Before her legendary career at NIH, Vivian Pinn was the second Black woman to graduate from UVA med school

Vivian W. Pinn: Well, I got interested in medicine when I was a young child. They tell me I said I wanted to be a pediatrician at age four, and I’ve said this before, but it’s true. My parents both worked. So I spent a lot of time with my grandparents, and especially my father’s parents—both were ill.

My grandmother had diabetes, needed insulin shots. That was a big deal back in the 1940s. And then my grandfather was suffering from colorectal cancer and had to get pain injections. And I remember, my father was the only one of the children, of his sisters and brothers, who had the nerve to give a needle. It was considered a big deal then. My grandfather said I was the oldest grandchild, “Teach Vivian.” So, I learned how to give needles to my grandmother and grandfather at a very young age, well, with my father overseeing it.

One thing I noticed was that everybody was in pain and suffering, but that was the time when you had house calls. General practitioners came to your home. When the doctor came and took care of my grandmother, my grandfather, when he left, he was smiling. My grandparents were smiling, everybody in the house was smiling.

Everybody felt better. It just seemed to me that the doctor was making everybody feel much better, and I liked that. I don’t like suffering, but I felt especially, for being with my grandparents, that I had a knack for being around people who were suffering to make them feel better, and just witnessing what a doctor could do. That’s what I wanted to do. I was around four, around that age, and I just stuck with it.

The only other thing I ever considered doing was being a dancer or a singer—and I can’t dance and I can’t sing. So, I was left with medicine as my other career path that I had thought about, and that’s how I did it.

With a lot of illness in my family, I lost my mother when I was a sophomore in college from a chondrosarcoma of her hip, which was never diagnosed by her physician. He treated her for poor posture with gold shots for arthritis and Oxford shoes. I remember going to the doctor with her that summer. She was a very shy person. I was shy. I wish I’d been there now. And he said to her,” Francena, you wouldn’t be having these pains if you wore those shoes and did your exercises like I told you.”

I went off to take my summer physics to go to Indianapolis at Butler. And at the end of the summer, the day of my final exam, I got a message from my mother. She was having surgery. My father had palpated a mass in her hip, and it turned out she had a chondrosarcoma of her iliac area that had actually grown through the bone.

That orthopedist must never have taken an X-ray. He couldn’t have worked it up because it had grown through the bone and was found, really, by my father. That was in college. And if nothing else, that just confirmed that I really wanted to be a physician and I wanted to do research. I’m not sure I really knew what research was, but in those days I really thought, I want to do research because I want to find an answer for this cancer thing. We want to cure cancer. And I want to be a researcher.

I went back to complete my last two years of college and then off into a research position, and then to medical school, and some nice little challenges at UVA, which you probably are aware of. The rest of my life was really just dedicated to those experiences I had in my early years.

VP: I did not grow up saying I wanted to be a pathologist. But this is an interesting story because, and actually, my father was tickled—I heard he was going around town showing pictures of me doing autopsies. He told me he didn’t know how, when I was scared to go to cemeteries and go to funeral homes, how in the world did I pick pathology?

But at the same time, he was evidently tickled inside. I told you that my mother died. I took a semester off of college to take care of my mother. I took care of her doing so. I’d been a real caregiver for six months, 24/7, taking care of my mother. Other than my grandparents, I had a real caregiver experience—taking care of my mother, from washing, to giving meds, to consoling. I went back to college the day after her funeral in February of 1961.

I had a semester to make up from having been out of school for a semester. So while I marched with my class, the class of ’62 at Wellesley, I had a semester to make up, and I decided I wanted to stay in Boston because there wasn’t much I could do at home in Lynchburg.

I’d worked as a nurse’s aide in the hospital, I’d worked in the drugstore for the local druggist, and there wasn’t much else to do. I wanted to stay in Boston. The first place that the Wellesley Student Placement Office gave me to go interview was at Mass General with the transplant surgeon. And even though he was looking for a research assistant, and even though he knew I’d be going back to school, I was fortunate because he took me on and sort of took me under his wing.

