Kate Powis: Plan C

Kate Powis in a maternity ward in Boston

By Martha Henry

Plan A
As a young adult, Kate Powis loved to solve puzzles. Her father was a Secret Service agent and she planned to follow in his footsteps. She took college courses in criminal justice, financing her education by working as a “loss prevention” officer at a chain of department stores. She questioned shoplifters and employees caught stealing, but she didn’t enjoy the work. She often found herself in tears following an interrogation. “At the end of the day, I needed to be doing something more positive,” she said.

Plan B
She switched jobs to work at a distribution center. By the time she finished her undergraduate degree at California State University, she was a district manager.

Kate moved to Virginia to work for another department store chain. After a few years, Circuit City approached her to start a nationally chartered bank so the company could issue its own credit cards. Kate helped establish the bank while putting herself through an evening MBA program.

The bank was enormously successful ahead of schedule. Kate, still in her 30s, became the bank’s vice-president, managing up to 1,500 people, flying on private jets, and earning an impressive salary. “My life was very different then,” she said.

She became active in a local church. In 1991, she volunteered for a trip to Jamaica to help repair a hurricane-damaged church. Working in the rural village was her first close-up exposure to poverty. “There was a little girl who had broken her leg when she was two—a compound facture that was never set,” said Kate. “She didn’t have access to healthcare and her leg was permanently deformed because of it. She would never walk right.” While pounding nails on a rooftop in Jamaica, she had a life-altering moment. “I realized I could be doing something better with my life than earning a profit,” she said. She decided to become a doctor.

Plan C
She had none of the required pre-med courses. While continuing to work at the bank, she took one course at a time, including physics and organic chemistry. “Though it was a radical decision, it was a slow transition,” she said, “but I never lost focus on where I was headed.”

To enhance her chances of getting into medical school, she became a certified Emergency Medical Technician (EMT). She spent one night a week riding in an ambulance, then went to work at the bank in the morning.

In 1999, at the age of 40, Kate was accepted to the Medical College of Virginia. After graduation, she did a combined residency in internal medicine and pediatrics at Massachusetts General Hospital (MGH) in Boston. She worked in Indonesia for several months, helping to re-establish the healthcare system after the 2004 tsunami. It had been over a decade since Kate’s Jamaica decision, but she had become the doctor she wanted to be.

At a colleague’s suggestion, she contacted Harvard AIDS Initiative (HAI) researcher Dr. Roger Shapiro, who was conducting a study in Botswana to determine the best methods for preventing pregnant women from passing HIV to their infants. He agreed to let Kate work as a study physician. After she arrived in Botswana and her skills became apparent, her role was expanded. “She’s a fast learner,” said Shapiro. “She understands every aspect of a trial—from the data needs to the larger public health implications.”She was awarded a Global Women’s Health Fellowship from Brigham and Women’s Hospital (BWH). Her plan was to expand a training program for midwives in Indonesia to help reduce mother and infant mortality. Kate bought her plane ticket, but the week before her departure, the project fell through. Dr. Paula Johnson, Chief of the Division of Women’s Health at BWH, remembered how Kate handled the setback.”She immediately began looking for another opportunity. She didn’t doubt that she would continue to move her work forward.”

“I come at medicine and research with a much different perspective than someone who came straight through as an undergrad to medical school,” said Kate, referring to her business background. “I enjoy taking a process and figuring out how to improve it. And by improving it, I mean being able to measure that an actual difference is being made.”

Drs. Made Afata and Kate Powis at Scottish Livingston Hospital in Molepolole, Botswana
Drs. Made Afata and Kate Powis (right) at Scottish Livingston Hospital in Molepolole, Botswana

Kate earned a Masters of Public Health from the Harvard School of Public Health in 2009. She now spends half the year at the Chelsea Urgent Care Clinic on the outskirts of Boston and the other half in Botswana. Her research focuses on how a mother’s HIV infection influences both the mother and child, even if the mother does not transmit the virus to her child.

Nearly one third of all infants in Botswana are born to HIV-positive women but remain uninfected because their mothers received antiretroviral drugs during pregnancy. The HIV-exposed infants have a two-fold higher risk of dying compared to unexposed infants. The reasons are unclear.

Kate and her colleagues at HAI are trying to determine why HIV-exposed but uninfected infants have a higher mortality rate and are working to identify modifiable risk factors that will save their lives.

Her research efforts are gaining attention. Kate was just awarded a K23 Career Development Award from the National Institutes of Health to help support her work for the next five years. “It was our lucky day when Kate joined the Botswana–Harvard program,” said Dr. Max Essex, Chair of HAI. “This is public health research at its best.”