Nancy Andrews Interview, January 10, 2019

Abstract

In the January 10, 2019 interview, Andrews discusses her transition to deanship at Duke; promoting inclusion and diversity; Duke’s characteristics as a younger institution; continuing research during deanship, specifically iron research and iron disease patients; achievements as dean; concluding term as dean; ongoing contributions to Duke including supporting new dean, Mary Klotman; and reflections on scope of dean responsibilities and the importance of a supporting team.

Interview

Interviewee: Nancy Andrews
Interviewer: Joseph O’Connell
Date: January 10, 2019
Location: Nancy Andrews’s office, Nanaline H. Duke Building, Duke University Medical Center

Joseph O’Connell: 00:00 And I’ll say something briefly to identify who we are. My name is Joseph O’Connell, and I am interviewing Dr. Nancy Andrews and we’re in her office right now. It’s January 10th, 2019 and this recording is for the Duke University Medical Center Archives and Libraries’ oral history program. So last time we talked, we left off with your last position at Harvard, and I believe that was the Dean for Basic Sciences and Graduate Studies.

Nancy Andrews: 00:40 That’s correct.

O’Connell: 00:42 And you were in that right role from 2004 to 2007, and then you made a transition to a new role. Can you talk about how the opportunity to take the position as dean at Duke–how did that come about?

Andrews: 01:03 Certainly. So, I think that I probably had some visibility nationally among institutions searching for deans. I had inquiries from several of them before Duke and felt that it would be good to move from Harvard. I had been there for 27 years. And it’s in my view better not to spend your whole career in one institution. But at the same time, I would only move for the right opportunity. I had actually never visited Duke before I came down for my interviews, but I knew about it by reputation and so when I had a call from the search firm and from people at Duke, I did come down to look at and was very impressed with what I saw.

O’Connell: Okay. 01:57 Can you describe that first visit? What was going through your mind?

Andrews: 02:01 Wow. You know, I think it struck me as a very big place, full of energy. It’s much more spread out than the northeastern campus I was used to, and everyone seemed very friendly and in a sense hungry for making a great institution even better. Very welcoming.

O’Connell: 02:31 Yeah. And so that seemed like a good fit for you.

Andrews: 02:35 It did, you know, it was a big move because I had never lived in any other part of the country besides the northeast, but it felt like the right place.

O’Connell: 02:50 Yeah. Did you have any concerns about the sort of cultural differences of living in a different region–?

Andrews: 02:59 Not– you know, I think, having grown up in the northeast and sort of becoming aware of national events in the mid-1960s, I had heard a lot of things about the south and what was going on here during the civil rights era, I guess, in the 60s. And so I had some general concerns and prejudices about the south, but I think those were put to rest pretty quickly by finding out that this was a very open, forward looking diverse and as an institution and probably as inclusive as any place that I had known.

O’Connell: Yeah. That’s interesting. So, what you saw here fit the kind of environment that you–fit your idea of the kind of environment and you wanted to be in in terms of diversity.

Andrews: 04:10 Yes, yes. Or at least it, you know, I don’t think that environment really exists yet, but at least it was on its way and continues to be on its way.

O’Connell: 04:22 It seemed like a place where progress could be made toward that.

Andrews: Yes. Yes.

O’Connell: Were there other tangible things either about the position or about Duke as an institution that made you think this is the one, this is the opportunity that’s worth uprooting for?

Andrews: 04:38 I saw a lot of potential in the faculty and in the students and some of that had been realized already, but there was more to do.

O’Connell: 04:51 Yeah. Do you want to, mention any particular examples?

Andrews: 04:55 Wow. It’s been, I guess it’s been almost, well about 11 years since I first came down. And so it’s a little hard to remember, but there was plenty of room for building new buildings. We did a little bit of that and for developing new programs and we did some of that also, working from a great sub straight of terrific people.

O’Connell: 05:28 Yeah. Okay. And I noticed that you were interviewed by several national publications shortly around the time you became Dean here. Did you know that taking the position here would put you in the public spotlight in that particular way? At the national level? And in the mainstream media.

Andrews: 05:50 I didn’t really expect it at that point. I mean, I saw it as, you know, taking a different administrative role. Duke made a big deal out of the fact that I was the first, and at the time I stepped down, still own the only ever a woman dean of a top 10 medical school. My successor Mary Klotman is the second and still only, at this point. But, and I guess that grabbed a lot of national attention. I hadn’t really thought about that before taking the job.

