Trisomy 21

Randy Engel interview with
Dr. Marthe Gautier,
discoverer of trisomy 21

Note:  Randy Engel is an Advisory Board member of PCUC

Marthe Gautier

By Randy Engel
RE : Dr. Gautier, before we begin this interview, I want to thank you for recommending to me the remarkable book by Professor Peter Harper of Cardiff University, Wales, First Years of Human Chromosomes – The Beginnings of Human Cytogenetics, which documents the groundbreaking efforts of scientific and clinical pioneers like yourself, in the field of genetics, from 1955 to 1960.[1] Professor Harper’s work, as well as his archived interviews, are a treasure trove of information regarding the history of human cytogenetics.

Now, Dr. Gautier, would you be so kind as to give our readers some personal information about your family’s background ?

MG : I come from an old family. We are French and Catholic and have always lived in the same area, the Île-de-France region, not far from Paris. We can trace our ancestors back more than 400 years. Originally our family was known for its barbers and surgeons. But many years later, one of my ancestors married a farmer, so we became farmers.

RE : You are the fifth of seven children ?

MG : Yes. I was born on the 10th of September, 1925. My parents had four girls and three boys. Two brothers became farmers, two of my sisters married farmers – and the youngest of my brothers became a veterinary surgeon and married a pharmacist.

RE : But I understand that of the four girls, your elder sister, Paulette, became the first member of your family to attend medical school – and that you followed in her footsteps ?

MG : Yes, I joined her in 1942 at the Faculty of Medicine in Paris.

RE : At what point did you decide to specialize in pediatrics?

MG: I always wanted to be involved in the care of children. I knew that if there was any chance of my success in the medical profession, it would be in the field of pediatrics.

RE : Before we go into your early medical background, Dr. Gautier, I wonder if you could explain to our readers the various stages of medical studies in France, at the time you entered medical school.

MG: Certainly. The first step in becoming a Doctor of Medicine (an MD) was the entrance examination, the difficulty of which varied from year to year, followed by six years of clinical training, with a written examination each year.

For applicants wishing to follow the competitive examination route, which was the case for my sister Paulette and me, this pathway involved one competitive exam after another, each providing access to the next level and another step towards the responsibility of caring for patients. Externship was the first grade attained, followed by an internship of four years, at the end of which the candidate wrote a thesis. At each stage, the number of applicants admitted decreased.

Having reached this point, the candidate had to decide if he wanted to work towards clinical practice, (“chef de clinique”), a post-graduate grade which included the teaching of clinical medicine to students for a period of 1 to 3 years. This charge was very important as it could often lead to a university career. I also sat for a competitive exam to become a medical assistant. The final step was the so-called “médicat” exam necessary to become the head of a department.

I successfully negotiated all these steps up to the médicat. Women rarely advanced to this level at this time in history, although it is no longer the case today.

RE: Was the career pathway different for a candidate who wished to specialize in medical research?

MG : Yes, although I am less acquainted with the particulars. One did not have to be an MD, although some were. I know there were Commissioner exams each year at which time the publications of the candidates were reviewed to see if he or she should be promoted to research trainee, or researcher, or advance upward to several intermediate grades. Few reached the master of research level or went on to become director of research and head of a laboratory.

RE: Thank you for this information, the importance of which will become manifestly clear, later in this interview. Let’s return now to your own medical career. You told me that your competitive examination for internship was very difficult. Can you elaborate?

MG: Well, since this was the only way to reach the higher levels and open the door to a professorship or department head, I had to persevere. The written examination test papers were labeled only with an identification number, with no name, to ensure anonymity and to prevent favoritism or sex discrimination. However, this was impossible to avoid in the oral examination. Anyway, I succeeded at my fourth attempt. I was 25 and it was in 1950. That year, only two women became interns in Parisian hospitals, versus eighty men. This provided me with four years of experience in eight different pediatric departments. That meant eight different bosses working in different specialties and with very different teaching practices. It was a wonderful experience.

RE: I understand that before Paulette’s untimely death when German troops were retreating from Paris in 1944, at the war’s end, she gave you some excellent advice on being a woman in a male profession.










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