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Pulling Back the Curtain: Siobán Keel, MD

December 30, 2021
Siobán Keel, MD
Siobán Keel, MD
Associate Professor of Medicine in the Division of Hematology at the University of Washington School of Medicine, and hematologist at the University of Washington Medical Center and the Seattle Cancer Care Alliance

In this edition, Siobán Keel, MD, recalls early inspiration to enter medicine from her mother, an Irish nurse, as well as those who mentored her along the way.

What was your childhood like?

I had a very happy childhood in Prior Lake, Minnesota, a small town that at the time was two-thirds farm town and one-third folks who commuted to Minneapolis for work. The town was in the process of transforming into what we'd now describe as a suburb.

My family – a very colorful Swiss dad, a spectacularly solid Irish mom, and six kids – was recognizably different from my Scandinavian friends' families. I think that lent itself to us spending a lot of time together and growing close as a family.

What was your first job?

I was a referee for an under-10 youth soccer league. I was FIFA-certified but still had only a limited understanding of the offside rule, which I regret may have affected the outcomes of some of the games. I remember that it was good money at the time – $8 for a 50-minute game, so I could pocket about $25 per week.

The games were played at the base of the big hill in town that everyone used for sledding in the winter. All the kids wore regular sneakers, rather than soccer cleats, so the natural grass fields remained pristine for the entire summer league, which allowed the younger kids to take a short, mid-game nap on the soft grass when they got tired. That was the level of competitiveness among the players. The parents were a different story.

Dr. Keel in Lake Tekapo, New Zealand in 2018.

What type of work did your parents do?

My father was an electrical engineer who worked for the Control Data Corporation designing disk drives, and my mother was a nurse. With six kids at home, there was a period when she wasn't working and her nursing license lapsed, but when I started school, she began the recertification process. That meant studying at nights and, eventually, working night shifts because she wanted to be there when we got home from school.

Did your mom influence your decision to go into medicine?

Yes – she is a giant figure in her children's lives and medicine was highly esteemed in our house. I think it was the only career I ever seriously considered.

She grew up the youngest of eight children on a farm in Ireland. She worked as a nurse in London, in the Middle East, and eventually at Mayo Clinic in Minnesota.

I remember hanging on her every word when she would tell us stories about her job, like her story of caring for a wealthy, elderly man in his home, which she described as a mansion way out on the moors. When he passed away, she said she could hear the banshee crying in the moors.

In another story – which she told maybe three times over 40 years, meaning it was a huge deal when she told it – she was rushing into the Royal Hospital in London in the rain. She was fumbling to close her umbrella while simultaneously wiping the rain from her eyes when she bumped into a broad figure – who she realized was Winston Churchill. He said, "Excuse me, madame." And my mom, who always delivered the next line of the story with pride in knowing that he had been very recently knighted by Queen Elizabeth II, replied, "Please excuse me, Sir Winston."

Getting a rare glimpse of my mom in her nurse's cap, which identified where she had trained, in one of our family slideshows or getting to try on that nurse's cap when she reorganized her closet were magical moments in my childhood. It felt like I was getting a peek into a spectacular profession where spectacular people like my mom worked to help others. I wanted to be a part of that.

Dr. Keel and her husband, Joseph Marquez, outside of The Church of the Good Shepherd in Lake Tekapo, New Zealand.

When you started your medical career, what drew you to hematology?

I rotated in the hematology clinic as a medical student and later as an intern at the University of Minnesota. Trainees would sit at the microscope and review the peripheral smear of every new patient they saw with the attending and discuss the case. I was fortunate to sit at the scope and learn from Nigel Key, MD, Dale Hammerschmidt, MD, Catherine Verfaillie, MD, Gregory Vercellotti, MD, and others. Hematologists thought deeply about the pathophysiology of disease and they seemed to be an optimistic bunch – they were determined to better understand the unknowns and help their patients.

I also remember thinking that blood and marrow are so accessible – not like studying the human heart. So, shouldn't we be able to figure everything out? This hooked me on hematology. The challenges seemed approachable and the people interested in those challenges seemed capable, kind, and committed.

At that point, I had lived very happily my entire life in Minnesota, but I thought it was important to train elsewhere for my fellowship. I moved to the University of Washington, which turned out to be a great move.

Having spent your life in Minnesota, was moving to Washington a big transition for you?

