Archives of Maryland
(Biographical Series)

Marilyn Hughes Gaston, M.D.
MSA SC 3520-14533

Biography:

Marilyn Hughes Gaston was born on January 31, 1939, in Cincinnati, Ohio, to Dorothy and Myron Hughes.  She was the second of three children and the only girl.  Gaston’s mother worked as a medical secretary while her father was a waiter.  Though the family was poor and lived in public housing, they moved out of the projects when Gaston was 12, allowing her to attend a college preparatory school.  Gaston remembered those early years of her life fondly, stating “We were poor financially, but not in terms of love or happiness.”1

When Gaston was only 9 years old, she witnessed a medical emergency involving her mother that strongly influenced her decision to become a doctor.  She recounted the incident in which her mother fainted in the living room:

I had no idea what was wrong.  It was very frightening to me, and back then we didn’t have 911 and I didn’t really know what to do…she had cancer of the cervix.  We were poor, we were uninsured, and she was not getting health care, and that’s why she fainted.  And from that point on, I knew I wanted to do something to change that situation.2

While Gaston certainly had the motivation to study medicine, she faced nearly insurmountable odds being poor, black and female.  Unfortunately, Gaston’s teachers and advisors offered little support; however, her family and friends, particularly her parents, encouraged her immensely.  Gaston remembered her parents constantly telling her “You can be whatever you want to be” and quoting Henry Ford’s saying that “there are people who believe that they can and people who believe that they cannot.”3  Importantly, Dorothy and Myron Hughes believed in self-fulfilling prophecy and supported their daughter, believing that she could achieve her goals if only she had faith in herself.4

Gaston’s childhood was equally influenced by individuals in her life who she referred to as “fierce black women” or women who were “self-confident and determined to succeed.”5  Gaston’s mother was one such woman, who Gaston fondly remembered as saying “Don’t give in, give up or give out.”6  Importantly, Gaston grew up in an era still wracked by segregation and racism; however Dorothy Hughes adamantly fought to keep her daughter from allowing such harsh realities to dictate her life and taught the young Gaston that there was no excuse for failure, and that racism especially was not an excuse or a reason to fail.7

Another “fierce black woman” who positively influenced Gaston’s childhood and gave her the skills she would need to accomplish the many things she achieved later in her life was her godmother.  Gaston’s godmother personally decided to desegregate the community pool and went about challenging such racist traditions by bringing a group of African American children, including the young Gaston, to the neighborhood “white” pool every Saturday until local officials finally relented.  This important lesson in Gaston’s childhood no doubt helped to teach her the value of determination and perseverance.  Significantly, Gaston has referred to the famous writer, Maya Angelo’s saying that “We live in direct relation to our heroes and ‘sheroes’” – a fact that indicates how truly important such influential figures were in Gaston’s life and the extent to which she values the role of mentors.8

After graduating high school, Gaston enrolled in the University of Miami in Ohio, where she studied zoology rather than pre-medicine, as she still faced significant resistance from faculty members and advisors.  Gaston graduated in 1960, somewhat unsure of the medical field, as she had faced so much professional opposition; however, it was at this point that Gaston finally received words of encouragement when a doctor at the hospital where Gaston was working offered her some advice, "He told me that if I really wanted to be a physician, I would never be satisfied with the nursing duties I was then performing…He told me to go for it, and I did.”9

Having finally received some validation and support, and as determined as ever, Gaston entered the University of Cincinnati School of Medicine, earning a degree in pediatrics in 1964.  Impressively, Gaston was only one of 6 women in her graduating class and the only African American woman in her year.10

Gaston completed her internship at Philadelphia General Hospital where she first became interested in sickle cell, an interest that would lead her conduct a revolutionary study on the disease.  Sickle cell disease, or SCD is “an inherited blood disorder that results in chronic anemia and recurring episodes of pain…over time it can cause weakness, even death.”11  The Sickle Cell Disease Association of America estimates that each year nearly a thousand children are born with the disease in the United States alone.

