If he’s not conducting research or caring for patients, Dr. Hal Scofield has a staggering array of passions that keep him busy. And the list is always growing.
By Adam Cohen | Illustrations by Jeffrey Smith
When his late mother was in the early phases of dementia, Dr. Hal Scofield and his younger daughter, Amanda, headed to north Texas to lend a hand. Scofield’s sister had been doing the caretaking, and they wanted to give her a break.
“My mother was at a stage where she was asking the same questions over and over again,” remembers Scofield. Amanda admired how patiently he responded each time. How, she wondered, did he manage to do that?
The OMRF physician-researcher told her it was a way of balancing the scales. “Because there may have been a time when I asked my mom a lot of questions.” For instance, as a boy, he recalls being intrigued by the behavior of certain household pests. “I wanted to know how flies walked on the ceiling.” So, the youngster interrogated his mother about it nonstop. He took a similar, more hands-on approach when trying to figure out how the toilet functioned. “I flushed it again and again and again.”
That sense of curiosity, he says, has been with him as long as he can recall. “It almost didn’t matter the topic. I wanted to understand how things work.” It only follows that he chose twin paths that lean into his natural inclination to ask why: physician who cares for patients with endocrinological conditions and laboratory scientist who studies autoimmune diseases.
For most, holding a pair of rigorous day jobs that require constant intellectual probing would be plenty. Plus, as associate chief of staff for research at the Oklahoma City VA Medical Center, he shoulders a host of administrative responsibilities. In other words, after a long day or week of work, what could sound better than an appointment with a reclining chair, a cold beverage and the latest streaming sensation or sporting event?
Well, for Scofield, let’s go down the list.
It might be a day of refereeing youth soccer. An evening volunteering at a local free clinic. A few hours working on his vintage cars. Rehearsals for the jazz and concert bands in which he plays. Scouring bookstores to add to his antiquarian book collection. Or, most likely these days, diving into the history of medicine, a subject that he both teaches and is pursuing a master’s degree in.
“Hal is insatiably curious about how the world works,” says Dr. Sarah Tracy, director of the University of Oklahoma Medical Humanities Program and Scofield’s teaching partner at the OU College of Medicine. Among a long list of traits she ticks off to describe her friend and colleague – “creative, kind, intellectually generous, upbeat, humble, honest” – his thirst for knowledge, Tracy says, “is one of his very best features.”
Scofield grew up in Lewisville, a rural Texas town of 5,000 or so at the time that has since been subsumed by the Dallas metroplex. As a kid, he had a habit of bringing home creatures like snakes, turtles and the flat-bodied and fierce-looking Texas horned lizards, also known as horny toads. He loved reading, feasting first on adventure novels by Robert
Louis Stevenson, Daniel Defoe and Jules Verne, and later on the works of Mark Twain and O. Henry. Musically inclined, he took up the tuba, and in high school, his idea of misbehaving was to use his lunch hour to drive with his “music buddies” to the nearby University of North Texas to listen to the jazz band rehearse.
At Texas A&M University, he flirted with architecture. “My uncle got his master’s degree with Buckminster Fuller,” he says, “but I quickly discovered I had no natural talent.” Instead, he followed the path of another uncle, a surgeon, studying chemistry and completing his pre-med requirements. Even then, he says, he had a bit of an academic wandering eye, minoring in anthropology. “I’d take classes like ancient Greek philosophy, and I’d be the only chem major in the room.”
When Scofield enrolled at the University of Texas Southwestern Medical School, he imagined he’d eventually head back to somewhere like Lewisville to be a small-town general practitioner. But that changed when a mentor introduced him to endocrinology, a specialty that treats diseases related to hormones. As an endocrinologist, he had to develop an understanding of a system of glands – thyroid, pancreas, pituitary and others – that ultimately regulate a number of the body’s vital functions.
“All these organs secrete hormones,” he says. “If they’re not working, they can affect every organ.” Malfunctions can cause illnesses ranging from diabetes to hypertension to thyroid cancer, along with many rarer diseases.
He was drawn by the breadth of the field, which mirrored his own wide-ranging interests. He also enjoyed the challenge that came with difficult-to-pinpoint conditions. “It’s like being a detective,” he says. Most of all, he relished the chance to take on the long-term care of patients with complicated conditions to help them manage their illnesses.
He came to the University of Oklahoma Health Sciences Center for his medical internship and residency. During his second year, he was doing rounds at the VA Hospital, which is sandwiched between OUHSC and OMRF, when he “went out on a limb” and diagnosed a rare rheumatological condition in a patient. The diagnosis caught the attention of Dr. John Harley, a rheumatologist who saw patients at the VA and ran a research lab at OMRF. Harley’s clinical and research interests centered on autoimmune diseases, conditions in which the body errantly turns the weapons of its immune system against itself.
