February 6, 2025 By Hannah Fairbanks From an early age, Dr. Marilyn Hill Harper’s father, a pharmacist who owned the corner drugstore in Seneca, South Carolina, urged her to become a doctor. Despite being unusual as it was not typical for women to go into medicine, because of her father’s encouragement, she never thought otherwise. After completing her undergraduate degree at Talladega College in Alabama, Dr. Harper earned her medical degree from Howard University College of Medicine in 1963. Originally envisioning becoming an Ob/Gyn, during a residency rotation at the University of Iowa, she discovered anesthesia. At that time, Dr. William “Bill” Hamilton was chair of the Anesthesia Department. In 1967, he moved to San Francisco to become chair of the Anesthesia Department at UCSF and recruited her. In 1972, Dr. Harper came to California and joined the faculty at UCSF. Although she considered “leaving many times for many different reasons,” she stayed her entire 28-year career here. Dr. Marilyn Hill Harper, one of the first Black woman anesthesiologists at UCSF, sat down with us to talk about her time at UCSF, her career journey, and how she persevered. This interview has been edited for length and clarity. Can you share a bit about your career at UCSF? What kinds of support–and barriers–did you encounter along the way? The faculty was sparse as far as women and especially Black women were concerned. But I just stayed on. I think that my decision to stay encouraged the women who finally came. I was there for two or three years before there were any other women and over 10 years before there was another Black woman faculty member: Dr. Renee Navarro. And that was it, the whole 28 years I was there. It was just Renee and me. In October 2024, Dr. Navarro co-hosted the Physician Medical Forum Benefit, which celebrates and supports the next generation of under-represented medical providers. Dr. Harper (center) attended as a guest. Women in general were judged more harshly than our male counterparts in terms of decision-making. I was even asked not to speak up in faculty meetings. But I stayed on. I worked on the admissions committee, helping get minority students admitted to medical school. That felt good. I was poised to take the position of chair of the admissions department until a new dean came in and said that the medical school needed the admissions committee to have a better reputation–and me leading it was not going to do that for him. After that, I just decided I wanted to live in San Francisco. I needed a job, and Black friends who were in private practice assured me that the racist issues were not going to be any different outside the university and if that was the only reason I was leaving, I should stay. And so, I stayed. I really enjoyed university life, in particular working with the residents. [Dr. Harper was the recipient of the Anesthesia Department’s William K. Hamilton Award for Excellence in Teaching in 1977, an award nominated by residents.] When UCSF acquired Mount Zion, I stopped doing research and began working exclusively clinically. It was an interesting career, and I enjoyed it for the most part. Racism and sexism are not isolated in academic medicine–it happens in private practice and in any other career choice that requires promotion by your peers or by people who are evaluating you. At the time, I didn't realize I needed a support system. But persistence and not allowing petty issues to trigger me was the reason I survived. Our department’s current mission is “excellence in patient-centered care that is guided by innovative research, education, and our commitment to health equity.” Our vision is “to advance perioperative care by cultivating the next generation of diverse leaders in our field.” Did you find the department had any kind of mission and vision during your time here? No. Diversity was not even a word that was used at the time. That’s a much more recent innovation and turn in our culture. I think the department thought of itself as cultivating residents who were going to grow up to be either major researchers or heads of departments: future leaders in the field. In addition to practicing anesthesia, you wrote Wearing Purple, a book of collected letters between four Black women who had been friends for more than 40 years. Can you talk about how that project came to be? That was a long time ago. Those women were