While working a shift at the hospital, Gaston encountered a small child whose hand was badly swollen and infected, and though it did not occur to Gaston, her supervising resident suggested that she test the baby for SCD.  Dismayed that she did not know enough about the disease to diagnose it correctly, Gaston began learning everything that she could about SCD, beginning an investigation that ultimately led to her pioneering study, which proved to dramatically affect SCD treatment in the United States, as well as throughout the world.  Following the completion of her residency at the Children’s Hospital Medical Center in Cincinnati, Gaston had successfully finished her medical training and began practicing medicine.12

Marilyn Hughes Gaston had known for a long time that she wanted to work with the poor and underprivileged, and as a result she turned down offers to work in comfortable, middle class neighborhoods, instead turning her efforts to Lincoln Heights, Ohio, an all-black community about 40 miles from Cincinnati.  Using grant money, Gaston helped get a small medical center running and worked as the center’s director for three years.  Originally called the Lincoln Heights Medical Center, the small, two-room operation has recently been renamed the Lincoln Heights HealthCare Center and includes three clinics that treat more than 12,000 patients a year.  In keeping with Gaston’s tradition, the Center’s mission is to provide quality health care to the uninsured, who pay on a sliding scale according to their personal situation.13

In 1972, Gaston began working as director of the Sickle Cell Disease Center in Cincinnati with grant money provided from President Nixon’s allocation of federal funds for the study of the disease.  Working at the SCD Center until 1976, Gaston left Cincinnati to work for the National Institute of Health (NIH) as a medical expert on sickle cell disease in the Sickle Cell Center of the National Heart, Lung and Blood Institute, eventually becoming “deputy branch chief of the Sickle Cell Disease Branch” when her husband, Alonzo Gaston, accepted a teaching position at Howard University .14  Gaston’s association with NIH continued, and in 1979 she became a member of the U.S. Public Health Service Commission Corps, eventually working for NIH for 14 years and reaching the level of deputy director of the Sickle Cell Center within this department.15

Marilyn Hughes Gaston continued her passionate study of sickle cell disease, publishing a ground-breaking study in 1986, which suggested that treating SCD infants with long-term antibiotic plans prevented the development of septic infections that potentially could be life-threatening.  Gaston’s study demonstrated the importance of widespread screening of newborns so that those with SCD could be treated immediately.  Gaston’s findings further indicated that long-term treatment with penicillin was more successful when begun at an earlier age and continued for several years.  These results drastically influenced the world of SCD and led to Congressional legislation to encourage and fund SCD programs throughout the United States.  One of the most important immediate results of Gaston’s study was that early treatment greatly improved chances of survival as well as quality of life for SCD patients, making such treatment “a central policy of the U.S. Public Health Service.”  Importantly, this study has been applied to work in Africa, where sickle cell disease is a major health problem.  In this way Gaston’s work has not only had dramatic effects for the American health care system, but has affected countless individuals internationally, as well.16

Gaston’s important work made her a preeminent member of the medical profession and in 1990 she became director of the Bureau of Primary Health Care (BPHC) in the U.S. Health Resources and Service Administration, becoming the first African American woman to direct a Public Health Service Bureau.  Under Gaston’s guidance, the Bureau focused on improving health care services for the poor and underprivileged, ultimately working with a budget of $5 billion and serving more than 12 million patients in more than 4,000 sites throughout the nation, particularly focusing on such marginalized populations as migrants, the homeless, those living in public housing, and school children.  Gaston’s vision for the Bureau was for it to “improve the access of quality health care to Americans” and provide “health care personnel, facilities, and supplies to the poor and isolated communities across the country.”17  In the BPHC Gaston worked in various administrative capacities, monitoring programs and evaluating the health of patients in ‘underserved’ communities.  She was especially concerned with reaching various “at-risk” groups, such as pregnant women, the elderly and immigrants and dedicated much of her energy to a program called “Movement Toward 100% Access and 0 Health Disparities,” which helped communities identify and maximize their resources to make them accessible to all members of the population regardless of race, ethnicity, gender, age, sexual preference or income.  Reaching the rank of Assistant Surgeon General in the U.S. Public Health Service, Gaston retired in 2001, leaving a lasting legacy not only within the BPHC, but the larger medical community as well.18