O’Connell: 06:30 Yeah. And were you excited about being part of that conversation or did it–I mean, it took you by surprise, but was it a pleasant surprise or was it uncomfortable?

Andrews: 06:41 It wasn’t really uncomfortable, but it was a disturbing in that in 2007, when some other fields had made a lot more progress, medical school, academic medicine in general, was kind of behind the times. And there had been women deans at other medical schools for at least a decade before. I can’t remember exactly. But what got the attention was it was other schools that people felt were not like Duke. And I think the proportion of deans who are women is still relatively small. It hasn’t improved all that much. So it’s clearly a symptom, I think of, a bigger issue in academic medicine, but–so I don’t think it really made me uncomfortable as much as just sorry that more progress hadn’t been made.

O’Connell: 07:44 Yeah. And was that a turning point for you in thinking about diversity and inclusion as one of one of your objectives or had that already been something you were working toward and, you know, already thinking about?

Andrews: 07:59 That was in my DNA my whole life. You know, I think that it was always something that was important to me, important to my parents, my grandparents. And so it was something I grew up with, both in terms of thinking about diversity of gender, but also diversity of race and nationality and ethnicity.

O’Connell: 08:25 Right. And before you were at Duke, what sort of–bringing that perspective to your work at Harvard,

Andrews: At Harvard?

O’Connell: What were some of the things that you did to try to foster sort of change that you wanted to see? In terms of the makeup of the students or the staff?

Andrews: 08:47 At Harvard?

O’Connell: Yeah.

Andrews: The kinds of things that I did were to sometimes set up special meetings with faculty. So my primary domain there was, in my last role, was the faculty in the basic science departments. And so I set up meetings with junior faculty members, who were women or I think there was only one at that time who came from a racial minority group, and tried to figure out ways that I could help nurture their careers. I set up a group of women faculty members that met about every six weeks with no strings attached. It was just drop-in and come talk if you listen to, and it gave the women not only a way to meet and get to know each other because coming from different departments that wasn’t a given, but it also I think help people realize that they had shared experiences.

Andrews: 10:01 I shared many of those experiences, and gave them ways to talk about strategies to deal with disadvantages.

O’Connell: And would you be willing to say a little bit about what the disadvantages was that you observed or that you experienced?

Andrews: Yes, sure. So they’ve been the same for a long time. And in the late 1990s, MIT where I did my PhD work, although this was after–well after I finished that–did a study initiated by some of the women in its school of science looking at disadvantages that women faculty had and they included salary. You know, I think it’s been known for a long time that, in most fields, and it’s true in medicine and science, women tended to have lower salaries than men at the same rank. It included the amount of lab space, that women faculty had versus men, the amount of administrative support, the likelihood of being put on important committees instead of unimportant committees. And I experienced all of those things. And you know, I think that hopefully it’s gotten better, but those kinds of disadvantages were ubiquitous and still are pretty prevalent. And I think that it was a real awakening for me to read the MIT report and realize it wasn’t just me. And so I–that was the kind of shared experience that in this group we could talk about and try to find strategies to fix.

O’Connell: 11:55 Okay. So part of your thinking was that rather than just face these obstacles as individuals you could actually come together and acknowledge what was going on and work together in some way—

Andrews: Yes.

O’Connell: To kind of create the kinds of changes you wanted to see.

Andrews: And make noise.

O’Connell: So there’s an activist dimension to this group.

Andrews: Yes. Yes.

O’Connell: What were some of the ways that you lobbied the administration or–?

Andrews: 12:21 Well, so I was the administration. So I tried to help keep very close tabs on salaries to find inequities and fix them. And it’s something I did at Harvard, something that I did as dean at Duke. And what became apparent was that over time the salary inequities even if you fix them can redevelop. And so you’ve got to keep watching all the time to make sure that they don’t pop up again. And it takes extra effort. But of course it’s important. I remember approaching the head of one of the Harvard hospitals who I knew quite well. Right after the MIT report came out. So I don’t remember which year it was, but it was late 1990s, and I asked him if women’s salaries in his hospital were lower than men’s. And he said yes. And I said, are you going to fix it? And he said, we can’t afford to, an answer that I found a little shocking. I mean, it’s practical. It’s true that it’s not easy to put the money in to do it. But I was really surprised that he not only knew it existed but wasn’t trying to make a change.

