Sofía Merajver: Using reasoning to save lives
ANN ARBOR—Dr. Sofía Merajver was 5 years old when she diagnosed her first patient—an uncle who was struggling to breathe and close to death.
An early reader who had become fascinated with the human body, Merajver had just finished reading an illustrated high school textbook about the respiratory system when she visited her beloved uncle, ‘tío Julio.’
As the adults discussed his condition with doctors outside the room, Merajver began questioning her uncle: “Does it hurt when you breathe in or when you breathe out? Does it hurt more at the beginning or the end?”
Based on what she learned from her book, it became obvious to her that the problem was in the diaphragm.
“I ran to interrupt the conversation of my parents with the doctors to share my diagnosis. They looked at me strangely, but they did take him to the operating room and that’s exactly what he had”—diaphragmatic abscess, the accumulation of pus in the cavity behind the diaphragm, she said.
“The doctor had the fancy word for it, but I was able to pinpoint what part of the body was involved. I was so excited. I thought I could have similar successes all the time,” said Merajver, professor of medical oncology at the University of Michigan Medical School, who treats patients and does research at the U-M Health System’s Comprehensive Cancer Center.
It was that experience and her hunger for knowledge, hard work and relentless determination to seek solutions that have helped her become the scientist she is today.
“That’s what characterizes me as a scientist from South America. I’m the product of intellectual wealth, not of material wealth,” said Merajver, who currently leads a multidisciplinary team studying how cancer cells spread through the body. “When I moved to the United States, everyone thought I was very poor. Of course I didn’t have any money, but I never considered myself poor.”
Merajver, who holds a doctorate in physics and a medical degree with an oncology specialization, is the medical director of the Breast and Ovarian Cancer Risk Evaluation Program, as well as scientific director of the Breast Oncology Program at the U-M Cancer Center.
“In research, I use the same reasoning that I used as a child,” she said. “Always try to find the truth and try to understand things in depth.”
Merajver grew up in a tight-knit family in Argentina’s capital, Buenos Aires. Her father, Abraham Merajver, was a medical school dropout who became a lawyer but was a writer at heart. In the family’s small apartment, her father would host the most prominent intellectuals of his time, including writers Carlos Mastronardi, Julio Cortazar and Bernardo Verbitsky.
He and her mother, Rebeca Rotman, had been married for a long time before they had children, choosing to travel instead. She was 40 when Sofía was born.
“My dad was a bohemian. He would write plays for the theatre and play chess, and sometimes he worked as a lawyer. But even then, he felt bad for the people who were poorer than we were. They would pay with chickens, quails. My mom would tell him, ‘Just tell them to pay with money.’ We had no freezer so we had to eat it right away.”
Although they weren’t rich, they weren’t poor. They didn’t have a TV set but they had plenty of books around the house. It was in that environment, surrounded by intellectuals and having to stay quiet when her father met with clients, that she became a bookworm as a young child. At 5, she attended one day of kindergarten and decided that she was not meant to be there.
“I came back and told my mom I didn’t like it. It was so boring,” she said recalling how students were given coloring books. “So I stayed home. We had books, my parents borrowed books, history and geography books. I knew all the names of the rivers in Europe, the mountains in Africa, not the kind of things most kids that age would know about.”
Becoming a scientist
Her teachers noticed her hunger for learning and would give her additional homework and grade her accordingly.
“Being so young and being so sure I wanted to be a scientist, I basically enlisted everyone’s help in furthering my education towards that goal,” she said. “At every step of the way, I encountered tremendous mentorship, people encouraging me to pursue my own ideas. If you want to be a scientist, it doesn’t get better than that.”
When she was 15, she prepared for her college entrance exams while taking turns with her mother and sister to care for her father, who had terminal lung cancer and died a year later.
Merajver enrolled at the Universidad de Buenos Aires to study mathematics and physics, working during the day and attending classes at night. But a couple years later, the civil unrest that characterized the mid-1970s in Argentina would prove to be too much for her.
If she was to become a scientist, she realized she would have to leave the country for a place where classes weren’t suspended every other day and where you didn’t fear violence could break out at any moment.
Leaving her mother and sister behind, she left to study at the University of Maryland, carrying a suitcase full of books in one hand and a bag of clothes in the other.
With tears in her eyes, she recalled the moment she said goodbye to the country she still loves so much, leaving her recently widowed mother behind.
“That tragedy of abandoning the home, leaving everything, abandoning my mom after my dad had passed away, it was a terrible thing that I did. It wasn’t easy and she supported me, of course, but it was terrible for her. We didn’t have money for her to come visit, nothing,” she said, a pang of guilt momentarily shadowing her eyes.
A year later, her mother died of a stroke when Merajver was 20. “I never saw her again,” she said.
At the University of Maryland, Merajver obtained a doctoral degree in physics and did a fellowship at the Naval Research Laboratory in Washington, D.C. But she knew that to be able to touch people’s lives, physics and mathematics were not enough.
“I felt a lot of the work I wanted to do was at the intersection of the physical sciences and biology and medicine,” she said. “And while I was very happy with my science, I didn’t think I would see an application to patients, to human beings, in my lifetime unless I pursued a medical career as well.”
She spent the next 12 years studying medicine and training in internal medicine and oncology at U-M.
Into the future
Things have changed a great deal since Merajver first started thinking about becoming a scientist. In the past, scientists worked in silos, but now they work in multidisciplinary teams to solve complex issues. Her education in physics, math and medicine has proven helpful in navigating and leading such teams, she said.
At Michigan, she has focused her work in translational medicine—translating scientific findings into treatments to patients—in the area of molecular genetics of breast cancer. She works with researchers from across the U.S. and Africa. In 1995, she founded the Breast and Ovarian Cancer Risk Evaluation Program at U-M.
Earlier this year, the multidisciplinary group she’s working with announced it had developed a device to study highly mobile cells to determine how cancer metastasizes. The scientists’ work is cut out for them as they try to replicate in the lab, with engineering devices, how cancer cells negotiate the physical and chemical environments in the body.
She’s counting on something she learned as a 5-year-old.
“It all goes back to sitting by my uncle’s bed,” she said. “And using reasoning to figure out how to save his life.”