Coincidentally, this is a quote from German poet Rainer Maria Rilke that Dr. Hein used to open a lecture in 2015 for the Academic Pediatric Association entitled “Outside In, Inside Looking Out – Expanding the Concept of Health.”
“I live my life in widening circles
that reach out across the world.
I might not ever complete the last one
but I give myself to it.”
These are among the many days of her life that Karen cherishes, filled with tending her cashmere goats and her home that she describes as “what we made of our love in this house.” Her husband, Doctor Ralph Dell, is her partner in this Vermont life that began for Karen when she was a child dreaming of climbing trees in Vermont.
In 1970, she and then-husband Mike Hein purchased the Braithwaite House. By 1983, the house was in Karen’s words “falling down.” Karen and Ralph were married that year and together they took the house down, rebuilding it using as many bricks and boards from the old house as they could. Karen said that as many fifty-one people “had a thumbprint on this project.” Karen remembers that “Percy White’s brother subsequently visited our ‘reconstituted’ home and cried when he stood in the living room reminiscing about where he got married!”
Hein has had an incredibly distinguished career in medicine that has brought her from the early days working in juvenile detention to national, even international prominence, working in Washington D.C. on children and adolescent health care initiatives with Hillary Clinton, as well as developing benefit packages that would be the building blocks for Obamacare. From 2011 to 2015, she served on the board of Vermont Green Mountain Care, created by Act 48, signed into law by Gov. Peter Shumlin for the purpose of evaluation and innovation in health care regulations related to Vermont hospitals. Her accomplishments and impact not only as a doctor but as she describes herself, “a citizen of the world (addressing) themes of helping people and organizations” are too varied and extensive to give justice in a brief profile. However, the name she has made for herself around the world is just as important to her as her life today in the home and in the community she loves.
It’s a remarkable story but similar to spirals and “widening circles,” there is a beginning.
Growing up in the suburbs of Long Island, Karen thought of herself as a “hot house flower.” She loved animals, even having a pet cricket, and saw herself as a future veterinarian. But eventually, she would embark on a career in medicine, following in the footsteps of her father, “a Jewish boy from Brooklyn,” the first in his family to become a doctor. Her mother, “a very smart, energetic woman,” pursued him and eventually they were a family of six.
Despite the demands of four children, Karen’s mother Ruth audited classes in medical school for two years to be the best doctor’s wife she could be, even volunteering in the genetics lab at the hospital where her husband was chief of staff.
Karen says she became a doctor herself “because my mother couldn’t.”
In medical school, Karen discovered she was a woman who didn’t fit the mold. During a recent keynote address on the 250th anniversary of Columbia University’s College of Physicians and Surgeons, she said, “When there is no ceiling, the sky’s the limit.” Karen refused to accept the much-examined glass ceiling that has been a reality for many women struggling to reach parity with men in every aspect of their lives: education, interpersonal relationships, sports and even volunteer endeavors but especially employment. She knew it was there, not just as a ceiling but confinement in a “constraining box” and her impetus was to get outside the box, even as a teenage camp counselor where she openly discussed sexuality and birth control with her young campers. For Karen, being outside that box was freedom and if a word comes to mind to describe Karen’s approach to life and the directions it would take her, it would be fearless.
Following a two-year program at Dartmouth Medical School, she transferred to Columbia’s College of Physicians and Surgeons where she continued the activism that began in camp, not only caring for abandoned babies but also writing about them in her first professional publication, “Boarder Babies at Lincoln Hospital.” Her first job as a doctor was in juvenile detention at Spofford Juvenile Center in South Bronx where she found, not surprisingly, that prison for kids “is not exactly a creative open space” and there were new demands to find ways to provide those young offenders with quality medical care. It was there that Karen would seek specialized treatment for a boy with an atypical cancer whom she now believes was one of the first adolescents to suffer from HIV/AIDS. That experience would eventually become a game changer, not just for Karen personally but the medical community and society at large. She came to believe that the “social determinants of life, work and play would have more to do with health” than biology. Later in 1987, with Ralph’s support and assistance in his capacity as a professor at P & S, Karen would establish the Adolescent Risk Reduction Program at Montefiore Hospital, a teaching hospital for the Albert Einstein College, the first program of its kind in the nation to address HIV/AIDS in adolescents.
One of her last major electives at P & S was a stint in Liberia where she worked in a remote bush hospital far from the few paved roads in the capitol. The experience would shape her identity as a doctor and a human being. “I wanted to go to the hidden places,” she said, “like jails and refugee camps to open the windows.” Later in Mongolia, she helped map a pathway for health policy and the education of health professionals. In the process, Karen and Ralph met a young woman they lovingly refer to as their Mongolian daughter, who became a civil servant of the highest rank in the Justice Department of her country defying class and gender expectations.
Today, Karen continues to participate in health care oversight, serving on boards, including the Rand Corporation, the Robert Wood Johnson Foundation’s Clinical Scholars Program, the International Rescue Committee, the Dartmouth Center for Health Equity and the Columbia Nursing Board.
While she tends her goats and spin her designs, Karen’s primary focus at home is on Ralph, in the beginning her colleague in medicine and research, and then her cherished partner in life.
Ralph was diagnosed in 2011 with Alzheimer’s disease, which she has described as a “kind of gift. We’re all living and dying at the same time and we’ve been given this chance for a long goodbye.” She wanted to share a link to a brief but very moving video: https://vimeo.com/162835203 that she finds “captures our spirit and our journey.”
In typical fashion, Karen has shone her particular light and influence on treatment and care available to patients, and their families, suffering from dementia in her area and around Vermont. One suspects that her insights would be applicable both nationally and globally.
Karen is a woman of implacable strength, optimism and intellect and every path she has chosen in life has benefited from her presence, all threads spinning outward from the center of who she is.