Teach. Pray. Heal.
Sister Mary Diana Dreger, M.D., MD ’01, has the best of many worlds.
By the time Diana Dreger was in junior high school, she knew she wanted to be a physician. Little did she know she would be 39 years old and a Dominican sister when she finally received her M.D. in 2001.
Dreger grew up on Long Island, the eldest of four children. Her parents, devout Catholics, stressed the importance of education, family prayer and church. If a question arose at the dinner table for which there was not a ready answer, the children were encouraged to find a book that had the answer and to share it with the rest of the family.
She jokes that she was leading a Dominican life before she knew what that was.
Accepted to Cornell University as a biology major, she became conflicted as to whether the medical field was really her call. Amidst what she calls a crisis, she left Cornell early in her junior year, questioning if the demands of being a physician would allow her to have a family, something she thought she wanted to do.
It turns out that there was an altogether different plan for her, and she delights in how it unfolded.
After taking a year off from school, she enrolled in the State University of New York at Stony Brook as a biology major, and added a concentration in secondary education.
“I did it a little bit halfheartedly because I knew you could never really make money at teaching, and if you’re going to be teaching, you need to love it,” she says of her change in direction. “It allowed me to pursue something else without giving up the idea of medicine in the future. I fell in love with education. I enjoyed it and did a good job with it.”
She earned a master’s degree in mathematics and enjoyed spending her summers in study. After teaching for a few years, a serendipitous trip to Arlington, Va., brought her in contact with a group of Dominican sisters who were also studying there for the summer.
The Dominican order was founded nearly 800 years ago by St. Dominic and is grounded in three mottos: truth, to contemplate and to give to others the fruits of one’s contemplation, and laudare, benedicere, praedicare, which means to praise, bless and preach. The sisters wear the traditional black and white habit and devote their lives to teaching. Dreger felt an immediate connection to them.
“I met the sisters in the summer of 1988 in what I thought were accidental circumstances, but God doesn’t have any accidents in life, really,” she says. “As soon as I met the Dominicans, I just knew that that was what the Lord was calling me to. I had never considered being a sister. I had never thought that was what the Lord would propose in my life.”
These particular sisters were from the St. Cecilia Motherhouse in Nashville, which was founded in 1860 to provide Catholic education for young women. This gave Dreger, a lifelong Yankee, cause for concern.
“I thought, well Lord, everything is perfect, but it can’t be Nashville, not Nashville!” she recalls with a laugh. “I didn’t have any particular bias against the South, but it was just so far from New York. I realized, though, it was too late to add that provision in.”
She visited the Motherhouse, the sisters’ residence, which sits atop a hill and overlooks downtown Nashville, in the fall and again in the spring and said she had no doubt it was a perfect fit. She joined the convent in 1989 and after her first year changed her name, as is customary, to Sister Mary Diana.
“My dad was excited for me, and my mom was really not happy. That’s changed in her life now and she really loves the sisters,” she says.
Her desire to practice medicine was replaced by a love of teaching. For the next seven years, she thoroughly enjoyed teaching biology, chemistry, anatomy and physiology and religion to the students at St. Cecilia Academy, where she was also head of the science department.
She took her final vows in 1996. One month later, she walked into the Mother Superior’s office to ask a question and was shocked to hear her say, ‘I am thinking about sending you to medical school.’
“I sat there with my mouth opened and realized it was not a joke,” Dreger recalls. “She said to me, ‘Think about it and pray about it and let me know what you think.’
“My initial thought was, ‘Lord, this is very interesting because I have just committed my life in a way I thought I knew where it was going and you have now just handed me something that I thought I always wanted but never expected at this point.’”
A week later, Dreger met with John Lukens, M.D., then director of admissions for Vanderbilt University School of Medicine.
“I basically said, ‘I’d like to go to medical school here at Vanderbilt, can you tell me what I need to do?’” Dreger recalls. “He nicely explained that I really didn’t have several necessary pieces to apply for medical school and that I had just missed the application deadline by a week.”
Lukens directed Dreger to the undergraduate pre-med advisor who pointed out that she had no medical experience to know what she was getting into; she had not yet taken the MCAT admission exam; and she hadn’t studied anything in 12 years.
“They weren’t sure I could still study,” she says.
She enrolled in a biochemistry class at Vanderbilt that happened to meet during her teaching free period. She got to know a physician who was helpful in giving her experience, and she started studying for the MCAT.
“All of those things just fell into place incredibly well. I got lots of good experience and met lots of good people in the medical field who were supportive of my education,” she says. “On the MCAT I scored a little
better than average for the medical school class I entered with, and I got the best grade in the biochemistry class.”
She submitted her application on May 14, 1997, as a late application.
“They gave me no promises,” she says.
She had two interviews in June, and on July 17 she got her acceptance letter to start in August.
“On a human level it doesn’t make sense that all of those things happened like they did. As I was watching this whole thing unfold, I was really fascinated by it, and I thought this is going to be great,” she says.
Dreger easily assimilated into the VUSM class of 2001. She was inducted into Alpha Omega Alpha, the medical school honor society, and received the Healthcare Foundation of New Jersey Humanism in Medicine award at Class Day. The award is given to a graduating student and a faculty member who demonstrate compassion and empathy in the delivery of health care.
“Sister is very conscientious, which is part of what makes her a very good doctor. She is also loyal and has a real care and love for her patients, as she does for her friends,” says Mother Ann Marie Karlovic, O.P., Prioress General.
