Dr. Lisa Schwartz dealt first-hand with the importance of accurate, understandable medical information while she was a resident in New York City nearly 30 years ago. With no translators on staff at a Chinatown health clinic, she’d enlist a janitor, a patient’s child, or someone in the waiting room to explain basic details to those who didn’t speak English.
And when she and her husband, Dr. Steven Woloshin, went to Dartmouth College on a research fellowship, they soon saw that language wasn’t the only hurdle patients faced. Imprecise details on medicine labels could mislead. Media reporting on medical studies often lacked skepticism and focused on a press release’s grand claims that the numbers didn’t support. Often the numbers themselves were needlessly confusing.
“Every time we’d pick up the newspaper, we’d read something that would get us really mad,” she told Dartmouth Medicine magazine in 2012.
Dr. Schwartz, who was 55 when she died of cancer Nov. 29, spent her career working with her husband to make the medical world safer by ensuring that information is presented clearly and accurately.
To help patients make better decisions, they collaborated on books, journal articles, op-ed essays, and memorable public presentations. They trained hundreds of medical journalists to be warier, and they advocated for the US Food and Drug Administration to mandate adding a “drug facts box” to prescriptions that would explain in plain language the benefits and potential harms clinical trials had revealed.
Dr. Schwartz and Woloshin, who by their own description and by those of everyone who knew them had an uncommonly close marriage and professional partnership, also spoke out about the limitations of research and highlighted the dangers of overdiagnosing patients – what they called “the medicalization of everyday life.”
“She taught a healthy skepticism without crossing over into cynicism,” said Dr. Barry Kramer, director of the Division of Cancer Prevention at the National Cancer Institute.
From their posts as directors of the Center for Medicine and Media at The Dartmouth Institute for Health Policy and Clinical Practice, which is part of Dartmouth’s Geisel School of Medicine in Hanover, N.H., Dr. Schwartz and her husband brought their call for clarity and honesty across the country and into Europe.
Collaborating with the National Cancer Institute, they helped create the Know Your Chances website. It allows people to create charts which gauge the risk that they’ll die of various cancers and other diseases – with categories addressing gender, race, and age.
Along with her journal articles and op-eds, Dr. Schwartz cowrote the books “Know Your Chances” and “Overdiagnosed,” and she was often quoted in media reports, partly because she always made herself available to reporters as part of her drive to ensure information was accurate and understandable.
“A lot of the work she did kind of naturally put her at odds sometimes with the pharmaceutical industry, sometimes with the FDA, sometimes with the conventional wisdom,” said Dr. Aaron S. Kesselheim, a friend who is an associate professor of medicine at Harvard Medical School and works at Brigham and Women’s Hospital.
“She never had any fear about taking on these big institutions on behalf of patients because she was always following the science and had the patients’ interests at heart,” Kesselheim added. “She was a voice for patients in the health care system.”
Dr. Schwartz also was a part of an indivisible team. Though she and her husband would collaborate with colleagues, they always worked with each other.
“We did absolutely everything together. We did our professional work together, we did our research, we did our teaching. It was a remarkable collaboration,” Woloshin said. “When we would write, we would pass things back and forth. We didn’t know who wrote what. Everyone knew us as a brand; everyone referred to us as S&L.”
‘She never had any fear about taking on these big institutions on behalf of patients because she was always following the science.’
“It’s not like we always agreed on everything,” he said. “We pushed each other a lot. But we reached a place where there was really no space between us.”
Lisa Miriam Schwartz was born in the Bronx, N.Y., in 1963 and grew up in Montville, N.J., the oldest of three siblings. Her parents were Leonard Schwartz, an electrical engineer, and Heda Teitcher, a vocational rehabilitation counselor.
In an interview for the Too Much Medicine website, Dr. Schwartz recalled drawing inspiration from her father, who “believed any problem could be solved with a clean sheet of scratch paper and was so excited by new ways of thinking.”
She graduated from the State University of New York at Binghamton with a bachelor’s degree in chemistry, from New York University School of Medicine, and later received a master’s from Dartmouth. Dr. Schwartz and Woloshin were medical residents together at Bellevue Hospital Center in Manhattan.
“It was really magical when we met. We were inseparable from the beginning,” he said, adding that by their count, they spent only 10 days apart after marrying in 1992.
They made their home in Norwich, Vt., and have two children, Emma and Eli.
A service has been held for Dr. Schwartz, who also leaves her mother, Heda of Florida, her brother, Mark of New Jersey, and her sister, Susan of Pittsburgh.
“Lisa pursued truth in order to do good for humankind,” Rabbi Edward Boraz said at her service in Hanover last week, adding that “her life has made the world a better place than it was before.”
Dr. Robert E. Drake, a professor and Dartmouth Institute colleague, said in his eulogy that “Lisa was brilliant. She could see to the ‘heart of the matter’ faster than anyone I ever worked with. Whether it was a scientific experiment, an abstract, a paper, or a grant, she could quickly identify the critical issue almost immediately and explain what needed to be done.”
He added that “she believed – and proved – that with more honest data and better communication, patients and doctors would make better decisions.”
The British researcher Dr. Iain Chalmers told Dartmouth Medicine that “it’s difficult to exaggerate” the influence of the couple’s work. In an interview, he added that it was virtually impossible to speak separately of Dr. Schwartz and Woloshin, who were legendarily seamless in public.
“One of them would start a sentence and the other one would complete it with absolutely no hesitation,” Chalmers said. “They were genuinely, greatly loved as a pair of performers of extremely high intellect.”
They could turn lessons for journalists about the importance of reporting absolute risks, rather than relative risks, and the need to weigh each study’s strengths and limitations into multimedia presentations that were as entertaining as they were informative.
Dr. Schwartz provided “important tools for working journalists to serve as honest brokers, the final common pathway to express evidence to the public,” Kramer said, adding that her work “will have a lasting impact.”
Just as remarkable, colleagues said, was that Dr. Schwartz continued her research and worldwide presentations after being diagnosed seven years ago. Just last year she and Woloshin were honored by the American Medical Writers Association.
“Having to talk about this stuff while knowing she was sick shows how brave and selfless she was,” her husband said.
“I’m so proud of her and feel so lucky to have had so much time with her,” he added. “I feel like I’m the luckiest person and the unluckiest person in the world right now.”Marquard can be reached at firstname.lastname@example.org. Follow him on Twitter @BryanMarquard.