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Citizen of the World

A conversation with Dean Dr. Augustine M.K. Choi

Introduction by Beth Saulnier
Portrait by John Abbott

Dr. Augustine Choi is the nexus of a three-generation medical family. His father — who narrowly escaped death in the Korean War — served as South Korea’s surgeon general and was a prominent cardiothoracic surgeon before emigrating to America. Dr. Choi’s wife, fellow physician-scientist Dr. Mary Choi, is an associate professor of medicine in the Division of Nephrology and Hypertension at Weill Cornell Medicine whose similar family history bonded the couple from their first meeting. And the couple’s two sons have followed in their footsteps: Dr. Justin Choi will join the Weill Cornell Medicine faculty after finishing his internal medicine residency at Yale, and younger brother Alex is a medical student at the University of Michigan.

Dr. Choi came to the United States with his parents and three siblings when he was 12, settling in Kentucky. He earned his undergraduate degree from the University of Kentucky and his medical degree from the University of Louisville, followed by an internal medicine residency at Duke and a fellowship in pulmonary and critical care medicine at Johns Hopkins. He was a professor of medicine at Harvard and chief of pulmonary and critical care medicine at Brigham and Women’s Hospital when, in 2013, Weill Cornell Medicine recruited him to chair what is now the Joan and Sanford I. Weill Department of Medicine and become physician-in-chief of NewYork-Presbyterian/Weill Cornell Medical Center.

After Dr. Laurie Glimcher stepped down as dean in mid-2016, Dr. Choi began serving on an interim basis; he was officially appointed to the position this past January. He sat down with Weill Cornell Medicine magazine in early March to discuss his vision for the institution, his unusual background — including a childhood partly spent in a Malaysian jungle town and a missed chance to be a U.S. Olympian — his family, his research and more.

You’ve assumed the deanship of an already strong institution with a clearly defined mission to care, discover and teach. Could you talk about the process of defining the next chapter in Weill Cornell Medicine’s history? It has to be a collaborative process. After I officially took office in January, I went on what I call a goodwill tour of all of our academic departments and translational research centers, through their monthly faculty meetings. I gave them an introductory overview and opened it up for questions, and it was wonderful. We are now in the process of evaluating what form our next strategic plan will take. The first strategic plan and accompanying capital campaign was 24 years ago, focused on boosting basic science and medical education. The second one resulted in the construction of the Weill Greenberg Center, which provides patient care. And the third led to the creation of the Belfer Research Building, which is all research. But for the next phase, we need to integrate the three different aspects of our mission into a comprehensive strategic plan addressing education, patient care and research all at once. After decades of focused growth, we’re at a place now where we have a firm foundation across our institution and can concentrate on advancing as a triple threat in academic medicine.

What do you like most about Weill Cornell Medicine? It’s a friendly place — unusually friendly for academia. People collaborate. I think we’re serious about our work but not serious about ourselves, which is why we can retain most of our faculty. And I think the friendliness here reflects the culture in New York City, which is much less reserved than other places. For example, when you get into an elevator in New York, people are talking. When Mary and I first moved here almost four years ago, we asked each other, “Are we supposed to be talking?” because we weren’t used to that.

What do you see as the biggest challenges facing Weill Cornell? Space is a huge issue. We just opened the Belfer Research Building, and it’s almost full. But even if you start planning now, how do we continue our growth, short of getting more space? We have to reorganize and get more efficient by forging closer ties among our clinicians, researchers and educators. The second challenge is New York City competition. We’re doing well, but you’ve got four academic medical centers, all with top-25-ranked medical schools, on the island of Manhattan, so that’s tough. And third, we’ve had three deans in the last seven years, with different styles, and I think that can be challenging; the passing of Cornell University President Elizabeth Garrett last year also was a terrible shock and loss to the community. Now we are fortunate to have a terrific new president: Martha Pollack is smart, down to earth and transparent. She’s also a scientist. I anticipate building a strong relationship with her that will help deepen the connections between the Cornell campuses in New York City and Ithaca.

Can you talk more about your thoughts regarding collaborations with the main Cornell campus in Ithaca and the upcoming Tech campus on Roosevelt Island?  We definitely want to increase academic integration with the Ithaca campus, and we are augmenting our infrastructure and research collaborations to do this. Weill Cornell Medicine and the Ithaca campus have areas of complementary strength that have not been fully tapped yet, and together there is huge potential for us to make an impact on medicine. Already, we have a number of exciting collaborations in cancer research and with the Meinig School of Biomedical Engineering that we hope will eventually enhance patients’ health. Another area in which we recently began collaborating in a very innovative way is through an executive MBA-MS program with the Johnson College of Business. The program will bolster the business acumen of future leaders at a critical time for our healthcare system. And Cornell Tech is going to be a game-changer, because it’s in New York — even closer to us — and part of the same ecosystem of high-tech innovation. There are several areas where we can really collaborate, such as on projects involving big data, health information technology and entrepreneurship. We’re also exploring possibilities for joint educational programs.

