Profiles in Improvement: Dr. Carola Eisenberg, IHI Senior Fellow

Eisenberg_Carola_SM.jpgCarola Eisenberg, MSW, MD, is a board member and founding member of Physicians for Human Rights. She has dedicated more than five decades to advancing human rights across the globe, including being a member of human rights missions to El Salvador, Chile, and Paraguay. A native of Argentina, she received her medical degree and completed her psychiatric training in Argentina, eventually emigrating to the US to serve as Fellow in Child Psychiatry at the Johns Hopkins Hospital in Baltimore. Among the numerous positions she has held, Dr. Eisenberg served as the first female Dean of Student Affairs at both Massachusetts Institute of Technology and Harvard Medical School. She has been a long-time lecturer in the Harvard Medical School Department of Global Health and Social Medicine, where she helped institute a course series on human rights. She is also Honorary Psychiatrist with the Massachusetts General Hospital in Boston. As a Senior Fellow at the Institute for Healthcare Improvement (IHI), Dr. Eisenberg is interested in contributing to IHI’s work in Latin America, the IHI Open School, and other areas.


Q: You’ve had an amazing life and career. What first brought you from Argentina to the United States?


Well, my background is easy to find. When I first came to the US in 1945, I thought it would be for one year. I came here to do a fellowship, because I wanted to learn child psychiatry and there was no one to train me in Argentina. I also wanted to travel.

So I applied to two fellowships — just the two names I had grabbed from thin air. One was to work with Anna Freud, the daughter of Sigmund Freud, in London. And one was to work with a professor at Johns Hopkins, Leo Kanner, who described for the first time infantile autism. And I did not have much chance to be accepted, I thought, so I applied to both. To my surprise, they accepted me at both places. And for a variety of reasons I decided to go to Hopkins, who opened the doors, and they were just wonderful to me.

Then in a few years, I moved to Cambridge, Massachusetts, with my husband — the day after we got married. He came with a full professorship at Harvard Medical School and as chief of psychiatry at Massachusetts General Hospital. And I came without a job — the only time in my life when I applied for one.

I also had trained in adult psychiatry and I began to see late adolescents. I wanted to work with college students and young adults, so I ended up at MIT [Massachusetts Institute of Technology] and then Harvard, in a variety of different positions.

Q: How did your journey bring you to IHI?

I had known Don Berwick [founder and former IHI President and CEO] socially. One time he came to visit when my husband was ill. He spent a Saturday morning telling us with a great deal of enthusiasm what he was trying to accomplish here at IHI. And I became intrigued.

Some time went by, and I had an occasion to talk with Don about something that had nothing to do with IHI; it was an issue about human rights – something I’m very involved with. So I came to IHI and we talked in his office, and I told him, “I want to learn more about what you are doing here.” So he gave me a book [The Best Practice: How the New Quality Movement Is Transforming Medicine], and I read it and became really intrigued.


When I saw Don again, he invited me to come to IHI on a Monday morning for a weekly staff meeting. That was about a year ago — and I’ve come every Monday since then. I have become addicted to IHI! I continue to come because I learn a lot from the presentations. I have a lot of respect for what everyone is doing here.

I have done a lot of things in my career in medicine, including somehow being at the center of political entanglements within the medical profession — even more now that I am retired, or semi-retired. I am very interested in ethics in medicine and how health care is provided in the United States. I have strong feelings and some ideas on what is wrong, from the point of view of my commitment and my sense of justice — a very important part of me. Social justice is like a cathedral in my head, and I want to continue to be involved in these issues for the rest of life.

But I never had much of an idea what was wrong with the medical care in hospitals, for instance, before I started coming to IHI.

Q: Well, you come from the world of academic medicine — elite teaching hospitals and medical schools that are not typically focused on quality improvement.

I have to say that you are correct, but it’s hard for me to say that because I think physicians do extraordinarily good work. But for me it was an eye-opener to read that book and some other writings on the subject.

Sometimes, the people at big hospitals get so involved in a routine that’s so rigid; they don’t have the time or some of them don’t have the interest. So, I began to have ideas about how to inform them about things going on here, and I try to share these ideas with some IHI senior leaders.

Q: When during your career did you get involved in human rights issues?


