Dr. Carol J. Baker’s passion for medicine has been lifelong–almost. “My father was a surgeon during World War II. My mother worked two jobs to put him through medical school,” she said. “After my father returned from the war, at times he would take me on house calls and that’s how I got introduced to medicine.” However, it wasn’t her first career choice. “When I was six, I was fascinated by our garbage collectors because they got to ride on the back of a truck,” Dr. Baker said. “When I asked my parents if I could do that, they said NO. My next career choice was to become a firefighter, because they, too, rode on trucks, but my parents discouraged that choice as well. Finally, when I realized doctors got to ride in an ambulance, I resolved to become a doctor, a choice my parents thought quite possible.”
Her parents’ approval may have been the initial impetus, but Dr. Baker’s commitment to medicine has never wavered since her childhood decision. When she began her medical studies at Baylor College of Medicine in the 1960s, she was one of only two women in her class. By her second year she was the only woman remaining. “It was such a different time,” she recalled. “There were moments I felt singled out by my professors. They would call on me with the tough questions, but I was usually prepared.” Dr. Baker has a way of turning challenges into positives in her life. “When I began my medical studies, there were no call rooms for women medical students and residents. My response…I’ll just learn more because I’ll be up all night. While my (male) classmates are asleep, I might get the chance to see an interesting patient.” Now when asked about her experience during medical school, she jokingly insists she was the only sister in a family with 82 brothers. Her tenacity won their respect and she continues to enjoy biannual reunions with these, now lifelong, friends.
Today, Dr. Baker is a Professor of Pediatrics, Molecular Virology and Microbiology at Baylor College of Medicine in Houston, Texas, where she is known as a tireless advocate for newborn infants and their families. “What can I say? I am not easily discouraged (maybe stubborn) when fighting for a cause. Take screening for group B streptococcus (GBS) carriage during pregnancy, for example. Early in my academic career, I showed that a quarter to a third of pregnant women exposed their babies to this potential pathogen just before or during birth.” One way to prevent life-threatening infection in newborns is to detect GBS carriage during pregnancy and give an antibiotic to GBS positive women during labor. When trials showed this method prevented disease, “it felt as though it became my job in the late 1980s and early 1990s to promote prevention guidelines. It was a long and challenging task.”
For more than a decade, Dr. Baker persisted to make screening for GBS routine care for mothers-to-be. “Working with the Centers for Disease Control and Prevention and other partner organizations we now have reduced the incidence of GBS disease in the first week of life by more than 80 percent,” said Dr. Baker. “I’m very grateful that I have helped to impact people in a positive way.” Now, carriers are routinely given an antibiotic during labor to prevent their babies from developing GBS infection in the first days of life.
Paving the way for routine GBS screening was not Dr. Baker’s goal, however. For more than 40 years, she has advocated for vaccinating pregnant women to prevent GBS disease. She began this work during her pediatric residency in Houston when she noted babies were dying of an infection that was not the gram-negative bloodstream infection common at that time. When querying her professors about this “emerging pathogen,” her concerns were largely ignored. So, she began to collect isolates of this new gram-positive organism from the blood and spinal fluid of sick infants. Still curious, she wrote a letter to a leading authority in streptococci, Rebecca Lancefield, PhD at Rockefeller University.
Dr. Lancefield’s enthusiasm was expressed in a return letter asking Dr. Baker to send case isolates (12 of the 13 were capsular type III, unheard of in Dr. Lancefield’s experience) and to come to New York to learn everything she could to explore this new bug. Dr. Lancefield’s generous and unofficial mentorship led to Dr. Baker’s first publications on the clinical features and epidemiology of early- and late-onset GBS, and subsequently led to her question, “Why did so many exposed babies remain well?” The answer came during her second infectious diseases (ID) fellowship at Harvard Medical School, where she worked closely with Dennis Kasper, MD, FIDSA to address her observation that GBS exposed babies were often born with protective immunity from their mothers. “So, I thought that if we could make a vaccine it could be given to all pregnant women, and babies could be protected from both early and late GBS disease,” Dr. Baker said.
“To me the idea of vaccinating pregnant women in the 1970s seemed reasonable, but I might as well have suggested that all pregnant women have a brain biopsy,” she said. At that time, physicians were hesitant to administer any immunizations during pregnancy. In the decades that followed, the concept of immunizing mothers to provide protection for their infants became acceptable, thanks to Dr. Baker’s work, and vaccines to prevent influenza and pertussis are now routine.
While she didn’t expect the development of the GBS vaccine to take so long – it’s still being developed and not yet available – Dr. Baker believed it was a battle worth fighting. She was also inspired by the parents of the afflicted babies.
“I will walk into the fire if it’s worth it. AND fighting for children and pregnant women is always worth it! If we’re not taking diligent care of our pregnant women, we aren’t going to have healthy babies.”
Despite these challenges, she pushed forward. “I’m an optimist. I have a lot of energy and there’s always work to do,” she said. Dr. Baker sees infectious diseases as a puzzle waiting to be solved. “For me, developing a diagnosis by gathering the clues from the patient and test results is stimulating and just plain fun.”
Her work in pediatric ID has earned Dr. Baker numerous awards, including the 2016 Alexander Fleming Lifetime Achievement Award from IDSA recognizing fellows or members for a career that reflects major contributions to the knowledge of infectious diseases. In 2007, Dr. Baker also received the Distinguished Physician Award from the Pediatric Infectious Diseases Society.
Dr. Baker notes that many of the major achievements in the field of ID are apparent only in the absence of disease, so in that sense they can go unnoticed. “ID is fundamental to all aspects of medicine. Without ID, you couldn’t do surgery or treat cancer. Every part of medicine is dependent on the success of ID physicians.”
In terms of work-life balance, one thing remains constant, she says. There are only 24 hours in a day. It’s important to her to take time for Rockford, her Australian cattle dog, to listen to classical music, work in the garden and host friends and colleagues at her home in Houston. An avid runner for more than 40 years, she began doing triathlons in the later phase of life. “I only gave up competitive swimming as a teenager when I realized I wasn’t Olympic material, a good life lesson,” she joked.
A prolific author, Dr. Baker has written or co-authored more than 400 original studies, as well as reviews and book chapters. She is a reviewer for several scientific journals and has served as an editor of five editions of the American Academy of Pediatrics Red Book on childhood infectious diseases, with the most recent edition being dedicated to her and her career-long dear friend, Larry Pickering, MD, FIDSA.
The IDSA Foundation honors Carol Baker, MD, FIDSA, FPIDS, FSHEA, an unstoppable maverick in the field of infectious diseases, for all the lives you’ve saved and your unrelenting commitment to healthy babies. Thank you, Dr. Baker!