That surgeon was Dr. Benjamin Barnes, working with Dr. Paul Richardson in the transplant center at Massachusetts General Hospital. And the immunopathologist with him was Dr. Martin Flax. It probably was before your time, but this is 1962. And in 1962, transplantation was considered research. Remember, they were only doing it on living, related relatives, mainly just for Goodpasture Syndrome, and experimenting on how to make them survive longer and develop cadaver donors.

I got that summer job and then they kept me, and I worked through while I finished my semester at Wellesley, and stayed there until I went to start UVA medical school in the fall. I made the decision to go back to UVA because it was close to my father, because I was an only child. And as I said, we lost my mother. But I was fortunate because every summer those two guys brought me back to Mass General to work.

Each summer, they gave me a research project of my own. One summer, Dr. Barnes didn’t have the money for a research project for me alone. The pathologist said, well, I’ll take care, and I’ll support her. I still was working with both of them, but I was based in pathology.

UVA was tough. I mean, I’m a really big alum supporter right now, but in those days there were some rough times I got through, there were some rough times, and I said to them, I really have got to take some time away so I could survive mentally.

And so they did allow me to take six months of my senior year, including the summer in a research position at Mass General. I was trying to figure out what I was going to do because I knew working with Dr. Flax and working with Dr. Barnes, I knew all about transplantation. I thought I could diagnose it. I was starting to do the diagnoses at Mass General on kidneys and transplants.

I was really into GU because that’s what my boss did. But not many places were taking women in surgery, and they certainly weren’t thinking about women in urology. And I didn’t know what I was going to do.

I was at a cocktail party, believe it or not, of the New England Society of Pathologists. Dr. Benjamin Castleman, who was then the chair of pathology at Mass General and who is legendary in the field of pathology. And he walked up to me, and of course I was quaking because here is the great Dr. Castleman, and he says, “Vivian, what are you going to do next year?” Meaning for my internship.

And I didn’t know what to say. And this resident standing beside me said, “Oh, she wants to be a pathologist.” True story. This happened. I can tell you his name right now. And Dr. Castleman looked at me and said, “Well, why didn’t you tell me?” And Arthur, standing beside me, said, “She’s too shy.”

So Dr. Castleman said, “If you’re interested, come to my office and talk to me.”

I’m standing there quaking and I’m thinking, there’s no way this little Black girl—not a Harvard med school graduate—I’m out of UVA, this little Black girl from the country in Virginia, and I’m spending some time here, but there’s no way I’m going to get an internship at the Mass General Hospital.

I didn’t say anything. And one day he walked through the lab and said, “Vivian, come in my office.”

And he said, “Are you really interested?”

And I said, “I would love to do this.”

And he said, “Have your dean send me a letter of recommendation.”

And in those days we didn’t have cell phones and I was poor. I can remember to this day. He had the secretary let me use the department’s phone to call my dean at UVA to ask him for a letter.

And I can remember, I spoke to Dr. James Q Miller—and he said, “A letter of recommendation for you?”

And I said, “Yes, he wants a letter of recommendation for me.”

And a few weeks later, Dr. Castleman walked through the lab and said, “Oh, by the way, Vivian, we’ll see you in July.”

I didn’t go through the matching program. And it turns out that what he gave me, which affected my whole career the rest of my life, I became an Research Fellow in Immunopathology at MGH, an acting intern and acting resident on an NIH research fellowship.

It paid $300 a month, no taxes, $300 a month. That was my salary for my three years of training there. But it was an NIH fellowship. And that’s how I got into the field.

My boss that I was working with, Dr. Flax, went on sabbatical during my internship year and left me to cover the transplant and kidney biopsy service. That’s where I really got into it. I got to know the folks at the other hospitals in Boston and ended up in that area. When Dr. Flax went to Tufts to build this new department, I went to Tufts. Alright, I gave you a paragraph instead of a sentence response.

But to me, it’s sort of interesting how one thing has built on another in my life, just sort of happenstance and things that have happened. If Dr. Castleman hadn’t walked up, and if Arthur hadn’t told him I wanted to be a pathologist, I would never have been in that field. I would’ve been looking for something closer to home that I felt, that maybe, I could get.

And that’s why, when I’m mentoring students or speaking to students, I tell them, reach for the stars. If you don’t reach for it, you don’t know if you’re going to get there. If you don’t aim for it, you’ll never know if there was a possibility you would have it. Just learn from the lessons of my life. It can make a difference for others.

