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Authentic gold: Celebrating the life and career of Cheri L. Canon, MD, FACR, FAAWR

  • Kristin K. Porter
    Correspondence
    Corresponding author at: University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America.
    Affiliations
    Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, United States of America
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  • M. Elizabeth Oates
    Affiliations
    Department of Radiology, University of Kentucky, Lexington, KY, United States of America
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      Abstract

      Since 1927, the American College of Radiology (ACR) has awarded Gold Medals to up to four individuals each year in recognition of their distinguished and extraordinary service to the ACR or to the discipline of radiology (American College of Radiology, n.d. [1]). As of 2019, only 10 of 194 Gold Medalists have been women. In May 2021, Dr. Cheri L. Canon will become the eleventh woman in ACR history to receive this prestigious award. Contemporaneously, in November 2020, she received the highest honor bestowed by the American Association for Women in Radiology (AAWR), the Marie Sklodowska-Curie Award, presented annually to an individual who has made outstanding contributions to the advancement of women in radiology or radiation oncology (American Association for Women in Radiology, n.d. [2]). Herein we celebrate Dr. Canon's remarkable life and impressive career achievements, and learn important lessons from her shared wisdom.

      Keywords

      1. Introduction

      Since 1927, the American College of Radiology (ACR) has awarded Gold Medals to up to four individuals each year in recognition of their distinguished and extraordinary service to the ACR or to the discipline of radiology.
      • American College of Radiology
      Gold medal award.
      As of 2019, only 10 of 194 Gold Medalists have been women. In May 2021, Dr. Cheri L. Canon will become the eleventh woman in ACR history to receive this prestigious award. Contemporaneously, in November 2020, she received the highest honor bestowed by the American Association for Women in Radiology (AAWR), the Marie Sklodowska-Curie Award, presented annually to an individual who has made outstanding contributions to the advancement of women in radiology or radiation oncology.
      American Association for Women in Radiology.
      Herein we celebrate Dr. Canon's remarkable life and impressive career achievements, and learn important lessons from her shared wisdom.

      2. Early life and influences

      Cheri L. Canon grew up in the 1970s and early 1980s in Garland, Texas, a suburb of Dallas. The younger of two siblings with an older brother, she was raised in a religious community permeated by gender discrimination and racism. Educated in the public-school system, Dr. Canon — as a girl — was encouraged by her counselor to pursue home economics and typing instead of her preference, advanced science courses. Her high school flew the confederate flag, boasted “Dixie” as its fight song, and had a gray uniform-clad southern colonel as its mascot. She did not encounter evolution as a scientific concept until matriculating at the University of Texas in Austin for her undergraduate studies in 1986.
      In her home environment, Dr. Canon's parents instilled a unique combination of values: they extolled traditional women's roles, however, they also encouraged willful independence. Her mother taught science until having children and when Dr. Canon was young, her father was the CEO of a company that published the metro newspapers. Today, on the wall of her office hangs her second-grade art project (saved by her mother) depicting what she wanted to be when she grew up. It demonstrates that, by age 7, Dr. Canon had inculcated these values. The paper doll version she made of her future self was of a veterinarian who earned three dollars an hour, cared for a family, cooked and cleaned, and lived in a house in “Floradu” (Fig. 1). While ultimately completing a B.S. in Zoology, Dr. Canon has yet to develop a passion for cooking and cleaning!
      Fig. 1
      Fig. 1When I Grow Up by Cheri Canon (with author's second-grade spelling and grammar). “When I Grow up I want to be a Vetnariun becuas I like anumls. I will go to collage. I will learn about anumls. I will wear a blue smoc. I will make about $3 an hour. I will live in Floada in a house. I will get married. I will have three children and ever day after work I will come home and cook and clean house and take care of my children.”
      In such a childhood environment surrounded by gender discrimination, Dr. Canon's adaptive response was to become traditional-gender-stereotype-nonconforming, or, as referred to at the time, a “tomboy”. This approach was encouraged by her parents, predominantly her father. She learned to hunt, fish, and drive a boat at a very early age. She still has the 6 mm Remington rifle gifted to her by her grandmother on her 15th birthday. Dr. Canon was a devoted Dallas Cowboys fan and spent many Saturday and Sunday afternoons studying the nuances of football with her father and learning the names of the players whose faces were depicted on a poster on her bedroom wall. Through these early life experiences, Dr. Canon became independent and self-sufficient. She cultivated a competitive spirit, and decided that shaping her behaviors along traditional masculine lines would lead to her success.
      Early on, Dr. Canon worked at various jobs; she babysat, mowed lawns, and worked every summer. While she only lasted as a telemarketer for a half-day, she worked as a Merry Maid for an entire summer! In high school, she told her family physician, Dr. Charles Tubbs, of her interest in medicine. Dr. Tubbs gave her a clerical office job, filing and answering phones. During her time with him, Dr. Canon solidified her interest in medicine and admired the pivotal role that he, as a primary care physician, played for families in the community.

