Dr Joanne Liu

Can you tell us about your medical education? What led you to a career in medicine and to Médecins Sans Frontières?

Actually, I went to medical school because I wanted to be part of Médecins Sans Frontières. When I was searching for meaning to my life as a teenager, I read books that really made an impression on me. For example, I read a book called Et la paix, Docteur?, about a doctor who worked with Médecins Sans Frontières in a war zone. I had also read The Plague by Albert Camus and in a passage in the book, the protagonist doctor is asked: ” ‘What motivates you? All your patients are dying, you have nothing to offer them, no medicine and you are not even religious’. Then, he answers: ‘I never got used to death’ “. When I read that, I promised myself that I would never get used to death and that I would work for the triumph of life. Following this wake-up call, I joined Carrefour Canadien International and went to work in international cooperation in Africa. After this 3-month mission, I told myself that I would come back to work as a doctor in developing countries. 

Why did you choose to go into the field of pediatric emergency?

During my clerkship, I found that the pediatric patient was the best patient. I quickly realized that I would always be glad to be woken up in the middle of the night to take care of a child. Then, I wanted to do trauma and emergency because I knew I wanted to work in countries at war.

You often said that being a visible minority was a more difficult variable to work with than being a woman. Why do you think that is? How has this influenced your career? 

I grew up in Quebec City where there were three Liu’s in the phone book: my father and my two uncles. Growing up as a visible minority was much more stigmatizing than growing up as a woman. I think it shapes us because there’s not a day that goes by that I’m not reminded that I’m different. For example, if you’re Asian and you’re walking around Montreal, everyone will speak to you in English. Once, when we entered a store in Charlevoix to warm up, the owner asked us: “How long have you been in Quebec?” It wasn’t mean, but we were still labelled. When I arrived at McGill, I was very happy that there was a Chinese community and my first apartment was in Chinatown. 

Have you had any mentors during your career? 

I didn’t have that many mentors when I was younger,, they came later in my career. Actually, at first, I was reluctant to go to medical school because when you saw a big house, you always thought it was a doctor’s house and that wasn’t a model I was interested in. I had more fantasized models, such as Gandhi. And, even though I knew I wasn’t going to go into basic research, Marie Curie was a model of mine, because of how she stood out. She made me realise how important it was to know that there were some incredibly high-performing women out there. 

In my personal life, I was more self-driven. I didn’t have any aunts or uncles or neighbours who were doctors or lawyers. Otherwise, I had a literature professor at Cégep Champlain St. Lawrence, who was a committed activist for Amnesty International, who did everything he could to help me succeed. To me, a mentor is someone who believes in you when you don’t believe in yourself yet. I think it’s less natural [to find one for under-represented minorities in medicine].  

During my interview at McGill, I was interviewed by two caucasian people and the first question they asked was: “why do you want to study medicine, are your parents doctors?” When I replied no, they asked me: “why do you want to go to medical school? You don’t have any role models.” I was completely thrown off guard and I thought I wasn’t getting in. I calmed myself down and thought that if I let myself be affected by these questions, only sons of doctors would get in again and restaurateur’s daughters like me would continue to be overlooked. If we want to change the face of medicine, we are going to have to diversify the people who get into medical school.

How would you characterize your approach to leadership? How do you characterize your approach to leadership, as opposed to the men you’ve worked with during your tenure at MSF? 

I don’t think men are very brave politically and I’ve been regularly let down by men during meetings. I will always remember a high-level meeting on Ebola in Germany, in preparation for the G7. There were Bill Gates, Dr. Peter Piot, who discovered Ebola, Dr. Jeremy Farrar, the director of the Wellcome Trust and Tim Evans from the World Bank. There were 18 people around the table and there were two women, the Ghanaian ambassador to Germany and me.  I spoke about the fact that we should not privatize the response to pandemics, that public health should remain a common right and that it was important for states to take responsibility instead of being dictated by philanthropy. There was a deathly silence. Then, Jeremy Farrar, sitting next to me, said, “She’s so right”. I realized that, as a woman, I still needed the support of a man around the table.

Have you been associated with the stereotype of the hysterical woman?

