by Darryl Gossett Christine Lawley doesn't ponder too long when asked what one thing she would change about her husband, Emory medical school Dean Thomas J. Lawley. "His tendency to work too hard," she says emphatically. "He puts in such long hours. In all other respects, he's learned to take pretty good care of himself, to eat well and all that, but when it comes to his job, he still pushes himself very hard." And the one thing she would never change? "The desire he has to push himself so hard," she admits with a laugh. "The fact that after all these years, he is still committed to giving something back to medicine and to the institution. And that he's not afraid to work hard to do so. It's a core part of his personality. I noticed it the first time we met." That initial meeting took place in 1964 in their hometown of Buffalo, NY, at a municipal swimming pool where the teenaged Tom and Chris were holding down summer jobs while on break from college. Although the encounter can't be described as love at first sight--they didn't begin dating for a couple of years and didn't marry until 1969, during Tom's second year of medical school--Mrs. Lawley says it was definitely a case of instant mutual admiration. "Tom was one of the first boys I met who knew exactly what he wanted to do," she says. "He was interested in a variety of things--baseball, history, politics, and of course medicine. He knew early on that he wanted to be a doctor, and I greatly admired his focus and determination." Focus and determination are traits common to both Lawleys, actually, which is not surprising given their similar upbringing. Both were post-WW II babies, vanguard Boomers, born in the late 1940s to blue-collar, two-working-parent families in a town that promoted itself as "The City of Good Neighbors." Buffalo in those days was a city whose virile canal- and railroad-based economy had been derailed by the Great Depression but whose citizens remained confident that their no-nonsense brand of bootstrap can-doism would pull them out of their troubles, and sooner rather than later. Buffalo was vibrant, forward-thinking, but serious--a place where hard work, team effort, and loyalty were civic as well as family requirements. Imagine the Lawley family as a microcosm, or a distillation, of such values. These same principles have guided the pair through 28 years of marriage ("Just say forever," says Tom Lawley after struggling with the math) and the raising of three children: Thomas, Jr., 24, who works for NextTel Communications; John, 22, a recent Emory graduate presently interning at The Carter Center; and Megan, 17, a high school senior at Marist Academy. Chris had worked as a teacher before the couple was married and continued to do so while Tom completed medical school and an internship at State University of New York in Buffalo. These were years of stellar academic accomplishment for Tom, who graduated at the top of his class and received the university's prestigious Pfizer Award. In 1973, the birth of their first child led to Chris's decision to work at home as a mom and coincided with the beginning of Tom's dermatology residency at Yale. She returned to teaching in 1985 when their youngest entered kindergarten and today is an assistant teacher of second-graders at Spalding Drive Elementary School in North Fulton County. "We both had high expectations of our children," Chris says, "and we're proud of the way they have met those expectations. In many respects, we've been no-nonsense parents, especially Tom. He wanted to bring our kids up to respect other people and to participate in the greater life, not to be insular. That is similar, I think, to his approach at work. He cares deeply about his colleagues, and he expects people to know their jobs and do them. "I think that serving as dean is part of his understanding of his commitment to medicine and to Emory. He understands that he is fortunate and has a responsibility to give something back. We've tried to infuse our children with this same idea."

Married 28 years, Tom and Christine Lawley met in their hometown of Buffalo, New York, in 1964. According to dermatologist Robert Swerlick, Tom Lawley is "just a regular guy, from down-to-earth roots, even-handed, smart, fair--all the things you want from somebody in a position of leadership."

