Inspirational Black Men and Women in Medicine: Eugene Manley of LUNGevity Foundation On 5 Things You Need To Create A Successful Career In Medicine

An Interview With Jamie Hemmings

Not everyone will like you. You can be the most upbeat and focused person, but no matter what you do, some people will make assumptions about your skills and intelligence because they have already made assumptions. Accept that and it will hopefully help you to stress less about one thing.

In the United States today, black doctors are vastly underrepresented. Only 5% of physicians nationwide are black. Why is it so important to have better representation? What steps can be taken to fix this discrepancy? In this interview series, we are talking to successful black men and women in medicine about their career, their accomplishments, and how others may follow their path. As a part of this series, I had the distinct pleasure of interviewing Eugene Manley.

Dr. Manley was the first in his family to attend college. During the course of his 20+ year STEM careers as a Mechanical Engineer, Biomedical Engineer, and Molecular and Cell Biologist, he witnessed firsthand many of the obstacles that minority researchers and clinicians face in academia and medicine. He has worked in orthopedic biomechanics and biology, as well as in pathology, imaging, and therapeutics in cancer. He has participated in mentoring programs as a mentee and a mentor for trainees at all career stages, and understands what does and does not work. He also has developed and administered grants, developed strategic alliances, and advocated for the underrepresented or invisible. That is why Dr. Manley developed the Minority Mentorship and Training Program at LUNGevity Foundation, the nation’s leading lung cancer organization. This program complements funding for underrepresented scientists working in Health Equity in thoracic oncology and aims to 1) increase diversity in the lung cancer workforce to better serve an increasingly diverse patient population, 2) ensure that researchers are cognizant of and addressing disparities in treatment, research, clinical trials, access, and care, and 3) ensure that minority researchers and clinicians have the support and training they need to thrive in their careers.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your childhood “backstory”?

I grew up in Detroit and am the youngest of 4 siblings. I apparently was very shy as a little boy, which no one will believe, but my mom said after I started going to Head Start (a federal program that provides education, health, nutrition, and other services to low-income children) no one could keep me quiet. So I guess I outgrew my shyness.

Growing up, I chronically suffered with severe asthma and numerous allergies. My asthma was severe until I was about 10 years old. It was not surprising for me to be in the hospital at least 20–30 times a year just dealing with asthma attacks. I eventually knew my medications so well that I could tell you every asthma medicine and inhaler that I used without looking at the labels. I was also very adept at using nebulizers. However, I also suffered with very severe anaphylactic allergies, and those exposures were never fun. Collectively, my asthma and allergy battles in my youth inspired me to want to understand how the body works and how it could heal/repair itself, particularly the lungs.

Can you tell us a story about what brought you to this specific career path?

I really do not know if there was one thing that brought me to this specific career path. But I believe my experiences visiting my father, who was a chronic smoker, may be partially the reason I suffered from severe asthma and allergy attacks and incidents. It did influence me, at some level, as one of my earliest science fair projects in middle school was to test the amount of tar and nicotine in cigarettes. (It was the 1980s, so it was easier to obtain cigarettes from the corner stores than it is today). I ordered a kit that had tubing, a chamber, filter pads, and a bulb that could be used to “smoke” the cigarettes. I bought several single cigarettes of about eight different brands, and measured the amount of tar and nicotine in each cigarette by assessing the change in the filter pads. In addition, I reached out to the American Cancer Society (ACS) to order Infographic materials which provided general information, risk factors, and lots of images of different cancers that may result from cigarettes and chewing tobacco. I can recall that a friend of my sister told me roughly six years later that she remembered my science fair project and those images made her quit smoking. I never knew that my project had such an impact. It helped solidify my curiosity in understanding the effects of cigarette smoke exposure and piqued my interest in conducting scientific methods to help individuals with cancer and other diseases.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

The best quote was inspired by my first experience in racism in science, which happened when I was in 11th grade at the Metro Detroit Science and Engineering Fair. I had this great project based on the work I did over the summer at the Michigan Cancer Foundation about why a panel of about 60 anticancer drugs by Kodak were not effective against leukemias. However, I used cream-colored paper instead of white paper on the poster. The next morning when I went to the exhibit hall, one of the pages became partly detached from the board (I likely did not use enough rubber cement). One judge spent time trying to insult me by saying I used old paper, I didn’t know science, and other derogatory comments. I am still surprised that a scientist from the suburbs could not distinguish between cream paper and old paper. I was told by my science department head, who knew I moved to my own beat: “You will always go down the road less travelled. People and the world will always try to put you down, and you will have keep smiling and moving forward. Get your revenge by showing them what you accomplish.”

Can you share the most interesting story that happened to you since you began your career?

