THE BRITISH MEDICAL JOURNAL
BMJ Career Focus 2004;328:s37 (24 January), 2004
PROFILE
Renaissance Woman
Desiree C. T. Cox (previously Cox-Maksimov) has a
PhD in medical history, founded a charity to promote live music in
hospitals, sings jazz, and is a psychiatry trainee. She told Gavin Yamey what
motivates her
Many doctors secretly dream of having a second career as a writer or performer,
but our dreams get thwarted by rigid career structures and heavy on-call
commitments. But if you're willing to step off the traditional career ladder,
says the inspiringly energetic Desiree Cox, anything is possible. "Focus on what
you really care about and don't just follow the crowd."
What Desiree really cares about are music and medicine. And growing up in the
slums of Nassau, Bahamas, she must have been a pretty focused child to realise
her twin passions. "My father's a barber; my mum started off as a secretary. I
was the first in my family to go to university."
"Focus on what you really care about and don't just follow the crowd "
When she was five, she gave her first public performance as a singer, and by the
age of 11 she was the soloist at the state funeral of the first governor general
of the Bahamas. A singing career clearly beckoned, "but apparently as a child I
said to my grandma that I wanted to be a doctor." To raise money to go to
university, she later gave recitals and also won two Bahamian scholarships.
Not wanting to rush into medicine, she first did a bachelor of science at McGill
University in Canada. She then won a Rhodes scholarship to study medicine at
Oxford University in England, the first Bahamian and first woman from the
British Caribbean to get this award.
The course was harrowing. "The two years of preclinical were fine, but the
clinical I found emotionally difficult." She struggled with "the sickness of
hospitals" and was close to leaving medicine when she found a way of viewing it
"that kept me sane." Through talking with friends who were historians and
philosophers at Oxford, Desiree discovered writers like Thomas Kuhn (who
popularised the concept of a "paradigm shift") and Susan Sontag (author of
Illness as Metaphor) and realised that medicine could be seen through lots of
different lenses: "I opened my eyes to seeing medicine as a paradigm, not
something real."
She decided to pursue an academic career and put off doing her house jobs. She
began with a masters degree in the history of medicine at Cambridge and was
encouraged to choose a topic by following her heart. "My tutor asked me, `what
do you love?' and the answer was, music. This was how I got interested in the
Renaissance, a period when there were no boundaries between art, music, and
medicine. This resonated with me."
Her master's thesis was on one of the most important works of 17th century
literature and science-Burton's The Anatomy of Melancholy and was published in
the journal The History of Psychiatry. For her PhD, she delved into the history
of the randomised controlled trial in Britain and loved the "thrill of the
chase."
"If you're enthusiastic, you can do it all."
At this point, she says, she could easily have turned the PhD into a book and
settled into life as a full time academic. "But I ran out of funds in the last
year of my PhD. I was on the dole and had to housesit as a way of getting by. I
realised I had to earn a living, so I thought I'd do house jobs and then go back
and write the book."
As with her clinical training, house jobs were a phenomenal challenge and she
turned to writing fiction as a way to process her experience. During that time
she helped to set up a website with Sir Ian Chalmers on the history of
controlled trials (www.jameslindlibrary.org).
She got the day off to present a paper at a BMJ conference to celebrate 50 years
of clinical trials. It was all rather surreal: "I was a surgical house officer,
up on stage with Sir Richard Doll and Philip D'Arcy Hart [two of the
investigators in the first ever RCT, of streptomycin for tuberculosis]."
She then looked for a medical specialty that would give her some flexibility so
she could write the book of her thesis. As a student, she had enjoyed her
psychiatry attachment at the Warneford Hospital in Oxford so she applied to the
training scheme at the Maudsley Hospital in London.
But after the privilege of Oxbridge, she was "shocked by the deprivation of
south London. I couldn't believe how much people with mental illness suffered."
She would hear patients' disturbing stories, then "go home and weep every
night." She continued to channel her emotions into writing fiction.
But although she was writing, "there was still an emptiness, something missing."
Life came full circle, and she started singing again, first taking opera lessons
at the Guildhall School of Music in London and then learning jazz.
Keen to pursue her renewed interest in music, she took a six month sabbatical.
It was then that she had the idea of trying to bring live music into hospitals.
Drug companies weren't interested in supporting the idea, but she managed to
find £1000 from a foundation at Guy's and St Thomas's Hospitals in London.
"I
went on to the streets to look for musicians who could really communicate with
people." The result was two days of live music, one at Guy's and one at St
Thomas's. After receiving many letters of support, she founded the charity
Performing Cures, which now has a
programme director and a commercial director, and which aims to "bring a spirit
of joy and possibility through live music and dramatic performances in the
public spaces of hospitals."
Desiree went back to working full time again at the Maudsley and miraculously managed to fit her medical, musical, literary, and academic pursuits into a 24 hour day. How does she manage it, and still get some sleep? "If you're enthusiastic, you can do it all."
"I don't see myself climbing up
the psychiatric ladder
in a traditional way."
She has just begun a post to consult on the Urban Renewal Commission of the
Bahamas, a commission set up by the Bahamian prime minister to help with the
social transformation of the country: "it's a dream come true: the privilege of
making a difference to the people and country of my birth."
Desiree's future looks bright: a first novel in the works, plans to record an
album, and the charity to promote. She is unlikely to follow a conventional
career path to becoming a consultant. "I don't see myself climbing up the
psychiatric ladder in a traditional way."
Instead of climbing the ladder, she'll be guided constantly by the question:
"What speaks to my heart?"
Gavin Yamey, deputy physician editor