Complete Fox Wetle oral history interview, recorded 22 March 2023
Terrie Fox Wetle, professor emerita of health services, policy and practice; founding dean of the Brown University School of Public Health
Play audio:
Transcript
Karen Scanlan
Director of Dean’s Events and Communications
Here I am at the end of March 2023, sitting with inaugural Dean Fox Wetle, and we’re going to do a little Q&A to find out some of the history of the school and some of the influence and a lot of the influence that you’ve had over the years. So my first question, Fox, is how was the School of Public Health conceived?
Terrie Fox Wetle
Professor emerita of health services, policy and practice; founding dean of the Brown University School of Public Health
Well, I have to say that Vince Mor came to me. I was at the National Institute on Aging, and he said, ‘Have I got a deal for you?’ This is Vince Mor. And he was recruiting Richard, my husband, to be the director of Geriatrics and the head of the Gerontology Center. And he said, We want to build a program in public health and I think we can build a school and you’re the person to do it.
So he had a vision. Vince and I had worked together before when I was at Harvard, and he was here at Brown, and I just loved his energy and his ideas. So I came to work here. Don Marsh approved the recruitment, and I reported to him as the Associate Dean of Medicine for Public Health and Public Policy. We began the first of a strategic plan to plan, actually, and then we did a strategic plan.
And since there have been, I think, two or three more. But I also, in addition to working with the dean of medicine, was also working with the provost because it was important, of course, we were within the medical school, but it was important that the university also understand and approve the School of Public Health. The reason that Vince was excited and the reason that I came was that there were several building blocks in place that were very strong and important.
There were several centers, the oldest of which was the Center for Alcohol Addiction Studies, and then the Gerontology Center, the Center for Gerontology and Health Care Research, and those centers, there were 11 or ten at the time that were there. There were also two programs, one in epidemiology and one in biostatistics. There was the nascent M.P.H. program that only had two students and was just getting started.
And there was the Department of Community Health, which was within the medical school, and that had ten tenure track faculty. I was the 10th when I arrived. And so those were kind of the building blocks to begin to say, What do we need to be a school? We had a very strong research portfolio. We had a building educational portfolio, we had some service activities, but I knew those had to be grown.
So that was the beginning. And I have to say that through this process I had five deans of medicine to work with over the years. It took 17 years.
Karen
Who was your favorite?
Fox
Well, of course, my husband was one of the deans, so he had to be my favorite. But also three university presidents, five provosts. So it took a lot of reeducation and education, if you will, of the senior administrative staff, who were always supportive, but always concerned. I mean, at the time that we became a school of public health, we accounted for 48% of the medical school’s external funding. And so there were disincentives to us becoming a school to work with some of our partners.
But in the end, they all were supportive. And it happened in 2013, we had a wonderful celebration of the approval of the corporation and we were launched right in 2013.
Karen
So roughly it took about, well, 30 years of, you know, real constructive work towards the School of Public Health and, you know, who were the original architects?
Fox
The original architects for the school. I’ve mentioned some of the senior administration up the hill who were involved. But I have to say that within the school we had developed four departments before we became a school. And so the department chairs at that time were Vince, Constantine Gatsonis for Biostatistics, Steve Buka for epidemiology, and Peter Monti in the beginning and later Chris Kahler were the academic leaders. And then we had the directors of the centers, of the various centers that were involved. And then we had the leadership of the educational programs. And so I have to say that Patrick Vivier, who was a major force in bringing our MPH program into its first accreditation and several accreditations after that, was a real partner for me in helping to build the master’s programs and educational programs.
So those were people, I have to say that we also had administrative people who were very important. Linda Laliberté was my right hand person for administration and finance. Karen Scanlan was very important to me in our work, in publicizing, as well as the development of many of our external program activities. Catherine Nellis was very helpful in our development and fundraising.
And so those were, Jill Paynter was my assistant for a very long time and then Kate Ellis. So we had a really important team of people and I, people sometimes laugh at me, but when I was asked about how I wanted to structure the School of Public Health, I always said I wanted it to feel like a family.
I mean, we could have squabbles in the family, as people do, but we always respected each other and the roles that we played; that when we had differences, we tried to settle them internally if we could, that we supported one another’s work, that we could be competitive in a positive way. But that really we were collaborative and that worked, I think, really well for us to build a school that was kind of punching above its weight for a long time.
I mean, early on we were in the top ten for NIH funding among schools of public health. I think we’re now six. It didn’t take long after we were a school for us to begin moving up in the overall rankings. And I also think that was because we had a very strong undergraduate presence. We’ve always been vertically integrated. We’ve always played a role on the campus, both at the administrative level but at the educational level. We invited undergraduates into many of our graduate courses. We supported their research activities, their honors thesis. All of our faculty viewed teaching undergraduates as a part of their responsibility, and so that undergraduates felt welcome. And in fact, they became among our strongest MPH and doctoral students as we moved forward. And they were the most diverse group, so it helped us with our diversity goals as well.
Karen
So Fox, you mentioned family, and that sort of brings me to the question about, you know, what is unique about the School of Public Health, in your opinion?
