In Memoriam
1929-2020
Of all the pioneers who helped shape the field of genetic counseling, it is likely that no one was more influential than Joan H. Marks, who died on September 14th at the age of 91. In 1972, when Joan took over the 3-year-old program at Sarah Lawrence College that now bears her name, there was no accrediting body, no national society, no Journal of Genetic Counseling. She stayed for 26 years, a dominating and charismatic presence, often intimidating, often demanding – a fierce advocate for both genetic counselors and their patients, who she insisted deserved more than a lecture on chromosomes and recessive inheritance.
When your friends and relatives ask you, as they still do, ‘what is a genetic counselor?’ the answer you provide, whether you know it or not, is an echo of Joan’s vision, distilled in a generation of students who went on to define their roles in workplaces across the country, to found NSGC and ABGC, and to serve as teachers and program directors in their turn, passing along the ethos that remains integral to the field.
I met Joan when I interviewed at Sarah Lawrence in 1999, when she was very much the eminence grise. “I imagine you’ll get in,” she said to me, looking over my transcript with a practiced air, and I was thrilled – an excitement that was immediately tempered when she mentioned that she would not be sticking around to educate this new class of genetic counselors. As a charter member of the post-Joan-Marks generation of Sarah Lawrence alums, I can attest to the lingering effects of her legacy.
Still, devoted former students have told me over the years that I was unlucky not to have known her better. No doubt this is true (and no offense to Caroline Lieber, who inherited the mantle at Sarah Lawrence and was a great program director in her own right). So today I would like to invite all of you who knew Joan Marks as a student or a colleague or a friend to treat this post as a sort of an invitation and add your reminiscences here.
First up, a lovely tribute form Caroline Lieber herself, who talks about her experience filling some very big shoes in the world of genetic counseling. I hope that many others will fill the comments.
Joan Marks: One of a kind
Caroline Lieber, MS, CGC Director Emeritus, Sarah Lawrence College Joan H Marks Graduate Program in Human Genetics
I met Joan Marks in February 1978. My then-boyfriend and I flew to New York and then took the train to the Sarah Lawrence campus, two California kids in New York for the first time. He waited outside of Morrill House while she and I “talked.” It felt more like she talked and I listened. After the interview I said, “I am not sure that went so well….”
But when I called my parents from South America that July to check-in, my father excitedly said, “You got accepted at Sarah Lawrence!” My boyfriend and I packed our meager belongings and headed east. Two California kids in New York for the second time. We arrived two weeks before classes were scheduled to start. I was going to be a genetic counselor!
Having been undergraduate genetics major, I was comfortable in the science courses. The psychology courses were a different story. As our instructor for “Issues in Genetic Counseling,” Joan had us read broadly about ethical concerns, the depth of emotional responses to genetic conditions in families, and articles to help identify counseling techniques and how to use them. She commented in detail on each paper we wrote. In one paper I found recently, she pointed out some inconsistencies in my thinking. She further remarked, “But what’s good is that you see yourself as a counselor and you see how tough it can be. I’d like you to reread what you’ve written carefully and try to be objective-aren’t you inserting some biases here and there?” Her critique was not always welcome, but she always made me reflect on each point she made, and to look at it from another view. I learned to be more empathic in a tough-love way. I am proud of the genetic counselor I became under her direction.
Fast forward to 1998. I discovered that Joan was planning to retire from Sarah Lawrence. I applied for the director position, and went through rigorous interviews. I recall the pointed questions, some designed to make the interviewee a bit uncomfortable, as a means of gauging responses to tough situations. Even though she wasn’t in the room, it was clear that Joan was part of the process. Fortunately for me, I was selected.
Following in Joan’s footsteps was daunting. Those early months felt exciting and overwhelming as I learned a whole new landscape. Not surprisingly, Joan had very definitive ideas about the future of the program and often wanted to share her thoughts. As my advisor and mentor, I made a point of responding to her calls and emails, listening to her guidance and counsel. As it was when I was a student, I was not always in sync with her thoughts, but I learned to incorporate many of her suggestions. As I gained confidence in my role, I learned to trust my instincts and experiences to find my own personality in the position. When in time, Joan told me that I was doing a good job, letting me know that she approved of my leadership, it meant a great deal to me.
During my tenure as program director, our relationship grew on many levels. Joan and I grew together professionally as we worked on several commemorative events. When the program was renamed in Joan’s honor, it was a proud day for the college and the Joan H Marks Graduate Program in Human Genetics. After I moved into New York City, we grew closer personally, sharing life outside of the program. We met for lunch and talked about some of her other interests, including art and gardening. I got to know her softer side.
