It can be a struggle to be a minority working in the sciences. It can be a struggle to be part of a dual-career (two-scientist) couple. When you combine these two well-known challenges, the difficulties are magnified. But, as the careers and marriage of pathologists Terrill Tops and Dorkina Myrick indicate, the difficulties can be overcome.

Tops, an M.D.-trained deputy medical examiner at the Armed Forces Institute of Pathology (AFIP) in Washington, D.C., and Dorkina Myrick, an M.D./Ph.D. physician-scientist, pathologist, and medical officer with the National Cancer Institute (NCI) in nearby Bethesda, Maryland, entered pathology from different directions. He was inspired by a chemistry set, she by a disease that afflicted her sister. Their career paths intersected briefly during their residencies, then diverged as they found their places in the field. Today, they have careers and a marriage that are rewarding, demanding, and mature. One of the keys to keeping that marriage strong and their two careers on track, they say, is communicating well but leaving work at the office.

Part I: He can't sing; he can't play basketball

Terrill Tops defies some of the stereotypes of the African-American male. He was a precocious, articulate child. He wasn't good at basketball, singing, or dancing. But he loved his cousin's chemistry set, and he was good at that. "I just had a knack for mixing chemicals together and getting some kind of a reaction," he says. "It was just something that was me."


(Photo: SSgt Michele G. Lacerda, AFIP)
Terrill Tops

Tops remembers sitting in his aunt's college classes when he was 8 years old and knowing the answers to the questions the professor posed. He knew he wanted to be a scientist and a physician; he just didn't know yet how to combine the two.

Tops grew up in Fort Wayne, Indiana, with his aunt, Rita Booker, who was a single mom, and her daughter. "My family always said that I could be whatever I wanted to be in life," he says. Booker made sure Tops was well-informed about careers in the medical field and knew what to expect. His options seemed unlimited until Booker, a member of ROTC, graduated from college and moved the family to Fort Belvoir in Alexandria, Virginia, where Tops entered a large, predominantly white high school. With few other African-American students in the honors classes he was attending, Tops found it hard to fit in. Lacking mentors and role models, he drifted away from science, he says. "The teachers at the time really didn't pay much attention to me because of my racial type."

When it came time to apply for college, his aunt, aware of his struggles, persuaded him to try Johnson C. Smith University (JCSU), a small, historically black university in Charlotte, North Carolina. He resisted at first, knowing nothing about all-black colleges. "But it was the best thing that ever happened to me," he says, "because I didn't have to focus on race." 

Alienated from science, Tops planned to major in business--but then he met Timothy Champion, a new chemistry professor at the university. Champion pulled him aside after class and asked about his career plans. Tops described his early love of science and the impact of his high-school environment--"my sob story," he calls it. Champion told him that he saw a great physician in him. Tops switched his major to chemistry. "It was all I needed," he says. Tops credits JCSU professors, including Champion and Henry Russell, with having a profound impact on the person--and teacher--he has become. "I'm an inclusive teacher. I'm a person who is patient and listens and tries to inspire others to go into the fields of math, science, and medicine." 

After he graduated in 1992, Tops took 2 years off. He moved to Oregon, spent his days on the beach, and "enjoyed life. Being a science major can take a lot out of you," he says. "You kind of put your needs on the shelf." The time away recharged his batteries and rekindled his desire to become a doctor and a scientist.

He enrolled in medical school at the University of Rochester in New York state, where he focused on pathology because it offered an opportunity to do research. After graduating in 2000, he moved to Georgetown University Hospital in Washington, D.C., for residency. "That's when I realized," he says, "that being a bread-and-butter pathologist who looked at microscope slides to make a diagnosis wasn't my cup of tea." He felt a need to branch out, teach, and travel. He moved to Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina, to complete a fellowship in forensic pathology. One day, while on rounds in the hospital, he noticed a flyer on a bulletin board recruiting physicians to join the Armed Forces.

Research at the AFIP

AFIP's research was the subject of a recent article in The New York Times.

Because of his aunt's ROTC experiences, Tops had always wanted to join the military. But he hadn't known how to make the military fit in with his other plans. He had been told that positions in forensic pathology at AFIP rarely came available, but he called the recruiter anyway. A position was open, and he was on his way to landing his dream job.

