By Shannon Wianecki
Joy Vink ’94 recently discovered something fundamental to women’s anatomy. The cervix is not made mostly of collagen, as doctors had long assumed. It also contains muscle. She determined this by inspecting tissue cells – something that hadn’t been done since the 1940s, well before advances in imaging technologies. Her discovery will help her tackle one of medicine’s lingering mysteries: How does childbirth work?
The summer before Vink started medical school, a leading physician told her: “Whoever figures out what triggers labor will win the Nobel Prize.” Vink was stunned. “We don’t know what triggers labor? That just blew my mind,” she says. “It’s mind-boggling to me that in a day and age when we are curing cancer and we have all these novel therapies, genetic modification, etcetera, we don’t understand why or how women go into labor.” She’s working to remedy that in her lab at Columbia University Medical Center.
Vink didn’t plan on studying medicine. She entered Georgetown University as a Japanese and business major. During her sophomore year, she worked for a public relations firm promoting a menopause drug. Studies showed that the drug actually might be harmful, but the company continued to push it. Vink found this unethical, so she quit marketing altogether. She pursued an internship at the National Institute for Health and applied to Georgetown’s OB-GYN program. She studied under Dr. Cathy Spong, a high-risk obstetrician with a research lab.
In Spong’s lab, Vink learned the basics of bench research – how to generate hypotheses and design studies. Later, during her residency training, Vink saw patients in all stages of pregnancy. Sometimes a patient would come in 20 weeks pregnant – carrying a fetus on the cusp of viability – and her cervix would fail. The woman would either lose the pregnancy, or deliver a baby that was extremely premature, with all the complications that involves. It’s an unfortunately common scenario; one in 10 women experience preterm birth. “Because we don’t understand what causes it,” Vink says, “our options to save a pregnancy are very limited.”
While many prenatal problems can be devastating, Vink says, this one in particular stuck with her. It revealed how little the medical community really knew about basic reproductive biology. So rather than open her own practice after finishing medical school, Vink followed the path of Spong, her mentor, and pursued a career as a physician scientist.
As the co-director of Columbia University’s Preterm Birth Prevention Center, Vink is both a clinical physician and a research scientist. “Not a lot of people do this because it’s a bit crazy,” she says. In addition to juggling patients and lab studies, “you take a huge pay cut, since you’re not seeing patients as often.” But for a person whose integrity is as great as her thirst for knowledge, the sacrifice is worth it.
Physician scientists are in the unique position to identify patients’ symptoms and then head to the lab to test what might be causing them. Vink’s lab focuses on the basic mechanics of the cervix, its structural architecture and function. Understanding how it works is key to understanding why it fails.
“The old map said the uterus was responsible for starting labor contractions, while the cervix was this little nub at the end of the uterus – this passive bystander made of collagen. As the uterus started to contract, it would somehow break up the collagen and the cervix would dilate to let the baby out.” But when her team looked through the microscope, they saw that the top of the cervix actually has a lot of muscle, which completely changed the paradigm. “If there is muscle, then we need to start thinking what regulates muscle function that’s hormonal or neuronal?” she says. “It opens a whole lot more avenues for research.”
While Vink appreciates the opportunity to investigate these questions at Columbia, she hopes to eventually relocate her lab to Hawai‘i – a place she’s deeply connected to. “It’d be great to build a multi-disciplinary research center and really establish Hawai‘i as place where research is flourishing,” she says. “I think there is a lot of potential in the Islands and a need for care.”
She was 13 when her family moved to O‘ahu. Having lived in Guam, Korea, Japan and Holland, she felt at home for the first time in Hawai‘i. “It’s such a big melting pot, and being biracial, it was finally a place where I felt like ‘ah-ha, I fit!’” she says. “It was transformative.” She enrolled in eighth grade at Punahou, where her mother taught Japanese. “Starting a new school is always intimidating, but everyone was so sweet and welcoming. It was really refreshing,” Vink says. “Punahou pushes you to be well rounded in all aspects of your life. The people that I met there are still my closest friends after all these years.”
Vink just gave birth to her first child. Like many of her patients, she experienced preterm labor. She doesn’t know what could have prevented it – yet. But while searching for answers, she might win a Nobel Prize.