The biggest change was obvious – the geography. There are mountains out here; in Minnesota, we skied on Buck Hill, a hill, as the name implies! I liked the culture in Seattle, and the people in the Division of Hematology at the University of Washington seemed very similar to the people I admired and worked with at the University of Minnesota. When I interviewed here, I thought, "This place is wonderful and a good fit."

Can you tell us about someone whose mentorship has had a big impact on you as a leader?

I am fortunate to have been mentored by many wonderful and amazing people throughout my career, who continue to enrich my life in innumerable ways. I would like to mention many people, but I will stick with the request to name just one individual. When I first came to Seattle, I worked in the laboratory of Janis Abkowitz, MD, on the coordinate molecular regulation of heme and globin synthesis. Dr. Abkowitz, who was the 2013 President of the American Society of Hematology (ASH) and is the current Chair of Hematology at my institution, is extraordinarily generous and diligent in passing her scientific and professional skills to colleagues and the next generation. Moreover, she is a person of true grit, relentlessly dedicated to the people and projects she invests in.

“[I was] hooked on hematology. The challenges seemed approachable
and the people interested in those challenges seemed capable, kind, and committed.”

–Siobán Keel, MD

When I think about Dr. Abkowitz, I'm reminded of comments that President Barack Obama made in his farewell speech. He said that, in the work of democracy, for every two steps forward it may feel like we take one step back, but that over the long haul we move forward. Dr. Abkowitz has taught me many lessons, including that making a meaningful change in science – or anything, really – requires patience, time, and focus.

What is the best advice you've received?

"Do something you enjoy." While it is a cliché, it is also true. I'll add a little something extra: Do something you enjoy and remind yourself to enjoy yourself while you are doing it.

What advice would you pass on to early-career investigators?

Very closely align your research activities with your clinical work. There are just so many examples of how really thoughtful clinical observations have informed meaningful science. You could be pulled between the two realms, but it's much better if the two can push forward together.

Dr. Keel with her parents (Beat Keel and Sarah Tracey-Keel) in Minneapolis in 2019.

What is the highlight of your day?

I am grateful that my days are generally filled with many wonderful moments – talking through projects or questions with lab colleagues or collaborators, crafting a clear experimental question and the steps needed to answer it, and, of course, caring for patients.

I particularly love hearing the details of a patient's experience to put together individual clues that help me establish a diagnosis or choose the best treatment. Since I work with patients who have so-called "rare disorders," and because we are still sorting out how to best help these patients, I routinely reach out to colleagues in other fields and institutions to review cases. I enjoy those high-level conversations and email exchanges about current science, clinical trials, and how to do the best we can right now for a patient. Later, with more work, we'll be able to do even better. These moments also come with the reminder that my field is populated by wonderful people – it's a treat to be part of that every day.

I am generally an upbeat person, so I don't dwell on the less enjoyable parts of my day (sitting in traffic, filling out EMRs, completing Doodle polls, etc.) and try to just keep moving forward.

What do you enjoy doing in your off hours?

My husband and I like to spend time outdoors. We generally train for a couple of half-marathons each year. And, while we are not hard-core about it, we enjoy hiking and camping in the Northwest. Our hikes and camping trips are generally centered on getting to someplace with a pretty view where we can have a nice snack or try out a new camping gadget. We also like to garden.

Dr. Keel with her family in Dellwood, Minnesota, in 2019.

How did you meet your husband?

We met in Minnesota, where we were both doing our residencies. Joseph was co-resident with a friend of mine from college, who thought that we would like each other.

Before we met, Joseph had flown to Los Angeles for a job interview, and, on the flight back to Minneapolis, he ended up getting bumped to first class and sitting next to the actress Sharon Gless, from the television show Cagney & Lacey. She and Joseph started talking and she gave him tickets to see a play she was starring in in Minneapolis, which turned out to be The Vagina Monologues. He didn't actually have a girlfriend at the time, but he said, "Oh, maybe I'll bring my girlfriend."

Our mutual friend told Joseph he should take me, and so our first date was to see Sharon Gless in The Vagina Monologues. After the performance, she came out and told me, "He's a keeper."

Who would be you dream dinner party guests? What would you ask them?

I like good food and I like to talk to people, so I can imagine many different people who would be fun to throw in the mix here. Two who come to mind are Bruce Springsteen and Michelle Obama. Both are heroes of mine. I would ask them how can we better nourish empathy within ourselves and those around us.

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