O’Connell: 13:41 They had documented it.

Andrews: Yes.

O’Connell: And publicized it and yet they felt that they were—

Andrews: 13:46 They hadn’t publicized it, but I knew because I knew him quite well, and I knew that the hospital quite well.

O’Connell: 13:54 Right. So kind of keeping constant vigilance and keeping constant pressure on certain people to address those issues.

Andrews: Yes.

O’Connell: That makes sense. Yeah. When you arrived at Duke, what else did you see going on here that you felt like the school was doing right? And what did you think needed to be changed, just broadly speaking? Not only in terms of inclusion.

Andrews: 14:26 I thought that, the science was even stronger than I had expected coming in. I didn’t know very many scientists here. And by science, I’m speaking broadly from everything from test tubes to doing clinical studies. And so I was surprised by the strength of research here but also that word hadn’t really gotten out. And so one of the things that I wanted to do was to try to give more visibility to the great things that were going on here. I thought that, I guess another thing that struck me was that in contrast to Harvard where there were hundreds of years of tradition, Duke was much younger school. And while there were decades of tradition, the school didn’t seem as bound by having to do things the way they always had been done in the past. But was more agile and more nimble in making changes and accepting changes. I think one of the, which I saw I was a very good thing, one of the negatives or the only one that really comes to mind is, and maybe it goes along with being young and with not having at that time the recognition that it deserved, I thought that people were hard on themselves and on others in their judgment of how someone was doing. It was more likely at times to hear negative reports then to hear the positives. It wasn’t as balanced as it might be.

O’Connell: 16:25 Yeah. What do you attribute that to?

Andrews: 16:28 I’m not sure. You know, I think it may have to do with having been relatively isolated. There’s UNC nearby, which of course is a great university, but without as many local places to compare to as there were in Boston, I think it’s both easier to, it’s easier to develop a unique culture and part of that culture was we got to keep working really hard to get better, and we’re not doing well enough yet.

O’Connell: 17:06 Uh huh. Okay. Yeah. Well, this is a heavy handed way to put it, but almost like an inferiority complex.

Andrews: 17:12 I think so.

O’Connell: 17:14 Um, or at least, you felt like people could be taking more pride in what they were doing—

Andrews: 17:19 Yes. Yes.

O’Connell: 17:21 The institution could have a stronger sense of self pride than it did.

Andrews: 17:26 Yes. And, you know, ideally not so much that it gets lazy, and people aren’t always trying to be better, but I thought there could have been more positive reinforcement.

O’Connell: 17:43 Yeah. I’m curious about, you know, the difference in the sense of tradition at Duke versus maybe a Ivy League school that has a longer history. What–do you have any examples of what, of what you mean when you observe that difference?

Andrews: 18:05 Well, when I was in the Dean’s office at Harvard, people would come and say, you know, we want to do this new thing and it would be an interesting thing. But very often the answer that they got back and that often I was in a position that I had to give was we can’t do it because we’ve always done it this other way. And there wasn’t that sense here. If there was a great new idea, we’d try it. And I made it a very deliberate point when I came here of, instead of feeling like I had to say no as I did too often probably at Harvard, saying we’ll find a way to get to yes.

O’Connell: 18:54 Yeah. And in some ways the culture of the institution allowed you to take that approach.

Andrews: 19:01 Yes, yes. Which I think is great and it gave us capacity to do a lot more. You know, there probably was a bit of a difference between the school and the health system. I think, you know, I was responsible for the school. My sense of the health system was that there, it wasn’t as easy to change approaches. It had had a lot of inbreeding in its leadership for a long time. And so I’d say that the culture of this is how we do things was stronger there.

O’Connell: 19:43 I see. Yeah. Is there a particular instance of somebody bringing an idea to you and you thinking, you know, the Harvard part of you saying like, no, but then the Duke part of you saying, “Hey, wait a minute, maybe there’s a way to do this.” Can you think of any particular cases of that?

