A wide-ranging conversation with the new dean of Harvard Medical School
In January, George Q. Daley ’91 walked through the door of his new office in Gordon Hall and began his tenure as dean of the Faculty of Medicine, Harvard University. The twenty-second physician to take on this responsibility, Daley joins a line of leaders tracing back to the School’s founding family, the Warrens.
A graduate of Harvard University and of HMS, where he followed the Health Sciences and Technology curriculum and also earned a PhD from MIT, Daley did his residency and chief residency in medicine at Massachusetts General Hospital, fellowship training at Brigham and Women’s Hospital and at Boston Children’s Hospital, then pursued a clinical practice in hematology/oncology at Mass General and at Boston Children’s. Since 1995, he has been a member of the HST faculty and, since 2010, a professor of biological chemistry and molecular pharmacology at HMS.
As a leader in stem cell biology and cancer research, Daley helped found the Harvard Stem Cell Institute and has been pivotal to the stem cell transplantation work undertaken at Boston Children’s and at other institutions at HMS. His love of research is deep, so deep that he has decided to maintain his laboratory at Boston Children’s during his tenure as the School’s dean.
Shortly before assuming his new role, Daley talked with Harvard Medicine. In a conversation that ranged from student financial aid to the science pipeline, from diversity to Immanuel Kant, and from research-facilities sharing to fishing, Daley displayed a clear-eyed enthusiasm for the role that he envisions for academic and clinical medicine at HMS.
HM: The School’s mission is to create and nurture a diverse community of the best people committed to leadership in alleviating human suffering caused by disease. That’s a tall order. How do you hope to approach helping the School continue to fulfill that mission?
GQD: I honestly think Harvard Medical School has multiple missions: to excel in fundamental research and discovery, to be an innovator in health care delivery and access to health care, and to continue to evolve how we educate our students to ensure they develop as practitioners who are comfortable with their role at the interface of science and medicine. As I look across these missions, I know I want to make a difference in how HMS addresses all of them.
I think the School has a responsibility to push the frontiers in every field. We’re all about excellence, we’re all about rigor, we’re all about being leaders intellectually. HMS must remain a leader across the spectra of discovery, education, and delivery.
HM: Addressing this multiplicity of missions will require building on a sense of common purpose. How do you plan to promote a collaborative environment among the affiliate hospitals, Quad-based research faculty, the students, and the medical school that make up this multifaceted entity we know as Harvard Medical School?
GQD: If I’m going to promote collaboration and help make connections among the members of our community, I need to know well what is happening throughout the School. Therefore, one of the first things I want to do is commission a review of the science done at HMS, including the basic science and the clinical translation done at the hospitals. I want to know the areas in which our faculty are contributing, not just in fundamental laboratory-based science, but also their work in pushing the frontiers of clinical medicine, discovering new therapeutics, gaining insights in health policy, developing new initiatives in global health, and creating new approaches to regulatory science.
I am a big supporter of collaborative efforts, whether in the lab, the clinic, or the classroom. I grew up within the Harvard Stem Cell Institute. HSCI is a vibrant place because investigators from many different institutions share a common purpose, a scientific mission to advance our understanding of stem cell biology. When HSCI was founded, we also faced an external threat of regulation and funding restrictions, and that, too, inspired us to succeed in our common purpose.
I think science today faces many of these same threats and concerns. So as dean, I plan to start stimulating more opportunities for our faculty to come together around common purposes; common missions; and common intellectual, medical, and social goals. I think we already have common missions around scientific goals, goals that cut across our institutions. If the medical school can provide small amounts of seed funding, convene think tanks and programs that bring together communities so that people can discover the synergies that could exist, we will generate a level of productivity across HMS that will be significantly greater than what our faculty is already doing individually.
HM: That would be a remarkable achievement, given the School is so decentralized. Yet, you have affiliations with the hospitals, the medical school, and with the HMS research community. Do you hope your broad sense of belonging will strengthen your position as someone who can help achieve a greater degree of harmony?
GQD: It is my aspiration. I know it won’t work for everyone, but there are certain areas where there are shared interests, where we can come together—for example, sharing core technologies that might be too expensive for an individual entity to maintain. Our recent work to advance cryo-electron microscopy led to the development of a consortium that includes certain Quad departments and hospitals. Cell-processing and cell-manufacturing technologies that help deliver engineered cell products represent another area in which shared resources could benefit our researchers. Cell processing is very expensive and labor intensive: A centralized core facility shared across multiple institutions could potentially improve our work in these technologies. Chemical screening and the maturation and refinement of chemical matter are other areas where centralized facilities that recognize and exploit economies of scale would make sense. We can do all this at HMS.
We already have a fantastic screening facility and a program in therapeutic science, and we are exploring the idea of an institution for protein innovation. There are advantages to organizing more critical mass around therapeutics development. That’s one of the initiatives I plan to amplify.
HM: And in education?
GQD: I’m starting as dean shortly after the launch of our major curriculum revision. I’m excited to help shape its vision going forward. I think it’s important to make medical education even more formative, to firmly establish principles of lifelong learning that bring together the strengths of science and the strengths of practice. I also think that it’s good that our students get to spend more concentrated time in the hospitals, that they develop a sense of ownership and responsibility for their patients in a longitudinal experience, and that they learn to understand that patient care is a shared responsibility.