Fox
Well, part of the specialness of the Brown University School of Public Health is Brown University. I mean, we have incorporated the mission of the university into our own fabric. So we believe that it is important to help develop individuals who have strong purpose and who serve the community and who have a moral center. Also, Brown’s curriculum has a long history of being student self-directed, and what used to be called the new curriculum, which is now very old.
But we also adopted, to the degree that we could, that the students in our program, undergraduates and graduates, would be able to direct their own path, that would match their career goals, that would provide them both educational background and skills, but practical experience that would help them to pursue their own goals. And that individual lived learning experience is very important to us.
Another piece that made her special, and that certainly when we asked folks why they chose us and not another place where they’d been accepted, was we had a very high professor to a low student ratio, or that every student had access to faculty and that the faculty felt that a strong part of their responsibility was their student contact.
In fact, in the letters of offer that we made to faculty to come join us, there was—and this was unusual—I’ve taught at other Ivy League schools, this is unusual. It had a strong statement that in addition to your research and service, teaching and student contact is a very important part of your duties and you will be judged on that.
But I don’t think we even had to have that kind of language. It was just that the ethos here is that we involve students. I mean, in all of my research projects, I have involved students, often undergraduates and many graduate students. In my teaching, I’ve involved students. It’s just been, and it’s not just I, but it’s how we view it. It’s important. Patrick was the one who developed kind of the mission statement for the MPH program, but as you know, learning public health by doing public health and in order to do that, you have to have contact with the people that, not just in the community, but the people who are doing public health research and our own service here within the school.
Karen
Okay. Fox I’m glad you brought up students in general, and I’m going to shift to ask you a really hard question. Can you give me an example of a student who touched your heart? And, you know, I know there has been Chima, there’s been Angela, Larry Warner, Khalid. I mean, just so many. And I’m going to ask you a tough, tough question. Who touched your heart?
Fox
Well, first of all, so many, and I’ve always said I’m not supposed to have favorites. But there are students who have been in special circumstances, particularly touched my heart. And you mentioned one, Angela, and I’m only using first names so I don’t embarrass anyone. But Angela was a PLME, she was admitted as an undergrad and was going to come to medical school and she decided to do an MPH between and I became her advisor and she decided that she didn’t want to go to medical school but rather to do public health.
And she was when she was here, as a student, and has become an absolute star. And she’s worked for government, she’s worked in the private health industry. She is amazingly brilliant and creative and an excellent manager, and she’s the kind of student who just gives you joy because every time you talk with her, she’s got new ideas and is supporting others.
And it is and my particular joy is that she brings her two little girls through my house about once every few weeks and we play. So that’s special. Another student who touched my heart is Khalid. When the Syrian war refugee situation became horrible, Rick Locke, the provost at the time, called me and I went up to his office and he said, ‘Fox this is horrible, what can we do?’ And we talked about bringing faculty here and we talked about bringing students. And I said, I think we could host students in our program. And he said he would help support that. And so he reached out and brought two faculty people. And then in another year, additional faculty, and we reached out and brought an MPH student and then next year another student.
But Khalid arrived. I remember interviewing him via Zoom. One of my first zooms ever, and he, I believe, was in Turkey at the time. He had been imprisoned in Syria and tortured. He’s a physician. He was at the time trying with the W.H.O., was trying to immunize more than a million children and young people for polio in Syria where there was an outbreak.
He was working on building underground hospitals that would be safe from shelling. And he came to us. He, on this interview, said he wanted to do an MPH program so that he could improve his management skills of those programs, but also to do research to prove their effectiveness. And he arrived and with his delightful wife, Jihan, who is also a physician and also a table tennis champion, I mean, she’s just an amazing person.
Anyway, they arrived. We cleaned out our basement of furniture so that they would have in their apartment a nice place to be. Over Christmas, he went to Turkey to help work on his hospitals. And Jahan stayed with us for part of the time. And he was not allowed to come back to the U.S. because there’d been an election and some other things.
So we worked very hard and we found him another master’s position. I reached out to all the deans of public health in Canada that I knew, and he was invited to Toronto. He finished that degree. He’s now working in international work. Jahan is doing her residency training and they have two lovely little kids. So he touched my heart. Here was this person who had been, his own government had imprisoned him and tortured him for trying to provide medical care to pregnant women and children. And he could have been cynical and angry and resentful. And he came with just an incredible open heart, you know, these big blue eyes that you just fall into, with this adorable wife and such love and such giving.
I mean, the students loved him, the faculty loved him. And we were heartbroken when our immigration would not let him return to the U.S. So he’s another special case. I mean, I just, there’s student after student who have something special you don’t know their story untill you talk with them and then you find out their personal stories led them into the arena of public health and it just makes you proud.
Karen
Fox There’s so much that’s happened at the School of Public Health in ten short years. I just wonder how we look at the future and sort of, what advice do you have for future leadership at the school and in developing this beautiful school even more?
Fox
Well, first of all, it’s a very different place than when, well, when I arrived it was very little. But the school has had tremendous growth. I mean, we have more than 400 faculty now. I mean, it’s amazing how we have grown and I believe that in different periods of an organization or a school’s development, different kinds of leadership are most appropriate. I think one of the nicest compliments I ever had was from Constantine Gatsonis, who said to me, ‘You were the dean we needed then.’
