Seeing Medicine Through the Eye of an Artist

Patricia J. Eifel, MD, has built more than 1 beautiful home from the ground up. She’s placed every piece of furniture, hung every strip of wallpaper, and even installed the electrical wiring.

The homes in question are in 1:12 miniature scale—but that still doesn’t make it an easy job.

As a miniaturist, Eifel can build and rebuild entire worlds with little more than a pile of wood scraps, sandpaper, and an eye for incredible detail. She’s also a photographer, pianist, and inveterate Francophile. But these aren’t merely hobbies for Eifel, one of the world’s leading gynecologic radiation oncologists whose research has transformed how those cancers are studied and treated. They’re “parallel priorities,” a term she coined to describe leaning into passions outside of work that serve all aspects of her life.

Eifel has helped treat thousands of patients throughout her career, most of which she’s spent at The University of Texas MD Anderson Cancer Center (MD Anderson) in Houston, and has produced more than 200 peer-reviewed publications. For decades, she has traveled the world, lecturing and mentoring others who aspire to follow in her trailblazing footsteps. In 2018, she won the American Society for Radiation Oncology Gold Medal, the highest honor in her field, for “outstanding contributions, both academically and personally, to the field of radiation oncology.”

It would have been easy, if not expected, for someone like Eifel to be consumed by her work, especially considering how crucial that work has been in her field. But she knew early on that she was inspired by personal and professional artistic ideas and couldn’t be as effective as a doctor without making room for those ideas in her life. Allowing her creative pursuits to complement her professional drive has helped her innovate gynecologic cancer research, treatment, and education.

The Road to Stanford

Eifel was born in an army hospital in Heidelberg, Germany, but spent most of her childhood in Chicago, Illinois, her father’s hometown. Her fascination with miniature houses and furniture was born in the Thorne Rooms at the Art Institute of Chicago, which house one of the planet’s most impressive collections of miniature interior design. Her family moved to California when Eifel was a teenager, influencing her decision to enroll for her undergraduate education at Stanford University in 1969.

Eifel was not unlike any other freshman with several different interests—art, history, and science among them—but she eventually settled on a pre-med concentration at a time when Stanford and the rest of the nation were reckoning with gender disparity in professional education. In 1968, only 9 first-year students at Stanford’s medical school, just 12% of the class, were women. That was considered tremendous progress compared with years past. The cultural implications of having more women in medicine couldn’t have been more apparent than when the editors of Stanford MD, then the quarterly magazine for the School of Medicine, asked female students if they were prepared to handle “the triple role of doctor, wife, and mother.”

In 1969, the Stanford School of Medicine experienced 2 monumental events: First, trustees accepted a $5 million gift from the estate of Katharine Dexter McCormick, a women’s rights crusader who funded most of the research that led to the development of the birth control pill. McCormick specifically noted that Stanford should use the money to aid and encourage women to attend medical school, and to support women involved in teaching and research. A few months later, according to a 2000 issue of the school’s present-day quarterly, Stanford Medicine, the faculty senate formed a committee with the goal of admitting more women, supporting their studies, and promoting their careers in medicine.

By 1971, women made up more than 20% of Stanford’s first-year medical students. And in 1972, the same year Title IX prohibiting gender-based discrimination in schools receiving federal funding became the law of the land, Eifel applied to the Stanford School of Medicine. “At the time, I didn’t understand the impact that [the McCormick gift] had,” she said. “I had heard some rumors about a group of women who were supporting female applicants to the medical school, but I was way too [focused] on classes and other demands to think very much about [that or] Title IX. ...But now I look back at it and realize, you know, who knows whether I would have even gone into medicine? It’s a remarkable thing.”

The Art of Radation Oncology

Eifel initially did a pediatric internship but says she was ultimately drawn to the multidimensional appeal of radiation oncology—clinical work, research, and teaching—and developing meaningful relationships with her patients. “The 3-dimensional visual aspect of radiation treatment planning appealed to my artistic nature,” she said. “Also, radiation oncologists often develop a very close relationship with patients during the 6-week course of therapy, seeing them frequently at a critical time in their treatment, often right after they’ve been diagnosed. I found that relationship appealing.”

After completing her residency and postdoctoral research at Stanford, Eifel took a “dream job” at Harvard Medical School’s Joint Center for Radiation Therapy in 1982 as the first woman to join the faculty. She was hired to replace radiation oncologist James Belli, MD, the man who would eventually become her husband.

