairs, administers an ultrasound to patient Patricia Wells, who is pregnant with a baby boy. “Ultrasound imaging captivates me,” Gray says. “It has revolutionized the practice of OB-GYN.”

The surgery was a success. Four months later, Gray’s patient gave birth to a healthy baby.

As a prenatal geneticist and surgeon, Gray uses noninvasive and invasive techniques to screen, diagnose and occasionally treat fetal malformations and genetic disorders such as Down syndrome, spina bifida and Tay-Sachs disease.

“Most of the time we’re giving out good news,” she says. “But even when babies have terrible problems and parents are faced with difficult decisions, it’s still rewarding because we offer something that many medical centers don’t — accurate and compassionate diagnosis.”

At the School of Medicine, Gray, a professor of obstetrics and gynecology and of radiology, and her colleagues focus on taking care of the patient from the beginning to the end of pregnancy. They believe if physicians are going to diagnose severe genetic disorders, they need to offer patients every option medically and legally available.

“Dr. Gray is skilled at dealing with complex medical problems, often in very tense and emotional situations,” says James R. Schreiber, M.D., the Elaine and Mitchell Yanow Professor and head of the Department of Obstetrics and Gynecology. “She is a knowledgeable and caring physician who has the ability to impart information to patients and referring physicians that is both accurate and supportive.”

Gray says the mantra of the genetics and ultrasound section of the obstetrics and gynecology department is non-direction. That is, physicians give patients information that is as factual and unbiased as possible and let them decide what’s best for their individual situations.

“This is one of the areas of medicine where we try especially hard to be non-directive,” Gray says. “Every patient’s situation is different, we don’t know what it’s like to be in their shoes.”

Revolutionary medicine

Gray and her colleagues’ groundbreaking work is helping advance genetic research that may someday offer cures for fetal abnormalities and genetic disorders.

She regularly performs one of the latest procedures in prenatal diagnosis, chorionic villus sampling (CVS), a definitive diagnostic test for chromosomal and other genetic disorders. CVS tests for the same conditions as amniocentesis but can be done earlier in a pregnancy.

The School of Medicine was the first medical center in the region to perform CVS and remains one of few medical centers in the Midwest that offers it.

“Unfortunately, we’re not at the point where we can pluck out diseased genes and insert healthy ones,” she says. “Someday we may be there. But right now we don’t have a lot of methods to fix problems once they are diagnosed.”

Gray’s research primarily focuses on using ultrasound as a noninvasive diagnostic screening technique for fetal genetic disorders. Her team also studies ultrasound as a diagnostic method for neural-tube problems and other fetal defects.

The introduction of ultrasonography into obstetrics about 40 years ago opened the door for the field of genetic prenatal diagnosis, which emerged in the 1970s.

Diana L. Gray with husband Mark Ferris and children Katie and Wyndham.
Diana L. Gray with husband Mark Ferris and children Katie and Wyndham.

The Prenatal Diagnosis Program in the School of Medicine was founded in the mid-to-late ’70s by James P. Crane, M.D. — just prior to Gray arriving at the medical school as an OB-GYN resident. (Crane is now professor of obstetrics and genecology and of radiology; associate professor of genetics; and associate vice chancellor for clinical affairs and chief executive officer of the Faculty Practice Plan.)

Gray followed her residency with fellowships in OB-GYN ultrasound and genetics at the University. From 1991-97, she served as the division co-director and director of genetics and ultrasound and as the director of prenatal genetic services for Barnes-Jewish Hospital.

“Ultrasound imaging captivates me; it has revolutionized the practice of OB-GYN,” Gray says. “Before the invention of ultrasound technology, obstetricians were really blind.

“It’s hard to imagine being an obstetrician or midwife delivering babies without knowing what was going on during the pregnancy. The access we now have to the fetus is amazing.”

A family physician

Growing up on her family’s farm in northern Illinois, Gray’s affinity for animals sparked an interest in veterinary medicine. But she decided early on that it would be frustrating to treat patients that couldn’t tell you what was wrong.

“I thought medicine would be much more rewarding with people,” she says. “The way the human body works has always fascinated me.”

During her undergraduate and medical studies at the University of Illinois, Gray joined several women’s groups, which further drew her to OB-GYN. “I have a special interest in helping women in all aspects of their lives,” she says.

Last fall, Gray was appointed associate dean for faculty affairs, a position in which she works with department heads and faculty to achieve a consistent, supportive work environment and to assure equitable compensation and promotional policies to sustain outstanding faculty researchers, clinicians and teachers.

Diana L. Gray, M.D.

Years at the University: 21

University positions: Professor of obstetrics and gynecology and of radiology; associate dean for faculty affairs

Hobbies: Running, skiing, cycling, reading, playing the piano, preparing family meals and baking — especially desserts

Favorite vacation spot: Northwest Montana; Gray and her family visit the area at least three times a year

Pets: Two cats — “I love animals. We just got a new kitten last fall.”

“Diana is an accomplished clinician and educator with wonderful personal qualities, just the right person to oversee faculty affairs at the medical school” a major responsibility with many challenges,” says William A. Peck, M.D., the Alan A. and Edith L. Wolff Distinguished Professor of Medicine, who appointed her to the position when he was dean of the medical school. “She has established an appropriate agenda and formed effective working relationships with many stakeholders and has begun to promote the implementation of strategies that will enhance our faculty.”

In the short time Gray has held the position, she has begun to assist new standing faculty committees in the development of equitable promotion and pay polices for women and minorities. “We have come a long way, and plan to do even more when it comes to assuring that our women and minority faculty are supported and progressing along in their careers,” she says.

Since its inception, Gray has been active in the Academic Women’s Network, serving on the board of directors and as president in 1999.

She has also been an elected faculty representative to the medical school’s Faculty Practice Plan Board of Directors. She is the co-master of the Cori Society and an appointed member of the governor’s Genetic Disease Advisory Committee for the state of Missouri.

But her successful career has never stood in the way of her family life. Gray relishes raising her two children, Katie, 18, and Wyndham, 12, with her husband, Mark Ferris, a business professor at Saint Louis University. They celebrated their 25th wedding anniversary this summer.

And she still finds time to regularly run with her neighbor and take spinning classes.

“I love being active,” Gray says. “When I hear people say, ‘If you’re going to have a career in science and medicine, you shouldn’t have children,’ I’m totally perplexed.

“Having a family allows me to be a better physician. And as a mother, I’m able to better sympathize with some of the very difficult dilemmas and emotional situations my patients face.”