The balancing act

There’s a telling slip of the tongue when Janet S. Rader, M.D., associate professor of obstetrics and gynecology and of genetics, lists the things she enjoys about her job.

“I love taking care of patients,” Rader says, “I love doing research, I love being a mom … ”

Rader pauses for a split-second to reorient herself and then jumps back into describing how her specialty as a gynecologic oncologist allows her to face a variety of challenges in the operating room, the clinic and the research laboratory.

She doesn’t bring up her three sons again until she describes what she likes to do in her spare time (attending her sons’ sporting events and orchestra concerts and going on family outings). But it’s clear that whenever Rader thinks of the greatest joys in her life, her family inevitably springs to mind.

“Her kids come first — they are so important to her,” says Dana Viviano, nurse coordinator for gynecologic oncology, who has worked with Rader for two years. “Her boys know that she has a busy, detail-oriented career, but they also have no doubt whatsoever that they’re very, very important to her.”

Rader is married to Charles Markman, an archaeologist who specializes in cultural-resource studies before construction projects begin to determine the impact a project may have on archaeological sites and historical properties.

Her oldest son, Nathaniel, is 17; Eliot is 13; and Gregory is 9. Several of Rader’s family members, including her parents and her brother’s family, still live in St. Louis.

Viviano can cite many examples of Rader’s devotion to her sons — instances when Rader brought one of her sons to work and when she took one of them along to an out-of-town conference. She also frequently touches base with her family from the office.

One early March morning, as Rader, gynecologic oncology fellow Barbara Buttin and others finish surgery on a woman with ovarian cancer, the conversation between Rader and Buttin turns to an upcoming surgical meeting.

“I had been thinking of going to that meeting and bringing my son along, but then I realized being there just wouldn’t be fun for him,” Rader says to Buttin.

Devoted to patient care

Rader, born and raised in St. Louis, earned a bachelor’s degree from Drake University in 1979 and a medical degree from the University of Missouri in 1983.

After a residency at Michael Reese Hospital and Medical Center in Chicago and fellowships at the University of Chicago and Johns Hopkins University, she returned to St. Louis in 1990 as an instructor of obstetrics and gynecology at Washington University.

“Washington University is such a rich place,” she says. “There are great scientists, there are great clinicians, and when you need it, there is always someone to pick up the phone and call and ask a question that falls outside your specialty.”

Rader’s research focuses on identifying the factors that can increase a woman’s risk of developing cervical cancer.

“Right about the time when I started my fellowship, I worked in a lab that was studying human papillomavirus (HPV), which is involved in cervical cancer development,” she explains.

“We know the virus is connected, but 70 percent to 80 percent of sexually active adults harbor the virus, and cervical cancer only develops in a much smaller percentage of women. So what other trigger factors are involved?”

Rader and her colleagues are looking for single-character changes in the genetic code that can increase cancer risk. Patients with weakened immune systems get cervical cancer at higher rates, so they are focusing a portion of their search on genes involved in immune system functions.

Scientists have also shown that HPV interacts with a number of proteins, and Rader’s group is scanning genes for those proteins for variations that increase the chances of developing cancer.

Rader loves the fact that her specialty straddles the worlds of research, the clinic and the operating room.

“I love seeing patients, but I also like going to the lab, doing research and thinking about how you can take what you learn in the lab all the way to the other end and use it to benefit your patients,” she says.

Rader and Paula M. Fracasso, M.D., Ph.D., associate professor of medicine, are good friends and frequent collaborators who often refer patients to each other’s care.

“Janet is an excellent surgeon and clinician,” Fracasso says. “She is very caring and always makes sure our patients are aware of all the latest treatment options.”

Viviano adds, “She takes her patients very personally. She takes care of these ladies for such a long period of time, and she shares their triumphs and takes it very personally when one of them has a recurrence or dies.”

Inspiring role model

Rader is the University’s only female faculty member in gynecologic oncology. She acknowledges that as a female surgeon, she’s had to face some sexism over the span of her career, but she prefers not to dwell on it.

“People say some inappropriate things sometimes, but you just ignore it and move forward,” Rader says. “The number of women in surgery has really gone up. I think a lot of the stuff we saw and heard is hopefully falling away.”

Fracasso says Rader has a helpful approach for dealing with tough situations.

“Janet has taught her nurses, residents, students and colleagues something that is one of her personal philosophies: When you hit a brick wall, take a right or left turn,” Fracasso explains. “She’s not discouraged by the right turn or the left turn — she’s creative and takes the turn.”

In addition to Rader’s everyday activities as a role model for female surgery students, she recently served as president of the Academic Women’s Network (AWN) at the School of Medicine.

“The network is very pro-women’s issues for students, residents and faculty, and she’s been very influential in it,” Fracasso says.

AWN has hosted seminars and sponsored speakers on scientific career development for women. It gives out awards to both M.D. and Ph.D. students for leadership and to faculty members for mentoring work. The group has also published a Family Resource Handbook for faculty members and students.

Rader suggests that one of the best ways she can inspire female students who aspire to be surgeons is to show them that it’s possible to be both a dedicated surgeon and a devoted mother.

“Last night, the residents went out to happy hour,” Rader says. “I don’t think I’ve ever gone to a happy hour. I just can’t.

“I’ve got to go home, I’ve got to see my kids, I’ve got to help them do their homework. I enjoy what I’m doing, and I do put in long hours, but when it’s time to go home, it’s time to go home.”