Remembering Jane

She was many things. One of five women studying with 98 men in the class of 1945, she brushed off any notion of sexism (“I had such good friends, it never rose as a problem,” she told a reporter years ago) and blazed her own trail. She was an extraordinary teacher, garnering teaching awards from her students at the medical school for 13 straight years. She was a top-notch editor. She was erudite; she was commonsensical. She lovingly held her patients’ hands and told them they could cry. She was a world expert in hematology—specifically anemia, sickle-cell disease and Hodgkin’s lymphoma. She admired mental rigor, disdaining frills. She maintained a magnificent backyard rose garden. Athletic from childhood, she loved driving and handled her car with such aplomb on Boston’s streets and European roads that her daughter says admiringly, “She could have driven at the Indy 500.”

What’s not to like? Jane F. Desforges, M45, professor emerita at the School of Medcine, who died last September, laid down a stringent new standard in everything she did and left a glowing legend behind. Unfortunately, I never got the chance to meet her. Desforges retired in 1995; I arrived at Tufts in 1998. Talking with those who knew Desforges in her prime, I got the sense of having narrowly missed a titanic force of nature. People were still shaking their heads in wonder at the figure she cut, 30 or 40 years after the fact.

Desforges was the daughter of Joseph Fay, a 1908 graduate of Tufts Medical School who was a general practitioner in Melrose, Mass. His example left its mark. After majoring in chemistry at Wellesley College, Desforges followed her father’s path into medical school at Tufts. “I didn’t have any grand visions of saving the world,” she confessed later. But she came in for an early stroke of good fortune nonetheless. Students were grouped alphabetically by last name, and so Fay and Gerard Desforges, M45, were frequently matched, including for a first-year anatomy class where the pair carried on a flirtation of sorts.

Subsequently, during a dance held at Boston’s Statler Hotel, “I kept trying to get his attention,” Desforges later told her daughter, Janie Desforges. Something clicked. The pair wed in 1948 and were married for 63 years, until Gerard’s death in 2011. “It was a match made in heaven,” says Janie.

From 1950 on, the couple shared a home on Lake Avenue in Melrose, occupying the same house where Desforges had grown up. It was a storybook kind of life. He was a thoracic surgeon; she a hematologist. Their home’s backyard sloped down to a pond, and here, on the hillside, they taught their daughter how to ski. Both husband and wife were avid gardeners, cultivating vegetables and roses. Neighborhood children were always welcomed onto the property, “where we spent countless hours collecting chestnuts from the gigantic trees. [Desforges] and her husband invited us to sled down the slopes right out onto the pond,” Ellen Peterson, a neighbor, wrote in an online condolence book at the time of Jane’s funeral, before adding wistfully, “Seeing the two of them walking hand-in-hand to Mass or around the pond is one of my favorite memories.”

Professionally, meanwhile, Jane Desforges didn’t miss a beat. After her two-year residency at Boston City Hospital (BCH) following graduation, she had ventured out to Salt Lake City to work with the noted hematologist Maxwell Wintrobe and hone her research skills. She returned to Boston to get married and held a variety of jobs at BCH, rising steadily over the next 25 years from research fellow in hematology to director of laboratories and physician-in-charge of the Tufts hematology laboratory, then housed at BCH.

Robert Schwartz, a hematologist who had been at Tufts since the 1950s, first working under legendary hematologist William Dameshek and later serving as chief of hematology/oncology from 1978 to 1990, had grown aware of Desforges during her tenure at BCH. He had heard her speak at conferences around the country and knew of her eminence in the field. Schwartz’s first direct contact with Desforges came in the form of a rejection letter he got from the New England Journal of Medicine, where she was an associate editor from 1960 to 1993 (and where Schwartz would later serve as deputy editor).

“I decided to call and find out why my paper had been rejected,” Schwartz relates. “Jane answered the phone and told me it was because they already had a paper showing the same thing. I countered this by saying, ‘Well, wouldn’t it be good to have a second paper on the topic?’ She said, ‘Yes, that’s a good idea. We’ll do it.’ That was her all the way: no-nonsense, no agonizing over decisions. It was like: ‘Just give me the facts. I’ll tell you what to do.’ ”

The two had good chemistry from the start. By the time Desforges saw her job at BCH eliminated as part of a general cutback in 1972, she was widely respected for her leadership and acumen. Schwartz asked a colleague if he had seen the news of her availability in the Boston Globe. When the colleague said yes, he had, Schwartz couldn’t restrain his excitement at the possibilities. “I’m going to go stand on the front steps of Boston City Hospital,” he exulted, “and wait for her to come out.”

Lean, not Fragile

The direct, emphatic approach that Schwartz used to entice Desforges to come to Tufts—because, of course, she did say yes to his entreaties—suited her to a T. She never liked dithering, or doing things at a slant. “What you see is what you get with Jane,” her husband and classmate told the Tufts Medical Alumni Bulletin for a profile written in 1989. “She’s pretty uncomplicated and absolutely honest.”

Lisa Watts, the author of that profile, got the chance to observe Desforges in action. “The doctor who inspires such awe and praise stands, perhaps surprisingly, at less than five-and-a-half feet tall,” she wrote. “At 67, she is as small-boned and thin as ever, but she is not fragile. On rounds, leading the house staff from the third floor of Proger to the sixth, she’s the first one out the door to the stairs and up three flights, leaving students 40 years her junior short of breath.”

“My mother,” confirms Janie Desforges, “had unbelievable energy.” As a high school student in Melrose she played field hockey, basketball and softball, captaining her teams. In college she pursued field hockey and fencing. Then she took up medicine and kept her motor revved in that dominion, too. From all accounts she had an alert, tenacious quality to her life.

