The memory surfaces as Dr. Janet Neslen discusses her 40-year career in public health.
It was a turning point in her life, but she was too young to know it. The event led her to pursue the study of medicine -- a field she's leaving after 15 years as the county's health officer.
It happened in 1928 when she was a 3-year-old in Paterson, N.J. Her mother was holding her infant brother and slipped on ice. Neslen remembers blood and a bone protruding from her mother's leg.
"As I grew up that kept haunting me, and I kept going back to it," said Neslen, who retired Oct. 1. "And in my own mind I see very clearly that's when I wanted to become a doctor. Making things right has always been kind of a goal for me since I was little."
Since 1957, when she started as a public health physician in Washington, Neslen has devoted much of her life to "making things right" for those who lacked proper medical care, first as a clinician, then as an administrator.
"It really has been a rich history," said Neslen, 71, who managed to build a career and raise a family when it was uncommon for women to combine the two.
She's had more than her share of challenges over the years -- facing discrimination, weathering state cuts in health department budgets four years ago, and dealing with her husband's disabilities after a serious car accident. But colleagues say that Neslen's patience, level head and commitment to improving the health of the community have helped her through trying times.
"She really understands public health, things like the importance of prevention and helping people who don't have insurance," said Olivia Myers, executive director of Junction, a nonprofit addiction treatment center in Westminster.
"The thing I respect most about her is that she's always been such a strong advocate for the person who walked through the health department doors. She never forgot what she was there to do."
Neslen said facing the end of her career in medicine is difficult, but she acknowledged that it's time. She decided to take advantage of a retirement incentive offered to state employees.
"Unlike Robert Dole, I don't think 71 is the best time to be starting any great projects," she said of the 73-year-old Republican presidential candidate.
Since 1981, Neslen has overseen the local health department, a state agency with 250 employees that also receives county funding. The department offers a wide array of educational programs and health services.
For many low-income people with no insurance, the health department is the only resource for medical care.
Neslen consistently has been an advocate for this population, her colleagues say.
"She is a quiet, unassuming powerhouse," said Don R. Rabush, who has worked with Neslen in her roles as county health officer and as a board member for Target Inc., a Westminster agency that provides services for the developmentally disabled.
"She's a great listener and she only opens her mouth when she has something very valuable to say -- and people listen," said Rabush, the founder of Target and a retired Western Maryland College professor.
Neslen said she couldn't remember a time when she didn't want to be a doctor. As a child, she looked to an uncle, who was a surgeon, as a career role model.
In 1945, Neslen entered the Columbia College of Physicians and Surgeons in New York. It was a time when medical schools followed strict quotas for accepting female students.
Neslen's class of 120 had 26 women, an anomaly considering about six women generally were in a class of that size. World War II was drawing to a close, and Neslen said that Columbia's medical school reversed its policy of accepting a large number ++ of students from the military and increased the number of women in the class of 1949.
"It was a long time before classes got up anywhere near that level again," Neslen said.
After graduation, Neslen and her husband, Earl, a fellow medical student at Columbia, planned to move to Denver, where he had been accepted as a resident at a military hospital. But the hospital at the University of Colorado where Neslen had hoped to do her residency didn't accept women.
"It was very obvious," she said. "I was well up in my class rankings and they took a man who was third from the bottom. But we did something different and it turned out fine."
Neslen and her husband completed their residencies at the University of Utah hospital in Salt Lake City. After a training program in pediatrics, Neslen decided to start her family instead of her career.
"I loved kids, and I decided that if I had any I would take off until they had some kind of grasp on things," said Neslen, who stayed at home raising her family until the youngest of her four sons was a year old.
In 1957, Neslen joined the Washington health department as public health physician, running school-based clinics in low-income sections of the city. She continued her clinical work until 1974, when she obtained a master's degree in public health from the Johns Hopkins University and accepted an administrative position with the health department in Washington.
The move wasn't entirely by choice.
In 1970, Neslen's husband, an obstetrician who had just completed his training in psychiatry, suffered severe brain damage in a car accident. He was left partially paralyzed and his ability to speak was greatly impaired.
"The responsibilities for the family became mine, and in the public health system I could earn more in administration," Neslen said.
She left the Washington health department in 1980, frustrated with the top-heavy bureaucracy and the lack of resources at the clinical level.
Neslen's move to the Carroll County Health Department in March 1981 was something of a culture shock for her.
"I couldn't believe things could be as organized in Maryland having examined kids in closets in D.C.," Neslen said.
At the end of her career, Neslen can't help but wonder about the future role of public health agencies as more of the medical services they offer become privatized. Her main concern is with people who make too much money to qualify for medical assistance but can't afford health insurance. She said 10 percent of county residents are in this "gray area."
"Access to health care is the biggest problem in the United States," Neslen said. "Our public health nurses are finding cases of teen-agers with diabetes who have no real care because they can't afford it."
Neslen said she's becoming "more optimistic" about retirement. She plans to rejoin her book club and devote more time to her work with the League of Women Voters and the Soroptimists. She'll spend more time at home in Westminster with her husband, who keeps busy making quilts, baking bread and growing Christmas trees.
"Most of all," Neslen said, "I want to get around to see my grandchildren, nine of them, flung all over the country."
Pub Date: 10/14/96