Andrews: 20:02 Well it’s not in a perfect fit for that, but not long after I got here, the general economy crashed and money was very tight. And we went ahead anyway and built what’s now the Trent Semans Center, the new education building. And I think the fact that we could move forward was partly due to a wonderful gift from the Duke Endowment and then other gifts from alumni and friends, which ended up paying almost completely for the building. But the fact that we could even consider building a new building during depths of the economic downturn was kind of exhilarating, and it wasn’t exactly that, you know, anyone was saying no, no, you can’t do it. But I think we could take that risk. And it worked out very well.

O’Connell: 21:04 Yeah. That sounds empowering to not have to sort of just obey the economic climate of the time.

Andrews: 21:11 Yeah. And we continued also hiring new faculty members when many other institutions stopped. They were worried about their finances. We were worried too, but we found ways to cut costs so that we could hire the people who were outstanding but not easily able to get as many job offers as they might have at another time.

O’Connell: 21:38 Interesting. So that almost became an opportunity for Duke to build its faculty at the time that other schools were slowing down and being more conservative. Yes.

Andrews: That seems like it would be a real leap forward, just that moment for the medical center here–just having being able to keep going at a fast rate.

Andrews: 22:03 I think it was important.

O’Connell: 22:05 Yeah. And am I correct in thinking that you brought your research to Duke when you became Dean, too?

Andrews: Yes.

O’Connell: Okay. And was that a given or was that a conscious decision that you made?

Andrews: 22:22 It was, well, I’d say most deans across the country stop doing research either before or at the time they became dean. So it’s unusual, but it was important to me to keep going. I don’t think I would have considered a dean job where someone said you can’t.

O’Connell: 22:43 Where were you in your research and why did you have that drive to keep doing it?

Andrews: 22:49 Mostly because it was a lot of fun and we were making progress. I’d had a very large lab towards the end of my time in Boston, probably for the last five to seven years in Boston. We were quite big and only four people moved here with me. The others either went to other labs to stay in Boston or finished up what they were doing and moved on to their next step. So the lab here was much smaller, but there were always plenty of ideas to things, ideas of things to do, and energy to do them. And so we hadn’t finished answering the questions that we were asking.

O’Connell: 23:37 Right. And what were the questions at that time?

Andrews: 23:40 Well, our overall question was to understand or overall problem we were trying to solve was to understand diseases related to iron. And there’s sort of two, three general groups of diseases: when the body has too little iron, when the body has too much iron, or when the body has the right amount, but it’s not in the right places. And we, in a variety of ways, tried to work out how those different classes of diseases were caused, mostly using mice but also sometimes doing studies with human patients, including patients that I had seen in clinic myself. And so we didn’t have all the answers yet, and we just wanted to keep going. You never have all the answers, but there were still some big open questions that we wanted to help answer.

O’Connell: 24:40 Yeah. So it was–it was really about trying to get a better handle on these iron related diseases.

Andrews: 24:48 And knowing that we had tools that could help us and help others as well. We distributed them to anyone who wanted them, but to try to make progress.

O’Connell: 25:02 Yeah. And it strikes me that you described lab work as fun. Probably not everybody finds it fun, but what do you find fun about it?

Andrews: 25:14 I think it’s just the essence of it is knowing that you’re learning something or seeing something that nobody has known or seen before. It’s very exciting, and also labs are very social places. I remember when I was young people would say, “oh, you don’t want to work in a lab. You’re more of a people person,” or “you’d rather do something with people.” And in fact, the community in a lab is as intense and interesting a social environment as you’ll find anywhere, or at least in the labs that I know.

O’Connell: 26:00 Yeah. Do you think that you set up your labs to foster that community at all–?

Andrews: 26:07 Yeah, definitely. You spend so much time there. I mean, people work really hard in labs and unless you enjoy and enjoy personally and, collaborating with the people who are around you, it’s a lot harder to go to work every day.

O’Connell: 26:27 Yeah. Do you, do you have any stories that sort of illustrate the kind of social atmosphere of the lab or anything that would be unexpected to somebody who was not familiar with working in a lab?

Andrews: 26:42 It’s hard to say.

O’Connell: If nothing comes to mind, that’s ok too.

Andrews: Nothing immediately comes to mind.

O’Connell: I think it’s interesting, as somebody who hasn’t worked in a lab, it’s interesting to me what that experience is like.

Andrews: 26:58 Well it’s, there are huge highs and very deep lows, and I think that the society of the lab helps people get through them.

O’Connell: Yeah.