The Dominican sisters paid for Dreger’s education, in part, so she could return to the Motherhouse and help care for some of the 270 sisters who live there. On a larger scale, it was felt Dreger could contribute to the Nashville community in a way that the sisters had not been able to, by providing health care to the underserved population.
“There is a real consciousness on the part of good physicians that they treat the whole person, not just the physical but the spiritual as well. I think this is what Sister really does bring to her practice,” Karlovic says.
Dreger agrees that she brings a unique perspective to the practice of medicine.
“I was certainly much more experienced at 39 than I was at 18 in terms of human interaction that I learned through being a teacher and administrator. I could see that I was going to bring something to the medical field in a very different way than if I had gone through with my plan to enter medical school at the age of 20,” she says.
Dreger, who completed a three-year Internal Medicine residency at Vanderbilt, works three days a week at the Saint Thomas Family Health Center South Clinic and has done so since 2007.
On a typical Monday morning, the waiting room at the clinic is full. Jesus Medina, a dapper, quiet man, patiently waits for his name to be called. After he is weighed and has his blood pressure taken, he is shown to an exam room at the end of the hall. He takes a seat and talks about his physician whom he is waiting to see.
“I think she is very smart and a very good doctor,” he says, adding that he has been her patient for six months.
When Dreger enters the room, wearing a white coat over her habit, they greet each other cordially.
“Hello, Sister,” he says, smiling.
Dreger extends her hand in a friendly shake, takes a seat next to him, and begins to review his chart with him – in Spanish.
“When I first got here, I knew no Spanish. They were willing to let me work with the staff as interpreters, translators,” she says. “That worked nicely, but it became awfully obvious to me quickly that the history of the patient is so important and if you can’t understand the patient or communicate, there is a big piece missing.”
Always the eager student, Dreger enrolled in Spanish I and Spanish II classes at Aquinas College and also studied medical Spanish. At the end of her first year at the clinic, she started communicating with the patients on her own.
“In terms of medical things we’re talking about, I am fine, but if they want to tell me about their family vacation, I don’t have the language for that,” she says. “I was never very good at languages. I am a visual learner. The whole auditory part of languages is very challenging to me, but so far, it’s worked well.”
About 90 percent of the patients at the primary care clinic are uninsured and are seen on a sliding scale, meaning most of them pay $20 for a visit. It is largely an immigrant population, representing more than 35 countries, the largest group being the Hispanic population.
“We take care of the usual things an internist sees like diabetes and high blood pressure and whatever else happens to come in. I have definitely seen things there that I heard about in medical school and residency but hadn’t seen yet,” she says.
She recalls that one day a young lady came in and told her she was depressed. She had been diagnosed with breast cancer a few years prior and had some depression at that time and was seen by a counselor at the clinic. She was asking Dreger to refer her to the counselor again. Dreger performed a medical evaluation first, but there wasn’t anything remarkable in the history or her exam. She ordered some lab work and sent the patient to the counselor.
“The counselor, who is very astute, came back to me and said, ‘Sister, she’s not depressed. And besides, she’s black and she used to be white.’ And I said to her, ‘Well, you just made the diagnosis.’”
The patient had adrenal failure, also known as Addison’s disease, which, among other symptoms, causes hyperpigmentation. Dreger had never seen the patient nor had she seen a case of Addison’s before.
“It’s a pretty serious disease. We got her back in quickly and had some tests done and she is doing very nicely,” she says.
One of her favorite parts of this job is that she gets to teach medical students who come to the clinic for their primary care rotation, a required component for fourth-year medical students at Vanderbilt.
Medical student Brian Cruz worked at the clinic in November 2010 and said he learned a lot about the importance of evidence-based medicine to guide treatment.
“This was especially important because so many of her patients were uninsured or underinsured, and many laboratory or imaging tests often represented a financial burden for them,” he says.
“Sister exudes a sense of compassion, but also authority, and is someone her patients can confide in and trust that she will do the right thing for them.”
When she is not at the clinic, Dreger participates in the daily activities at the Motherhouse, which include rising at 5 a.m. for prayers, Mass, chores, shared meals, an hour of recreation in the evening, followed by a period of silence for reflection and study.
She is the primary care physician for about 80 of the sisters, who range in age from 18 to 102. She holds clinic at the Motherhouse on Saturday mornings, but is “on call” 24 hours a day for acute illnesses and emergencies. One young sister tore her ACL while playing football on the front lawn of the Motherhouse on Thanksgiving while another older sister complained of chest pain in the middle
of the night.
“Occasionally, I say ‘call 911.’ There are situations when that call is necessary,” Dreger says.
As the sisters age, they are cared for at the Motherhouse, and with very few exceptions, they die in the comfort of this beautiful, historic place they have called home their entire adult lives. Dreger considers it her distinct privilege to have a position at the bedside when a sister reaches the last days of her life.
“It’s actually an incredible blessing and a piece of my training that none of my classmates, certainly not while at medical school or residency, had experienced like I had here,” she says. “I have been with a number of sisters when they died. This is our home. For the sisters it’s a really special time because we really see it as fulfillment of what life is about.”
Dreger said she feels that her Vanderbilt education provided excellent preparation to care for both of her unique patient populations.
“I think the combination of my medical training at Vanderbilt and my personal training as a sister are very complementary in terms of being able to take care of the whole person. It’s hard for me to imagine what situation I could be in that would be better than what I have because I really have the best of many worlds,” she says.