VP: Well, I came back from Boston after finishing college in my year of working at Mass General to go to medical school at the University of Virginia.

I walked into the classroom and I remembered the auditorium in the old medical building at UVA. I didn’t know a soul there. I walked up and sat in the back of the auditorium and waited for the rest of the class to come.

I didn’t see anybody else who looked like me, but I figured, “Well, for once I’m on time, the other women and other people of color must be late.” And then they called the roll. And I’m sitting in the back and I see, everybody’s there.

Now remember, I went to a women’s college, and here I am all of a sudden back in the South. Charlottesville was just starting to integrate. It was not integrated when I came back in ’63. UVA was still an all-male school except for nurses and those in graduate school.

Remember, they didn’t start taking women in the undergraduate school at UVA until the 1970s, after I had long finished medical school, because I finished in ’67. And so women, and of course minorities, that’s another story we know—they’d only had a trickle here and a trickle there. I’m not quite sure how I got in, but I did.

For those in medicine, you know how important it is as a first year in medical school to think about anatomy lab, and how important it’s going to be to have the right anatomy lab partner.

And I knew that from having worked at Mass General, and having worked with a lot of Harvard medical students and hearing a lot of stories about anatomy. I’m sitting in the back of the room looking at this sea of white men in the South, in the segregated South, wondering, how am I going to survive this?

When the dean says, “OK, it’s time for a coffee break. There’s coffee in the lounge down the hall, and I want you all to go there, and I want you to get yourselves into groups of four for anatomy lab.”

Well, I almost melted into my seat and I thought, “I don’t know any of these guys. They know each other through fraternities, through their parents, through their schools, or just have connections that I don’t have. I’m going to end up with the dumbest folks in the class who don’t get partners.

Because nobody’s going to want to take on, in Charlottesville at this point, a Black woman as a lab partner.”

And I really was thinking when I left the back, I was not going to go down to that coffee lounge. I was still a little shy then and I wasn’t going to go down.

I was thinking, maybe I should just go on down, get in my old car, and drive home and tell my father.

I just don’t see how I could do this because it’s going to be tough enough being a medical student, and now I’m not going to have lab partners.

And as I was walking down from the back, these two guys in the front of the auditorium yelled up and said, “Hey, Vivian, do you want to be our lab partner?”

Somebody questioned me saying, “How did they know your name was Vivian?” I don’t know. They may have said, “Hey boo,” I don’t know. But at least they yelled out to me and I can remember they yelled out and asked if I wanted to be their lab partner.

And I went, ‘Well, yes.” Because all of a sudden that gave me somebody to connect with. They said, “Well, we’ll get a fourth guy, and this will be our group. Let’s go get coffee.” I would never have gone to coffee. They took me to coffee. When it came time for the break to go for lunch, they took me across the street. And so I had my group.

I was the second Black woman at UVA, Barbara Starks was the first Black woman in the class ahead of me.

When she came back, she asked me where I had been eating, because it had been a thing for Black students at UVA that they mostly ate in the cafeteria, because most of the restaurants were still segregated.

And I said, “I’ve been eating across the street on the corner.” For those who don’t know UVA, the street across from the medical school that’s called “the corner.” It’s really just a street, but it’s referred to as “the corner.” And I told her I’d been eating on the corner, and she said, “You couldn’t have been, they’re not integrated yet.”

And I said, “Well, they are now, because I’ve been eating there.” And it took me maybe 30 years before I told my lab partner that, “Kenny, you didn’t know it, but you played a role in civil rights, because you helped to integrate the restaurants on the corner in Charlottesville without even realizing what you were doing. You could add that if you want or hide it if you want, but you played a role in civil rights, because we integrated some of those restaurants and nobody knew.”

Almost all of these instances in my life, I’ve drawn conclusions from. Reflect back 80 years, you think on things. Everybody talks about inclusion and belonging. That’s a perfect example, because if those guys hadn’t reached out to me, I might well have just tuck-tailed and gone home thinking it was going to be too much of a challenge for me, and too stressful.

