ASAP Member, Dana Hardin, M.D., a former Pediatric Endocrinologist and now an Adolescent and Young Adult Psychiatrist (Board Certified by ABAP in 2022) speaks with ABAP Board Member and Newsletter Editor, Jonathan Bauman, M.D., LFAPA about her passion for her second career.
Interview With Dana Hardin, MD, Diplomate ABPN & ABAP
By Jonathan Bauman, MD, LFAPA, ABAP Newsletter Editor and Board Member
Dr. B.: Dr. Hardin, congratulations on your recent certification by ABPN and ABAP. May we begin with my asking who or what inspired you to pursue a career in medicine, and, in particular, your first specialty, pediatric endocrinology? Where did you train?
Dr. H.: My mom left when I was 5 and my brother 4. We lived with our dad, who was a wonderful man. He encouraged our relationship with my mother’s parents and took us to see them in the mountains near Prescott AZ where they lived in a small cabin. I loved spending time with my grandmother. While dad, my brother and grandpa went fishing, she and I hiked, read books and cooked. When I was 5, I witnessed her having a seizure. She told me that she was a type 1 diabetic and explained the disease to me. I wanted to learn more, so she let me help her test her blood sugar by dropping a tablet in her urine. Eventually she let me give her insulin injections. I declared before I was age 6 that I would become a doctor and take care of diabetes. Grandma and my dad always encouraged me.
I was the first person in my family to go to college and my grandmother sent my SAT scores and transcripts to many colleges resulting in my accepting a great scholarship to attend Indiana University. Before I left home, Grandma wrote to one of her cousins and asked her to “keep an eye on my grand-daughter.” The cousin, Opal, and husband, Martin L., came to visit, which resulted in their offering me the opportunity to live with them and clean and cook for them in exchange for room and board. So I moved to Indiana to live with them and go to college. Opal was 80 and a retired home economics teacher, and Martin was a very gruff attorney who was still practicing law at age 82. They had never had children. My grandma died two weeks before I left for this new life.
I kept my scholarship for all 4 years of college, as it renewed based on GPA. I became close to Opal and Martin L., and learned a lot about toughening up from him. He died my senior year of college. I had planned to return home for medical school, but Opal said she had grown close to me and offered to pay my way in medical school if I would stay with her. She even waived the cooking and cleaning “so you have time to study.” So I went to medical school at IU.
I planned to do endocrinology the entire time I was in medical school; however, I said that would never do pediatrics. I had loved babysitting and was very afraid that my heart would not be able to endure the loss of a child. That sentiment changed when I did my Pediatrics rotation in the ICU the final month of my junior year. There was just something so endearing about children, and I realized that good compassionate care was what was needed even in the face of death. I did not have to fear their death, just do my best. I decided to do pediatrics then pediatric endocrinology. I did my residency and fellowship at Riley Children’s Hospital in Indianapolis to be near Opal.
Dr. B.: Please tell us something about your practice of that specialty.
Dr. H.: I practiced pediatric endocrinology at major academic institutions. I was especially driven to take care of children with diabetes or growth problems who had other chronic illnesses such as cystic fibrosis, Crohn’s disease and cancer. I realized there were so many things that needed to be understood regarding the causes of diabetes and growth problems in children, along with other illnesses. I used my curiosity to develop questions that I sought to answer with clinical research. I was able to obtain multiple research grants and had a successful research and clinical career in pediatric endocrinology.
Dr. B.: What motivated or perhaps inspired you to switch to psychiatry? Where did you train? Were your experiences of moving to psychiatry consistent with your expectations?
Dr. H.: I was drawn to psychiatry in medical school. I loved sitting down and talking to patients and listening to their problems. I was encouraged by my professors to pursue psychiatry, but I had gone into medicine to be an endocrinologist and I did not think I should deviate from my plan. Nonetheless throughout my career in endocrine, I kept being pulled toward psychiatry. Many of my patients had mental health issues such as depression, anxiety and eating disorders. There were never enough providers to see them, so I began to work directly with some psychiatrists who taught me what medications I should use until they could see the patient. I also began working with two child psychologists to develop a program to teach other endocrinologists how to recognize and overcome mental health barriers to adherence with diabetes. The more I learned, the more I knew I wanted to learn and do more. Once my sons were no longer living at home, I decided to pursue psychiatry so that I could learn the things I wanted to know.
