Dr. Monica Bertagnolli
Dr. Monica Bertagnolli: National Institutes of Health director embraces Wyoming roots, focuses on rural medicine
Monica Bertagnolli, MD, director of the National Institutes of Health, remains rooted in Wyoming personally and professionally. She returns to the Cowboy State for visits and also seeks to improve medical information and access in rural areas.
“I grew up on the western slope of the Wind River Range – that’s where the ranch is,” Dr. Bertagnolli said. “It’s 98 miles to Rock Springs – that’s where I went to school – [and] I understand what it’s like to be 100 miles from the doctor’s office.”
She was bucked off a horse as a child and broke her arm. A full day passed before she went to a medical clinic in Rock Springs. That difficult access to medical services and the life and career of an uncle who worked in family practice were two motivators for Dr. Bertagnolli’s decision to become a physician and to focus on helping people living in rural areas.
“He was the VA doctor,” Dr. Bertagnolli said of her uncle, Pierre Carricaburu, MD. “He used to care for veterans over the whole state ... and did a lot of work on the reservation, taking care of the Shoshone and Arapahoe veterans. He was a big inspiration to me when I was a kid. He was the first one in my family to go to medical school, and I so admired how he took care of people.”
She said she was always interested in math and science and really wanted to help people.
“The best way to use science and help people is to go into medicine,” Dr. Bertagnolli said. “There were so many directions I could go. It’s a very broad field, and I could find my place there.”
She discovered a strong interest in research and immunology while attending the University of Utah medical school. However, her direction changed course her senior year.
“One day I walked into an operating room ... and just felt that I belonged there,” she said.
She moved to Boston and served as a surgeon but also had a research laboratory. She specialized in cancer surgery and was “heavily involved in research,” including clinical research.
“I didn’t want to only be a mouse doctor, I wanted to be a person doctor,” Dr. Bertagnolli stated.
She spent more than 35 years in the fields of surgery and research, including running a large clinical group that focused studies in rural and remote areas, including Billings. That is the type of work she deeply enjoys, she said.
Nominated by President Joe Biden to oversee the National Institutes of Health (NIH) in May 2023, the U.S. Senate confirmed Dr. Bertagnolli last November. She is the first surgeon and only the second woman to hold this position.
According to Dr. Bertagnolli, NIH is the largest supporter of biomedical research in the world and has a $47-plus billion- dollar budget, allowing the organization to help find answers to society’s biggest medical issues.
“It’s just a delight to be in this job,” Dr. Bertagnolli said. “It’s such an honor and a privilege to be in that environment. We can do a tremendous amount of what people really need and that’s what we’re going to do.”
She previously served as the director of the National Cancer Institute (NCI), an organization within NIH. The NCI research studies the causes of cancer, and also develops effective treatments and possible cures. She said steady progress has been made, and survival of different cancer types, such as breast cancer, has vastly improved.
“The death rate from breast cancer has decreased tremendously even though the incidence is going up,” she said. A breast cancer survivor, Dr. Bertagnolli understands the necessity for such research and treatment advances.
“My prognosis is excellent,” she said. “That wasn’t true a number of years ago, and it’s getting better and better
every day.”
Another important NIH research program is exploring new gene therapies which will be used to move closer to a cure for rare diseases such as sickle cell and hemophilia.
“It’s really going to take the National Institutes of Health to tackle these diseases because they’re not something the pharmaceutical companies are going to naturally gravitate toward – even though they help – because so many of the diseases that can be treated with gene therapies are rare,” she said.
New project for rural communities
A $30 million project was recently announced and ties back to Dr. Bertagnolli’s desire to help rural communities. Called Communities Advancing Research Equity (CARE) for Health, the pilot program seeks to integrate clinical research with community-based primary care in order to improve access to such research to medical providers in underrepresented and underserved communities.
“We have to learn two things: what do rural communities need? And how do we make it possible for those communities to contribute to our learning?” Dr. Bertagnolli explained. “We have to know what kind of resources we need to bring and what kind of research is relevant to them.”
The point is not telling people what they need, but instead, listening to them and learning what they need.
“We’re big, we’re the whole NIH," she said, "so we’re going to have some programs that will help us deliver, or learn how to deliver, what [those communities] need. We need to get people access to research that will benefit them. And even if we think we know what might benefit different communities, we won’t succeed without going into communities, asking what [they] need and then inviting [them] to participate in research programs that we have that are of the community’s choice.”
The CARE pilot program covers 2024 and 2025. As of July 2024, no announcement had been made as to how many communities will participate or the locations. Dr. Bertagnolli said she hopes some in Wyoming will be part of the study.
She returned to her home state this summer, spending time at the family ranch and visiting Fort Washakie, where she learned more about a substance abuse program at the Warm Valley Health Care clinic.
“They are bringing the Native culture into helping people recover and helping people live a full, complete, and healthy life, and they’ve had some great success so far,” Dr. Bertagnolli said. “It’s heartwarming to see. And it was also heartwarming to see a community so absolutely dedicated to the well-being of its people.”
A partnership between the clinic and NIH may develop.
“I got great feedback from the Warm Valley clinic that they were willing to bring a lot to any partnership we could develop there, and that’s exactly what we’re looking for,” she said, adding that partnerships are crucial to NIH projects.
She and her NIH team look forward to implementing the CARE program, Dr. Bertagnolli said.
“This is a very ambitious program [but] I can tell you, everyone at NIH is so excited,” she said. “They care so much about people and about doing what’s right for people. They’re very excited about understanding and addressing the needs of rural Wyoming, rural Alabama, rural Maine, and rural Alaska – to name a few locations already engaged.
Projects like CARE for Health bring her back to her rural roots.
“A lot of our [medical] research is done at big, academic medical centers. I want to see it reach rural America ... and we can do that,” she said. “That’s one of my biggest priorities. We need our research to learn from the wonderful environment of Wyoming so that we learn better how to serve people in all rural communities. And, most of all, we want to help everyone in Wyoming live long and healthy lives.”
She added, “I mean it seriously – we really need to serve every community, and we’ve got a lot of learning to do to know how to deliver what people really need.”
From Wyoming to Washington, D.C., Dr. Bertagnolli remains focused on helping rural communities from Acadia to Alaska and all areas in between.
“I deeply care for communities like we see in Wyoming where it’s a long way to a doctor or a long way to a specialist,” she said. “My guiding principle when I became NIH director was this: our work at NIH is not done when we deliver new discoveries; our work is only done when all people are living long and healthy lives.”
She maintains a Wyoming physician’s license.
“I am a Wyoming girl still [and] I am proud, proud, proud to be from Wyoming,” she said. “I bring my Wyoming heritage to everything I do.”
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