Valentina Nardi, MD
Valentina Nardi, MD, is a staff pathologist at Massachusetts General Hospital, and her current clinical work includes implementing molecular assays for hematologic malignancies at the Center for Integrated Diagnostics. “I was born in Rome, but I did my high school and college education in Genoa. I did not plan on pursuing a career in medicine until the end of high school. I loved science and felt I wanted to do something with my life that would have a positive impact on humanity,” shared Dr. Nardi.
Deciding to Become a Doctor
DR. NARDI explained that in the Italian educational system, students matriculate straight from high school into higher education, such as medical school. “When I decided to go to medical school, there was quite a lot of pressure, as you must pass a national exam and only the highest achievers are admitted. It was a multiple-choice exam and a pretty intense process, and I was accepted to the University of Genoa School of Medicine,” she said.
When Dr. Nardi was in medical school, a family member developed leukemia, which went undiagnosed until it was too late. “He died at age 36 even before a diagnosis was formulated. It was a highly treatable form of leukemia if caught early (acute promyelocytic leukemia). That personal experience had an influential role in my choice to study leukemia,” explained Dr. Nardi. She continued: “I also had a family friend whom I admired who was a hematologist. So several things early on began to shape my career, even if subconsciously. Moreover, the University of Genoa was prominent in hematology; I believe it was the first institution in Italy to begin bone marrow transplants. When you decide on a specialty in Italy, it’s not just a matter of interviewing; you have to take a series of tough exams, which I passed.”
Opportunity to Come to the States
AFTER SERVING 1 year as an intern, Dr. Nardi began her hematology fellowship at the University of Genova. “In Italy, the hematology training is 4 years long. I did 2 years in two different institutions: one at a cancer center and the other with hospitalists; this way, I got a different perspective on care. At that time in 2002, I had a great opportunity to do a year of research in Boston and was fortunate to work in the lab at the Massachusetts Institute of Technology with George Daley, MD, PhD. But 1 year of basic research is not enough time to get anything accomplished, so I asked for another year extension. In the interim, I returned to Italy and took my boards, so I was a certified hematologist in Italy when I returned to Boston,” she added.
When Dr. Nardi returned to continue her postdoctoral studies, Dr. Daley had moved his laboratory to Boston Children’s Hospital, where he was Director of the Stem Cell Transplantation Program. “I was supposed to study stem cells and then go back to Italy and work on a stem cell manipulation project, but at Dr. Daley’s lab, I began working on leukemia projects, specifically in drug resistance to some of the newly developed targeted therapies, a new generation of tyrosine kinase inhibitors,” said Dr. Nardi. She added: “We were looking at mutations to predict drug resistance in vitro in the laboratory and also in patients. At that time, it was a relatively new field of research in which molecular diagnostics was opening doors in translational research.”
“Pathology is like being a medical detective in that you have to put all the pieces of the puzzle together in the right way to solve the case.”— Valentina Nardi, MD
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Molecular Diagnostics
DURING A PERIOD of introspection, when Dr. Nardi was wondering how she could apply her love of the lab to a medical career, a colleague suggested she become a molecular pathologist. “At the time I didn’t even know what a pathologist was. After looking into opportunities in molecular diagnostics, I decided to do a residency. I passed the U.S. Medical Licensing Examination and applied to residency programs in Boston; lucky enough to match at Massachusetts General Hospital, I chose a program called anatomical pathology because, for one, it was only 3 years. I enjoyed it more than I anticipated; it was very exciting work,” she shared.
Dr. Nardi continued: “I discovered that pathology is like being a medical detective in that you have to put all the pieces of the puzzle together in the right way to solve the case. I then did two fellowships: one in molecular diagnostics at Brigham and Women’s Hospital and one in hematopathology at Massachusetts General Hospital.”
After her hematopathology residency, Dr. Nardi commented that she was at the right place at the right time. “I was offered a job at Massachusetts General Hospital and jumped at the opportunity. I respected the core values of the institution and had made a lot of good friends and colleagues here during my residency. That was about 4 years ago, when I took a staff position here,” she noted.
From Diagnosis to Treatment
ASKED HOW she manages the multiple duties in her challenging career, Dr. Nardi responded: “Part of my job description, one that I really love, is to diagnose patients who may have leukemia or lymphoma or some other hematologic malignancy so their oncologist can work up the best possible management plan. The other exciting part of my job is working in molecular diagnostics, in which I not only attempt to diagnose certain leukemias, but also find if there is any new targeted therapy based on genetic mutations I’ve seen that might be particularly useful in individual patients. We were already looking at solid tumors, but given my interest in blood cancers, I also pushed for our laboratory to develop some assays for hematologic malignancies. Knowing what genetic mutation drives the disease helps us decide whether a patient might be a candidate for a targeted therapy or in the case of aggressive disease perhaps a bone marrow transplant.”
“One of the exciting challenges of pathology is that we have to adapt our tools and methods in the laboratory to coincide with new treatment modalities, which seem to be popping up every week.”— Valentina Nardi, MD
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Given her interest in immunotherapy, Dr. Nardi said her lab is also setting up assays to be useful in this burgeoning field. “We are trying to adapt our assays to facilitate immunotherapies. We would like to be able to predict which patients will respond to immunotherapy and also which patients might develop a drug resistance to certain approaches. One of the exciting challenges of pathology is that we have to adapt our tools and methods in the laboratory to coincide with new treatment modalities, which seem to be popping up every week,” she said.
Busy Schedule
DR. NARDI is currently setting up molecular assays for hematologic malignancies at the Center for Integrated Diagnostics. She teaches and supervises residents and fellows as well as presents at weekly educational conferences, which include journal club; didactics; in-depth discussion of interesting cases; and presentations by invited speakers for pathology residents, fellows, technicians, and attending pathologists. Dr. Nardi has also served as an Instructor in Immunology, Microbiology, and Pathology at Harvard Medical School.
What does a super busy pathologist do to decompress? “I do spin cycling, some running, and I am learning to play guitar. I definitely use physical activities as a way to relax and reboot. And I also love walking around Boston. It has a European feel and is full of history and art. And it is a great place that nurtures science and medicine.” ■
