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Hallowed Yalow: The 4th female ACR Gold Medal winner

Published:November 13, 2020DOI:https://doi.org/10.1016/j.clinimag.2020.11.019
      Dr. Rosalyn (Sussman) Yalow (1921–2011) was born and raised in the Bronx, and spent most of her life and career in New York City. She had an early interest in science, particularly chemistry while attending Walton High School. However, while attending Hunter College (now the City University of New York) her professors encouraged her to pursue Physics as a career. While she was an undergraduate in the 1930s, Physics was a seemingly new and exciting frontier: in her own prescient words, “When I was in college, Physics, and in particular Nuclear Physics, was the most exciting field in the world. It seemed as if every major experiment brought a Nobel Prize.”
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      But given that the field at the time (and even to this day) was overwhelmingly male dominated, the glass ceiling she would have to shatter to enter the profession would be a difficult obstacle to overcome.
      Furthermore, the push back she received was not only in the professional realm. In 1941, as Rosalyn approached graduation from Hunter College and started to plan her graduate education, she met with resistance from her parents about pursuing a career in physics given her gender. They wanted her to become an elementary school teacher instead. Despite this and her own self-doubt, which could have held her back, she graduated as the first female physics major from Hunter College. A month after her graduation, she was accepted into the University of Illinois at Champaign-Urbana PhD program.
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      She was the only woman at her first meeting with the faculty of the Graduate Program as well as the first woman at the college since 1917. Although her acceptance turned out to be well deserved, it is important to note the historical context in which she was living. As she remarked: “the draft of young men into the armed forces...made possible my entrance into graduate school.”.
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      The University of Illinois would be the first co-ed school Rosalyn had attended since before junior high,
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      and, in her first class, she would meet her future husband, Aaron Yalow, who was also a graduate student in Physics. Aaron's struggle with diabetes mellitus would be a source of inspiration for some of her future research. They married and, after completing their degree work, returned to New York. They had two children: Benjamin and Elana. Throughout her graduate education, Roslyn Yalow faced many challenges, from having to sit in on extra physics classes to supplement her knowledge (as Hunter College's first physics major, she felt her undergraduate course work was lacking compared to her graduate school peers), the second world war, and professors who were sexist. She received her Master's degree in 1942 and a PhD in Nuclear Physics in 1945. Upon returning to New York, she was an assistant engineer at Federal Telecommunications Laboratory (the only woman engineer)
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      for a short time but then began teaching Physics at Hunter College.
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      She wanted a career beyond teaching but had trouble finding a research position which she attributed to her identity as a Jewish woman.
      In memoriam: Dr. Rosalyn Yalow, PhD., 1921–2011.
      She volunteered in a Medical Physics research lab at Columbia University under Dr. Edith Quimby (the second woman to win the ACR Gold Medal, in 1963) and Dr. G. Failla (Dean of American medical physicists). In a short time, Dr. Failla introduced her to Dr. Bernard Roswit, the Chief of the Radiotherapy Service at the Bronx Veterans Administration (VA) Hospital, as “someone here you must hire”
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      and he did. Dr. Yalow began work at the Bronx VA in 1947, as the Physicist in Radiation Therapy but took on responsibility for clinical studies using radioactive isotopes. She created her own laboratory space by equipping a janitor's closet to function as a research lab, and within 3 years, she had published eight clinical papers under supervision of Dr. Falia.
      • Yalow Rosalyn
      Biographical. Nobel Prize.org. Nobel Media AB 2020.
      By 1950, the clinical procedures using radioactive isotopes had increased to the point where Dr. Yalow told Dr. Roswit that she needed an MD to work with her. A young physician, Dr. Solomon Berson, who had completed training in Internal Medicine at the Bronx VA, was recommended. Berson took the clinical position in the new field and together they went on to pursue joint research and development of new applications. Working together, she strengthened her basic science skills and learned to use radioactive isotopes to measure blood volume components and iodine metabolism which became a useful tool to diagnose thyroid disease. Their experience with handling radioactive materials enabled the team, Yalow and Berson, to pursue investigations that lead to the development of radioimmunoassay (RIA) and groundbreaking clinical application of the method. The initial investigation involved binding radioactive iodine to insulin to study the kinetics in normal subjects and diabetics since a theory had arisen that since the insulin producing pancreatic Islets of Langerhans in maturity onset diabetics were intact and even hyperplastic, it was suspected that the insulin produced was metabolized more rapidly than in normal subjects.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      After observing that in patients who had received insulin injections either to manage their diabetes or as a form of shock therapy in the case of veterans experiencing post-traumatic stress, the radiolabeled insulin cleared from the plasma more slowly than in normal subjects. After demonstrating that the radiolabeled insulin had bound to the globulin fraction in plasma in subjects who had previously received insulin, Yalow and Berson concluded that antibodies had developed.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      This observation alone was remarkable as it had been believed that molecules as small as the polypeptide insulin could not stimulate antibody production. Further research on the kinetics of the production of antibodies to insulin and investigation of the binding affinity lead to the realization that high affinity antibodies could be used in a competitive binding assay to measure insulin in plasma, even in very small volumes, less than a milliliter of plasma.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      This provided the first measurements in small samples of body fluids of this important hormone. A short time later, Yalow and Berson sought to develop antibodies to human growth hormone [HGH], another biologically important polypeptide hormone that could not be conveniently measured in plasma.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      Within a few years, they had developed a clinically useful method to measure HGH in plasma. Hence, the development of radioimmunoassay [RIA] ushered in a whole new era in endocrinology.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      Subsequently, using the general principle of RIA, Yalow, Berson and a small team of young associates developed methods to measure ACTH, Gastrin, parathyroid hormone and glucagon. Other investigators, using RIA were able to develop methods to measure other pituitary hormones, prostaglandins, Australia Antigen and other substances of interest present in plasma in very small quantities. RIA was an incredibly fast, cost effective, and accurate method to measure levels of small molecules in body fluids.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      Based on this ground-breaking work in the development and application of RIA, Dr. Yalow received the Nobel Prize for Physiology and Medicine in 1977, forever cementing her legacy.
      In memoriam: Dr. Rosalyn Yalow, PhD., 1921–2011.
      This recognition came three years after the death of her colleague, Dr. Solomon Berson. Dr. Yalow paid tribute to her late collaborator's legacy by renaming her lab The Solomon Berson Memorial Lab so his name would appear on all her subsequent publications.
      The Editors of Encyclopedia Britannica.
      She also had a replica of her Nobel Prize medal made for Mrs. Berson as Nobel prizes are not awarded posthumously.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      In addition Dr. Yalow received the National Medal of Science in 1988.
      The Editors of Encyclopedia Britannica.
      Dr. Rosalyn Yalow's career was one of excellence but was also full of firsts as she was the first woman scientist to: be elected to the National Academy of Sciences (1975)
      In memoriam: Dr. Rosalyn Yalow, PhD., 1921–2011.
      ; receive the Albert Lasker Basic Medical Research (1976)
      The Editors of Encyclopedia Britannica.
      ; and to be elected as the President of The Endocrine Society (1978–1979).
      In memoriam: Dr. Rosalyn Yalow, PhD., 1921–2011.
      In 1993, Dr. Yalow became the fourth woman ever to receive the American College of Radiology (ACR) Gold Medal, after Marie Curie (1931), Edith Quimby (1963) and Alice Ettinger (1984). Her accomplishments in Medical Physics had an incredible impact on the treatment of diabetes and other diseases, and are a testament to her incredible work ethic and perseverance despite diverse challenges along the way. In the face of obstacles from sexism to the death of her research partner, Dr. Yalow provides valuable contributions to the scientific community, all while raising a family.
      Dr. Stanley J. Goldsmith, Professor Emeritus of Radiology and Nuclear Medicine at Weill Cornell Medical Center, who worked with Dr. Yalow in the late 1960s recalls, “After learning of the discovery of RIA, it was my dream come true [to work with her]…She was the smartest person I ever met. She was brilliant.”

