The Female Leaders Who Shaped an Epilepsy Icon: Reflections From Jacqueline A. French, MD

National Women Physicians Day, celebrated on February 3, honors the contributions and achievements of women in medicine while marking the birthday of Dr. Elizabeth Blackwell, the first woman to earn a medical degree in the United States. For neurologists, the day serves as an opportunity to reflect on the critical role women have played in advancing the field, from pioneering neurological research to enhancing patient care with a holistic and collaborative approach. It also highlights the ongoing need to address challenges such as gender disparities in leadership, pay equity, and representation within neurology, inspiring a commitment to fostering an inclusive and equitable future for the specialty.

Jacqueline French, MD, a leader in epilepsy research, shares her journey from studying classics to becoming a neurologist fascinated by how seizures reveal brain function. French, who serves as a professor of neurology at the NYU Grossman School of Medicine and as the director of the Epilepsy Study Consortium discussed the influence of trailblazing women in her field. She also commented on the unique collaborative approach women bring to medicine, and recent advancements in epilepsy research focusing on women's health issues like pregnancy and medication risks. Furthermore, she highlighted the challenges of balancing autonomy and safety in epilepsy treatment, emphasizing the complexities of progress in gender-focused medical care.

In college I switched my major from classics to Biological Basis of Behavior-The workings of the brain and how biology shapes our reasoning, thoughts and emotions always fascinated me. So it was not surprising that I chose Neurology as a specialty. The same fascination led me to study Epilepsy, as the manifestations of seizures are truly a window to brain function. My career path in research was a slow transition-I started as a pure clinician. At the University of Pennsylvania, where I started my career, the non-research faculty track was "*80-20" (but at that time the 20% academic effort actually meant something). That 20% slowly increased, as I realized the satisfaction of approaching a clinical research question, analyzing data, and coming up with useful insights, until now it is my main focus.

When I began in academic neurology there were few woman chairs. Now, there are many, and I am happy that I can call several of them friends.I am in complete awe of Merit Cudkowicz, MD, MSc, now Chair of Neurology at Harvard. She does amazing research and is an amazing leader, one who leads by building the respect of her colleagues and those in her department. Others include Page Pennell, MD, at Pittsburgh, and Barbara Jobst, MD, at Dartmouth. And my first idol was the late Susan Spencer, from Yale, who with her husband Dennis really put epilepsy surgery on the map. I remember when I first laid eyes on her, during my fellowship, I might as well have been seeing the Beatles.

I do think women see things through a more collaborative lens, which has been good for medicine as a whole.

There has been a great deal of advancement in my field of epilepsy, in our understanding of the impact of the disease, as well as the drugs we use to treat the disease, on issues important to women (birth control, pregnancy planning and impact on offspring). One major issue has been the impact of some anti-seizure medicines on developmental outcomes of children exposed in utero (up to 30% risk of autism in the case of one very effective medication). As a result, in Europe they have made it very hard to prescribe this medication in women of childbearing age. This protects future children, but may deprive women of a life saving drug, even if they have no plans to become pregnant, and raises issues of autonomy. These types of issues could become very important in the future.