Recognizing Those Who Have Changed Nephrology: Michelle Winn, MD, FASN

Michelle was an incredible physician scientist and human being. She was the heart and soul of our podocyte community. To me, she was the perfect role model, and exemplified everything that is good in medicine and the world. I feel privileged to have counted her as a colleague, a confidante and most of all, my friend. Her passing left many of us heartbroken. To her tribute, her legacy lives on in her many groundbreaking discoveries and amazing nephrologists like Dr. Gentzon.

Susan E. Quaggin, MD, FASN, President, American Society of Nephrology

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Michelle Winn, MD completed residencies in internal medicine and psychiatry, and a fellowship in nephrology at Duke University School of Medicine. She joined the Duke faculty in 1999, and was a founding faculty member of the Duke Molecular Physiology Institute.

During her nephrology fellowship, Winn began to identify and characterize families with familial forms of focal and segmental glomerulosclerosis (FSGS), a form of kidney disease that is one of the more common causes of kidney failure requiring dialysis.

Her research initiated a breakthrough in nephrology, describing a mutation in the TRPC6 gene causing familial FSGS . Before this publication, several reports described genetic variants causing inherited glomerular disease, but the altered genes all encoded structural proteins in the glomerular epithelial cell or podocyte. Winn's finding that altered function of an ion channel could cause glomerular disease substantially shifted paradigms in the field. Her discovery also suggested a new therapeutic approach in proteinuric kidney disease.

Winn received several prestigious awards, including the Presidential Early Career Award for Scientists and Engineers and the Young Investigator Award from the American Society of Nephrology. She was inducted into the American Society for Clinical Investigation. After her death on July 23, 2014, the American Society of Nephrology announced the Michelle P. Winn, MD, Endowed Lectureship, with support from a partnership including ASN, Duke University School of Medicine, the Department of Medicine's Division of Nephrology, and a number of individuals.

Winn was a major advocate for diversity, inclusion and equity, and revered as a role model and mentor. She served as Chair of the Duke Department of Medicine Minority Recruitment and Retention Committee, and she was a member of the Medical House Staff Selection Committee and the School of Medicine Admissions Executive Committee

Working with Dr. Winn:

ASN asked Gentzon Hall, MD, PhD to discuss his experiences working with Dr. Winn. Dr. Hall is an Assistant Professor of Medicine at Duke University School of Medicine. He received his MD and PhD degrees at the University of Maryland at Baltimore School of Medicine and completed his Internal Medicine Residency and Nephrology Fellowship training at Duke University.

Dr. Hall was first interested in a career in cardiology and cardiovascular research. His early career objectives changed after meeting Dr. Winn during an inpatient Nephrology rotation. During that experience, he was particularly moved by the predicaments of young African American patients who often had few therapeutic options after being diagnosed with focal segmental glomerulosclerosis (FSGS).

After his clinical nephrology training at Duke University, he began a postdoctoral fellowship in human genetics research under the mentorship of Dr. Winn. He is now a faculty member at the Duke Molecular Physiology Institute where his laboratory focuses on the genetics of inherited kidney diseases with a special focus on FSGS. Dr. Hall is the inaugural recipient of the ASN-Robert Wood Johnson Harold Amos Medical Faculty Development Award.

Dr. Hall first met Dr. Winn as an intern at Duke University Medical Center:

"Michelle's focus on patients, and the patient experience, informed everything she did. Rounding with her awakened me to the suffering that had been in front of me. Every time she entered a patient's room, she spoke to the person and took the time to make a human connection, rather than immediately addressing the person's illness.

Drawing the patient out of their current circumstance and always knowing their name made her human and relatable; she quickly established trust in many people who did not have a lot of trust in the healthcare system. She challenged any intern, resident or fellow who drifted into the casual use of certain medical descriptors. She steered us away from stigmatizing comments, saying things to us like, 'Don't call a patient non-compliant if you don't understand why.' She shaped our character and how we delivered care. She understood what shut patients down, and always called us back to our humanity."

Working with Dr. Winn, Dr. Hall became interested in kidney research and care. In 2010 he began working in her lab.

"Being exposed to Michelle was special. When she walked into any room, she changed the atmosphere. She was an extraordinary role model and a great ambassador for Nephrology: an African American physician scientist who was doing incredible work, who was so humble and accessible despite her success, and who never lost sight of the patient in her approach to work.

Michelle cherished the experience of learning. She was well aware of vulnerability of young learners, and committed herself to arming those she mentored to be able to carry their own careers with compassion and integrity.

In academic settings, many senior researchers regard the output of the lab as their own work product. Michelle's approach stood out from that. She treated every trainee and junior faculty person in her orbit with respect, gave each of us room to develop our interests, and always credited us for our contributions. She held us to very high standards, but was patient, kind, generous, thoughtful and fair.

At my first ASN meeting, Michelle said to me one morning, "Meet me in front of the convention center at 9:00. We'll start walking." And she took me everywhere, introduced me to everyone she knew, showing me the lay of the land, committing to mentorship as she committed to everything else.

It is truly an honor to have had the opportunity to get to know her."

Dr. Hall reflects on what he remembers most from knowing and working with Dr. Winn:

"Michelle defied what is common for human beings. She was a remarkable personality.

As a physician, she transcended the usual limitations of the doctor-patient relationship.

As a scientist, she never lost sight of the patient and elevated them in their lowest moments.

As a mentor, she inspired confidence in and modeled integrity for her trainees.

As a successful faculty member in a competitive and high-pressure work setting, she consistently demonstrated confidence, poise, determination and creativity.

What were my most important lessons? Compassion for others. Professionalism. Collegiality. Resilience. How one should mentor. How one should teach. And how meaningful it is to others when someone of such great accomplishments remains humble in their walk."

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