I did my training in psychiatry at Indiana University. One of my favorite medical school professors was Dr. Hugh Hendrie. When I was a medical student, he was the Chairman of the Department of Psychiatry. He had strongly encouraged me to go into psychiatry during medical school. Although he had retired, I actually had his contact information because, just six months prior, I had noted the last name of a medical student who came to me after my lecture to ask a question. He turned out to be Dr. Hendrie’s grandson. When I asked Dr. Hendrie if he thought I was crazy for thinking of going back to do another residency, he said “Well, it took you long enough; of course you must. It is where you belong.” He was able to get me an interview and I was offered a place in residence at my alma mater, Indiana University. I really enjoyed residency this time around. I concentrated on learning about the field I found fascinating.
Dr. B.: Tell us about your current position and practice. Have you had any patients or situations of particular interest?
Dr. H.: Currently I am working as a consult-liaison psychiatrist at Ohio Health. I very much enjoy the role and feel it melds my endocrine/medical knowledge with my newfound knowledge of psychiatry. I try to see all the young adults and teens that our group is consulted on, and in the past 12 months I have thus far been consulted on 126 patients aged 26 and younger. I am grateful for my knowledge in pediatrics when dealing with this age group. As part of my job, I also provide ECT care for Ohio Health. The young adult patients with intellectual disability and the young severely schizophrenic patients have really captured my heart. So often they have little or no family support and there is no good place for them to go once they are discharged. I wish there were adequate mental health funding for group homes.
Dr. B.: What motivated you to become certified in Adolescent and Young Adult Psychiatry?
Dr. H.: I always enjoyed treating teens and college students in my endocrine practice and thought I would do a CAP fellowship after residency. However, during residency I realized that I was drawn to the psychiatric needs of teens and young adults. This age group is especially vulnerable. They often hide that vulnerability by withdrawing or by anger and insolence. In short, they are a “tough crowd.” Maybe my years as a physician helped, or maybe surviving the teen years of my sons, but I found I did well with them. I decided to focus on this age group. Obtaining board certification seemed the natural thing to do. I also wanted to be part of a group of psychiatrists who have special interest in working on behalf of this age group. I have always believed the support of colleagues and platforms for discussion provide the best path forward in patient care.
Dr. B.: How did you become interested in treating transgender patients and what motivated you to do so? Tell us about your current practice in this area.
Dr. H.: The final guiding force to my decision to train in psychiatry was gender dysphoria. Even early in my career, I saw children and teens who knew they were different in the way they viewed their birth gender. The families struggled with what to do for their child. The children struggled with their self-confidence and had external pressures such as bullying. I had hormone tools that I could use, but I did not have the training to know when, or if, hormones were appropriate. There really was not much true, unbiased scientific work in this field. I longed to do research in this area. I needed to understand more about psychiatry so I could be part of an informed solution.
In addition to my full-time work at Ohio Health, I work as a national consultant in the field of transgender care for Wexford Healthcare. This company provides medical and psychiatric care to the Department of Corrections. My consultant role is to provide advice to physicians who care for these patients in the prison setting. Prior to becoming a consultant to them, I worked for them by directly seeing adult and youth transgender prisoners in the Indiana prison system.
Dr. B.: Have you experienced any societal issues in your treatment of transgender patients? Are you concerned about any limitations of this practice in a red state?
Dr. H.: I can truly say I have not experienced any major societal issues in my treatment of transgender patients. Perhaps because I worked at major academic institutions, there simply was not any actively voiced dissention about the need to care for the patients. However, many of my patients have reported experiencing stigma and familial lack of acceptance. The amount of reporting I have heard seems to match that reported in the literature and does not seem to be state centric.
I do not think that transgender support, or lack of support, is a political issue. I have lived and worked in “red states”, yet never have I been told that I could not move forward in the care of these patients. Indiana University has a wonderful transgender clinic that trains primary care and psychiatry residents. Ohio has multiple transgender clinics.
Dr. B.: The issue of puberty blockers in transgender treatment has been prominent in the news lately. Given your unique expertise, I imagine you’ve had thoughts about the practice.
Dr. H.: I have long had concerns about prolonged used of puberty blockers. I have used them, but very judiciously. There are many more children and teens who state they are transgender now than even 5 years ago, and that increase in volume suggests social media influence. The role of psychiatry in discerning true gender dysphoria has never been more important!
Dr. B.: Do you have any plans or goals for your career as a psychiatrist going forward?
Dr. H.: I want to do be a part of developing solid scientifically driven guidance on the care of transgender patients. I also want to be a fierce advocate for national funding of mental health that includes housing solutions, particularly for young adults and teens.
Dr. B.: Dr. Hardin, thank you so much for talking with us. It’s a pleasure and honor to have you as a representative of our organization.
Dr. H.: Thank you.