From studying art history to tackling antibody immunity, the path Liise-anne Pirofski, MD, FACP, FIDSA, took to get where she is today in the field of infectious diseases is anything but typical. However, one thing has remained constant throughout her career: her drive to make the world a better place and help others.
As chief of the Department of Medicine’s Division of Infectious Diseases at Albert Einstein College of Medicine and Montefiore Medical Center and holder of the Selma and Dr. Jacques Mitrani Chair in Biomedical Research, Dr. Pirofski is an accomplished leader and dedicated researcher in the field. The IDSA Foundation is proud to honor her as a 2021 Women of ID honoree.
We sat down with Dr. Pirofski to learn more about her journey in ID, her passion for mentorship and what she hopes to see for the future of the field.
Why did you decide on a career in infectious diseases?
Before choosing a career in medicine, I studied art history and psychology in college at the University of California, Berkeley. I actually began to learn about infectious diseases through my studies of art. I was influenced by images of the plague and suffering, and I was also very focused on Dutch art, which centered around the effect of society on people and how they lived. In psychology, I was studying behavior. Putting those two things together, there was always this image in the back of my mind of infectious diseases wreaking havoc on societies and on individuals. After college, I decided to go to medical school because I saw it as a career that would enable me to try to make the world a better place and help to alleviate suffering.
Many images from my studies of art history came forward as I learned about infectious diseases in medical school, first in the classroom and then on the wards. My best teachers were ID experts and researchers, and they planted some of the seeds for me to become a physician-scientist. I then pursued residency training at Bellevue Hospital in the early 1980s as the AIDS pandemic was spreading in New York City. It was an overwhelming experience; our patients were dying, and we could not help them. Also, working with marginalized and socially disenfranchised populations, I saw firsthand the critical role that social determinants of health play in disease pathogenesis. Taking care of patients with AIDS at the onset of the pandemic, when we had no specific therapies or ways to make a diagnosis before it was too late, motivated me to pursue a career that would enable me to understand the immunologic underpinnings of AIDS and other diseases of immunocompromised people. This led me to a career as a physician-scientist in ID.
What were your early career goals and your steps to achieve them?
My career goals are still evolving. A pivotal moment for me was during my fellowship when I realized that I wanted an academic career. I knew that practicing medicine every day in a clinical setting wouldn’t be a good fit for me, and I wanted to contribute to knowledge in ID as a scientist. I saw becoming a physician-scientist as a path to help people by contributing to our understanding of why microbes make some people sick, but not others, but I had a big problem, which was that I had no research background. I was fortunate to find a very patient scientific mentor and to have the support of other mentors and colleagues who believed in me. I think everyone’s career goals are shaped by what they believe they can do, what they do and what the world shows them they can do. I was lucky that things worked out.
A lot of the ID research at the time I entered the field was on drugs and bugs, and it seemed that the pivotal contribution of immunology to the earliest discoveries in the field had been forgotten. I was interested in the influence of the immune response on the pathogenesis of infectious diseases and became focused on diseases that were caused by organisms that had polysaccharide capsules because there was a unifying theme; people with AIDS and others who were susceptible to them had impaired antibody responses to carbohydrate antigens. There weren’t a lot of other people working on this, and that suited me well. I made my own way, and I think that has helped me mentor people who may be uncertain about where they fit.
Did you have any mentors who helped you achieve your goals?
There is a village – probably a metropolis – of people who have supported me. I wouldn’t be here without my scientific mentor, Matthew Scharff, MD, or the clinicians who taught me ID as a medical student, including Stephen Baum, MD, who has been a constant advisor throughout, and the late Marshall Horwitz, MD. Dr. Horwitz was a physician-scientist and pediatrician with whom I rounded on the pediatric wards during medical school. I found out he had a research lab, and it was like a news flash to me. I did not know one could have such a career, and this served as an example of a path I could also take.
Another person in ID who was influential for my career was Dan Musher, MD, an ID physician and leader at Baylor College of Medicine in Houston. I was having trouble getting my first grant on pneumococcal immunity funded, and I cold called him and asked for his help. He thought what I was proposing was important for the pneumococcal field and wrote a letter of support for my grant, which would not have been funded otherwise. He has continued to be a trusted advisor and supporter throughout my career.
As for women in the field, Joy Glaser, MD; Carol Baker, MD, FIDSA; Ada Adimora, MD, MPH, FIDSA; Emily Blumberg, MD; Cindy Sears, MD, FIDSA; and Judy Aberg, MD, have all inspired me to follow in their footsteps. They inspired me not because they were women, but because of their expertise and accomplishments as clinicians, researchers and leaders. These women have brought so much know-how and knowledge to our field, and I stand on their shoulders. They were and are still terrific role models, and their support has meant the world to me.
Why is it important to invest in the next generation of ID professionals?
People need to find and do something they think is important, and they need to feel supported on their journey. They need to see that there is a path forward and a place for them, but they also need time to explore different paths. Exploration is very important. It allows people to find their passion and then successfully navigate and adapt to the path they choose. One of the biggest mistakes we make is trying to pin people down on what they want to do too soon. The beauty of ID is that there are so many possibilities. There are opportunities in clinical care, education, clinical research, basic research, public health, data science and so much more. I would like to see the field embrace behavioral science, environmental science and other fields to create more diversity and the robustness we need to answer difficult questions. We need to bring more people to the table, and the only way we can do that is by supporting them with the tools to be there.
What advice would you give young women considering a career in ID?
Find your passion. Take the time you need to explore different areas and get to know people in the field. Once you feel like you’ve found your niche, pause and consider how things are going, what is working and what isn’t. Celebrate what is working and if things are not working, keep your spirits up, embrace change and adapt, just like our field has done during the COVID-19 pandemic. The pandemic is a humanitarian catastrophe that called for us to pivot from what we were doing to contribute our knowledge and expertise to help get the world back on track and alleviate human suffering. One uplifting byproduct of the pandemic is that so much impactful work has been done by young ID trainees and faculty. They are our future, and maybe some have found a passion they didn’t know of before, whether that’s in epidemiology, virology, immunotherapy, vaccinology, public health, data science or something else.
What do you hope to see for the future of the field of ID?
What I’d like to see is the world be a better and healthier place. That has been my goal for more than 50 years. I hope we’re better prepared for the next pandemic. I hope we’ve learned how to be better prepared. I also hope we recognize that the world isn’t safe when there are infectious diseases threats anywhere, whether it’s a pandemic; antibiotic resistance; the rise of fungal, vector borne and other diseases due to climate change; or the absence of effective therapies and vaccines for so many deadly diseases.
I’d love to see our field integrate more with policymakers and people who focus on health disparities, data science, behavior and environmental change. I’d like to see the removal of some of the silos that are currently in place. We’re much stronger and better together, and I think strategic planning that embraces transdisciplinary collaborations can move us forward and increase interest in ID. This will make our workforce even more diverse, robust and connected, and we will be even more effective.
About Dr. Pirofski
Liise-anne Pirofski, MD, FACP, FIDSA, is chief of the Division of Infectious Diseases at Albert Einstein College of Medicine and Montefiore Medical Center, where she also serves as a professor of medicine and microbiology and immunology and holds the Selma and Dr. Jacques Mitrani Chair in Biomedical Research. A physician-scientist, her research programs are focused on antibody immunity, vaccine development and immunity to encapsulated pathogens.
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