Janie remembers one time, when she was a graduate student, visiting her parents at home in Melrose; suddenly she realized she had a flight to catch and not much time to spare. She and her mom scrambled into the car and raced toward Logan Airport, her mom at the wheel, slicing through the back streets, utterly composed and confident. “I remember thinking, I don’t know a boy who can drive like this,” says Janie.

Desforges’ mental traits reflected her athleticism. They, too, were whittled down and lean. “My students would say I emphasize logic, common sense and focusing,” Desforges told Watts in 1989. “I stress not doing 20 different tasks at once. If we’re not parsimonious, then we’re not thinking.”

Schwartz, who worked for a while beside Desforges at the New England Journal of Medicine, recalls the degree to which the two of them enforced an old-school Yankee ethic in their editing style, saying, “Jane and I disliked adjectives and adverbs in scientific articles. We crossed them out wherever they appeared in a manuscript. There is no point in writing, ‘Our results are very interesting. . .’ That’s a judgment best left to the reader.”

The doctor’s reticence concealed a detailed and profound understanding of her field. Schwartz, a world-famous scientist in his own right who served as Desforges’ boss in the Department of Hematology/Oncology at Tufts for more than 20 years, says simply, “She knew more hematology than anyone I ever met. She was a walking encyclopedia of hematology, but she never paraded it around.”

Desforges’ knowledge shone at the clinical conferences that the pair held for fellows each week. As a rule, Schwartz would introduce a case, and then turn to his colleague and say, “Jane, what’s your opinion of this case?”

“I would let her lead the discussion,” he admits. “I mean, I was pretty good—I don’t deny that—but she was superb. Students loved to see the way the mind of a master clinician works.”

“You always left more educated than when you went in,” says John Erban, M81, remembering those days. Erban, medical editor of Tufts Medicine magazine, professor of medicine and a breast cancer specialist at Tufts Medical Center, got extensive exposure to Desforges during his time as a medical student, when he worked with her in the lab over two summers, and later, when he trained under her as a fellow in hematology. Often he was lucky enough to be standing “at her elbow” as she saw patients. “She was an extraordinarily principled and ethical physician. I learned a tremendous amount from her about how to be a physician,” he says. Schwartz estimates that Desforges trained as many as 250 hematologists over her career.

The Role Model

Desforges was a complex package, and different people took away different things from her example. For Christine Peterson, M76, Ellen Peterson’s sister, who grew up on the same Melrose block with Desforges, the fact that her neighbor was a woman with a professional life and a family life and a community life rang like chimes. “That was her most important function in my life, being a role model,” says Peterson, who works as an obstetrician/gynecologist in student health services at the University of Virginia. “You have to remember the thinking in the 1970s that said women can’t go to medical school and also have a family. She was proof that you could do it.”

For David Schenkein, who first met Desforges as an intern and fellow in the early 1980s—and who is now CEO of a Boston-area biotech company doing research on cancer therapeutics, as well as an adjunct clinical professor at Tufts—it was her uncommon balance of smarts and common sense that impressed him.

Desforges and he saw many patients together. Often, he relates, he would argue for one approach to a patient’s condition, based on the technical merits; she would respond with a simpler alternative. “I can think of a dozen or more cases where I suggested one thing and she said no,” Schenkein relates. “She was the epitome of [that realm] where medicine is more than just a science, it’s an art form. And she was an artist in how she did it.”

In 1988 Desforges was the first woman to receive the American College of Physicians’ distinguished teaching award, which was named in her honor in 2007. Schenkein keeps a photo of Desforges on his desk for inspiration and says there is not a day that he doesn’t think about her example.

How to Eat Lunch

At home the great doctor could be subdued in her habits. Janie Desforges describes her mother perusing medical manuscripts in the evening, a giant stack of rejected submissions off to one side, perfectly content to be spending time alone. “She was very interior,” Janie observes. “She didn’t go to parties and chat over guacamole—that didn’t really interest her. She wanted to talk with you.” Desforges’ ability to connect with her patients came from that quiet inner place.

Schwartz recalls her empathic style. “She might have a patient with acute leukemia,” he suggests. “She would go to that patient and explain the disease, describe the treatment and offer hope before asking, ‘Do you have any questions?’ Then, before she went home at the end of the day, she would go back to that person and say, ‘I just want to be sure you understand everything we talked about.’ Very few doctors do that,” he says.

“She was a somewhat reserved person,” Schenkein confirms. “You’d never go out for beers with her, but she had an uncanny connection to her patients at a very human level, and made them feel comfortable in a context of often life-threatening disorders. She would touch their hands and talk about the patient, and know that that patient had a brother who had been in the hospital, and remember what occupation that brother had.”

Associate Professor Rachel Buchsbaum, who trained in hematology/oncology under Desforges in the late 1980s, saw the same thing. “She was someone who was this great person of national and international reputation, but she remembered all the details of her patients’ lives. She could tell you that Mr. So-and-So was very proud of his tomato plants.” Desforges would routinely sit down and eat lunch with her students, Buchsbaum says, at a time when no other faculty members she knew made such efforts.

Jane Desforges died on September 7, 2013, at age 91. She lived her life humbly and unassumingly to the end. Janie recounts how, after the funeral, she went through the house, rounding up her mother’s artifacts, and in one room found “all these accolades leaning up against the wall. They were all framed, but I had never seen them before. My mother had never bothered to put them up on the wall.”

This article first appeared in the Spring 2014 issue of Tufts Medicine magazine.

Bruce Morgan can be reached at bruce.morgan@tufts.edu.