Pediatrics
Research
UH Manoa
Faculty
Throughout her medical career, renowned infectious disease expert Dr. Marian Melish has been making key contributions in science. Whether it be making discoveries crucial to understanding Staphylococcal Scalded Skin Syndrome, diagnosing the first case of Kawasaki Disease in Hawaiʻi and being at the state’s forefront during the COVID-19 pandemic. The humble pediatrician and professor at the University of Hawaiʻi medical school says that her passion for her work initially stemmed from her day to day as a clinician. “Mostly, I am a working doctor with her eyes open because all of my experiences have started from cases.”
In fact, her advice to other up and coming physicians and scientists is quite simple: “ I think they should keep their eyes open.”
Marian explains that pattern recognition in her patients is what allowed her to spot the first cases of Kawasaki Disease outside of Japan in the early 1970s. Though Kawasaki Disease is considered rare to most of the world, it occurs most commonly in Japan and Hawaiʻi. She mobilized with her colleagues and established the first international group to work on the disease and together, “we discovered a treatment in 1984 that we’re still using today,” Marian said.
As the UH John A. Burns School of Medicine celebrates its 60th Anniversary this year, Marian celebrates 50 years as a faculty member at JABSOM. Originally from New Jersey, it’s hard to fathom that her arrival in the islands was quite serendipitous.
“ I never expected to be in Honolulu as it happened,” said Marian. “My husband (John) was drafted in the Vietnam War and instead of getting sent to Vietnam, we got off the plane in Honolulu and he became a physician at Tripler for three years.”
Both Marian and John joined the JABSOM faculty just as it was preparing to transition from a two-year pre-clinical program to a fully-accredited, four-year medical school. The couple had met and wed in 1963 while attending Yale School of Medicine.
Through five decades at JABSOM, Marian witnessed how the advent of a medical school in Hawaiʻi immediately made an impact on the community and the quality of healthcare received.
“It was disturbing to me that patients seemed to belong to their doctors,” said Marian as she reflected on her early years in Hawaiʻi.
“If their doctors were well-prepared, the patients received good care. If their doctors were not well-prepared, they didn’t receive good care– there wasn’t really a standard,” Marian explained. “So to me, the coming of the (four-year) medical school has brought much higher standards and I think that we do practice medicine to the level of the state of the art here. And in some ways, we exceed the state of the art.
Compared to the continental U.S., Marian says she experienced a stark contrast in the work culture in Hawaiʻi, mainly due to the warmth of its people.
“When I came here, there was such a feeling that we were on an island and that we had to work together,” Marian said. Without a PhD, Marian lacked certain technical bench skills. She recalls needing to learn how to do a very sensitive assay to measure in hundreds of a milligram, the amount of material in the blood of animals and people. At the time, she knew that Dr. Frederick Greenwood, a Nobel prize nominee, endocrinologist and famed UH researcher, had a lab that could do just that.
“When I called him (Greenwood) up, he said, ʻoh come right over and bring your technician and I will let you work in my lab for two weeks until your assay is absolutely perfect,’” said Marian, grateful and surprised at his welcoming and helpful spirit.
“Other people never would’ve had enough time to really talk to somebody because they were so busy with their own work,” she added. And that, “the culture here values hard work and it allows people to work together.”
Ultimately, the pleasant work experience in Hawaiʻi along with its multicultural environment brought her back here as the best place to raise her family.
Since the beginning of her career, Marian has been fascinated by how closely science and health are interwoven. She strongly values physician scientists and encourages all medical students to do research if they are so inclined.
“The very best research comes out of a really strong need to know. Need to know: What is wrong with this particular person?” For example, with her own discovery of Staphylococcal Scalded Skin Syndrome, “why did this particular staphylococcus cause children’s skin to slough off? When and what exactly did it? And take it down to that level.”
As an educator, Marian adds, “you want them to be the best doctors they can be, but you also want them to be curious about what they can do to further the science.”
As she reflects on her 50 years at JABSOM and her decades of service in medicine, she is worried for the future. disheartened about the volatile federal climate and terminations to many federal research grants.
“We used to value research,” Marian said. “My brother had polio. I stood in line with my mother the day that the vaccine came out.”
“It’s going to be a difficult time for everyone in the current climate of attacks, actual attacks on research and science,” said Marian. “I think, if we want to be proud Americans, why are we not proud that we lead in medical research?”
Nevertheless, the esteemed researcher carries on with her work. At 84 years old, Marian remains sharp as ever and still very curious about the world.
“I’m fascinated by many things right now. I’m fascinated by some immunologic problems. I was fascinated by this condition that I was telling you about from the New England Journal. I’ve got papers that I need to write about rat lungworm. So I’ve spread myself in multiple directions, but that was my choice,” Marian said.
“I like what I do and I am not that interested in stopping,” she adds.