Charting her own course
As a student at Vanderbilt University School of Medicine in the 1980s, Alice Clark Coogan, MD, thought she’d end up in obstetrics and gynecology. Her soon-to-be husband and classmate, Phil Coogan, had chosen orthopaedic surgery.
“At the time, surgery residency was every-other-night call and OB was every third, so we’d see each other every sixth night,” she recalled.
The couple, married three days after Match Day in 1988, wanted to start their family as soon as possible, so Coogan chose pathology. It combined many of her interests, including OB-GYN, and allowed the couple to see each other more often.
During their residencies at Duke University, she and Phil had five children in four years. “We had a 1-year-old and a 3-year-old, and when I got pregnant with our third child, it was triplets,” she said, laughing. “We had five kids under 4 and four under 2. It worked out great for us. I ended up having my OB experience, on more of a hobby level.”
Coogan, professor and interim chair of Pathology, Microbiology and Immunology, and vice chair and executive medical director of the Anatomic Pathology Laboratories at Vanderbilt University Medical Center, has ended up with both a career she loves and a family she’s immensely proud of, balancing both but admitting that it was rarely uncomplicated.
“It’s worked out very well,” she said. “I feel I wasn’t led into pathology, but I came to it and I’ve been so pleased with that decision. As for parenting, one thing I learned early on, and I’ve passed this along to other parent/physicians: lower your expectations.
“Early on, I’d see someone with one or two kids, with an organized diaper bag and managing everything well. With our kids, if they were just in clothes it was a miracle,” she laughs. “It was chaotic, but I think our kids learned a lot of resilience because they had to be responsible for some things on their own.
“It worked out, but it wasn’t easy. If you could have seen what our home looked like… and when the kids were in school, if the school wanted a parent to bring the snack, they’d say, ‘Alice can bring the paper products,’” she said, laughing. “There was no way I’d ever be the parent trusted to bring something baked or decorated.”
Coogan grew up in Chevy Chase, Maryland, just one block from Washington, D.C. She graduated from Sidwell Friends School, whose alumni include presidential offspring Chelsea Clinton and Sasha and Malia Obama.
Her father, Roger Clark, was an attorney, and her mother, Kate Dawson Clark, a 1960 Vanderbilt University graduate, was an educator. Coogan has three younger siblings. Early on, she wanted to be a lawyer, like her father, but she became interested in science during college at Stanford University and opted for a career in medicine.
She chose Vanderbilt partly because her VUSM roots run deep. Coogan’s grandfather, James Robertson Dawson Jr., was a Vanderbilt University and VUSM graduate and faculty member, a professor of Pathology who taught Robert Collins, MD, who ended up teaching Coogan in medical school. Coogan’s great grandfather, James Robertson Dawson Sr., also graduated from VUSM.
Her time at VUSM was “fabulous,” she said. Faculty members who greatly influenced her were Collins, Jeanette Norden, PhD, Phil Felts, MD, and Virgil LeQuire, MD.
“Dr. LeQuire would have students over to his house and Dr. Felts was so engaged with the students.”
Her classmates were “amazing and wonderful people,” including Jeff Balser, MD, PhD, now President and CEO of Vanderbilt University Medical Center and Dean of VUSM.
Coogan remembers the difficulty of making a decision about her career path. “At that time, you spent two years in the classroom, and after that, we went into the hospital. Every rotation we went on, I’d think, ‘I want to do this!’ It was because of the residents, fellows and faculty we interacted with, we just loved them so much. I’d think I wanted to be a neurosurgeon, then I’d step back and say, ‘That’s not really what I want to do.’ I just loved the people. That made it really hard to make a decision in the end.”
What intrigued her about pathology was that it required her to keep up with all the different fields, because she’d get specimens from all of them — pulmonology, neurosurgery, pediatrics, etc. “You have to know what’s going on with all of them and it gives me the opportunity to dabble in all those areas.”
Once she set her sights on pathology, she never looked back. “A lot of people said I should consider it. Ultimately, I did, and it’s the best choice I ever made. It’s a wonderful field.”
