Medicine

Portrait of a Woman Scientist. To us, she was Lola. To her students… | by Deana Lorenzo | Sep, 2021

It’s difficult to know exactly where to begin the story of how my grandmother became a doctor. All I can say for sure is that it began long before she was a medical student in 1950, back when she was just Angelina Cortez Tolentino, the daughter of a judge from Magsingal, a small town in Ilocos Sur, Philippines.

Magsingal is located on the northern island of Luzon, 260 miles away from bustling metro Manila. The name comes from the Ilocano phrase maysingal, which roughly translates to, “let it be transferred there.”

According to local legend, this was what the village’s leader, a sturdy woman by the name of Palungo Galcia, uttered in 1676 to a group of Spaniards presenting her with a large bell, a symbol of colonial rule. “Maysingal,” she told them, pointing towards a belfry operated by her twin brothers, Palungo Andoriguis and Palungo Tolentino.

By the 1930s, a family by the name of Tolentino had risen to prominence in Magsingal. What distinguished these Tolentinos, however, was not any tenuous links to the town’s founding myth, but rather their education: both parents and all five of their children who survived to adulthood graduated from college.

During that time, it was unusual to see a provincial family with one college graduate — let alone seven. It was rarer still to be a college-educated woman. But four of the five Tolentino children who left the nest to pursue degrees in the big city were women — including my grandmother.

Before World War II, getting an education in Magsingal was difficult. The town lacked modern infrastructure, such as electricity and indoor plumbing, and without cars, few could commute to the closest secondary school in Vigan, 10 miles away.

As his children approached school-age, my great-grandfather Felipe Tolentino decided to take matters into his own hands: he built the town’s first high school. His wife Fidela inherited a large, Spanish-style property that would serve as the main schoolhouse. There, my lola, her siblings, and other children of the town received an education that many of their parents did not have. As a whole, the graduates did very well, many going on to attend university in Manila.

Lola (far left) with her parents, siblings, niece and nephew.

For the Tolentinos, the only thing that would get in the way of a good education was the Second World War. My lola remembers the Japanese Occupation of 1942 to 1945 as “a really bad time for all of us.” During those years, her father closed the school, so Angelina — then in her early teens — found other ways to stimulate her mind. She took refuge in the school’s then unused library, teaching herself out of her father’s vast collection of books, including a complete Encyclopedia Britannica. Her efforts paid off: she returned to school after the war and graduated valedictorian of her class.

It was then that her father, a lawyer by training, gave her that fateful ultimatum: either follow in his footsteps and go to law school, or else take up medicine. She chose medicine.

In 1950, Angelina matriculated at the College of Medicine at the University of the Philippines (UP) in Manila. There, her high school achievements did little to distinguish her among her urban peers.

She was one of the 22 women who comprised almost one-third of the first-year class. This ratio may seem surprisingly high for 1950, but many of these women came from exceptional circumstances that gave them advantages over others of their gender. Lola remembered one female classmate in particular, a premed from Stanford, who approached the demands of medical school with alarming nonchalance. “We were all having a hard time because there was so much to learn and remember, while she would go out on dates every night.”

“And yet,” Lola said, “she didn’t flunk!”

As a woman from the province, Angelina Tolentino had a lot to prove. Her peers attributed her previous academic success to the fact that she was the headmaster’s daughter. Male colleagues would scoff, “What are you going to do after graduation? You cannot work as a doctor and be a housewife.”

And yet, she would prove them all wrong. In 1955 she finished sixth in her graduating class and got into a residency in Pediatrics at UP. Around the same time, she married Victor Tantengco, a fellow UP grad in the beginnings of a promising career in Public Health.

For my lola, being able to have both a medical career and a family was the icing on the cake. “Not bad for someone who graduated from a small high school owned by her father!” she laughed.

The Tantengcos with their first child, Victoria, in Madison, Wisconsin, 1959.

The only downside was her starting salary: 120 pesos — or $60 USD — a month. She applied to transfer to the University of the East Magsaysay Memorial Medical Center (UERM) and was accepted into a higher paying residency. There was a catch, however: the residency was not in pediatrics, but in pathology.

It was a dramatic change from her old field, but it ended up suiting her. It was almost a relief to not have to deal with the drama of pediatrics anymore, with the crying children and anxious parents. “I wanted more answers as I took care of patients, and pathology gave me more answers than any other specialty.”

Being a pathologist was like being a detective, spending hours squirreled away in chilly labs, dissecting organs and peering at tissue samples, looking for clues as to what made someone sick or how someone died. She didn’t mind the cadavers — they were quiet at least.

Her new field had its downsides, too. “Because of all the autopsies I was doing, I had trouble cooking and eating.” Even decades after putting down the scalpel for the last time, Nona still felt uncomfortable handling raw meat.