Andrews: There can be bad things too, like competitiveness and, you know, people who aren’t fitting in well, but at least in my own lab that was rare.

O’Connell: 27:23 Yeah. And so, did you feel like you made the discoveries that you hoped to make in the science that you were doing at Duke?

Andrews: 27:37 I think we got, we finished and in a sort of big picture way what I wanted to get done. There’s always more to do, and they’re always more interesting questions to ask. But we got a lot of it done.

O’Connell: 27:55 Yeah. And is there a way to sort of summarize the conclusions or the applications, or is that still really something that you see as ongoing, and that other researchers are taking up?

Andrews: 28:06 Well, it’s definitely ongoing and people around the world are continuing, but I think the big questions were, “how do three particular diseases come about?” One of them is a disease of too much iron called hemochromatosis. And we, and others, went from knowing nothing about how it came about to understanding a lot of what’s behind it. Still not everything but we had a big role in that. Another is a disorder that we named iron-refractory iron deficiency anemia, which is too little iron and it’s not only iron deficiency but it’s inherited iron deficiency. So we knew that there had to be a gene responsible. And we went after it and found the gene, and I first got interested in that hearing about patients who had inherited iron deficiency. But then I think really got hooked on it when a patient walked into my clinic at Boston Children’s hospital. 29:21 And both he and his sister were affected, and I really wanted to figure out what was going on, and we did actually very shortly after I came to Duke. And then the third one is I wanted to understand something that’s called the anemia of inflammation, a kind of iron related anemia that people get when they’re, they have a chronic infection or cancer and other chronic disorders. And a lucky insight helped us contribute a lot to understanding that.

O’Connell: Okay, what was the lucky insight?

Andrews: Oh, it’s–the lucky insight occurred in Boston, although we continued after that. But it was realizing that a patient with a very rare disease had a picture that looked like this anemia of inflammation, but the problem wasn’t due to inflammation. And so we made a guess about what might be going on in him and proved that we were right. And then could generalize that to understand the disorder more broadly. Again, a patient that I took care of myself.

O’Connell: 30:42 Wow. So a lot of your ideas really came from these encounters with individuals?

Andrews: 30:46 Yes. And I still get asked from time to time–it used to be very often, now it’s just occasionally–about patients with unusual iron diseases from around the world.

O’Connell: 30:58 So other physicians will track you down and say, “Have you ever seen anything like this before?” And that’s ongoing.

Andrews: 31:07 Yes. It’s, you know, now maybe it’s every few months. At one point it was probably at least once a week.

O’Connell: 31:14 Yeah. How often are you able to give them insights?

Andrews: 31:17 Hard to say. Sometimes I can say I think the diagnosis is such and such, but most of the time what I do is I suggest other ways that they can do tests or other questions they can ask the patients that may lead them to a diagnosis.

O’Connell: 31:39 Okay. So giving them some diagnostic tools.

Andrews: Yes.

O’Connell: Yeah. Okay. Yeah. So have you seen–I think you mentioned this yesterday–that one of the biggest impacts of your research that you’ve seen is really just being able to identify what’s going on with a patient.

Andrews: 32:03 Yes, yes.

O’Connell: 32:06 Not necessarily the treatment path itself. Is that—

Andrews: 32:09 I think that’s fair. Others have picked up on our work and used it to develop treatments. But I think our focus was always on the understanding, not as much on the translating, although we were involved in that too.

O’Connell: 32:24 Yeah. We need to be able to identify what’s going on in order to treat it.

Andrews: Yes. Yes.

O’Connell: That makes sense. And I believe that you decided to close down your lab or to cease doing research before your dean, your term as dean was finished.

Andrews: Yes.

O’Connell: And I think I read that maybe that had something to do with the funding climate or–can you talk a little bit about the decisions that went into that?