uring his medical school years, Dr. Lawley recalls being focused on going into clinical medicine, with only a limited interest in research, but that changed during his studies at Yale. "After I started training in medicine and dermatology, I began to realize there were many unanswered questions about the pathophysiology and pathogenesis of disease," he says. "I would read journal articles and come away frustrated at the lack of answers. I couldn't imagine we didn't know more than this." After his second year of residency, he accepted an offer from Dr. Steve Katz, now the director of the National Institute of Arthritis, Musculoskeletal, and Skin Diseases, to do a two-year research fellowship at the National Cancer Institute. He ended up staying at NCI for 13 years, rising from the level of clinical associate to that of senior investigator in the dermatology branch. A colleague of his from those days is Dr. Robert Swerlick, associate professor of dermatology at Emory. He served as a fellow in Dr. Lawley's laboratories during the mid-1980s, where the two collaborated on endothelial research. "Tom's office back then was about 5 by 8 feet and had no door, just an accordion-fold screen," Dr. Swerlick remembers. "He once told me his major goal in life had been to be either a physician or a professional baseball player. He's just a regular guy, from down-to-earth roots, even-handed, smart, fair--all the things you want from somebody in a position of leadership. He has an impeccable reputation in the national dermatologic community. Believe me, in that community you can drop the names of various figures and elicit both positive and negative responses, but with Tom Lawley you hear only positive things, no matter where you go." "Back at the NIH, by the time Tom had decided he was interested in seeking an academic chairmanship, the joke was that he looked at every chair opening in the country, and he was always the number 1 candidate wherever he interviewed. He was very much in demand, and that enabled him to base his ultimate decision on determining the exact right time and place to make such a move. Ultimately, Emory offered all that he was seeking." But not immediately so. As early as 1985, Dr. Lawley had been approached by Emory to head up the Department of Dermatology, which had been without a permanent chair for about a year since Dr. Henry Earl Jones (the department's first and only chair at that time) had left the university to enter private practice. Although the dermatology search committee had been very impressed by Dr. Lawley, Dr. Richard Krause, the dean at the time, made it known that he was not yet ready to appoint a new chair. When the acting chair, Dr. Robert Rietschel, accepted an appointment with the Ochsner Clinic in New Orleans, Dr. Marilynne McKay, chief of the Grady dermatology service, was promoted to associate professor and named acting chair. A few months later, Dean Krause suspended the chairman search indefinitely to mull over the idea of making dermatology a subsection of medicine as it once had been. This period of administrative limbo lasted 3 years, leaving the department unsure of its future. "Needless to say, there was significant attrition among the remaining faculty members, and it was virtually impossible to recruit new faculty under such uncertain circumstances," says Dr. McKay. "I just gritted my teeth and thought of Tara." "The department owes a special debt of gratitude to the dermatology search committee, who helped negotiate Dr. Lawley's eventual move from the NIH to Emory," she adds. That search committee was headed by Radiology Chair William Casarella. "When Dean Krause asked me to head this committee," recalls Dr. Casarella, "he said there were two candidates we couldn't afford. Dr. Lawley was one of those. "In discussing the position with Dr. Lawley, the committee felt that his requirements were relatively modest. Drs. Juha Kokko, Ken Sell, and Dean Warren joined me in pledging some of our departmental resources to Dean Krause to put together the package for Dr. Lawley. The group was so impressed with his accomplishments and character that they wanted to assure his coming by giving some of their funding and research space to the dean. Once that was accomplished, we were fortunate to complete the recruitment. I believe that this degree of faculty enthusiasm is unique in the annals of Emory School of Medicine recruitment." At the time that Dr. Lawley accepted the chairmanship, the number of full-time faculty in dermatology had dwindled to just three--Drs. McKay, Mary Spraker, and Hans-Jurgen Ristow--and their entire efforts were focused on maintaining the nine-member residency training program and the provision of clinical services. Despite this adversity, Emory dermatology had managed to keep its residency accreditation and provide daily inpatient care at Egleston and Emory University hospitals, outpatient care at The Emory Clinic, and, with the support of clinical faculty, active dermatology services at Grady and the Veteran's Affairs Medical Center. "The dermatology faculty was elated to hear that Tom had accepted the position at Emory," says Dr. McKay. "It was truly a new lease on life for us to be able to turn over active clinics and an intact residency program to a world-class investigator and clinician. We got an inkling of just how important his appointment was when we saw the extent of the renovations for his labs in the Woodruff Memorial Building. It was clear that dermatology would be well situated for a new era." "I think there was some skepticism in the minds of some of my NIH colleagues as to whether I was making the right move in leaving the mother ship," says Dr. Lawley, "but I had looked at the issue carefully and had no doubt whatsoever." He remembers seeing enormous potential within the department. "When I came here, the Department of Dermatology had clearly fallen on hard times and I was charged with rebuilding it, but that was something I saw as eminently doable as long as the resources were there, and they were, thanks to the support of Dean Krause and Dean Houpt," he says. "The fun of creating a premier department of dermatology was in recruiting new faculty, to have the opportunity to bring the best and the brightest in my specialty to a university and city with such an enormous amount to offer." Under Dr. Lawley's leadership, the faculty grew from three to 18, and the department went from having no NIH funding to become the third-highest NIH-funded dermatology department in the nation. Dermatology also became one of the most interdisciplinary of Emory's departments. In 1993, Dr. Lawley was named William Patterson Timmie Professor in recognition of his contributions to the school, and he has received numerous national honors.