      3. Medical education and early career

      After completing her undergraduate degree at the University of Texas at Austin, Dr. Canon attended medical school at the University of Texas Medical Branch Galveston. Surgery appealed to her, and by her third year, she was seriously considering a career in orthopedic surgery. Fortunately, she enrolled in a radiology elective, thinking it would be beneficial for orthopedics. During this elective, Dr. Canon met two influential radiologists, Dr. Mel Schreiber and Dr. Sandy Rubin, and her career trajectory completely changed. The intellectual problem-solving aspect of radiology fascinated her, and she found that she loved everything about radiology as a specialty.
      Radiology was one of two lifelong relationships that began during her third year of medical school. Dr. Canon also met her husband, Dr. Malcolm Nelson, at that time. He began training in emergency medicine in Baton Rouge during her fourth year, and proximity to him factored into her decision to look at radiology programs in the southeast. Until she visited The University of Alabama at Birmingham (UAB, at Dr. Sandy Rubin's urging), Dr. Canon had been quite analytical about evaluating residency programs. She had constructed a complex table of pros and cons on butcher paper, listing all of the possible programs. After her interview day at UAB, she ditched the pro/con chart, and went with her gut feeling that UAB was the perfect place for her. Dr. Canon joined UAB as a diagnostic radiology resident in 1994. Both decisions of the heart that year would positively shape the rest of her life.
      At UAB, the residency program director, Dr. Robert Koehler, became Dr. Canon's mentor. She completed a six-month mini-fellowship with him during her fourth year in 1998, and intended to stay at UAB for an abdominal imaging fellowship. Then-department chair, Dr. Robert Stanley, offered her instead the opportunity for a faculty position, which she eagerly accepted. Dr. Canon quickly assumed leadership of the medical student elective in radiology. When asked where she wanted to be in five years, she conveyed to Dr. Koehler that she wanted to be in his position as the residency program director! He mentored her into that position as well as sponsored her to join a subcommittee of the UAB School of Medicine's Curriculum Committee. She was appointed chair of the Curriculum Committee, which was charged with implementing a new organ-based curriculum. She served as one of the primary authors of this curriculum. To date, the challenging process of change management in transitioning the decade-old traditional medical curriculum to the new organ-based one remains one of the proudest accomplishments of her professional career. Dr. Koehler continued to champion Dr. Canon as she took on the role of Vice Chair of Operations at UAB Radiology; even today, she often finds herself contemplating, “What would Bob do?” when making decisions.
      As Vice Chair, Dr. Canon began to develop her own personal style of leadership and problem solving. She has a passion for change and is restless with the status quo. She strives to remove clutter and reduce friction, while balancing empathy and patience. Reflecting on being appointed to that position, Dr. Canon remarked, “Everything just unfolded. You see things that you can make better, and you step in and you try to do it.”
      • The University of Alabama at Birmingham
      It was this passion and the resultant accomplishments that led to then-chair, Dr. Reginald Munden, sponsoring Dr. Canon to serve as the interim chair of the UAB Radiology Department when he returned to Texas in 2010. One year later, she became the permanent Department Chair, a position she has held for nearly a decade and one which she describes as one of her most satisfying achievements. Initially, Dr. Canon admits she was terrified of the responsibility and of leading those who had trained her. However, she overcame this “ultimate imposter syndrome” and learned to focus instead on celebrating her faculty's and trainees' successes.

      4. Developing a professional network and reputation

      During and after her rapid ascent to Radiology Department Chair at UAB in 2011, Dr. Canon has developed a vast professional network, serving in many key roles and positions that underscore her breadth and depth of service. The list of major national organizations is impressive, and includes but is not limited to: The Academy of Radiology & Biomedical Imaging Research, Accreditation Council for Graduate Medical Education, AAWR, American Board of Radiology (ABR), ACR, American Medical Women's Association, Association of Program Directors in Radiology (APDR), Association of University Radiologists, Radiological Society of North America (RSNA), Society of Abdominal Radiology, and Society of Chairs of Academic Radiology Departments (SCARD).
      Regarding the ACR, Dr. Canon's service began in 1996 when she served as the resident representative of the Alabama Academy of Radiology; she has given back to the ACR ever since. A few highlights of her many ACR endeavors include: founding member of the Board of Directors and faculty for the Radiology Leadership Institute; Vice President; Board of Chancellors; Commission on Education Chair; Executive Committee; and, of course, Fellow. Dr. Canon has served on several editorial boards, notably the Journal of The American College of Radiology (JACR).
      Befitting an academic superstar, Dr. Canon has received many teaching, scholarly, and service awards and honors, including the JACR Recognition of Exceptional Manuscript Review in 2014, as well as the ABR Distinguished Service and Lifetime Service Awards in 2012 and 2013, respectively. She has delivered nearly 130 invited talks to audiences at many national and international meetings and conferences, and has served as a Visiting Professor at many major universities. Dr. Canon has authored nearly 70 publications, including game-changing papers related to diversity and inclusion, women and parental leave, wellness and professionalism.
      As a member of the Intersociety Conference Executive Committee, Dr. Canon was instrumental in developing and disseminating the first (2019) Statement on Professionalism aimed at creating a safe and more inclusive environment for the House of Radiology; it is being accepted across radiology's professional societies, and perhaps most significantly, it was adopted by the ABR in its Maintenance of Certification Attestation. As only the second woman president in SCARD's more than 50-year history, Dr. Canon spearheaded a statement on parental leave, which has been endorsed by both SCARD and the APDR.