Scofield accepted an offer from Harley to join him for a day staffing a clinic at the Lawton Indian Hospital. In Lawton, they spent most of their time treating patients with rheumatoid arthritis. On the drive back, Harley talked about how joint disease seemed to present a different set of symptoms in Kiowa patients than the other Plains Indians they’d seen in the clinic. Scofield soon began working with Harley in his OMRF lab, and that car-ride discussion would form the basis of the first of many research studies the pair conducted together.
When Scofield finished his residency, he began a fellowship in endocrinology at OUHSC. But, true to form, he decided he’d do double duty, simultaneously taking on a postdoctoral fellowship in Harley’s lab. “I wanted to learn about autoimmunity so that I could apply it to problems in endocrinology,” Scofield says. He wrote a grant about autoantibodies – proteins created by the body that attack a person’s own cells – in two autoimmune illnesses, lupus and Sjögren’s disease. When the National Institutes of Health funded the proposal for five years, Scofield opened his laboratory at OMRF to study autoimmune diseases. Three decades and counting later, he’s still at it.
The history student
Right around the time he started his lab, Scofield and his wife, Bea, were shopping for antiques for their home when a handful of old medical textbooks and biographies caught his attention. He scooped them up (for $56), and a new hobby was born.
Since then, he’s amassed an impressive collection of volumes on medical history. The tracts mostly date from the late 19th and early 20th centuries. To Scofield, who says he’s enjoyed reading history of any kind since he was a child, the works help cast the practice of medicine in a sort of historical context that’s often lacking when people think about changing therapeutic approaches.
“At any given time, everybody believes they’re on the cutting edge of science and doing the right thing,” he says. Take, for instance, a practice now widely dismissed as pseudoscience. “You can read papers from the Middle Ages during the Black Death that sound a lot like something you’d see in a scientific journal today. Except that they’re discussing where to bleed people if they have giant lymph nodes.”
The authors, says Scofield, “sound like they knew what they were talking about.” To him, that kind of perspective “helps you understand that medicine is changing rapidly.” There’s a good chance future physicians will look upon today’s practitioners in much the same way we now view those who leeched their patients, he says, “and that keeps you humble.”
About a dozen years ago, aware of Scofield’s growing trove of medical history texts, the then-dean of the OU College of Medicine asked if he’d be interested in teaching a class in medical humanities to second-year students. Scofield happily accepted, and the dean paired him with Tracy, a Ph.D. historian who’d been teaching similar courses. “The rest,” says Tracy, “is history.”
Since then, the two have provided future doctors with an eight-week history of Western medicine, from the Greeks to Covid-19. “We try to get students excited about the history of their chosen profession,” Tracy says. While she supplies the “big picture” backdrop, Scofield provides real-life examples from treating patients and “connects past to present from a clinical perspective,” she says. The students, all future physicians, “appreciate his stories from medicine’s ‘trenches.’” They also seem to enjoy his sense of humor, candor and the zeal he brings for both clinical practice and medical research.
“Hal really is a blast to teach with,” says Tracy.
After years of guiding sessions on medical history, Scofield says he decided he needed “some qualifications” beyond his clinical bona fides. He began taking distance learning classes on the subject at Johns Hopkins University. He enjoyed them so much that he applied for and was accepted as a master’s student in the program, which Tracy says is one of the best in the country. He’s now one class and a dissertation shy of his degree.
He plans to write his thesis on Dr. Isabella Vandervall, a Black New York physician from the early 1900s. Despite facing persistent racism, she became only one of a handful of Black women practicing medicine in the U.S. at the time and an early leader in the state’s birth control movement. Scofield has identified a cache of her personal documents that, as far as he can tell, have never been reviewed. He’s planning to apply for a small grant that will allow him to travel to New York to comb through the nine linear feet of letters and personal documents that Vandervall and her husband, also a Black doctor, donated to the New York Public Library.
“I think Dr. Vandervall’s story is an important one,” he says, “I’m hoping I can help more people learn about her.”
Despite, or perhaps because of, having a great-great-grandfather who was a surgeon in the Confederate Medical Corps and owned enslaved people, Scofield has long committed himself to helping underserved communities. He volunteers weekly in a free clinic whose patients are almost all Hispanic. He researches autoimmune illnesses that disproportionately affect people of color. And since OMRF inaugurated its Langston University Biomedical Research Scholars Program, a mentoring partnership with Oklahoma’s only historically Black college or university, he’s put his shoulder into the effort. He’s hosted multiple Langston students in his lab and wrote a VA grant that secured long-term funding to support the program.
Dr. Valerie Lewis worked in Langston’s career planning office before joining Scofield’s lab, first as a technician, then as a graduate student. As program liaison, she’s been instrumental in building the Langston partnership, and she says it couldn’t have happened without her mentor’s support. “He saw this was important to me, so he encouraged me to participate and make it a part of my career development.”