Both Lawleys were post-WW II babies, vanguard Boomers, born in the late 1940s to blue-collar, two-working-parent families in a town that promoted itself as "The City of Good Neighbors." The Lawley family at John's 1997 graduation from Emory College (l to r): Tom, Jr.; Tom, Sr.; John; Christine; and Megan.

n 1995, Dr. Lawley was named executive associate dean of the School of Medicine and in May 1996 was asked to serve as interim dean following the resignation of Dr. Jeffrey Houpt, who stepped down after eight years to pursue a sabbatical. Following a national search for a permanent replacement, Dr. Lawley was named to the position in September 1996. His was the first major appointment of Dr. Michael M.E. Johns, director of the Woodruff Health Sciences Center and executive vice president for Health Affairs, who came to Emory from Johns Hopkins in July 1996 and who played an active role in selecting the dean before his arrival. Beyond consolidating the achievements of his predecessor, Dr. Lawley spent much of his first year as dean focusing on laying the groundwork for the future. Early on, he was appointed by Dr. Johns to co-lead an effort to develop a strategic plan for research for the medical school and for the entire Health Sciences Center at Emory. Dean Lawley's partner in this effort was Dennis Liotta, PhD, the university's vice president for research. "In working with leaders throughout the health sciences, our most critical discovery was that we all share a reasonably common vision of where we need to go, in research as well as in clinical delivery," says Dean Lawley. "Everything else is the details of how we get there." "It was clear as we worked to develop the strategic plan that we had to address some fundamental issues--like having faster turnaround time for grant submissions in the Office of Sponsored Programs and having adequate laboratory and clinical space, space for research animals, and classroom space for teaching." University and Health Sciences Center leaders collaborated on formulating the plan, meeting over the bulk of the past year to discuss impact on university-wide collaborations, clinical services, faculty and graduate students, technology transfer, and other issues. The completed plan was presented to Dr. Johns for his review in September and was approved by the University Board of Trustees at their December meeting.

ut even before the plan got any official stamp of approval, nothing was ever going to be the same, say both Lawley and Liotta. The planning process has changed how we do business forever, replacing a culture of insularity with one of increased collegiality and shared purpose and programs. Some of the themes that sounded with drumbeat regularity were the value of interdisciplinary work, the need for mechanisms and structures to encourage and reward such efforts, and the importance of supporting and encouraging researchers at all levels, from students to senior faculty. "The strategic plan acknowledges that discovery and innovation in basic and clinical research form the foundation of excellence in medical education and health care," says Dean Lawley. Some specific goals to be met within the next five to seven years include the following: develop about 500,000 gross square feet of new research space increase the number of research faculty, to be selected from nationally recognized, innovative senior leaders in their fields develop multidisciplinary centers of excellence that combine clinical evaluation and care with clinical and basic research expertise ensure the school's investment in researchers' expertise through bridge funding for researchers who are between grants enhance partnerships with industry require leadership accountability in all clinical departments for contributing to the growth and success of research raise internal expectations for excellence, for responsibility, for productivity, and for collaborative contribution to the goal of making the School of Medicine a top-tier medical institution.

r. Lawley is hoping for the enthusiastic support of alumni as the school implements this plan. "I recently met with several Medical Alumni Association officers--Drs. Walker Ray, Barbara Croft, and Maggie Mermin--to discuss that very issue and was gratified by their response. We also discussed ways that the school can establish stronger institutional support for the MAA. We want to work much more closely with alumni and become more attuned to their needs and desires. We hope to provide all alumni with easier and more frequent access to information from the school and any support they need. An immediate goal is to fill a vacant professional staff position and hire a new director of alumni relations for the school. This is a key link between the school and its graduates that has regrettably been missing for the past couple of years." The ultimate purpose of these changes, Dr. Lawley says, is to improve the state of medical education at Emory, to allow the school to produce physicians who are capable of delivering the best possible care to their patients. "A constant theme--whether we're talking 1958, 1978, or 1998--is that the patient has to come first," he says. "The nuts-and-bolts practice of medicine never stops evolving, in terms of new technology we can apply to diagnose and cure disease or in terms of the environment in which we practice, with the advent of managed care. Technology and environment have changed enormously since most of us went to medical school, and Emory is striving to stay ahead of these changes. It is my sincere wish that our alumni will contact me personally with their suggestions and concerns as we work together to make Emory one of the nation's pre-eminent schools of medicine."

Darryl Gossett