      5. Later career and reflections for the future

      A hallmark of Dr. Canon's early career was “he-for-she” sponsorship. She has remarked, “For the first half of my career, I didn't think about gender at all … I actually thought that we should be agnostic to gender.”
      • The University of Alabama at Birmingham
      As one of only a handful of women radiology department chairs in the country, she quickly realized that, “If we're going to get the equity and diversity that we all know we need, we're going to have to be a lot more intentional.” As such, Dr. Canon has dedicated herself to the advancement of women in radiology with a goal of seeing 50% of radiology chairs as women before she retires. As co-creator and co-director, she co-chairs the steering committee of the SCARD GE Healthcare LEAD (Leading, Empowering and Disrupting) women's leadership program. Founded in 2018 in partnership with the General Manager of Academics at GE, Ms. Rachel Gilbreath, this innovative program has taken off, gaining in reputation and competitiveness. Dr. Canon has solidified an important cornerstone of her vision and legacy; her ultimate goal for this program is a world that no longer needs such programs!
      Throughout her career, Dr. Canon has observed overt sexism morph insidiously into microaggressions, which are more challenging to deal with; such microaggressions must be uncovered and mitigated. She emphasizes that diversity is not a women's issue, but rather a community issue. Much like her early career, there has to be collaboration between men and women to effect real change. She emphasizes that we have to push for progress, as there is much catching up to do. Moreover, Dr. Canon emphasizes that many women still have two full-time jobs, including the “second shift” [at home], and that they still do not receive the recognition and support they need and deserve. In her role as department chair, she embraces part-time and creative scheduling, explaining that it promotes both gender and generational diversity. She abhors gender- and race-based wage gaps, and she has worked diligently to abolish them in her department.
      Dr. Canon's empathy for the challenges that women and parents face comes from personal experience. She is the mother of two and in a strong partnership with her husband, Dr. Nelson, an emergency medicine physician, whom she credits as her first emotional intelligence coach. He has given her the perspective into the occasionally adversarial radiologist and emergency medicine physician relationship with the radiologist playing armchair quarterback to the emergency medicine physician's decision-making and the emergency medicine physician's assumptions that the radiologist is sitting in a dark room, drinking coffee and passing time. Dr. Canon credits him for much of her success, emphasizing that without him, “It would not have worked. He is beyond supportive. He is the main caregiver for our children … The first half of our marriage, I raised the family, and then it flipped. He's been the one who for the last 10 years has been getting the kids to school, to doctor's appointments. He's the household organizer; he keeps the kids when I travel.” Their partnership has strengthened while tackling professional and personal challenges, including caring for and raising their son, Evan, who has battled seizures, neurosurgeries, neuroablations, and countless imaging procedures since he was three. Dr. Canon, who admits to not being fearless, but rather instead working hard to act courageously in the face of fear, describes Evan as the bravest person she knows.
      By refining her emotional intelligence and through self-reflection, Dr. Canon has since rejected her childhood notion that conforming to traditionally masculine behaviors are necessary for success. Rather, her message now for women and her own daughter, Olivia, is to be their authentic self. She still holds tightly to independence, imparting this empowering, practical advice to Olivia and other women, “Always own your own car.” Dr. Canon recalls that she had many negative experiences in dealerships as a young woman, fielding questions about who would be signing the car loan with her. Two years ago, she knew the exact car she wanted. The salesperson walked by her, extended his hand to her husband, and inquired what could he show him. Dr. Nelson responded to the salesperson that he had just made a huge mistake, and they left the dealership. Resilient and determined, Dr. Canon went back the next day and bought her car from a different salesperson!

      6. 2020 AAWR Marie Sklodowska-Curie Award and 2021 ACR Gold Medal

      Now an AAWR fellow, Dr. Canon has always looked forward to the AAWR luncheons at the annual RSNA meetings where she has witnessed strong, supportive women leaders selflessly sharing their wisdom. She describes these women as larger than life and the luncheons as a respite with friends after long mornings traversing the halls at McCormick Place. Dr. Canon reveals the vestiges of “imposter syndrome” when asked about receiving the back-to-back 2020 AAWR Marie Sklodowska-Curie Award and the 2021 ACR Gold Medal. “Women like Marie Curie, Ruth Bader Ginsberg, and so many others have done truly remarkable things, things that will be impactful for generations of women to come. I pale in comparison and feel my modest efforts really reflect daily efforts of so many women. We all need to step-up to make-up not for the ground we have lost, but for the ground we never had.”

      Acknowledgments

      The authors wish to thank Dr. Cheri L. Canon for her responses to a personal interview, conducted remotely on 15 November 2020.

      References

        • American College of Radiology
        Gold medal award.
      1. American Association for Women in Radiology.
        (24 November 2020)
        • The University of Alabama at Birmingham
        Profile: Cheri Canon, MD.