April 13, 2017

Pathologist Rauch relishes opportunities to help

Pathologist Carol Rauch, M.D., Ph.D., likes being prepared.

Pathologist Carol Rauch, M.D., Ph.D., is medical director of two clinical laboratories and leads the School of Medicine’s Diagnosis and Therapeutics course. (photo by Anne Rayner)

Pathologist Carol Rauch, M.D., Ph.D., likes being prepared.

“I like plan B, I like plan C. I like training. I like paper copies as backup in case the internet goes down. I like to know the names and addresses of people who may be needed.

“And I love outbreaks and emergency management — nothing gets me as excited as managing a real crisis,” she said.

Rauch joined Vanderbilt’s department of Pathology, Microbiology and Immunology in 2011. An associate professor, she leads the School of Medicine’s Diagnosis and Therapeutics course, a core element of the curriculum. She’s currently medical director of two clinical labs — the Virology Lab, located on campus, and the Rapid Response Lab, a high-volume satellite operation that supports outpatient care at Vanderbilt Health One Hundred Oaks. Rauch has also acted as interim chief of the Division of Laboratory Medicine.

She positively lights up when talking about laboratory medicine standardization and quality assurance, and she even enjoys the challenges posed by compliance with changing regulations.

As disease outbreaks occur and as Vanderbilt’s clinicians bring her their more mundane problems, Rauch sees them as opportunities to improve and elaborate lab capacities and procedures.

“A lot of what I do now is troubleshooting. I work really hard to find a way to make somebody’s job easier, because I think they can transmit that support to the patient and the family in the form of confidence in Vanderbilt.

“When you have a patient to interact with, there’s a very immediate problem, and also a very immediate, personal problem, because it’s not just their tumor or their infection but their experience of it. You can impact how a patient and family experiences illness. We want to do the right things and show that we care about their outcome in every way. I work very hard to represent the laboratory as a support system.

“We’re here to help providers, to serve, to give you a good experience so that you can represent Vanderbilt to that patient as doing absolutely everything possible.”

In the 2014-2016 West African Ebola virus epidemic, she coordinated the clinical laboratory’s portion of Vanderbilt’s preparedness, and she coordinated the laboratory’s response to the September 2012 multistate fungal meningitis outbreak.

In September 2001, a week after the Sept. 11 attacks, anthrax spores were sent through the U.S. mail to five national media outlets in New York and Florida, and in October two more contaminated letters were sent to U.S. Senate offices. The attacks infected 22 people and killed five, including two postal workers. At the time, Rauch was working at Bay State Health in Springfield, Massachusetts, running the area’s largest medical lab, located near New England’s largest postal package processing center.

As the anthrax attacks unfolded, she soon felt as though she were living with Springfield’s public safety leaders. She was named to the Governor’s Bioterrorism Coordinating Council. In the end, her lab had a single suspected case of anthrax exposure, but the specimens collected from this postal worker proved negative.

Rauch got married that December, and among the guests at her wedding were the chief of police and the city’s directors for emergency management and the health department. (No arrests were made in the 2001 anthrax attacks; in August 2008, the FBI attributed the attacks to a Department of Defense scientist who had committed suicide in July of that year.)

And the groom, what does he do for a living?

“He’s a regular person,” Rauch says with some amusement. Steve Henschel designs kitchens and remodels houses. He likes watching medical dramas, Rauch says, while she likes HGTV.

By the time of her wedding, Rauch had witnessed more than one public health threat ultimately traced to actions by a scientist. During her post-graduate studies at Yale, one afternoon in a campus biohazard research facility, a centrifuge bottle cracked, releasing the highly dangerous Sabià virus.

The faculty researcher who was working alone in the lab covered up the incident, until he became gravely ill a few days later, having meanwhile spent the weekend out of town visiting his girlfriend. He ultimately survived.

“And then he insisted on being an author on the papers about the incident, which I find horrifying at another level, because he put a major metropolitan area at risk, in my opinion, by not following safety procedures for how you’re supposed to work in a research lab on dangerous pathogens.”

After Yale, while working in Springfield, Rauch was keen to prepare for outbreaks and for bioterrorism. She attended national meetings and began training others.

In western Massachusetts, “I thought I had better plan to be self-sufficient, because I wasn’t sure I could count on the troops coming down the pike to save us when they might be focused on metropolitan Boston. I got into emergency preparedness early, and I really got into it when it became a reality with the anthrax attacks and our new understanding of the world.”

Rauch grew up just outside Philadelphia, in Cherry Hill, New Jersey, where she attended public schools. One of her great-grandfathers lived with the family, until his death at age 101. “He was the illustration of the maxim ‘everything in moderation.’

“I’m sort of the opposite, I sort of do things in extremes and then move on to something else.”

Rauch attended Dartmouth to study biochemistry. She competed on the varsity lacrosse and equestrian teams, and undergraduate internships took her to the National Institutes of Health in Bethesda, Maryland, as well as to the research lab of Nobel laureate Baruch Samuel Blumberg at Fox Chase Cancer Center in Philadelphia.

After college she attended Johns Hopkins to concurrently earn a doctorate in biochemistry and a medical degree, through the National Institutes of Health Medical Scientists Training Program.

For her doctorate she studied trypanosome parasites and DNA topology. She then completed a laboratory medicine residency at Yale, staying on in New Haven for a research fellowship in medical microbiology.

“I would be a student forever if I could, but at some point somebody said I had to stop and get a job.

“My first interest was really just ivory tower basic science. But I have a social side, and I wanted my work to be more immediately applied and tangible.

“There is nothing like knowing that you have helped someone,” she said.

Rauch’s stepson, Alex Henschel, lives with his wife in Denver, Colorado, and is studying toward a graduate degree in business.