Andrea Birch was 9 years old and on top of the world. Her visiting cousin had challenged her to a tree-climbing contest, and, as a competitive kid always up for a challenge, she had outclimbed him. She was looking down at him from her lofty perch and, as she recalls, “goading him from the top.
“The only hitch was,” she remembered, “I was allergic to the pollen in the tree.”
Extremely allergic, as it turned out.
She ended up spending a few days in the hospital being treated for a severe allergic reaction. She was hooked to IVs, “got so many shots it was unreal,” and, although she never needed a ventilator to breathe, one was nearby just in case. She also recalls the nursing staff who cared for her.
“They were thoughtful, skillful and deliberate and their compassion was evident.”
What she realizes now, looking back at the whole cousin-induced tree-climbing contest and the subsequent allergic reaction, is that this childhood encounter with the medical system was one of the factors that led to her career in medicine and her current position as professor of Clinical Radiology and Radiological Sciences and director of the Office of Diversity and Inclusion for VUMC Radiology.
There were other major childhood influences, too. Her mother, Janet Scott Birch, MD, was a professor at Nashville’s Meharry Medical College, and her father, Adolpho Birch Jr., taught legal medicine at Meharry before being appointed a judge and eventually becoming the first African American Chief Justice of the Tennessee Supreme Court.
And she had an uncle who was an orthopaedic surgeon in Houston, whose office she would work in during the summers she spent there.
In that pre-HIPAA time, especially at a private medical practice, patients were very accepting of having the doctor’s 15-year-old niece help out by taking histories and observing exams.
Her uncle was very supportive and encouraging of her decision to pursue a medical career, although “his only regret was that I didn’t become an orthopod,” Birch said.
Her decision to become a radiologist was influenced by a family friend who was a radiation dosimetrist at Meharry who showed her how seeds of radiation can be used to give different doses to treat patients. Young Andrea Birch was inspired to create a science project based around radiation.
All those influences — her parents, her uncle, friends and, not least of all, a competitive cousin goading her to climb a tree — led her to attend medical school at Meharry after earning her BS at Spelman College. She came to Vanderbilt in 2009.
Birch says she chose radiology for several reasons.
“I’m a visual person; it was gratifying to me,” she said. “I also liked the mental challenge, the sleuth-work that it entailed. I liked being at the center of the thought spoke-wheel.”
Her main clinical interest is in breast imaging — mammograms, ultrasound and MRI — and in that role she is often called upon to allay the fears of patients.
She describes that part of her job as “delivering information in a way that makes patients feel better and have hope,” and she says that ability comes from lessons from her parents, uncle and mentors.
“I have to alleviate their fears and gain their confidence. If the patient is facing a cancer diagnosis, I’m the first person they see on their cancer journey. I want to give them hope.
“I especially like to talk to African American women. The stakes are higher for them, because Black women are more likely to die from breast cancer.”
As an African American woman in an overwhelmingly white profession, medicine, and in an overwhelmingly white specialty, radiology, Birch has had her share of challenges.
“It was hard early on,” she says. “I was a Black female in a white male-dominated specialty.”
Challenges that came from patients: “I was constantly having to prove that I was the radiologist, even when I walked into the room and said, ‘I’m Dr. Birch, the radiologist.’”
And challenges that came from her own profession: “There was little career development. That was reserved for the white male doctors.”
Birch is among those working to bring those longstanding barriers down. In her role as director of the Office of Diversity and Inclusion for VUMC Radiology, and with the support of Medical Center leaders, including Reed Omary, MD, chair of Radiology and Radiological Sciences, she is leading a team to bring diversity and inclusion into all aspects of the department.
“Dr. Birch’s expertise in breast imaging, equity, diversity and inclusion is nationally recognized and serves to enhance our care of patients, educational programs and research. We are so lucky to have her at Vanderbilt,” Omary said.
Her efforts in diversity and inclusion take several forms.
“We want to implement some policies and take some actions that can be sustained,” she said.
“We are called upon to look for what we are not doing to promote equity in our department and how what we are doing undermines it.”
Among the tools the group has employed is a series of thinking sessions that examine how the work of the department is perceived in the community, and how the resulting information can be used to improve service to patients and to the community.
The group is also looking to improve diversity within the specialty of radiology.
Currently, about 6-8% of radiologists are Black, and with the use of mentorships and other educational outreaches, Birch says her goal is to raise that percentage.
“I’m passionate about education. I’m passionate about getting under-represented minority students and women interested in radiology. I want to be seen as someone whose shoulders others can stand on.”
When she speaks about working to care for patients, improving diversity in her field and working with colleagues to break down barriers, you can still hear the competitiveness and the drive of the girl who raced her cousin to the top of the tree at her Nashville home when she was 9.
“I’m from Nashville,” she said simply. “And I care about making sure that all Nashvillians get the very best care.”