Andrews: 32:51 Yeah. So I stopped taking new people into my lab around the time I started my second five-year term, because it takes a while for people to finish their work and go on to whatever else they’re going to do. And so I very deliberately started to, or stopped taking people and let the lab get smaller and smaller until we eventually closed. I knew I wanted it to close before I finished as dean–my second term. But there was no particular deadline or a particular date. I also stopped applying for grants at the same time and just let the things that I had finish. I think that the main reasons for that were first–and actually they all have pretty similar weight. But the first one that comes to mind is I wanted flexibility after I finished so that if I went and did something completely different I wouldn’t have to worry about moving people in my lab or having a graduate student who was halfway through have to figure out how they were going to finish. Na: 34:06 Second reason was the funding climate, not so much for me personally because we were able to get the funding we needed to do our work, but thinking that just generally I had other things I could do, but young people starting out needed the funding more than I did. And so making it available on a small level by not taking it myself. And then the third thing I think is I’ve seen some scientists who try to continue for too long and their work just isn’t the same. And I figured I’d rather go out on a high than on a low.

O’Connell: 34:49 Yeah. So you chose to step back from that side of things while you felt like you were still doing your best work.

Andrews: Yes. Or at least good enough work.

O’Connell: Okay. And I imagine that must’ve been pretty emotional to leave that behind, especially since, like you said, it was a source of community, and what was that like?

Andrews: 35:16 It was sad, but it happened over years, not days or months. And I think that made it easier. It was still very sad and I miss it. But what I realized was that I could still think about science and suggest experiments to other people and stay in touch even if I didn’t have my own lab. And so I think the last day was very sad, but having had a long time to make the decision and then let it play out helped.

O’Connell: 35:54 Right. Yeah. Well, I have more questions about that topic, but I think I’ll move on because I want to make sure that we stay within our time limits. I think I’d like to ask you next sort of about, just in general, about the things that you’ve achieved as dean of the medical school. I have a list of some of those. 36:27 Which you’re welcome to look at it if you want.

Andrews: I might need notes.

O’Connell: 36:31 But essentially I think that you were able to bring about quite a few new facilities, departments, research initiatives. Which of those–are there particular 36:51 facets of your achievements that you’re most proud of or particular projects that you think, you know, “that was really great.” Like “that was, that was a big success for me.”

Andrews: 37:04 Well, I think the things that come to mind, I mean, the first thing that comes to mind is, any great institution is defined by its people. And I think that we brought in–during my time, I recruited 21 new department chairs, and hand picked them with a lot of help from search committees and for the most part got really outstanding people. And those are the people who shape the institution and will into the future. Also some terrific vice deans including people who hadn’t really seen administration in their future but had a lot of potential and could grow into a job that gave them a new opportunities afterwards. So I think the thing I’m probably most proud of, although I can’t even begin to take credit for it by myself, is that the group of people that we managed to assemble, and terrific faculty members, terrific students also recruited during that time.

Andrews: 38:19 I think the things that were especially fun, included–and this is one of those things that would have been really, really challenging at Harvard but was not here–we started, in around 2010, 2011 as a pilot, and then we went straight into doing it full force–we started a program called the primary care leadership track, which is a small part of the medical school class. Students who self-select as they’re applying because they’re interested in becoming leaders in community health and finding new ways to improve community health. So that was wonderful to see that go from being an idea–probably around the time I came I started thinking about it–but really grow into a mature idea around 2009, 2010 and then take off as a program a couple of years later. Another educational program that I think has turned out better than I ever imagined is something we call the masters in Biomedical Sciences. 39:39 And the original idea was to have a masters degree program for students who had done science in college but didn’t need to do a PhD in order to do whatever they wanted to do for their career. It morphed as it developed into something a little bit different, although that’s still a major theme. And what it turned out to be is a sort of launching pad for students who wanted to go into the health professions, medical school, dental school, physical therapy, physician assistant programs, and—but didn’t have as much foundation as they needed and needed either to improve grades or to get more experience or to get more familiarity with health professions. And that program has turned out to be a wonderful way to help students who otherwise might not have made it into what they wanted to do.

Andrews: 40:46 Have that extra boost in order to do it.

O’Connell: So you’ve been happy with some of these opportunities to structure new paths in some of these programs that are helping people adapt—that are adapting to people’s needs as those needs are changing.

Andrews: Yes. And another–that reminds me of another—and, by the way, for all I know there are problems with those programs now. I haven’t kept up. But at least at the time I stepped down, they were thriving and doing very, very well. Another area was in trying to help our faculty as well as our students reach their full potential. And so we invested quite a bit into our office for faculty and their offerings in terms of grant writing programs and leadership courses and mentoring possibilities and so on, and really expanded a lot what that office does. Made it– changed it from being just a place where there were a few offerings but mostly administrative management of faculty to really being a resource for helping people make the most of their careers, and that was a lot of fun.