Tops performs autopsies on people who die suspiciously, including members of the military, Department of Defense contractors, and civilians who die while on military property. The remains of all active-duty service members who die in Iraq or Afghanistan are transported to Dover Air Force Base in Delaware, where Tops investigates the circumstances that led to death. The autopsies provide cause of death and, in rare cases, are used in court as evidence. Most importantly, Tops says, an autopsy provides closure for the families of the fallen soldiers. 

Unlike most forensic pathologists, who are tied to local hospitals or jurisdictions, AFIP medical examiners travel the world. "We're kind of like the rock stars of forensic pathology," he says. Tops enjoys dropping in on an unknown hospital, meeting new people, training the local staff, and learning from them.

And the research opportunities are limitless. AFIP's research collection contains more than 7 million specimens of tissue, including amputated limbs, brains, and bodily fluids that date from the Civil War era. "It's like the Smithsonian of Pathology," he says. Medical examiners can use modern techniques to unravel disease processes from the past.

Tops's research, however, looks to the future. Along with mentor and collaborator Howard Harcke, an active-duty colonel who is the chief of forensic radiology at AFIP, Tops is investigating the use of a specialized computed tomography scan to document gunshot injuries. Called a virtual autopsy, the scan provides a full-body three-dimensional reconstruction of the decedent's injuries. The technology allows radiologists and forensic pathologists to collaborate in more accurate determinations of the cause of death. Tops hopes the work will also help the military make improvements in procedures and equipment to avoid similar deaths in the future. 

Part II: She can do everything

Serendipity plays a part in every scientist's career, but Dorkina Myrick has a gift for being found by opportunities. Every time she has faced a transition, the perfect next step has appeared swiftly. Myrick was born in Hollywood, California, but her family moved around the southwest, eventually settling in Lancaster, Texas, a Dallas suburb. King and Dorothy Myrick, Dorkina's parents, were both teachers. King was also a school-district administrator. They provided a strong academic foundation, Dorkina says, teaching her at home after school and in the summer, and making sure she participated in enrichment activities such as band. 


(Photo: Michael Spencer, NIH)
Dorkina Myrick

Myrick learned early about the world of hospitals, medicine, and incurable diseases. Debra, her older sister by 15 years, was ill with Crohn's disease throughout much of Myrick's childhood. Debra was the one who gave Dorkina her name, after their parents, Dorothy and King. The family spent so much time in hospitals that Dorkina began to feel at home there. When she wasn't doing her homework or keeping her sister company, she was roaming the halls, fascinated by the activity and the people she met. "That immersion and exposure ... made me feel that medicine was something that I could do one day," she says.

Myrick was troubled that her sister's disease had no cure. Debra was often in a lot of pain, and "I couldn't understand why," she says. "It really bothered me." She started taking more science classes and discovered how much she enjoyed learning about biological systems and finding answers to serious questions.

Dorkina began taking college classes in her junior year of high school, attending evening classes at a local community college, and juggling a grueling school-sleep-school study schedule. "I know [the schedule] sounds sort of strange, but I really did like it. It was a challenge," she says. "And I met some pretty neat people in community college who were good life mentors." She graduated from high school with 2 years of college credits.

Prairie View A&M University, a predominantly black university, recruited her out of high school, offering a full academic scholarship. She was selected for the Brown University Summer Research Early Identification Program, which identifies minority students with an interest and commitment to a career in research. After graduating magna cum laude from Prairie View in 1992, she enrolled in Brown's M.D./Ph.D. program.

The National Institutes of Health (NIH) recruited Myrick to do a residency at its Laboratory of Pathology at NCI. She accepted the offer, happily bypassing the traditional National Resident Match Program that most medical students endure.

NIH was an opportunity clearinghouse, Myrick says. She was exposed to pathology cases rarely seen elsewhere. She learned about clinical trials. "I saw a lot of things that many pathologists don't see in a lifetime," she says.

Myrick was one of few minority students in her honors-level courses in high school and the first African-American woman to graduate from Brown's M.D./Ph.D. program. Yet she says she has not experienced many of the situations that traditionally hold African Americans back. "I can't say that I've never experienced racism or sexism, because I have," she says. "I feel that having experienced some of these things has made me stronger. Because when you don't have the opportunity, or you feel as if you have experienced racism or sexism, you sort of have to figure out ways to become more resourceful." Her parents helped, she says, by exposing her to positive role models and experiences early on.