Joan Marks was the most committed and passionate advocate for the genetic counseling field that I have ever known. As Laura Hercher said, “I doubt any other single individual did as much to shape the field.” She put the profession on the map with style, charm, directness and savvy. It was my privilege to be her student and mentee. It was my pleasure to be her friend.
The DNA Exchange 
Laura, thanks for this beautiful tribute. I interviewed with Joan in 1986, and was quite intimidated indeed! While I decided not to attend SLC, I always admired Joan and appreciated her enormous dedication and contributions to our field. And what Joan did for Caroline, Caroline did for me as a mentor and friend when I transitioned to academia and became a program director. Caroline had been the interim director before me, and it is because of her that I can do what I do. She provided the same mentorship and encouragement to me that Joan did for her, and in this way I feel connected to Joan. Huge debt of gratitude to both of them.
Thank you to both Laura and Caroline for the fitting tribute to Joan. I interviewed with Joan in 1977 and was quite intimidated to be in New York as I was living in Portsmouth, New Hampshire at the time, but she was delighted that I was from New England, as she was, and she put me right at ease. She wanted me to go back to New England to practice but I ended up falling in love with New York City and staying in New York for my entire career. Joan was an extraordinary woman of incredible strength and vision and I will always be grateful to her for seeing something in me and accepting me into the SLC Human Genetics Program. She had the ability to bring out the best in her students. I had the most wonderful classmates who went on to do wonderful things for the field. Joan was a pioneer and she will not be forgotten. Rest in Peace Joan.
Caroline and Laura thank you for your tributes to Joan. Whether it was coincidence or fate, I was going through a box of old papers today and came across a handwritten letter that Joan sent me when I became the program director at Arcadia University, 20 years after graduating from SLC. The letter wished me well but included a vote of confidence that she knew that I was well suited for the job. In this digital age, I am glad that I saved this handwritten letter from Joan, a piece of our shared history. Joan always took the time to ask about my family and was interested in finding out what were my next professional advancements. I am glad that we had a friendship that moved beyond teacher and student. Joan was a champion of our field and a fierce supporter of her alumni. Those us lucky enough to have been mentored by her will keep her legacy alive for future genetic counselors.
Personally, Joan helped me when I needed it most. I was a student in her program from 1995 to 1997. Yes, I was intimidated by her, but I respected her. Respectfully, I wanted to steer clear, remain out of trouble and fly unnoticed under her radar. But on one particular afternoon in April 1997, I needed to be on her radar. After waiting 45 minutes to see her for an unscheduled meeting, Joan finally allowed me into her office. She was annoyed by my repeated requests to her secretary to let me in. I was sweating with nervousness. The news I had to give her – Joan- of all people sent shock waves through me. Would everything I worked for over the last two years be flushed by what I had to tell her? I wondered what would be more difficult- telling Joan that I had breast cancer or my own mother? (Actually, Dad won that award). Thankfully, I had just handed in my thesis.
I take some pride in saying that I shocked Joan, but only for about 45 seconds. At the 46th second, Joan launched into a series of questions. I stammered out my answers while she crafted a plan. She insisted that I take my pathology slides immediately and directly to the path lab at Memorial Sloan Kettering. I resisted, because the idea of driving in NYC was absurd. (The idea of ME driving in NYC during rush hour felt LIFE threatening. Really, I could drive anywhere, but there. I had a phobia). She insisted. As many of you know, when Joan insisted, it was to be done.
I did it and survived! But those lone experiences of my mustering the courage to tell Joan my news, and then surviving the “brutal” commute alone strengthened me for what was to come. I also felt a sudden strength and new confidence having Joan in my corner. She and her husband (MSK MD, VP) checked on me after my surgery. She also would not let my two years at SLC mean nothing and was intent to see me complete my work there.
Before as a student, especially an introverted one, I didn’t always have the best confidence. I learned Joan did have confidence in me then. In 1998 she contacted me to ask if I would speak to a young woman, recently diagnosed with breast cancer about my experience with cancer and the stressful decision making that accompanies it. Once again, I was grateful to Joan for confidence in me.
I will always be grateful to Joan for this and for allowing me to follow my dream to become a genetic counselor.
Thank you for sharing this story. It cuts right through to who she was. I’m glad you had her in your corner. And congrats to you for rising to the occasion! It turns out there really is nothing more terrifying than driving in NY traffic…