Do you think there’s something special about this scientific corridor, and our collaborations with neighboring partners? Absolutely. This 68th Street corridor is amazing. Our patients get the best care because of our partnership with NewYork-Presbyterian and our close affiliation with Hospital for Special Surgery; and the research opportunities at Memorial Sloan Kettering and The Rockefeller University for our students and trainees are second to none. Our alliance with NewYork-Presbyterian is strong and I have a close partner in NewYork-Presbyterian President and CEO Dr. Steve Corwin, who shares our goal of providing the highest quality care for our patients. It has been a pleasure working closely with Dr. Corwin. We’re growing our relationship with Hunter College, which has a floor in the Belfer Research Building and is a vital partner in our Clinical and Translational Science Center. All of these reasons are why Governor Cuomo and Mayor de Blasio will be investing more than $1 billion in state and city life sciences initiatives. California and Massachusetts are way ahead in terms of public and private investment in the life sciences and in the number of startups and incubator sites. In New York, we arguably have as many discoveries, but many of those researchers leave town and set up their companies elsewhere. The next step is to leverage those discoveries in New York.

EXPLORING FUTURE CURES: Dr. Choi (center) with members of his laboratory team, which investigates the science of lung disease. Photo credit: Roger Tully

How do you see Weill Cornell’s global reach as an asset? Globally, we are a major player. We are the only U.S. medical school with a branch in a foreign land, Qatar. We have some of the best global health programs in Tanzania, Haiti, India, Ghana and Brazil. We have an exceptional educational program in Salzburg, Austria. We have started some movement in both education and clinical activities in China, as consultants. There are more than 100 million middle- and upper-class Chinese people who want private healthcare, and only half a dozen or so Westernized hospitals to accommodate them. Obviously the need is there. Some of our peer institutions are getting into the market, but you’ve got to be careful because the culture, language and political system are different, so economically you’ve got to be prudent.

Could you describe your leadership style? One, I’m transparent. I’ve found with faculty and trainees, if you are transparent and honest, even if the news is not good, they’re all professionals and they’ll handle it. Number two, consensus building is important. In my work, 85 percent of the stuff is relatively easy, because everyone agrees; it’s the other 15 percent where you have to come to a solution. My third style is motivation. I can’t see patients for our faculty, do research for them or teach for them. My job is to motivate them, to keep them interested in our mission.

What role can mentorship play in Weill Cornell’s mission? This is an area I’m very passionate about. I truly believe that mentoring is the key to whether trainees and early-career faculty are successful. At that level, they’re all hardworking and smart. But what dictates that some of them succeed and some do not? Good mentoring. Many times in academic medicine there’s no right or wrong answer, and mentors can help navigate that. In mentoring, there are not obvious metrics, because the fruits are not next year, or even five years from now. It may be 10 years later when that person is not even at Weill Cornell, but you’ve done something for the common good. I think we as an institution are ahead of the curve in our mentorship of students, trainees and faculty. But we want to lead the curve, and it starts from the top. A challenge is figuring out ways to incentivize faculty to mentor when they have so many other demands on their time and to create a culture of mentorship, not just formal programs.

Could you talk about your current research and the clinical trials you’re directing in pulmonology? As a student, my first interest was oncology, but I switched to lung disease because I liked the ICU. I liked the fast pace. And to be successful in the ICU, you essentially have to become a lung expert. I worked in basic science for about 15 years, and it turns out that a molecule I was working with produces a gas that has potent anti-inflammatory properties for lung disease. I’m delighted that this discovery has been translated to three clinical trials, all in phase 1/2—on sepsis, idiopathic pulmonary fibrosis, and pulmonary hypertension.

A GOOD TEAM: Dr. Choi and his wife, Dr. Mary Choi, associate professor of medicine, whose lab focuses on the cellular and molecular mechanisms of tissue inflammation and injury. Photo credit: John Abbott

Your wife, Dr. Mary Choi, is also a colleague. What have been the joys and challenges of sharing a life as two busy physician-scientists, having a marriage and raising a family? We love it. We appreciate each other’s work, and we both know what it means to be a physician-scientist; we share the pains and successes and understand each other’s goals. I am so proud of Mary, who has been continuously funded by the NIH since her fellowship years without a gap, initially with an F32 NRSA grant for postdocs, transitioning successfully to a K08 career development award, and then to a standard independent R01 grant. She’s had successful R01 renewals of multiple cycles through today, even during the tough NIH paylines. Mary was able to juggle these academic achievements while ensuring the happiness of a tight-knit family with our two sons. It’s been wonderful, even more so now because our laboratories at Weill Cornell have joint meetings, grants and papers. We didn’t talk a lot of shop at home when we were raising our kids, but now that we’re empty nesters we tend to do that a little more.