O’Connell: 42:16 Okay. Yeah. So that office also became a hub for professional development opportunities and training.

Andrews: 42:23 Yes. Yes. In a way that I think we went further than most or possibly all of our peer institutions in really investing in helping make our faculty the best they could be.

O’Connell: 42:40 Yeah. What kind of results did you see based on that?

Andrews: 42:44 Well, it’s hard to say that there are great short term metrics. I mean we saw things like people’s success at getting grants improved and people’s confidence in starting their–particularly young people’s confidence in starting their own research group and managing their own research group probably improved, but they’re mostly pretty squishy metrics.

O’Connell: 43:13 Yeah. Kind of anecdotal evidence.

Andrews: 43:15 A lot of great feedback, which was good.

O’Connell: 43:19 Okay. Yeah. And I could see how that sort of investment in faculty could help address one of those deficiencies that you saw when you first came here and just sort of like the way that Duke Medical Center looked at itself.

Andrews: Yes.

O’Connell: How have you seen that change?

Andrews: 43:41 It’s hard to say. It’s hard to see change from the inside. I think you’d have to ask someone who was here before and then just came back.

O’Connell: 43:51 Yeah. Well, maybe that’s a question for the new dean.

Andrews: 44:00 Although she was here, she was our chair of medicine for six or seven years before she became dean. So, but she might still have a perspective.

O’Connell: 44:10 Yeah. Is there anything that you really wish you could have accomplished here that didn’t–just wasn’t in the cards?

Andrews: 44:20 You know, I think there was never enough money to do everything we wanted, and if it weren’t for the economic downturn and if we had had better resources, I mean everyone always wants that, I think there’s more we might have done in developing new programs and in recruiting faculty members. We generally recruited a junior level. It’s less expensive. So it makes it very important to help nurture people as they started in their careers. Some of our peer schools recruit much more at a mid level or at a senior level where you know what you’re getting because, or you have a better sense of what you’re getting because people have already got track records and developed their careers. I think it would have been good to do some more of that kind of recruiting if we had had the resources.

Andrews: 45:19 But it wasn’t going to happen. But we managed I think to do some really interesting things on a shoe string budget or what felt like a shoestring budget. One of those, and this is another thing that I really enjoy, have enjoyed watching develop, is a partnership with the School of Engineering. It was one of the lost opportunities I saw at Harvard was, although it has many great schools, they don’t collaborate with each other very much and that, we call it MedX. That was actually a name suggested by a biomedical engineering student. That program is one of a number of ways we tried to reach out to other schools at the university and really they had limited resources. We had limited resources, couldn’t put a lot of money into it, but by making a deliberate choice to work together, we managed to get some synergies and start some new exciting things. So one of the lessons I learned was that in contrast to Harvard where I had a lot of resources to invest, here we could do really interesting things without spending nearly as much money. Which is always good.

O’Connell: 46:54 When you stepped down as dean, what were the factors in that decision?

Andrews: I had always thought that 10 years is probably about the right amount of time. At Harvard I helped put in place a plan where department chairs would serve five year terms and then be reappointed once or twice usually–could be more than that. But the idea was that two five year terms is probably about right. I did the same thing when I came here. The chairs were all appointed on five year terms with the expectation that 10 years or maybe 15 years would probably be right. I think it’s really important to refresh leadership. And so I came in with that philosophy, and it wouldn’t have made any sense not to stick to it myself. And I think that all of the reasons I thought that was the right thing for department chairs also applied to deans. And so I had never intended to go any longer than 10 years.

O’Connell: 48:05 Okay. So it was already planned that way.

Andrews: 48:09 I think it’s best for institutions to have that kind of turnover.

O’Connell: 48:12 Yeah. And what would you like to contribute to Duke going forward?

Andrews: 48:21 Well, you know, I think that I want–the first big priority is, and I think this has worked, not to do anything that in any way compromises Mary Klotman’s leadership. You know, I don’t want to have people come to me instead of going to her if they have something they should go to her about. I don’t want to say to her, “you should do this or you should do that.” So I’ve kept way back. That’s part of the reason my offices is in this building. But at the same time, I can help with the long term issues that I mentioned before, in a sense, helping the faculty get more recognition, helping in recruiting, as Mary would like me to, or as department chairs would like me to, helping young people get off to as strong a start as possible in their careers. And those are the kinds of things that, you know, anybody can do in a way, but I have a little more leverage to do those things as a former dean.