But they reached out to me, and what a difference that made in my life. And so one of my messages when I’m talking, and you’re getting my messages point by point, is to look out for someone who may be different when you’re in a room or in a group or in a gathering, because the smallest of gestures can make a big difference.

That small gesture really made a big difference for me. And it probably was 20 or 30 years after graduating before I really realized the significance, the significance of that gesture. I have thanked Kenny. The other guy, unfortunately, is no longer alive, but the other two are.

We are still friends. We still communicate after almost over 50 years. When I tell that story, he jokes: “Oh, I just went to an all male school and I just wanted to have a pretty girl in my lab group.” And he dismisses it. But you know what, if you think about it, it took nerve for those white guys in the segregated medical school to reach out and ask the only Black woman. They didn’t know whether I was dumb, or smart, or what—to have me work with them. And I was lucky, because it turned out they were two of the smartest guys in the class.

I ended up with a wonderful lab group. It just seems to me, so many things happened along in my life that I just have to give credit up above. Somewhere, somebody was looking out for me, because so many things made a difference.

VP: When I was a resident at Mass General, I saw a different side of medicine. I saw academic medicine. You don’t know much about academic medicine. You don’t get that exposure. And I saw that academic medicine is where research is done, where decisions are made, where doors to medicine are being opened, where articles are being published that determine who gets what treatments.

I just fell in love with academic medicine. And that was during the time when everybody was promoting Blacks in medicine by saying, “We want more Blacks so they can go back to their communities to practice.” And I started pointing out, well, our communities are not just the ghettos and the barrios.

Our communities are everywhere that medicine is, including academic institutions, including insurance companies, including public health physicians. I really just fell in love and started promoting this aspect of—I didn’t get back to my hometown to practice medicine, but I did everything I could to encourage those who were in primary care to think about my hometown and other small towns, to go back.

Looking over my life, the things that I’m proudest of—I’ve got lots of honors and awards. My plaques are all in a storage unit. I’m paying to protect them. I don’t want to throw them away, but what do you do with plaques when you get to my age and don’t have an office for them?

What I am proudest of is seeing the accomplishments of those I have taught, or mentored, or just seen along the way. I can’t take credit for what they’ve all done, but when I hear from students I had in the seventies or the eighties.

I just heard from a Howard student I had 35 years ago who reminded me of a program that’s going on today at Emory where she’s going to be speaking, but reminded me that I was the first speaker. When I hear from my former students, it means so much to me. .

I’ve had students who’ve been presidents of universities, not only in the U.S., but outside of the U.S. Those who’ve had the largest practices. Look at Malcolm Taylor from Jackson, MS, who was one of my first students at Tufts, and his group was the largest Black group of cardiologists in the country for a while.

When I see that so many of the Black doctors in Jackson, Mississippi, at one time were graduates of Tufts, that I happened to have been able to put my fingers on. When I look at the accomplishments of those that have come through me, or around me, or maybe just passed by me, I am just so proud of them, because they reached prominence in ways that I never could have. But the fact that most of them at least remember who I am, and I can just be proud.

I’m like a parent. All of my former students, all of my former residents. Since I don’t have children of my own, I think they’ve just sort of become my extended family.

And that’s what I’m proudest of. I love my awards, I love the honors. That’s great—but they can’t put on a piece of paper that you hang on your wall what it means for something—seeing that there are people who are contributing to society, who are contributing to the wellbeing of others. That’s what I mean.

And not just Blacks, Hispanic people, I mean Asian Americans. I mean I’ve got a variety of diversity of former students, but even those who are not minority who are contributing to the scholarship fund in my name at Tufts, or who still recognize me.

It shows that if you hang around long enough, you can see the benefits of those who learn from your mistakes. And I like to point out to those, remember and think about the things that were negative findings in your career, because they can be as important as the positive things, because you learn from those and you learn to not be like those who were negative in your life. To me, it’s important. There’s another one of my pearls of wisdom. It’s important to recount not just the positive episodes, but the negative episodes, so that you don’t recreate those negative episodes for others.

VP: I remember when the Heckler Report was being written, because it really was mostly written by Tom Malone, who was a deputy director at NIH. Did you know that? And I heard Dr. Herbert Nickens, who later was the first head of the DHHS Office of Minority Health, and then was at the AAMC, assisted Dr. Malone in preparing that report.