What inspired you to go into medicine? You might say, “Your dad was a physician, so wasn’t it obvious?” After my family left Korea, my dad was the only doctor in a small town in the jungles of Malaysia, and our home was around the corner from the infirmary. On weekends I used to help him — with menial things, but I got exposed to patients, nurses and doctors — and it probably affected me more than I remember or admit. That said, I’m the only one of my siblings who pursued medicine, and it wasn’t a forgone conclusion. In high school, I wanted to be a priest. To get into seminary school, they were testing on Dante and Hegel and Plato, but I’d come to the United States when I was 12 and my English wasn’t there yet. I also thought about anthropology, because that’s the study of the history of humankind, and I found the science behind it fascinating. In the end, medicine best fit with my interest in participating in human issues.

When your father was a medical student during the Korean War, he barely escaped with his life. Would you share that story? My dad was a second-year student when the war started. If you had not yet reached your fourth year of medical school, the communist party killed you for being a capitalist. But if you were in the fourth year they kept you, since you’d know some basic medical care. My father was in front of a firing squad multiple times — blindfolded, the whole bit. Several times the gun did not work, and twice his mom bribed the shooter to spare him. The last time, he was asked if he was a fourth-year. I never saw my dad lie in his life, ever. But he told me the one time he lied was when he said, “Yeah, I’m a fourth-year student.”

How did your family end up in Malaysia? My dad was the surgeon general of South Korea, which was at that time one of the most unstable political environments and countries in the world. He did not like that life and didn’t see a future there for his kids, so he did it the hard way — he took us to Malaysia. Back then Malaysia was a developing country with very poor medical care, so the government recruited physicians from Korea. They did not need help in Kuala Lumpur; they needed help in the jungles. I remember my dad saying, “This will all be good for you.”

COMMON CAUSE: The Choi family boasts three physicians—Justin (far left), Augustine, and Mary—and a future one, University of Michigan medical student Alex. Photo provided

Do you have any specific childhood memories that influenced you? My dad’s job was basically 24/7, but he made a point of coming home for dinner, because he wanted to catch up with the four kids. That influenced me. As busy a life as Mary and I had juggling our careers, we always made sure that from 6 p.m. to when our kids went to bed, it was family time. And I got a lot of push-back from my bosses: “What do you mean you’re leaving at 5 o’clock to go to soccer practice?” But I’d never trade that, because at the end of the day your family is the only constant in life.

Why did your dad decide to bring your family to the U.S.? He was a successful cardiothoracic surgeon, but he felt that for his four kids, the educational system in the U.S. was the future. So he came here when he was 43 and had to do his internship all over again — and you’re talking about the first man in Asia to do open-heart surgery. Sometimes I wonder: When I was 43 and chief of pulmonary care at the University of Pittsburgh, would I have gone to a foreign country to be an intern for the sake of my kids? For my kids, I would have — but would I have had the strength to start again from the bottom of the totem pole, as my dad did?

What do you like to do in your spare time? How do you think your experience as an immigrant to the U.S. influences you? When your peers are preparing for the PSATs and you have just begun formal schooling in English, you’ve got a challenge. The cultural aspect was also huge. But I think it helped me grow up quicker and made me stronger, and gives me a better balance when I’m on a tough road. There’s a drive for survival. I really think this is what has made America so strong, so great — the strengths that immigrants bring.

Mary and I are foodies, so we love the cuisine in New York. Mary likes the opera quite a bit. We like to travel. Personally, I’ve always been a history nut. I love to read about ancient history, like Mesopotamia and China, but I also like post-World War I history. Korean history fascinates me, and I try to read up on that. I love to watch sporting events on TV, because at one point I was a very competitive athlete.

What sport did you play? I played competitive table tennis for more than 15 years. When I was 13, the Chinese coach came to my home and said to my dad and my mom, “We’re going to take your son for five years and make him into an Olympic champion.” My mom was crying and saying, “We didn’t immigrate to the U.S. for you to become a ping pong player.” That was a family crisis. Ultimately, I trained for the U.S. team when I was in college and condensed my undergraduate studies to three years to prepare for the 1980 Olympics, but then the USSR invaded Afghanistan, and President Carter boycotted the Games. I still joke that I should have delayed my medical career to be in the next Olympics.

 This story first appeared in Weill Cornell Medicine, Vol. 16. No. 2

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