O’Connell: 49:36 Yeah. And what about outside of Duke in your research field and in academic medicine more broadly? Do you have any plans for what your activities will be, can you describe what they are?

Andrews: 49:51 Yes, so I enlarged my portfolio of external activities that are all in some way related to my career as at Duke and before. So there’s kind of a long list–I mean, I travel a lot–but have all been fun for me and I think, mostly indirectly, occasionally directly, helpful to Duke. So in no particular order, I’ve been very involved with two of the three national academies: the National Academy of Medicine, which is an obvious link and National Academy of Sciences, which is also pretty obviously related to what we do here. I’m a member of both. I’m on the Council for the National Academy of Medicine. I’ve been very involved in member selection for the National Academy of Sciences over the last couple of years and also contributing to two committees through the National Academies, one on women in science, engineering and medicine. Again, avery natural fit. And another on helping young scientists get their careers going and have opportunities. 51:16 Again, something I’ve been interested in for a long time. I’m currently the chair of the board of another honorary organization not based in Washington but based in the Boston area called the American Academy of Arts and Sciences. And that’s a bit different because although it does include people in medicine and science it also includes people in the arts and in journalism and in public life in various ways, CEOs of companies, and the full academic spectrum, not just science and medicine, but English and philosophy and history. So it’s made up of both academics and non-academics. And I’ve been on the board of that organization now for five and a half years. I’ve been chair of the board for a year and a half. And so that is advantageous to Duke in that I can make connections for Duke up there. And I have. I can make suggestions for Duke faculty members who might be electable to get into that organization. 52:31 And I can’t interfere with the elections but I can help give insight into what the academy is looking for. Also in the Boston area, I’m on the corporation, which is the equivalent of the board of trustees, for MIT. And so I get to see that very different institution from the inside and you know, I think that’s been helpful, in that they do things in very different ways, and I can bring those back and make suggestions here for things we might try. And it’s been fun to reconnect with MIT after a long history going back to when I was getting my PhD. And then I’ve also been until recently the chair of the board of directors, and I have one more year on the board, for the Burroughs Wellcome Fund, which is a philanthropic organization based here in RTP

Andrews: 53:37 that gives funding for biomedical research mostly for young people. Again, that sweet spot for my interests. And during my time as chair, we developed a program of giving 2.5 million dollar grants to institutions to help them think about creative ways of increasing the number of physician scientists. And we had 92 applications for the first round. I recused myself from the evaluation of Duke’s application, but Duke was one of five institutions that got the award. And we’re doing a second round of it now. And then, I may be forgetting something, but the other thing that comes to mind is I’m also on the board of directors of a pharmaceutical company, Novartis, which makes many medicines. And that’s been a great experience to learn about how, from an inside look at the company, learn about how you go from having a scientific discovery to having a pill or an injection that actually makes people better. And so that’s also been great fun.

O’Connell: 54:59 Wow, that’s so interesting. So you really have a hand in things outside of just academic medicine.

Andrews: Yes.

O’Connell: You’re involved in sort of the private sphere of medicine, of pharmaceuticals, and also in sort of academia and academic leadership outside of medicine as well. Is that fair to say?

Andrews: 55:27 Yes. Which is fun because medicine and biomedical science are great, but there’s more to the world, and it’s nice to be able to have some influence in other areas as well.

O’Connell: 55:42 Yeah. That’s so interesting. So if there were a researcher coming back to this interview, who was looking for insights into your time as dean, is there anything else that you would want that person to know that we haven’t covered?

Andrews: 56:00 Oh, I think the main thing is it’s a huge job, but I was very fortunate that I had a team of vice deans and associate and assistant deans, although primarily the vice deans and some other very senior people—our chief diversity officer. Our communications director–who made it a lot easier for me to oversee this huge organization and brought ideas and energy that went way beyond what I would have come up with on my own. So I think what at the end of the day made it both doable and rewarding was having great people to work with.

O’Connell: Well, thank you again for being willing to do these interviews. I really enjoyed it. I’ll stop the recorder if you’re comfortable with that.

Andrews: Sounds good.