Eifel and Belli have been married for 40 years, and, although they both worked at Harvard, they never did so at the same time. She replaced him on the faculty for a year after he left for a position at the University of Texas Medical Branch (UTMB) in Galveston. Eifel later joined the faculty at UTMB before moving to MD Anderson in 1987. “When I first made the decision to leave [Harvard], which seemed like the best job in the country at the time, many people said, ‘You’ll wreck your career,’” Eifel recalled, noting that it was considered even more of a mistake because there weren’t very many women in the field at that time. “It turned out to be the best thing for me because MD Anderson has been a great place to work, with a wonderful multidisciplinary tradition and a long history of leadership in gynecologic oncology and gynecologic radiation oncology.”

Her interest in gynecologic cancers started during her residency at Stanford when a faculty member asked Eifel to review years of data from approximately 350 patients with endometrial cancer, which allowed her to work with 2 leading pathologists in the field. Their research helped identify a subset of patients who represented about 10% of the population but accounted for more than half of recurrences. Eifel calls it her first “Eureka!” moment as she witnessed firsthand how thorough research methods could change how cancers are treated.

“You put it together, and [suddenly] there’s this whole new idea, a new way of thinking about something and a recognition that patients needed to be managed differently—in this case, not just those with a rare aggressive subset, but other patients whose recurrence risk was lower than we had thought,” she said. “For many people who go into research, there’s a moment somewhere along the way that is immediately addictive and makes you want to experience that over and over again. And it’s part of what feeds my job as a teacher because I want to see our students and our residents have that experience, as well.”As the director of MD Anderson’s radiation therapy residency program for most of the 1990s, Eifel said she’d often ask candidates to share their own “Eureka!” moment and what it meant to them. “I think you can see the impact of it if they’ve experienced it, and it will tell you a lot about whether they’ll wind up going into academic medicine,” noted Eifel.

Forming Authentic Relationships

Eifel says her clinical work is ultimately rooted in the relationships she is able to form with her patients. She credits the late Henry S. Kaplan, MD, a pioneering radiation oncologist and one of her mentors at Stanford, for helping shape her view of how to treat and communicate with cancer patients.

“Following him, I sensed that he could spend 30 seconds with a patient and make them feel like [he’d] been with them for half an hour,” Eifel said. “And other clinicians that I worked with could spend half an hour and make the patient feel like they hadn’t connected at all.”

She said a powerful lesson came early in her career when she observed pediatric patients’ tendency to panic when she walked into the room. Eifel developed a strategy by counting to 10 before stepping into the exam room and directly looking at the child, not the parent.

“I learned quite a bit from that, because adults are not that much different from children in their reaction to that kind of stress,” Eifel said. “To this day, I stop and take a few breaths before I walk in the room to see a patient. And I’m very careful that I’m not distracted when I do it.”

When it comes to newly diagnosed patients, Eifel knows how easy it is for them to Google statistics and outcomes, even encountering information that isn’t necessarily reliable. Perhaps surprisingly, she doesn’t discourage it, but tries to discuss their findings openly in the context of her own experience.

“I don’t believe in beating people over the head with the truth, but I also don’t believe in withholding it. And that’s actually a very narrow margin to walk,” she said. “I believe in treating [patients] as adults who are worthy of respect, and communicating that you trust their ability to use available information to make a decision for themselves.

“There’s nothing in this world that’s definite....I think you have to have respect for patients and understand that they don’t want to be left in a morass of uncertainty, but they also don’t want to be sold a bill of goods.” It helps that it’s pretty tricky to Google anything about gynecologic cancer treatment or research without seeing Eifel’s name attached to it. She was the primary investigator for the RTOG 90-01 trial, which demonstrated that combining pelvic radiotherapy with concomitant fluorouracil and cisplatin resulted in a 51% reduction in the risk for recurrence and a 52% reduction in the risk for death for patients with locoregionally advanced carcinomas of the uterine cervix. These findings have been cited nearly 900 times since they were published in 2004.

Furthermore, Eifel’s investigations into the internal motion of pelvic target volumes have illustrated the complexity of highly conformal external beam delivery and underlined the continued importance of brachytherapy, which requires specialized applicators specifically designed for each anatomic site or clinical circumstance in body cavities and/or tissues. 

Although her track record has undoubtedly made her competitive for administrative positions over the years, Eifel said she never wanted it to be a goal that dominated her career. “I think I have more freedom to say I want to move forward. I don’t need to move up,” she said. “I like teaching, taking care of patients, and doing research. That’s what gives me a rush.”At her core, Eifel is driven by her passions, whether for medicine or a miniature table, or a trip to Paris, France, to expand her photography portfolio.

Passions aren’t always easy to balance, especially with a career like hers, but she says balance shouldn’t be the goal. Instead, the goal is not to give up the things that make you a happier, more well-rounded person. “It is a stressful job and it’s important to get away from it sometimes,” she said. “It’s another kind of ‘Eureka!’ moment, right? You can create something beautiful out of nothing. It brings you closer to other folks who have done wonderful, artistic things with imagination and soul. And I think that’s as important as anything we do academically.”