Before long, the requirements of her residency at UERM would take her out of the cadaver lab and back into the classroom — this time, as an assistant professor.

For someone who rejected a law career out of a fear of public speaking, lecturing classrooms full of diligent medical students did not come naturally to her. However, she didn’t get this far to let shyness stop her, so she dedicated herself to learning how to teach, and to teach well.

Compared to UP, UERM was a newer, smaller medical school. Eventually, they wanted my grandmother to teach not just pathology, but also genetics, a field that was rapidly advancing in the postwar period. To keep up, “I needed more and more training,” she said.

UERM partnered with the Rockefeller-owned China Medical Board (CMB) Foundation to grant fellowships for medical faculty at universities around the world. In 1968, Dr. Tantengco — already an associate professor and mother of five — found herself at the University of Michigan in Ann Arbor as a CMB fellow in Human Genetics.

At Ann Arbor, she dove into the growing field of cytogenetics — the study of chromosomes and inherited cell behaviors. “Before and after class and on weekends, I would be in the lab until nighttime, learning how to grow chromosomes, identifying them, seeing what’s wrong with them,” she recalled.

She worked tirelessly to complete her program as quickly as possible so that she could return to her young children back in the Philippines. In 1969, she graduated with a Master of Science in Human Genetics, completing what was normally a two-year degree in one year.

Lola on a beach vacation with her children.

Back in Manila, she set her sights on starting her own cytogenetics lab, one of the first of its kind in the country. Over the next decade, she learned the ins and outs of running a lab from observation trips to facilities across the U.S., including Boston University, Mt. Sinai Hospital, Johns Hopkins, and the University of Pittsburgh.

Starting a lab at UERM was an uphill battle. “I didn’t get any support for from the University. I had to get my own data, get equipment from CMB for culturing cells, and buy culture media from the United States.” She would send her American students home during breaks with shopping lists of lab supplies.

This experience taught her an important lesson that would shape the rest of her career: if she wanted something to get done, she would have to do it herself.

When it came to getting funding for her projects, my grandmother stopped waiting around for opportunities to fall into her lap. She mastered the art of asking for what she needed, even if it meant going directly to the university’s Board of Trustees. “I was the first professor who wrote directly to the Board with ideas,” she said proudly. “Normally, people only wrote to them to complain.”

The experience taught her an important lesson that would shape the rest of her career: if she wanted something to get done, she would have to do it herself.

One of her proudest moments was securing $25,000 US — almost $60,000 today — to build a state-of-the-art audiovisual classroom. It was a lot of money for that time, and it helped seal her legacy at the school. After she retired, she went to visit the Dean of the College, and there was a student leader — a young woman — sitting at her desk. When the Dean introduced Lola to her, the student looked at her in awe and said, ‘Oh, you’re the legend.’”

Not everyone was impressed by her ability to get what she wanted. When the Board gave her funding to do a one-year teaching sabbatical at a Caribbean school on the little island of Domenica, some of her colleagues were livid. Nona just shrugged it off. “People get jealous when you do something that they didn’t do.”

Throughout the 70s and 80s, she visited other schools and labs in Australia, Denmark, Hong Kong, and the United States, expanding her training in clinical microbiology, nuclear medicine, and pathology instruction.

From her visits to American universities, she brought new teaching materials back to the Philippines. She once gave her second years an exam she picked up from Johns Hopkins. The students were so baffled by the unfamiliar questions that afterwards the entire class, including one of her relatives, marched into her office to complain. But she stood her ground. “I shooed them away,” she said flatly. “It was for their own good.”

In the long run, she was right. A year later, one of the American students who was in that class came by her lab while she was conducting an autopsy. “Thank you so much for what you taught me,” he told my grandmother, who in the middle of dissecting an organ. “I passed the board exam.’”

Before her retirement in 1995, Lola was made Head of the Department of Pathology. She spent the twilight of her career at UERM advocating for a Problem Based Learning curriculum, an approach to teaching medicine that emphasizes practical application, student autonomy, and self-directed learning.

Although my lola did not set out to follow in her father’s footsteps, perhaps the apple didn’t fall far from the tree after all. For what she achieved throughout her career in Manila, she gave credit to her roots in Magsingal.

During her first year of residency, a major newspaper printed the country’s top ten medical board exam results. The second through ninth highest scorers that year were graduates from her class at UP. She was number four.

She didn’t know it at the time, but all of Magsingal heard the news.

“My uncle attached a little bell to his bike and rode back and forth along the main street, ringing that bell, saying over and over again, ‘number four, number four!’”

For what she achieved throughout her career in Manila, she gave credit to her roots in Magsingal.


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