I started Physicians for Human Rights [PHR] 25 years ago with four of my colleagues, other physicians. We started with no money but with a great deal of commitment — for a variety of different reasons, but with one common goal: to defend human rights. My reasons were personal. I had left Argentina before Perón’s dictatorship, but then I began to hear stories from some of my friends back home. Two of my best medical school friends had sons that were killed by Perón’s regime.

When I had been a US citizen for several years, I was in Washington, DC, on one occasion, for a meeting of a committee on emerging issues of the American Psychiatric Association [APA]. They introduced two of us who were new members — the first women appointed to the committee, incidentally, which was my situation several times in my career. 


I began to talk about what was happening in Argentina, and they got very upset because the newspapers didn’t report all that much. Some time later, the APA committee asked me whether I would go to Congress to testify. I said of course I’ll go because I was full of anger and disappointment in Argentina — when I was living there it was very peaceful. (Well, we thought it was peaceful.)

But when I got home I realized that it would be just stupid to do this. How could I go testify when my whole primary family — my mother, my sisters, my nephews — everyone was in Argentina. They would have come after them. So I withdrew. I did not go to Congress. But I was frustrated, because not having the ability to speak for a just cause is not within me.

A couple of years later, someone asked me whether I wanted to be part of a new organization with four other doctors — to give voice to the people who could not afford to talk. I said yes, so that’s how we formed PHR. It was an adventure — we rented one room in Somerville [Massachusetts]!

I went, representing PHR, to several nations who had dictators, starting in Latin America, mostly because I did not need a translator and I knew a bit about the area. In the 1980s I went to El Salvador two times, to Paraguay, and to Chile during Pinochet’s regime. I could tell you a lot of stories — horrible people in different countries.

When, for many reasons, I felt I couldn’t travel to other countries, I became very involved in the asylum work PHR does: trying to help people who had come to this country [the United States] to escape the tortures and atrocities in their home countries, and either they were afraid to go back when their visa ran out or they did not know the rules about how and when to apply for asylum.

So we would help them: we were physicians doing psychiatric or primary care work, and we would write full reports and testify before immigration officials that the stories the asylum-seekers were telling us were correct. I am pleased to say that PHR has hundreds of people doing asylum work now.

These are the two organizations [IHI and PHR] where I spend most of my time — or the organizations I am most excited to talk about when I am with people. Because I am convinced that both of them are doing a wonderful job.

Q: What do you hope to do with IHI as a Senior Fellow?

Well, every project intrigues me — I have a list in my head, but I know I will go home tonight and think of one or two more.

Because of my background, I hope to contribute to IHI’s international programs — particularly in Latin America. When I was at a recent meeting with Latin American executives who came for a meeting at IHI, I was just itching with ideas about what else IHI could do to expand in Latin America. It’s a complex issue because Latin America is not one country. It’s full of political and economic issues. Health care is very different in each country; education systems are different — it’s a huge challenge. 

I also want to be involved in the IHI Diversity Council. At the [Harvard] medical school, one of my responsibilities was to supervise a program which we call Recruitment and Retention of Minorities. So this is an important area to me.


I very much want to do mentoring — particularly with the “junior” IHI Fellows. This is something I have done for much of my career [as Dean of Students at MIT and Harvard Medical School], and the students responded very well to my interest in them.

But I also want to support the young mothers (and fathers too, at some point) working at IHI. It is another area where I have had a lot of experience. I think the women working here face many of the problems I have faced myself: how to divide one’s time; how to contribute to the profession they have and to family life. It’s very hard, but it can be done.

And I am very excited about the IHI Open School. I defend the idealism of students because it’s something I share. I never was ambitious; I just wanted to do what I felt was right by my set of values. My moral guideline has always been that I don’t want to do anything that only might benefit me, whether it’s money or positions of importance.

To my delight, more and more medical students are very interested in issues so important to me, issues of ethics and social justice. And they are much more open to learning about improving how health care is delivered.

I didn’t think I would get as involved in IHI as I am, but I became intrigued. I have never been to an organization like this one. To me, it’s a strange combination — a wonderful one, but one that I never experienced before: a combination of medical sciences, medical issues, business school, communications school, engineering school, and education school (and I know I am forgetting three or four others).

Whenever I come here, I learn something that intrigues me. This keeps me entangled in interesting issues. (At my age, I want to maintain my amyloid plaques in the brain circulating and not gluing together.) But very early on I had this need — I continue to have the need — to do something in return. So, I am delighted that hopefully now I can contribute to IHI.

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