That Scofield recognized her passion and found a way to fuel it came as no surprise. “He’s sensitive and attuned and wants to support minority populations,” says Lewis, who is Black. She also appreciates his efforts to create a welcoming environment in his lab for all. “He’s very no-nonsense about microaggressions and discrimination. He doesn’t tolerate them in any form.”
When Lewis completed her Ph.D., many advised her to follow the standard course for her postdoctoral fellowship: find a new mentor to broaden her base of knowledge and experience. Instead, she opted to stay with Scofield. “Hal makes sure I’m a priority,” she says. “He always puts me in a position to succeed.”
Most weekends, Scofield spends at least one day refereeing youth soccer. He started 20 years ago, when his son, Stuart, then a middle-schooler, expressed interest. Scofield, who’d never played soccer, thought it sounded like fun. The two earned their certifications together, and they spent the next decade officiating games as a father-son team. “We had a great time,” says Scofield.
Although Stuart, now 32, has since hung up his whistle, his father’s still gets plenty of use. Scofield says he especially relishes the buffer that refereeing provides from his life as a clinician-researcher. “At least for a few hours, work doesn’t come into my head.”
Making calls on the soccer field, he says, requires a different mindset than the one he employs in the lab or clinic. “At work, you have the luxury of time and thinking about what you’re going to do next.” But as a referee, “you have two or three seconds, and then you have to make a decision.”
Not surprisingly, his favorite part is working with the 12- and 13-year-olds who get assigned as his officiating partners. “I really enjoy mentoring them and training them to be good refs,” he says.
Also a golfer, he makes it a point to play regularly and holds a three-stroke handicap. While most would consider that level of skill admirable, trying to maintain such a low handicap is “almost a curse,” says Scofield. “That means one bad swing will foul up your score for the whole day.”
Then there’s the concert band where he plays tuba and the jazz ensemble in which he’s a trumpeter. The pair of vintage cars, a Corvette and a Volkswagen Beetle, that he’s lovingly restored and is forever tinkering with. And the week he spends each summer volunteering at Camp Blue Hawk, where he helps 9- to 16-year-olds with Type 1 diabetes learn how to manage their health.
After a while, it can all sound like a little much. And, frankly, like a recipe for sleep deprivation and personal and professional disaster. But, with the help of Bea at home and a supportive lab staff well versed in the art of “Hal wrangling” at OMRF, the formula works for Scofield.
“Hal is brilliant. He is a visionary and a big-picture thinker,” says OMRF Executive Vice President and Chief Medical Officer Dr. Judith James, who’s worked with Scofield since the 1990s. She admits that his comically overcrowded schedule and tendency to think about “the next big experiment or the big unanswered questions” leads to the occasional missed meeting and a reputation around the campus as “being a bit of an absent-minded professor.” However, she says, “He is also one of the best scientific ‘finishers’ I know.” Nearly every one of his experiments culminates in a scientific publication, an accomplishment that those around him attribute to his remarkable ability to pound out a paper in a single sitting and a work ethic that routinely yields 3 a.m. emails.
All told, his unique combination of talents has resulted in a steady stream of groundbreaking research totaling more than 300 scientific publications. With James and Harley, he coauthored a study in the influential New England Journal of Medicine about autoantibodies that precede the onset of clinical symptoms in lupus. That work has since become one of the most cited papers ever in the field of lupus. He’s also been a pioneer in establishing the role the X chromosome – of which women typically have two – plays in a series of autoimmune diseases.
Meanwhile, he continues to see patients. In that role, James says his talent for tackling challenging cases still amazes. “Hal is a master diagnostician,” she says. “He can put together the most esoteric compilation of symptoms and find ‘zebras’” – rare conditions – “missed by many other physicians.”
For his part, Scofield shrugs off the praise. “I like the long-term relationships with patients. You get to know them medically but also as people.” What he finds most rewarding is not a high-profile publication or a diagnosis that impresses peers. “It’s finding patients who have not been communicated with very well and talking to them at a level they can understand so they can get a clear picture of what’s going to happen to them.”
He recounts the story of a 29-year-old with thyroid cancer he’s now treating. “Most people her age will be cured. But even if she is, she’ll never quite be out of the woods. She’ll have to keep coming back to us for decades.” His job, really the job of every doctor, he says, is to make sure she not only gets the treatment she needs but that she knows exactly what to expect.
With that, he’s off. Maybe it’s to see patients. Perhaps he’ll parse the results of the latest data generated in his lab. Or maybe he’ll help a junior scientist sketch out a new experiment. It’s still only late morning on a Wednesday, so golf and refereeing and music and cars and volunteering will have to wait. Ditto for his thesis and the class he’s teaching that week. But somehow, some way, Dr. Hal Scofield will find a way to do it all.
Read more from the Winter/Spring 2023 issue of Findings