Since her retirement in 2001, Gaston has worked on several different projects; however, most of her efforts have been geared toward promoting the importance of prevention as a health care strategy.  In doing so, Gaston co-authored a book with clinical psychologist, Gayle K. Porter, called Prime Time: The African America Woman’s Guide to Midlife Health and Wellness.  The book focuses on women over 40 and covers such topics as heart disease, diabetes, menopause and depression from a holistic standpoint, stressing the intersection of mental, emotional and physical well-being.19  In Gaston’s own words, “The book is about living a lifestyle of prevention” and focuses specifically on African American women because "The fact of the matter is that we as black women are dying at rates greater than any other group of women in the nation.  We’re dying earlier, and we’re dying from many preventable things."20

Gaston has received numerous awards for her work, including every award given by the Public Health Service and the most prestigious award offered from the National Medical Association, the NMA Scroll of Merit, which she earned in 1999.  She has also received the NMA’s Lifetime Achievement Award and several honorary degrees.  Cincinnati and Lincoln Heights annually observe “Marilyn Hughes Gaston Day” in celebration of the pioneering work she did in Ohio to ensure that the poor received the health care they deserved.  One of the honors that Gaston values the most, however, is the scholarship fund established in her name at the University of Cincinnati College of Medicine, which provides two full medical scholarships to underprivileged, minority students each year.21

Additionally, Gaston was named one of the Outstanding Black Women in America in 1973, and one of the Outstanding Black Women in Cincinnati in 1974.  In 1975, she was awarded the Phyllis Wheatly Award from the State of Ohio and an appreciation award from Jack and Jill.  In 1976, Gaston earned the Woman of the Year Award from the Harriet Tubman Black Women’s Democratic Club and in 1980 she was given the Excellence Award from the Pittsburgh Sickle Cell Society.22  In 1990, Gaston was inducted into the Ohio Women's Hall of Fame, followed in 2006 by induction into Maryland Women's Hall of Fame in recognition of her considerable accomplishments.

Marilyn Hughes Gaston has truly shaped health care in the United States, both by targeting marginalized and forgotten groups of individuals, ensuring that they receive quality health care, and through her revolutionary research on SCD that has dramatically altered the lives of those born with the disease.  Equally important, Gaston withstood tests of racism, sexism and poverty to provide an example of perseverance and national leadership for future generations of aspiring young women.
Endnotes:

1. "Marilyn Hughes Gaston," Biography Resource Center, Accessed on 7 March 2006.

2. "Changing the Face of Medicine: Dr. Marilyn Hughes Gaston," National Library of Medicine, http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_124.html, Accessed on 16 June 2006.

3. "Marilyn Hughes Gaston."

4. Ibid.

5. Ibid.

6. Ibid.

7. Ibid.

8. Ibid.

9. "Changing the Face of Medicine;" Barbara A. Gabriel, "In Their Footsteps: The First Women Physicians and the Pioneers Who Followed Them," AAMC Reporter, December 2001, http://www.aamc.org/newsroom/reporter/dec01/womenphysicians.htm Accessed on 20 June 2006.

10. "Changing the Face of Medicine."

11. Ibid.

12. Ibid.

13. "Marilyn Hughes Gaston;" Tim Bonfield, "Lincoln Heights - Neighborhood Health Pioneer," The Cincinnati Enquirer, 9 August 2005.

14. "Marilyn Hughes Gaston;" "Changing the Face of Medicine."

15. "Marilyn Hughes Gaston."

16. "Changing the Face of Medicine."

17. Ibid.

18. "Marilyn Hughes Gaston;" "Changing the Face of Medicine;" "For the Record," Modern Healthcare, 14 January 1991.

19. Elizabeth Williams, "Prime Time: Book Review," Library Journal 126, no. 8 (1 May 2001): 120.

20. Cassandra Spratling, "Midlife Health Book Offers Tips First for Black Women: Take Care of Yourself," Detroit Free Press, 5 June 2001.

21. "Changing the Face of Medicine."

22. "Marilyn Hughes Gaston."

Biography written by 2006 summer intern Amy Huggins

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