classmates in college. Much later, in 1989 or 1990, we had the idea of designing a study course for women to transition from working into retirement and that time, we couldn’t find anything–any books, any references, any help–for women, especially Black women, to make that transition. And so, we decided that we would write a book. It was a lot of fun. Tell me a little bit about raising children while working full time as an anesthesiologist. How did you navigate a work/life balance? There is always a lot of talk and writing about that, but it always seemed like a white thing to me. A lot of the women in my community when I was growing up as a child worked, so I never thought of it that way. I just thought that working was a normal part of life–everybody worked. You had to work to live, to have enough money to survive. You just manage the schedules. If you love your children and they know you love them, that’s the key, whether you’re working or not working. What advice would you give to the next generation of women going into medicine? In anesthesia or anywhere in life, persistence is key: identifying your goal and sticking with it; dealing with the obstacles as they come along. Compassion for the people around you is helpful to anybody in any field. What projects are you currently working on, and what impact do you hope they will have? I like to write, and I wrote a memoir over these last few years. I may write some more; maybe not. It took me a while to get rested up. I’ve been learning Bridge for the last few years and have been playing a lot; it keeps your mind active. Dr. Odi Ehie, vice chair of Diversity, Equity, and Inclusion for the Department of Anesthesia and Perioperative Care at UCSF shared, “As one of the few Black female anesthesiologists at UCSF, I feel incredibly grateful for the path that Dr. Marilyn Hill Harper paved for me and so many others. Her journey—stepping into a field where few looked like her, staying the course despite challenges, and dedicating 28 years to UCSF—fills me with admiration and gratitude. Her story reminds me that representation matters, that perseverance pays off, and that we all stand on the shoulders of those who came before us. Dr. Harper’s legacy isn’t just about breaking barriers—it’s about creating space for the next generation to thrive. I’m honored to celebrate her contributions and the impact she continues to have on all of us.” Image A selection of Dr. Harper’s publications: Nitrous oxide does not hinder the repair of halothane-induced hepatic injury in the rat. Fassoulaki A, Eger EI 2nd, Johnson BH, Ferrell LD, Smuckler EA, Cahalan MK, Eger RR, Harper MH. Anesth Analg. 1985 May;64(5):465-7. PMID: 3994007 Nitrous oxide, too, is hepatotoxic in rats. Fassoulaki A, Eger EI 2nd, Johnson BH, Ferrell LD, Smuckler EA, Harper MH, Eger RR, Cahalan MK. Anesth Analg. 1984 Dec;63(12):1076-80. PMID: 6507907 Isoflurane does not prevent hepatic injury produced by halothane in rats. Fassoulaki A, Eger EI 2nd, Johnson BH, Ferrell LD, Smuckler EA, Cahalan MK, Eger RR, Harper MH. Anesth Analg. 1984 Oct;63(10):888-90. PMID: 6486486 Brief periods of hypoxia can produce hepatic injury in rats. Fassoulaki A, Eger EI 2nd, Johnson BH, Ferrell LD, Smuckler EA, Harper MH, Eger RR, Cahalan MK. Anesth Analg. 1984 Oct;63(10):885-7. PMID: 6486485 Celiac plexus block does not alter hepatic injury in rats. Harper MH, Johnson BH, Eger EI 2nd. Anesth Analg. 1984 May;63(5):479-81. PMID: 6711842 Hepatic injury induced by anesthetic agents in rats. Shingu K, Eger EI 2nd, Johnson BH, Van Dyke RA, Lurz FW, Harper MH, Cheng A. Anesth Analg. 1983 Feb;62(2):140-5. PMID: 6829914 Postanesthetic hepatic injury in rats: influence of alterations in hepatic blood flow, surgery, and anesthesia time. Harper MH, Collins P, Johnson BH, Eger EI 2nd, Biava CG. Anesth Analg. 1982 Feb;61(2):79-82. PMID: 7198881 Hepatic Injury following halothane, enflurane, and isoflurane anesthesia in rats. Harper MH, Collins P, Johnson B, Eger EI 2nd, Biava C. Anesthesiology. 1982 Jan;56(1):14-7. doi: 10.1097/00000542-198201000-00004. PMID: 7053663 Minimum alveolar concentrations and oil/gas partition coefficients of four anesthetic isomers. Koblin DD, Eger EI 2nd, Johnson BH, Collins P, Harper MH, Terrell RC, Speers L. Anesthesiology. 1981 Apr;54(4):314-7. doi: 10.1097/00000542-198104000-00011. PMID: 6782912
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