Interview with Megan Cooper, MD, PhD

Megan A. Cooper, MD, PhD

Megan Cooper, MD, PhD, is a pediatric rheumatologist/immunologist at St. Louis Children’s Hospital. She is the Director of Clinical Immunology at Children’s and an Associate Director of the Medical Scientist Training Program at Washington University School of Medicine. She received her MD and PhD from The Ohio State University before coming to Washington University School of Medicine in St. Louis for her pediatric residency and fellowship in pediatric rheumatology. Currently, her lab focuses on elucidating mechanisms of immune cell control with an interest in both natural killer (NK) cell activation and the molecular mechanisms of pediatric immune-mediated disease.

To introduce yourself, can you tell me how you chose your specialty?

I’m a pediatric rheumatologist/immunologist. It was not what I thought I was going to do – I thought I was going to be a chemist. When I spent a summer as an undergrad in a chemistry lab, it was not for me. I found it kind of isolating. My senior year of college I did my thesis project with a local biotech company working on encapsulating chemotherapy drugs for endometrial cancer. That was much more exciting for me, to see how science could really impact human health.

I didn’t have a lot experience with MD/PhDs, so when I applied to medical school, I applied to MD. It seemed overwhelming to commit myself to eight years of something (laughs). 

During my second year of medical school, I applied to do research between preclinical and clinical years. I remember this one meeting for the American Society of Hematology, hearing some talks about gene therapies for SCID (Severe Combined Immune Deficiency). It started to click for me that I liked immunology, and I liked pediatrics, and I liked the idea of being able to apply my research interests directly to the care of my patients. I was in Mike Caligiuri’s lab for a year, and I applied for another one-year fellowship, and then I thought, well, I should get my PhD. So I stayed for my whole PhD.

Clinically, pediatrics was an obvious choice. I like working with kids, I don’t mind working with parents (laughs). I really appreciate in kids that they always want to get better. Rheumatology interested me because here at WashU pediatric rheum and immune deficiency are combined in the same specialty. I liked that it was understood here that a good grasp of the human immune response is important for treating both autoimmune and immune-deficient aspects. In my fellowship, I did both rheumatology and immunology. I now mostly focus on immune deficiency, but I still see rheum patients. It’s a nice combination and it works well together.

Many paths in medicine, especially for physician-scientists, are not always straightforward. Can you speak about having different models and mentors to learn from?

The most important thing is that I’ve had mentors that have been supportive of what makes me happy and fulfills me. I’ve never had a mentor where I want to do exactly what they do. I have had mentors that I’ve thought, ‘Wow, they are a great scientist. I want to approach scientific problems like they do.’ Or ‘Wow, they’re a really great clinician, I want to have that type of relationship with my patients.” One of the advantages of an academic career is nobody’s career is the same. I don’t think anyone in academics, if you asked them twenty years ago, could have predicted where they are now. It’s ever-changing.

Now that you are in the position of mentor, how do you interpret the importance of diversity, and how do you try to foster your mentees who have different paths than you?

I think what I didn’t realize before I became a mentor is that you cannot have the same mentorship style with all of your mentees. Everybody needs something different out of the relationship. I think that gets back to having different types of mentors for different things.  Something important to think about in academics is diversity of careers. For far too long, in academics, it was thought that if you’re a successful mentor your mentee is going to be an academic investigator leading a lab. There are so many different ways to contribute to science and medicine now, and it’s important to expose your mentees to that and support them, and help them to get to their goals.

As a physician-scientist, how do you balance, or integrate, or whatever your approach is, medicine, science, and life?

Some days I’ll think, wow, I’m killing it, I have it balanced. And other days are just a wreck. That’s how it goes. I have learned to put limits on things. I have one clinic day a week, and I stick to that. When one of my patients comes in on a different day, or they’re in the hospital while I’m not on service, I am 100% comfortable that they are being well cared for because I have great colleagues. Being able to trust them is really important.

Research-wise, establishing a good group that you trust is really important. Part of my role as PI is managing people, and managing the research direction of the lab. And then grants and administrative duties. That can get overwhelming at times.

I have two, grade-school aged children, and my philosophy is that my family always comes first. However, when I’m with a patient, that patient comes first. When I’m talking to a student, they come first. You have to focus on the moment. But if I am invited to give a talk somewhere, and it’s my son’s birthday, I’m going to choose my son and choose to be the mom that I want to be and be there with my family. It is not easy. I don’t have any wise words that will solve this.  You just have to decide what’s important to you.

It’s interesting to hear that so much of your answer is about building a strong team.

I love how you put that – building a strong team. Yes. You have to be comfortable delegating and you have to trust your team. There is no way to do this all yourself.

You said that anyone in academic medicine, twenty years ago, probably wouldn’t have predicted their career paths. Have there been times when you’ve thought to yourself, I don’t really know what I’m doing or where I’m going? And what about times you feel satisfied that this is how you’ve dedicated your career?

Ah, so you mean like last week and yesterday? (Laughs). My career has not – and I don’t think any career in academics has ever been – straightforward and boring. That’s part of what I enjoy about it. There have been some key points in my career, like trying to get my first large NIH grant, trying to recruit some of the first trainees to my lab—those were big points.

There have been times that I have questioned why I am working on a grant all night, when I’m not going hear about it for months and it might not be funded. It’s frustrating; there’s no question.

A couple of things make it worth it. When a student comes to me with a really exciting piece of data, and we go back and forth talking about new results and new directions. That is really exciting and fun. Another thing is the friends that I have made in my field. That has been a fun and unexpected part of the job.

Part of what we do in lab is to try to identify molecular mechanisms of rare disease in kids. The minute when I can tell a family that we’ve found something, that we know what’s wrong with their child – to see the sense of relief that that brings to the family. And to say ok, now we can start to address this and think about how to treat it. That has been incredibly gratifying.

We all rely on those high points to get us through. A lot of research is testing things, and testing things again, and things not working. But when you get those positive and unexpected results, that’s really fun.

What makes you most proud of yourself?

I’m most proud to be a mom.

What is one piece of advice you would give to a young female physician or physician-scientist, what would it be?

Never limit yourself in what your expectations of what your achievements can be. And keep in mind that you need to be in control of your career, and you need to make choices that will fulfill you in work and in life. You will never be happy in anything if you’re not happy in your home life. I would say that to a male trainee, too. Don’t put limits on yourself, but think about what’s actually going to make you happy.