The most interesting story was probably the time I gave a presentation in Montreal at the Shriner’s Hospital for Children on the work I was doing as a Postdoctoral Fellow at the University of Michigan. I went with a friend, who was driving us back to Ann Arbor. As we entered U.S. Customs, they questioned what we were doing. As soon as I said I gave a presentation, the Customs agent kept questioning me. I was not sure if he thought I was paid (not), sharing secrets (nothing to share), or not telling the truth. Finally, after 6 questions, I just went super deep and technical. We finally were allowed to re-enter the U.S., and my friend found that exchange hilarious. I am glad that one of us found it funny.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

Honesty

• This is directly linked with trust. If you say you are going to do something, then make sure that it is done. There is nothing worse than someone, especially in a leadership position, saying they will do something or facilitate something, and then they don’t do it or are too busy. One student asked me how to go about doing study abroad where English is not their primary language and their family was upset with them going for so long. So I said ”Your future is yours to decide. If you are worried about being gone for a year, then go for a semester.” I also encouraged the student to study in another country that speaks their native language. The experience is the most important thing.

Authenticity

• Being your true self and using your lived experience are the best ways to bring credibility when doing patient advocacy and STEM Outreach. If your audience is diverse, from a low socioeconomic (SES) background, or has never seen anyone like them talking about science, they are more likely to respond to someone who has lived that experience. It allows you to make a connection, without it being contrived.
• It is why I can go to conferences like the Society for Advancement of Chicanos/Hispanics and Native Americans in Science (SACNAS) and the Annual Biomedical Research Conference for Minoritized Scientists (ABRCMS) and talk about navigating STEM fields and career opportunities. Empathy is embedded in my life experience. I have been in STEM programs, mentoring, and leadership programs throughout my career and it empowers students when you can freely engage and discuss the challenges.

Self- Motivation

• The ability to motivate yourself is a trait that is hard to teach, but if you can motivate yourself, it enables you to lead others. I did not grow up with much and did not have any role models, so my drive and desire developed from wanting to help people, fighting for the marginalized, and my desire to do something with my life and break the cycle of poverty. I was an avid reader and always questioned everything, which would get me teased for being a nerd or sellout. This also made me start assessing people, and it taught me to always evaluate who I hung out with and if they were moving forward. You had to have self-discipline to not deviate. By the time I got to college, I knew I wanted to do biomedical research even though I was majoring in engineering. I conducted research and learned about summer research opportunities, received information packets, and applied for a lot of programs. If you are waiting for someone else to manifest what you want, you are not taking charge of your narrative. From this lens, it is easy to inspire and uplift others.

Thank you for all that. Let’s now shift to the main focus of our interview. This might seem intuitive to you, but it would be helpful to articulate this expressly. Can you share three reasons with our readers why it’s really important for there to be more diversity in medicine?

1. A more diverse workforce will more accurately reflect the rapidly changing diversity of the country, and this should decrease the bias in care delivery and increase outcomes.
2. Different racial and ethnic groups may experience specific conditions that may only be readily thought of or seen by people from those backgrounds, so if we do not have doctors who understand this, then all interventions will be created based on majority populations. This will likely keep contributing to disparate outcomes.
3. More diverse teams will have better problem-solving skills as group-think is minimized.
4. Morale for the staff and trainees will be higher if they actually see leaders and patients who look like them, if promotions are representative, and if outcomes are better.

As things stand today, what are the main barriers for black men and women to enter the medical field?

1. Income. As currently constructed, application costs for med school, MCAT exam costs, travelling for interviews, and low stipends keep many scholars in debt. Many first-generation and low SES students do not have families with money to help navigate these stages.
2. This also ties into the fact that many are not from families of doctors, so they cannot afford to pay for test prep courses. These courses don’t really say that you are more intelligent, but they can help one get a higher score without having any more competency.
3. Medical schools including organizational systems and structures tend to be very hierarchical, resistant to change, and lack diversity. Inherently, there are many unconscionable abuses and power dynamics that underrepresented scholars see and face, but they are expected to accept this because this is how things “have always been done.“ If you raise issues that clearly can impact the care of underrepresented patients or scholars, and you are not in a leadership position, it can and often will negatively impact your ability to get letters of reference or advance.
4. Children do not see enough Black men and women in medicine or allied health growing up. If their life is already challenging, and they see no one who looks like them in a field, then they would feel like they should not do it or that they won’t belong.
5. Public education funding is a major problem. A lot of money is going to charter schools, which is taking money out of the public school system. That means there is less money that can be placed into education and increasing core competencies.

From your perspective, can you share a few things that can be done by the community, society, or the government, to help remove those barriers?