I think that women are more easily labelled as hysterical when compared to men.. While men are seen as demonstrating leadership,women would be seen as rather hysterical. I am fairly firm in my speeches. If someone tries to cut me off, I would kindly say: “Give me a few minutes, I will just finish what I have to say”. On the other hand, to my advantage, I represented an organization that didn’t talk through its hat and was based on a reality on the ground. 

Have you ever experienced impostor syndrome?

I think we’ve all felt it at some point. We all have doubts and I think it’s healthy to have some to a certain extent because it allows for some humility. But, if doubt becomes your permanent mode of operation, that’s when it becomes problematic. I think that during the last six years as the international president [at MSF] I have had many moments of doubt, but this mandate is also probably the greatest lesson of humility that I have ever had.

How many times have I probably made the wrong decision?

 I ended up understanding that there is no perfect solution and that we have to sort out imperfect solutions. Who am I to claim to always choose the right imperfect solution? Personally, I had mentors who allowed me to get through it. Among those I regularly called is Louise Arbour. I’m a big fan of hers. We became friends and we connected fairly quickly. I told her, “listen, I am facing this [problem]” and she always had a way of sorting things out. She often said to me: “Joanne, you have good judgment, you will find the right answer”. To answer the question you asked me earlier, she’s probably the only woman I could call a mentor.

What mistake would you make again?

I don’t know if I would call it a mistake, because afterwards it was a good decision, but I would say that it is to have refused to complete my fellowship in toxicology to join Doctors without borders. When it happened, I thought for a long time that it was a mistake. I cut myself off from a prestigious job in New York, I went on my first mission, a mission that went awry, and it lead to a divorce. For a few years, I told myself that it was not such a good decision to have refused the fellowship so I could instead go on a mission. A decision is never without consequences: it has a domino effect. At that time, everything was bad in my life and today it has become a single  sentence in an interview. Today I know it was the right choice, but we can’t know that when it is happening to us. 

How can medical students and doctors help defend human rights?

I think that everyday we already do it without knowing it. Being the ones who provide health care, I think we kind of personify access to the right to health. After that,, it’s about knowing how much we want to be part of a more visible with amore public approach. For me, the patient’s right is fundamentally linked to human rights. Personally, when I was in your place we hardly talked about it. Today we talk a lot about it, but it is not really put into practice. I still find there is a very paternalistic side to the way health care is delivered. If we look, for example, at the case of medical aid in dying, this is a debate that was opened decades ago so that today we begin to accept it. Doctors are exceptional beings, like in many professions elsewhere, but it takes a lot to mobilize them into creating movements. They’re busy people, so doing activism on top of that is not always possible. However, I think the best way to defend human rights is to raise awareness around us. I believe that fundamentally, people violate human rights out of ignorance, intellectual laziness or out of convenience. However, when put before the facts, there are common values ​​and what I call “common humanity” that leave no one indifferent. These moments of convergence must be exploited to create a bond of humanity. Instead of focusing our energy on our differences, what separates us and what divides us, we must cherish the unifying moments and use them to get closer to our human condition.

What do you think a “strong” woman is?

I think the idea of strong woman is an oversold rhetoric. I think all women are strong in their own way. I think we get too attached to a glamorous idea of what a female hero is supposed to look, when female heroes are everywhere. For me, the hero is the mother who, during the Darfur crisis, walked for weeks with a child on her back to come to the nutrition center. It was not me, simply doing a small two-or-three-months mission, that was the hero in that story. I have to say I foster an endless admiration for these women.

What advice would you give to future generations of women in medicine?

Be unapologetic. It is very important to understand that as a woman in medicine.. You do not have to apologize for you wanting to take maternity leave or refusing to work a 110 hours per week schedule, because you have decided you needed  balance in your life. I think we have to stop making ourselves feel guilty for wanting to commit to medicine differently than previous generations when medicine was dominated by men. We are going to lose some things, we will gain others and that’s life.  Also, I think you have to be a little stubborn in wanting to achieve your dreams. It’s very easy to have your ambitions swayed when you get diluted  in comfort, flattery or promotions. On the other hand, it is difficult, but very important to hold on to your ambitions and to follow your own path.

What message would you like the reader to take away from this interview?

Life is not about you. Life is not about you, it’s about others. We are so incredibly interconnected that if we want our own life to be balanced, it is imperative that the lives of others are well balanced as well. Remember in your journey, that we do not live in the ostracism of others.