And I knew that he meant it in several ways. But I believe now that there’s a different kind of leadership than I gave. I was kind of the mother who grew this, and now the school is large enough and complex enough that it needs an organization that is more complex in order to run it.
I think the advice and the advice I gave Bess Marcus and the advice that I gave Ashish Jha and the advice that I gave Ron Aubert is to work to understand the history and culture both at the school and at Brown, because there’s something very special there that we need to honor and that it’s a distinguishing characteristic of the school from other schools of public health.
And it doesn’t mean that we have to stay the same. We will evolve and change, and I am enthusiastically supportive of that evolution and change, but always, I believe there should be an understanding of that core culture, an ethos that helped spawn us and made us strong. And I was an outsider who came in. I came from NIH and discovered that Brown is a very different place than other institutions that I had worked in.
But I came to value the fact that faculty meetings are New England town halls. I came to value that faculty in every department on the hill believe that they have an investment in and something to say about how the school develops. They approved it. They had to vote to approve it and still care about that.
Students feel, and they should, that they could move fluidly from classes in the social sciences and hard sciences on the Hill and public health move back and forth with ease. And those are values that I think are important to keep in mind as we undergo the kind of growth and change that we are. I am thrilled at the quality of the faculty that we are recruiting. I mean, they are just stellar. It’s so exciting to go to the faculty meeting and to see the new faculty introduced. But I also hope that with that growth, with the continued and perhaps growth and excellence that we maintain, you know, keep in our rearview mirror, that we come from a very important place. And to keep that in mind.
Karen
What inspired you to go into public health in the first place?
Fox
Yeah, I trained first as a psychologist and then in urban studies, in gerontology. I’ve always been interested in vulnerable populations. I worked, I did training at veterans hospitals with very old and very vulnerable older veterans, and then started my research in nursing homes. And I saw how important population health throughout the lifespan is for the condition of people at the end of life, that many of the conditions that I saw people suffering with at the end of lives were consequences of, you know, war injuries, or smoking, or alcohol abuse, or poverty, you know, throughout their life.
And I was working at the administration on aging as a social policy analyst, a grants officer, and had the opportunity to go to Yale to work in the School of Public Health as the director of their program in long-term care administration. And I saw what the opportunity was to train future generations of health professionals who would have an understanding of both aging and population health and how those intertwined, you know, that public health wasn’t just chronic disease, but it was really understanding aging.
And after two years there, I left to go to Harvard on a fellowship, and there grew my interest in how research on populations could help us better understand and develop interventions. So it was exciting to me when Vince raised the opportunity to first develop a program in public health and then a school of public health here at Brown, that I could work with others in putting into place what I thought were important opportunities for students and researchers.
And it’s just been an amazing career. Public health is so exciting because it spans the most basic of basic sciences. You know, viruses and pandemics and then moving along to the social determinants of health that you have this broad view of the political influences, the economic influences. It’s so rich and it’s such a fun place to be, to learn from your colleagues and from your students because they do such interesting work that you do every day.
When I was dean, every day someone would come in and talk about their science and I just get excited and think, Well, what’s that? Would that be fun to do? And it is. It’s fun.
Karen
I want to know what was it like being a woman in the health sciences when you started and became a leader and were really probably one of the few. Can you talk about that?
Fox
Sure. When I was an undergraduate, I got good grades and I was pre-med, and our, the director of the anatomy class was the person who wrote all the medical school letters, advice letters, reference letters. And I went to him with all my materials and he said to me, ‘Girls like you don’t go to medical school.’
And shame on him, but shame on me for believing him. And I switched my major to psychology and I graduated and then went to graduate school. And I look back on that now. I mean, I’ve loved my career, I’ve loved my work, but I look back on that now and hope that no other young woman has to face that, and I’m sure they do.
When I was at the VA hospital, I looked very young. My white coat was too big. I had to roll up the sleeves. I’d walk in and they’d think I was a candy striper volunteer. I mean, it was hard. But over time, when I got to a nice age, it was not unusual, as deputy director of the institute, to be the only woman in the room. And I learned some skills, I think, to handle that in a non-aggressive way. But by listening to be sure that when I spoke, I had something to say. I used humor because it would disarm some of the, I think, misogyny. But over time I’ve seen the world change and I’ve seen that my daughters have a much different view of what they accept, or is reasonable, or what they believe are opportunities for them.
And in the world, I don’t think it’s perfect, but I think that there is a higher awareness, at least of what is inappropriate to say. I don’t know what people think. I myself have been very supportive of diversity initiatives both in the school, but around the country, because I know what it feels like to be someone who’s not taken seriously because of their size with their gender, or that their voice is too high or whatever.
And I want to help people. I want everyone to feel comfortable in the workplace, in the educational setting, so that people can reach their full potential and their goals. I mean, different people want different things, but I’ve always viewed my role as a mentor to help people see opportunities and to identify clearly what they want to do and then to help them do that.
Karen
So I’ve gone through all my questions, and I think your succinct answers were just fantastic.