Tom Malone was the NIH deputy director, and I knew Tom Malone, because when I was at Howard, his wife was the head of my Cytology Laboratory. He would come to visit his wife and stop in to see me.

I saw drafts of the Heckler report before it was done. When it was done, [Tom Malone] gave me a complete set of the Heckler Report, all the volumes. It’s not just one volume, as you know, there are many volumes. He gave me copies of all the volumes.

And that was prior to ’91, before I went to NH. Many of us who know that refer to it as the Malone Report, but it really was Tom Malone who was a scientist, extraordinary, wonderful individual who was at NIH who really put that report together. And Herb Nickens, who most people have heard of—he contributed to that.

One of the phrases that’s most often quoted from that report, is that patients seem to relate better to physicians who are like them. Herb confided in me that, actually, he was the one that put that language into the report. I’ve been around a long time. I’ve got a few inside stories from just having been around that long.

VP: But it is interesting, that report came out and no one paid much attention to it until Louis Sullivan became secretary, and he started referring to it. People treated it like it was a brand new report. I have to give Sullivan credit, because he really pulled it out of obscurity.

That’s when people first began really paying attention to it, because they didn’t give it that much attention. They knew Heckler released it and it just sort of went off and set on shelves. and Louis brought it and made it a living force. Since then you hear people refer to it all the time.

VP: Oh, I look up to her. Well, she really was a pioneer. Yes.

VP: You have to credit that report, because all of us had thought, and we all talked about and said, more people, more Black women are dying of breast cancer. More Black men have prostate cancer. We see more heart disease, we see more diabetes. But it had never really been documented.

And so the fact that the Heckler Report documented it. It had resources, It had references. And it had data, true data. It wasn’t all just something that was observational. Examples in the Heckler Report were the first time we really had a true collection of data from the federal government. Remember, this is coming from the federal government, so it couldn’t be accused of being biased, that documented what we had all thought.

That became our Bible in terms of being able to quote, and here’s the data. We’ve been telling you for years that we are sicker, but here’s data that shows that that is true. Here are some examples, here are some facts. And that’s what made the difference.

Louis Sullivan used that to the nth degree in his speeches. He was the first person, I mean Herb Nickens used to talk about it, Tom Malone, but it was the Heckler Report, and they would use it. It was Sullivan as Secretary of Health and Human Services in that position. I have to give him credit. I give credit where credit’s due. I don’t give credit if you don’t deserve it. He deserves credit, because as secretary, he kept quoting that report and talking about why the Department of Health and Human Services needed to be focusing more on health disparities. So he played, I think, a more integral role in that than many people realize.

VP: I think a few years ago, maybe 10 years ago, I would’ve said we’ve made a lot of progress and we’re moving forward. Seeing what’s happening in society these days, the lack of hesitancy about espousing racist comments, the way women’s health is being looked at today, the way we can’t even refer in an application to being Black, we have to be neutered because the Supreme Court doesn’t want race to be used.

Even though we can’t talk about the effects of slavery. And I mean, I don’t care if somebody else who’s white wants to talk about the fact—that’s fine, but why can’t I talk about it? Or my friends, or my family talk about it? And then seeing what’s happening in terms of legal things.

It’s going to be years before we can reverse some of the problems we’re having right now with those who are in legal positions to block some of the progress that we have made by accepting and approving some of the local actions coming from those who are less aware of, or really don’t want to be aware of looking at issues of diversity, and equal access to healthcare, equal access to health, equal access to living, really, that’s what it’s all about.

Right now, I hate to say that as I’m coming to the end of my life, and I hope it won’t be that soon, but still, it’s discouraging because we’re fighting the same battles that we fought in the 1940s and the 1950s. And I can remember those. And the people who lost their lives just so we could vote.

I remember the hangings and the lynchings in the South. I remember, when we drove south to visit my relatives in Tuskegee, we had to drive during the day, and my mother would have to put her head down if we passed the cop because she was fair-skinned, so they wouldn’t think a Black man was with a white woman. Nowhere to stop. Talk about those boxes of fried chicken. Yeah, because by the time you left Virginia, there was no place to stop to get something to eat till you got to Paschal’s in Atlanta.

