The pathway to accomplishment is rarely without challenges. For scientists investigating a new concept and members of minority groups — including female scientists — trying to make a name for themselves in their chosen field, the barriers to success can multiply exponentially.

“The more novel something is, the more the field resists it,” said Zea Borok, MD, ATSF. “It takes time to get it accepted, so perseverance is key.”

In the J. Burns Amberson Lecture at the ATS 2023 International Conference, Dr. Borok, a physician-scientist and the Helen M. Ranney professor of medicine and chair of the Department of Medicine at the University of California, San Diego, will discuss how her own resolve led to paradigm-shifting observations about cell plasticity and established her as a leader in medicine. She will present “Type I, Type II and Everything In Between: Unlocking the Plasticity of Alveolar Epithelial Cells” during the Awards Ceremony on Sunday, May 21, from 4:30–5:30 p.m. ET in Hall E (Level 2) of the Walter E. Washington Convention Center.

Each year, the Amberson Lecturer is chosen based on lifetime contributions to clinical or basic research that have advanced the fundamental understanding of basic, translational, or clinical approaches to respiratory disease, critical illness, or sleep disorders. It is also awarded for exemplary professionalism, collegiality, and citizenship through mentorship and leadership in the ATS community.

Dr. Borok is the fifth woman to receive this honor in the lecture’s 67-year history, joining the ranks of Mary Ellen Avery, MD (1969), Lynne M. Reid, MD (1978), Marlene Rabinovitch, MD (2016), and Sally E. Wenzel, MD, ATSF (2021). She said she felt humbled to be among this elite group of women, but that there is still much work to be done to acknowledge the diversity in the contributions to respiratory health. It’s a goal she worked toward during her tenure leading the ATS’s Awards Committee.

“I think the ATS is a very equal-opportunity society in the sense that the program chairs, the committee chairs, and the Assembly leaders are very well represented by women,” she said. “Where we struggle is in recognizing the accomplishments of not just women but other diverse groups. We need a constant reminder.”

Still, Dr. Borok credits the welcoming environment of the ATS as a contributing factor in helping her overcome some of the barriers she faced regarding gender equity and her status as an immigrant to the U.S. early in her career.

“The ATS is the one place where I didn’t feel as much of an outsider as a woman leader as in my day job,” she said. “The ATS was always very accepting and full of opportunity.”

After graduating from the University of Cape Town, South Africa, Dr. Borok came to the U.S. to complete her internship and residency at the University of Pittsburgh. She completed postdoctoral training in critical care medicine at the University of Pittsburgh and pulmonary medicine at Pulmonary Branch at the National Institutes of Health. She served as chief of the Division of Pulmonary, Critical Care, and Sleep Medicine and inaugural director of the Hastings Center for Pulmonary Research at the University of Southern California. Dr. Borok also served as the director of the Fellowship Training Program in Pulmonary and Critical Care Medicine (2000-2013) and established a Center for Gender Equity in Medicine and Science, of which she was the inaugural director.

Initially, Dr. Borok envisioned a future as a clinician but decided to give research a try.

“I ended up enjoying it, even though I struggled hard in the beginning. I thought I’d give it another few years and see what happens, and I was suddenly able to get funded. The rest is history,” she explained.

The focus of Dr. Borok’s laboratory is on alveolar epithelial cell biology and plasticity in the context of lung injury repair and fibrosis.

“My talk will build on an observation we made almost 25 years ago around the fact that cells in the lung can change from one type to another, which was paradigm-shifting because people didn’t recognize it. It was, ‘This cell is this cell, that cell is that cell,’” she said. “While we were met with a lot of skepticism at the time, more recent studies with single-cell sequencing and state-of-the-art technologies have suggested that while our interpretation may not have been 100 percent correct, the observation was absolutely correct. Epithelial cells, especially those that have adopted an abnormal phenotype, play a central role in the pathogenesis of pulmonary fibrosis.”

In the Amberson Lecture, named for James Burns Amberson, an international authority on chest disease and tuberculosis, Dr. Borok will discuss normal changes in plasticity, which are a component of normal homeostasis and repair, as well as abnormal plasticity, which leads to fibrosis. 

“The bottom line is that the cells can change in a way we never thought that they could,” she said. 

Dr. Borok has been continuously funded by the NIH since 1993. She received both a MERIT award (2010) and an R35 Outstanding Investigator Award (2017) from NIH. She is an elected member of the Association of American Physicians and recipient of the ATS Recognition Award for Scientific Accomplishment (2014). She has served as both an ad hoc and permanent member of the Lung Injury and Repair NIH Study Section.

Her contributions to the ATS have been extensive. Dr. Borok has held several leadership roles, including chair of the Program Committee, chair of the Assembly on Respiratory Cell and Molecular Biology, and chair of the International Conference Committee. She has also served on other RCMB Assembly and ATS committees, including, until recently, the Awards Committee.

Amid her professional achievements, Dr. Borok prioritizes mentoring, advising, and supporting her colleagues at all stages of their careers. In 2017, she was recognized for her contributions to pulmonary, critical care, and sleep medicine, and as a mentor by the ATS Elizabeth Rich Award. 

“Helping other people be successful is something I am trying to bring to this role as chair,” she said of her current position at UC San Diego. “It has been an important part of my ATS career, as well. The ATS has been my scientific home, and a lot of what I’ve accomplished is due to my ATS family and the opportunities afforded by the ATS.”

Despite the barriers she has had to overcome on her career path, Dr. Borok has found the journey a fulfilling one. She offers the following advice to early career clinicians and researchers.

“Find something that you love that intellectually captivates you, and then, persevere when everybody tells you you’re wrong. Several of the observations we had, we were just told it was wrong, and we had to persevere to get it into the mainstream,” she said. “It does take hard work.”