The Coogans spent nine years training at Duke and having their family. Phil’s residency and fellowship lasted nine years and hers, six.
She spent three years on faculty there waiting for Phil to finish his training. While at Duke she served as the associate director of the residency program and received the Bernard Fetter Teaching Award in Pathology. In 1997 they came back to Nashville.
“When I came to medical school, after growing up on the East Coast and going to college on the West Coast, I wasn’t sure how Nashville was going to be. We ended up just loving it and we were always interested in coming back if we could,” she said.
Coogan, who completed a fellowship in cytopathology while at Duke, said that cytopathology was the perfect field for her because it allows the pathologist to interact with the patient.
“Often in pathology, you don’t have the chance to interact with patients, but in cytology, we actually go in and do the fine needle biopsies on palpable lesions. We get to see patients in the clinic, take the specimen, examine the specimen and provide feedback to the clinician in a same-day type of situation.”
Upon joining the faculty at VUMC, Coogan discovered her passion for teaching. She became the director for the pathology course (then called Path501) and won numerous teaching awards, including the Jack Davies award for teaching basic science and the Shovel Award in 2002.
A seven-year break
In 2002, after five years on the VUSM faculty, Coogan retired.
“Our kids were starting middle school and that’s when they can really go off the rails,” she said. “I thought at the time I had done everything I wanted to do.”
So, she remained at home with her children for seven years, then came back in 2009 to the same job, even the same office. “It was a time warp. I remember going to the cafeteria and one of the staff there said, ‘I haven’t seen you in a while,’ and I said, ‘Yes, it’s been seven years.’”
When she came back, she continued to teach students and residents. “Now I get to work with faculty members at the Medical Center who I taught. It’s so great to see them in their own leadership roles now.”
She has served in various roles in the admission process since 2010 and was chair from 2014 to 2018. She has greatly enjoyed recruiting students.
Coogan said that VUSM’s current curriculum has changed the way students incorporate pathology into their education. “Students are so much more knowledgeable about clinical medicine early on. When I was in medical school, we took histology and anatomy and biochemistry and we just had basic science at first. I remember we were chomping at the bit to see patients after two years in the classroom. The first time we saw disease was in the second year.
“Our students are now seeing patients in the clinic from the get-go. So now when we’re talking about an organ and a disease, they’ll say, ‘Oh, my gosh, I saw someone in clinic with this yesterday.’ They’re bringing in information that everyone is learning from. There’s just a completely different type of responsiveness because they’re coming in at a totally different exposure level from an early stage. It makes things stick with you so much more. If you’re in the clinics and someone is explaining the physiology of hypertension, you think about the patient you have just seen with it and you understand why it’s so important — instead of just memorizing it.”
Leading the department
Coogan said she never imagined she’d be interim chair of her department. It was never on her career to-do list. But in 2019, she succeeded Samuel Santoro, MD, PhD, the Dorothy Beryl and Theodore R. Austin Professor of Pathology who stepped down as chair. She’s busier than she ever imagined, mainly because of the COVID-19 pandemic sweeping the world. “It’s been a steep learning curve, taking over as chair during a pandemic in a department that was instrumental in developing much of the early testing for the state of Tennessee. I’ve had to learn the intricacies of the testing and supply chain issues. Our faculty have done a tremendous job and it hasn’t been easy. It’s a strange time.”
Coogan’s triplets are now 26. George lives in Boulder, Colorado, and is a consultant with KPMG, working on health care mergers and acquisitions. John is an officer in the U.S. Marine Corps, and Anne is following in her parents’ footsteps and beginning her fourth year at VUSM. Coogan led organ recitals for her daughter and her classmates during their first year. Organ recitals involve showing gross organs from autopsies and surgeries to help students understand how diseases affect various organs in the body.
Her son, Mike, 30, is in commercial real estate and beginning a fully-employed MBA program at Emory University and son Tom, 28, is a chemical engineer, also enrolled in a fully-employed MBA program at UCLA.
She’s glad she came out of retirement 11 years ago. “Kudos to Vanderbilt. They said they’d love to have me come back and it turns out there were more things that I hadn’t even thought about doing, that I ended up doing.”