1. We need to have better funding of public-school systems and we need to bring back or add more extracurricular after-school activities. In the late ‘80s/early ’90s there started to be this emphasis that everyone needed to go to college. This meant there became less of an emphasis on vocational tech programs and trade schools. We should ensure that art, music, libraries, sports, and vocational tech in school are still funded and being taught. You never know what will spark a kid’s interest or what path they will take.
2. If we are really trying to increase the number of kids that we want to enter STEM fields, we should be engaging and exposing these kids to people in these fields who look like them by 3rd grade. If you wait any later, depending on the environment they are living in, other interests or priorities will appear. Light the spark in them early and let them flourish. Many spend most of their time being told what they can’t do or amount to, so they must see people in these fields as early as possible.
3. We need to change the paradigm and assessments for admission. If we are only obsessed with grades at all costs, then only those with money and financing will get in. If we look at the massive disparities and inequities in underserved neighborhoods, we clearly need doctors from these communities who look like these patients. They will receive better standard of care, should have less bias, and are more likely to believe the doctors will treat them.
4. We need to own up to all the medical mistreatment, bias, and racism that diverse patients have experienced. Medical textbooks should contain accurate information. There is no excuse that some books still say that black patients do not feel pain.
5. There should be actionable requirements and accountability when institutions, programs, or people don’t consider health equity, addressing disparities, and/or reducing bias. It should be part of tenure and promotion.
6. We may need external diverse boards to assess hiring, promotion, and dismissals to avoid biased assessments.

What are your 5 things I wish someone told me when I first started my career in medicine, and why? Please share a story or example for each.

1 . Not everyone will like you. You can be the most upbeat and focused person, but no matter what you do, some people will make assumptions about your skills and intelligence because they have already made assumptions. Accept that and it will hopefully help you to stress less about one thing.

2 . Embrace being different. It took me the longest time to get diagnosed with ADHD, and after I did it explained so much. I am always thinking about ways to improve and optimize things, and I can see multiple sides, but I have often been told I move too fast or need to spend extra time explaining what I have seen. I often have thought of the next 6 steps and sometimes and wonder why others aren’t keeping up with me. Only when I talk to another ADHD person does it make sense.

3 . Stipends don’t pay for living expenses or moving. I had very little debt coming out of my undergraduate program, even though I spent 2 years in different exchange programs. Most of my debt came from graduate school. While a stipend pays your tuition and fees, it does not account for the cost of living or major medical procedures.

4 . Build a real network of friends or activities. There will be a lot of time spent in the lab or clinic, and often there will be people who do not know what you are going through. You can try to explain it, but it may never register, as you are in different points in your lives. Thus, it is critical to have a friend or friends or activities that you do to help you deal with stress and decompress. I found solace during my PhD program in doing jujitsu. It was the one thing that let me to do something outside of the lab that I enjoyed. With all the other structural and systemic issues you will face, these outlets will be the one thing that will reduce the chance of burnout and keep you sane.

5 . Never apologize. This does not mean you should not apologize if you genuinely make a mistake, but it does mean you should never apologize for being and doing great things. Never let anyone else try to control your shine because of jealousy or they want to put you in place. Anyone trying to hold power over you will keep doing it if you permit it. If people cannot keep up with your vision, keep it moving, in spite of them.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

There are so many disparities and inequities across multiple cancers, and we need to be able to effectively increase awareness, increase representation, and increase/improve outcomes.

Using that as a caveat, I would love to run my own Cancer Health Equity nonprofit or consulting corporation. It would have diversity and inclusion throughout all levels of the organization, have individuals from groups with lived experiences, and actively seek to encourage younger generations to consider STEM careers. It would fund research grants and have diverse reviewers; continue to do virtual and in-person educational events about cancer and screening; work with communities to fight for their specific needs; offer internship programs; advocate for diversity in the workforce, research, and clinical trials; do strategic partnerships to address health equity and disparities; run a mentorship program for scholars from BS through PhD and Postdoc; and advocate for policy initiatives that address the needs of marginalized and underserved populations. STEM outreach and engagement would also be a large emphasis, and it would work to provide afterschool or monthly programs so that kids see scientists who look like them and learn how to advance. If it is a for-profit, then consulting on clinical trial diversity, health equity, and equity in grant writing would be ways to bring in additional funds to support the rest of the mission.

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.

I thought of several names, but the name that just came blaring in my head is Serena Williams. She grew up in the inner-city and she and her sister Venus faced many obstacles and barriers as they were advancing in tennis. Many people tried to dictate what she could do, how she should act, how she should behave, and she faced so much racism and discrimination throughout her career. She still managed to forge her own path forward. She has also created several fashion businesses and now is a venture capitalist. She has invested in at least 50 companies, and many are owned by women and people from minoritized communities. She also has her own experiences in dealing with a health care system that did not listen to what she clearly articulated during her pregnancy. It shows that those who are famous still have the same challenges as the rest of us. I would just be elated to pick her brain to see how she started to think about and do these transitions.

How can our readers best continue to follow your work online?

My twitter is @EugeneManley

My LinkedIn can be found under Eugene Manley Jr https://www.linkedin.com/in/eugenemanleyjrphd/

You will often find me talking about health equity, disparities, first-gen and low SES issues, grants and programs, lung cancer, and information about screening programs (generally for different cancers)

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.