When she was recruited to NIH, her adviser made it clear that, in addition to becoming a pathologist, she was expected to become a leader in the field--a senior researcher, dean, department head, policymaker, or CEO of a biotechnology firm. But by the end of her residency in 2005, Myrick found her attention pulled in a different direction. Instead of moving to a general pathology or subspecialty fellowship, as is the norm, Myrick became intrigued with scientific policy and administration.

One of her advisers pointed her toward a short-term position as a program officer at NIH. She felt guilty for not pursuing clinical practice, "especially after all the years I had invested in training," she says. But she knew she would find this new direction more rewarding. After a year in the short-term position, she applied for her current job as an NIH medical officer. Today, she manages individual and institutional grants and oversees a portfolio of research projects. "The careers of individuals are often dependent upon the funding decisions made in our office," she says. But she also deals directly with those individual researchers. She's like a researcher's fixer, identifying appropriate NIH grants, shepherding grant applications through the process, and offering career advice.

Act III: Together they dance (maybe--we'll see)

During their residencies, a rotation in gastrointestinal and liver pathologies at AFIP brought Myrick and Tops together. The ensuing chemical reaction was one-sided at first and slow to catalyze. It was 4 August 2004, a Wednesday, and Myrick was late arriving to the lab. Tops looked up as she entered the room, and he knew that she was the one.

It took her a while to realize it, however. "What I remember most about Terrill was that he seemed to--how can I say it? He seemed to follow me around. And he talked a lot; it was really bothersome," Myrick says. "It wasn't love at first sight."

"I had to use my charm to get her to pay attention to me," Tops says. "I had to use my lines." Eventually, his charm wore her down. At first, they didn't discuss their careers or their futures, Myrick says. They just enjoyed each other's company. As their relationship deepened, they were faced with the dilemma of many dual-career couples: Whose career would chart the course of their marriage?

Myrick wanted to continue her career at NCI after completing her residency. She hoped Tops would remain in the D.C. area, but when he found a fellowship 5 hours away, she consoled herself with the knowledge that the separation was temporary. "Both of us understand that we have a responsibility not only to ourselves but also to our families and community to be the best that we can be," Myrick says. If that means being apart for ongoing training or career opportunities, they would accept the separation.

They were separated for about a year. Then, 3 years to the day after they met and 1 month before Tops took the position at AFIP, Myrick and Tops were married. They are glad to be working in the same city. "I definitely wanted to solidify our first years of marriage by being together in case we have to be separated in the future," Tops says.

For many scientist couples, sharing career interests improves the marriage--they speak the same language and better understand the stress and long hours of a career in research. The downside is a tendency to talk shop at the expense of other topics. Communication works differently for Myrick and Tops. Because much of Tops's work is classified, he can't discuss it even with his wife. Myrick, who has done countless autopsies herself, says she has no curiosity about the details of Tops's cases. "It allows us to leave work at work," she says, and frees up time to do what they love most: discussing politics, literature, and new restaurants.

Tops says he can't stay in one place for long, which works out well because his job keeps him moving. He'll fly off at a moment's notice to complete an autopsy, and Myrick never knows if he'll be gone for one or  several days. She can be sure, however, that he'll bring her a souvenir when he returns. 

And no matter where his travels take him, he is sure to stay in touch. Sometimes that means designating a time to talk each day. Other times it means giving each other space to finish a project before reconnecting. Always, it means keeping their weekly date nights and sharing new experiences, from Indian cultural recitals to the swing-dance classes that Myrick still hasn't persuaded Tops to take.

There's no guarantee that their careers will continue to let them live and work in the same city, and they're prepared for the possibility of a future separation. Meanwhile, they feel blessed. The death last May of Myrick's sister Debra and the nature of Tops's work "make both of us realize that life is short," Myrick says. They endeavor to pack as much passion, service, and fun as they can into their time together.


(Photo: SSgt Michele G. Lacerda, AFIP)

Anne Sasso is a freelance writer and may be reached at AMSasso@aol.com.

Anne Sasso is a freelance writer and may be reached at amsasso at nasw dot org.
10.1126/science.caredit.a0900070