Astrid Heger, M.D., Founder Violence Intervention Program, U. of Southern California School of Medicine

Factors in career choice: The major factor in my decision to become a physician was the theme put forward by my parents that life should involve making choices that have an impact on individuals and potentially society as a whole. Medicine presented unique opportunities to be involved on both fronts.

Pivotal point: It came after I had my first child while in my senior year in medical school. Up until that point I had always envisioned myself in clinical research in an academic environment. However when Andy was born, I became intrigued by the question of why children are abused and/or neglected.

Achievements: After choosing to become a pediatrician who specialized in Child Abuse—I was faced with a new challenge of establishing standards for the evaluation and diagnosis of children who had been sexually abused. The use of photodocumentation in cases of sexual abuse and sexual assault changed how victims are evaluated, became the basis for research and established a scientific basis for diagnosis. When I started in this field children commonly were subject to having multiple genital examinations in the course of a legal proceeding. I am most proud of the fact that the new technology was used to establish case law that prevented children from having such exams.

Obstacles: There have been two major hurdles in my career. First was being a woman in medicine at a time when there were few of us and I was also a mother of three during my residency. This required enormous levels of energy as well as careful time and priority management. Income was not important. Second and probably more important in my career, was the challenge of making the issue of violence against both children and women an important priority in the field of medicine. There is an ongoing differential in the quality and availability of medical services provided to victims of family violence and sexual assault, especially women. However, I found that if I could identify creative funding resources to establish a service that I was often successful in asking the local government to fund the program as a permanent entitlement to the community.

Mentors: Probably the person who had the greatest influence on my life was my father. He was a profoundly spiritual man who epitomized service to others. In medicine I credit Shirley Anderson, a pediatrician in Seattle, with challenging me to stay in the field of child abuse, to think creatively and to never compromise patient care or the quality of scientific research.

Advice: Define success not by income, but by how you make your life significant to others; never settle for average; think outside the box and practice your craft with a sense of generosity and unselfishness. Come to the end of your career knowing that you made a difference!

Goals: Currently, I am working on a book that tells the stories of children who have grown up with violence. I realize that they will probably never be empowered to tell these stories, but I do not want them to be forgotten. #

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