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      In regards to Dr. Yalow's work ethic, Dr. Goldsmith said “She was tireless. She was always at work, regardless of how early I got in. If I arrived at 7:30 AM, she was there…I think I was there for a couple of weeks when I asked her secretary. ‘does anyone ever eat here?’ She never to stop working – but always had time to talk to me, either about the past observations or to discuss possible new research.”

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      Dr. Goldsmith also spoke on how Dr. Yalow, even with her tremendous career accomplishments, managed to be a dedicated mother: “I knew that if she was bothered by something, I could get her to relax… by asking her how her children were, her mood changed and she would glow…Certainly, she was her children's biggest fan.”.

      Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.

      The life and career of Dr. Rosalyn Yalow is not only a story of an individual's extraordinary contribution to science and medicine, but also an inspirational tale about a woman who overcame many obstacles and went above and beyond in her field. Although Dr. Yalow is not a household name like Marie Curie, the first female ACR Gold Medal winner, Dr. Yalow should be similarly hallowed for her groundbreaking-discoveries and glass ceiling-shattering achievements.

      Acknowledgements

      The authors wish to thank Dr. Stanley J. Goldsmith for his invaluable contributions to this article, including granting a personal interview and reviewing the manuscript prior to submission and double-blinded peer review.

      References

        • Yalow Rosalyn
        Biographical. Nobel Prize.org. Nobel Media AB 2020.
        • Yalow Rosalyn Sussman
        (n.d.). Retrieved July 10, 2020, from
      1. In memoriam: Dr. Rosalyn Yalow, PhD., 1921–2011.
        Mol Endocrinol. 2012; 26: 713-714https://doi.org/10.1210/mend.26.5.zmg713
      2. The Editors of Encyclopedia Britannica.
        (Rosalyn S. Yalow. Retrieved July 10, 2020, from)
      3. Teshome S, Arleo EK. Personal interview via Zoom with Dr. Stanley J. Goldsmith regarding Dr. Rosalyn Yalow. 22 July 2020.