I think as we get deeper insights into disease mechanisms, as we fragment diseases into ever more refined genetic subtypes, the ability to understand the way those genes and pathways work will be essential to making accurate diagnoses and prescribing appropriate courses of treatment. I think all this requires a new form of learning, one that makes students comfortable with the interface of science and medicine.
There’s also the delivery aspect of health care that not only needs to become more cost-effective and efficient but also needs to address inequities in access and distribution, whether within our local population or across populations globally.
HM: There is growing activism among students on such issues as improving access to medical care and bringing greater diversity into the medical profession.
GQD: And there should be, absolutely. Part of what I’m most proud of and celebrate among the medical students is that they are engaged. They come to medical school because they want to make a difference, they want to change the world. Medicine is by its nature an unselfish and altruistic calling. The fact that our students bring their idealism with them is part of our great strength. Not only am I inspired by them, I’m expecting them to be activists, to hold me to challenging and high standards—and to hold HMS to those standards. These students are going to lead the world.
HM: Should fostering students’ passion for the profession and the people they serve be more deeply integrated into education at HMS?
GQD: Yes. You know, three or so decades ago, I was in medical school with a guy named Paul Farmer. He spoke his mind; you knew this guy had passion. He was already seeing the world as a very small health care community that he would serve. He has inspired generations. I think we’ve got the next Paul Farmers in our classes right now, just waiting to emerge and flourish. Fostering those passions is one of the reasons we need more resources to support our students. I don’t want the idealistic young student to come here and be passionate about becoming a primary care doctor, then realize they will emerge from school $200,000 in debt.
HM: Many believe that the cost of education also prevents many students from entering a school such as HMS.
GQD: Yes, and I don’t want the best and the brightest students to avoid coming to HMS because of the cost of the education. I think it’s imperative that we raise more funds for financial aid and financial support so that we build a student body that is representative of the communities we serve. I don’t think we should rest until the composition of women and minorities underrepresented in medicine is comparable to the broader community.
HM: What other plans do you have for advancing diversity and increasing the representation of women and underrepresented populations at HMS?
GQD: I’m going to take a very close look at how we’re vetting our medical students, the way we are searching for and recruiting faculty, retaining faculty, and developing faculty, so that I may better understand where the hurdles are for women, for minorities, and for the disabled who seek to achieve success in this community.
I’m also going to establish a task force on diversity and belonging, similar to what has been established at Harvard University. The University task force is taking a comprehensive look at diversity across all schools. Our task force will focus on the issues in medicine that we need to pay more attention to.
HM: What sorts of issues?
GQD: I think we need to focus on the kinds of challenges that face people who want to enter the field of medicine, to get a sense of why young people, for example, choose fields other than medicine for a career. We also need to assess what motivates our students. We need to get a sense of what keeps our faculty satisfied and engaged in academic medicine. And we need to determine why people are leaving medicine.
HM: I’d like to shift focus here a bit to ask about your time as a student at Harvard and HMS. Did you live in Vanderbilt Hall?
GQD: I did! I had a small room with a bathroom down the hall. The room had a couch that was originally a seat from a horse-drawn carriage; something like the jump seat from a car. My room was also right over the dumpster, so I was awakened each morning by the garbage truck—or throughout the night by ambulances. That experience put me on a hair trigger for sleeping, which served me well during my residency.
HM: With all the responsibilities you have already, and those you’ll be taking on soon, do you have time to read for pleasure?
GQD: I love to read U.S. history, but I also love to read economic history. The most influential book I’ve read recently was Dan Kahneman’s Thinking, Fast and Slow. It led me to read a number of books by behavioral economists. They got me thinking in a different way about the scientific method and how it helps protect us from our intrinsic, innate cognitive biases.
In college, I started as a philosophy major and studied Kant. I had a whole tutorial with John Rawls, who was a modern Kantian, on Kant’s Groundwork of the Metaphysics of Morals. I consider Kant to be perhaps the greatest philosopher of all time in terms of his contributions to ethics, moral philosophy, epistemology, and logic.
HM: If you could, would you like to invite him to dinner?
GQD: Yes. And Bacon and Shakespeare. Einstein and Darwin would be two scientists I’d like to share a meal with, too. But I enjoy real dinners with contemporary scientists, too—members of my lab. We organize a lot of social activities, many involving cooking and enjoying good wine. It’s a good way to come together and relax.
HM: Someone mentioned to me that you like to fish. True?
GQD: Oh, I’ve recently discovered fishing! I got into it because it connected me with my two sons. They’ve picked it up; one son is a real student of the sport.
I’m unsuccessful, sadly. But there is a Zen about it that takes me away from the ongoing buzz of everyday life. I relax and I get to connect with my boys.
We usually fish the Charles River for bass, but up in Maine, we do offshore fishing for stripers. We spend hours on the shoreline just casting and looking out at the beautiful coastline.
It’s just wonderful.
Ann Marie Menting is the editor of Harvard Medicine magazine.
Image: John Soares