And then from there to Tuskegee. Boy, that was a fast hop, drive down there quickly to get off the road. We’ve come a long way since then. We can drive fine cars, or poor cars, and we can be with a group of blended complexions in the same car, but all of a sudden now it’s getting scary to do that again.

And so, thinking about what so many people sacrificed for, including my relatives, and all of us coming up, and what we went through, it’s just so disheartening to think that young people are having to face that. When I talk to young folks, and they start talking about some of the insults they get, let’s say in medical school or in hospitals, since we’re talking about medicine. I want to laugh at first and say, you think that’s bad? You should have experienced some of what I experienced. But then I can’t do that because to me, maybe it’s worse because we’ve come now 40, 50 years—and the fact that they’re experiencing this—at all—is not good.

And maybe it’s almost worse because they know that it can be better. We didn’t know that it could be better. We hoped it could be better, but we know it can be better now. I can’t laugh and dismiss what they’re going through now saying, “What would you have done if you had been me?” Because I’m not sure what I would’ve done in their circumstances now, knowing that there was hope once, but that hope is being destroyed.

I want to be positive, and I don’t want to leave it as a negative message. That is disheartening. What is encouraging to me is that a lot of my generation are beginning to die out, as you know. Right now, I’m working on a proclamation for Dr. Edith Mitchell as a past president of NMA, and that was a shocker.

VP: That’s right. I talked to her the night before, just a few hours before she died. Thinking about what she went through—a lot of us older folks are leaving, or going, or becoming disabled. But I see young folks, young meaning anywhere from the teens to the 60s, who are not accepting this, and who are willing to fight for the rights as their ancestors did.

I get fed up with those who say, “I don’t need to vote. My vote doesn’t count.”

Where are their heads? Where did they go to school? Where are their families? Didn’t they learn what it was like coming up?

I have no patience for them, no patience at all. But I have great patience, and great admiration, and great hope lying in my confidence of those who are coming along, who have got a backbone, and who aren’t saying, “I’m tired.” If you’re tired already, imagine how I feel at my age, gee whiz. Don’t tell me you’re tired. Get up out of that and go do something, because if you’re tired, and I’m tired and gone, who’s going to take care of us? Who’s going to look out for us?

And fortunately, we’ve got some folks who are doing that, and so we’re raising a whole new generation of leaders, and we just have to support them and encourage them, and do what we can to help them get along and to keep them on their feet, and to keep them from being discouraged.

VP: There are a number of things, thinking from my point of view. One, I have to say, after having been the founding director of the Office of Research on Women’s Health at NIH, that one of the things is that medicine has come to recognize that there are differences based upon both sex and gender, as well as, if you don’t want to use race, whatever our cultural backgrounds are. I don’t want to get into that argument over whether race is effective as a scientific principle, because before it was always let’s use the white man as the norm, and anybody else follows in that.

I think that science and research today have benefited from that change. That’s a major change in policy related to research, which has implications for public policy, implications for health care, and implications for what we can expect as patients. I have to say that because I was involved in that, and I think, if you think about it, it really has changed the face of science now.

I think that’s one. Of all the discoveries—and I’m not an expert on this, but I think learning more about, and finally learning about the genetic basis of disease, especially for example, I remember I was at NIH when we had that town hall, and all got together when they first announced they discovered the BRCA gene. That was earthshaking.

I can’t say I’ve kept up with all the findings since then, but to me that started a whole new era in the field of medicine and health care, when that genetic basis for diseases led to possibilities of altering, or predicting, or just understanding more about some of the conditions that have been affecting us for years. I’ve given you my field, which I think is important, but also if I just looked at it from the abstract, genetics is not my field.

The guy that taught me genetics in medical school, we’re talking about in the 1960s, I later ran into him and he remembered that he had taught my class, and I went back and looked at my class notes and I had summarized them all on two index cards. That’s about where we were, talking back in like ’63, ’64. We have come a long way since then, so I didn’t start out in that area, but that to me represents probably the greatest area of growth and the greatest area of expansion.

I mean, there are some frightening aspects to what we’re learning about the genetic basis of disease, but there are also some very exciting aspects of the genetic basis of disease.