UNIVERSITY OF WISCONSIN-MADISON ARCHIVES
ORAL HISTORY PROGRAM

Interview #784
BRENNAN, PATRICIA FLATLEY

Narrator: 	Brennan, Patricia Flatley
Interviewer: 	Sandy Pfahler
Date: 		2006
Location: 	Madison, Wisconsin
Oral History#:	784
Series: 		Women in Science and Engineering

00:00:00	Start of First Interview Session

Sandy Pfahler (SP):  Today is Wednesday July 5, 2006. I am Sandy Pfahler from the University of Wisconsin Madison Oral History Project. Today I'm interviewing Patricia Flatley Brennan, Lillian Moehlman Bascom Professor of Nursing and Professor of Industrial Engineering at the University of Wisconsin Madison. Good morning. 

Patricia Flatley Brennan (PB):  Good morning. 

00:00:26

SP:	We're going to start with the beginning of your life, where and when you were born. If you would talk about your childhood, your early schooling, talk about your family, people in your family or outside your family that influenced you in any way in your education. 

PB:	I was born in Darby, Pennsylvania, which is right outside of Philadelphia. I was the second of what eventually became 10 children in an Irish Catholic family. Nine of the children are still living and my older sister lives in Boston, I live here in Wisconsin, and everyone else lives within 20 minutes of where we grew up. 

	I remember living in what seemed to me to be a very normal environment, and as I look back on it, it was very dense. And I was used to quite a bit of stimulation, which I think has affected my whole life since I'm very comfortable in large groups, I'm used to having to compete for attention, I know how to make scarce resources stretch. And I watched my mother convince us that things like creamed hard boiled eggs on toast was a delicacy. So I know how to make good things out of everyday things. 

	My father worked for the military when I was very young, two or three years old, and then he worked for the Catholic Charities in a series of Catholic mission groups his whole life. He was a businessman and he was a public relations person, so all the while we were growing up my father worked for difference charitable groups in the development and in raising funds for them. And for the bulk of my childhood that I remember, probably from-- [coughs] excuse me-- the time I was maybe 10 until I was 22 or 25, my father worked for the Society for the Propagation of Faith. This was a program, a mission program that was well known nationally through an effort called Mission Sunday. 

	And why that's important here is that from the whole time I was growing up I was used to a couple things-- I was used to the fact that grownups travel because my father had to travel for his work. And I was used to the fact that there were many dimensions to complex, high-profile professional activities. And I began to understand the importance of different disciplines. And I frankly got used to being important and famous and well known. My father was quite well known, nationally. And I grew up thinking that, which has, again, shaped my career. I have a high-profile, very public career. 

00:03:12

PB:	My father has a master's degree in education, my mother has a diploma in nursing. And for very long point in my life I would have said I followed in my mother's footsteps. I'm the only one of my siblings-- four sisters, five girls, and five brothers-- I'm the only one that's gone into health care on the service end. I have an older sister who eventually came in on public policy. But I would have said I followed my mother's career, but as I look at what I've done, I've really followed my father's career. I've really followed passions and finding ways to fund passions, is the characteristic of my work. 

	And I was very heavily shaped by what my parents would be loathe to hear me say was a liberal then, but they were really true liberals of the '50s and '60s. I was very shape by the idea that when you've been given much, you give much. And so the expectation that I would work in a public service environment made perfect sense. My parents would probably not agree that I was raised as a traditional woman, but I think I was raised with very, very traditional expectations of being female, which I've found a struggle with through the better part of my career since they also raised me to be very independent. So I have the struggle between being dependent and not. 

00:04:31

PB:	I don't remember excelling at school. I remember constantly being off the point, off the point. Things weren't making sense to me they made to other people. And I would tell you that's actually characteristic of where I think my intellect comes from-- it's off the point. It happens to be quite good, but it never fit with what was valued at the time I went to a parochial school. There was 82 children in my third grade. Nobody could be off the point when there's non and 82 children in the classroom. My parents sacrificed quite a bit to send us all to private high schools, and then when time for college came, they gave us each $1,000 and said, you can go anywhere else you want in the world. Go for it. And we all did. And so I learned very early on that you can get people to pay you to do the things you want to do. 

	So my college first degree was in nursing, and I was following my mother's footsteps, but I was funded under federal training grants. And second degree was in nursing, and then I moved into engineering, and all that was funded by other people's money. So I learned early on to pursue my dreams. They didn't fit with what the norm was, but there were ways to get them done. 

SP:	So you knew early on that you would go to college. 

PB:	Oh, yes. I can remember thinking very clearly in the eighth grade thinking, I wish I didn't have to wait to go through high school to get to college. And I just can remember that nobody else thought that. It was a very private thought. I thought, why do I have to go through all this high school thing. and I went to a small Catholic girl's high school and tolerated it. I was really not the sharpest student in the class. I was probably more impatient and off point than I should have been, but I knew from the very beginning that I would go to college. It was an expectation in my family, and in fact, every one of my brothers and sisters has graduated from college. 

00:06:30

SP:	So how did you decide where you wanted to go with your $1,000. 

PB:	I knew I wanted to get a baccalaureate degree in nursing and at the time-- this is 1970-- it had only been five years since the American Nurses Association had made a commitment that nurses' education should be at the baccalaureate level, not at the training school. And I knew I wanted to do that. At the time, I looked around at schools in the area, there area we lived. Quite close to Villanova, which was a well respected nursing program. And University of Delaware was close by. I applied there because someone of the family friends said, maybe you should think about Delaware. And then I figured out that-- Villanova at the time was $2,200 a year for tuition and I'd have to live at home. And Delaware a $1,000 a year for tuition and $1,200 for the dorm and I wouldn't have to live at home. 

	So I had my $1,000 and I got the rest from school and that's why I went to Delaware. And as I look back on it now, at the time the program was not an accredited program. I would never tell a young person not to go to an unaccredited program in nursing. I ended up very lucky. It was a terrific program. And I was able to support myself and go to school, and it was close enough so that I could get home if I wanted to but I didn't have to. 

00:07:59

SP:	Now did you work as well as go to school? 

PB:	Oh, yes. From the time I was—probably right after my freshman year in nursing school I worked. I know I worked in the summers when I was 16 and 17. I had—we had summer jobs at a shop or something. And then I became a nursing assistant at the local hospital in Philadelphia and was able to get-- at the time it was really important-- see you have to remember back what's going on then. Wage and price controls were in place. Health care was under its first big constraint. There wasn't a lot of jobs and there wasn't a lot of good jobs for students. You could work as an orderly, you could work in the kitchen. But to get a clinical nursing job was a real desirable thing and it was very hard to get. They also paid very well at the time-- I think $4.60 an hour, something god-awful, but it really, it was a lot of money. 

	So I was able to work as a nursing assistant in the summer, and I worked there at the hospital in Philadelphia every summer between freshman, sophomore, and junior year in college, and then starting, I think in my junior year, I was also working every other weekend during the year. And then while I was at school, I didn't work work-study, but I cleaned houses. It was it was a way to have sort of a flexible job that I could get a little spending money. 

SP:	Now, did it cause a problem later that the school was not accredited? 

PB:	Uh-uh.  Nothing that anyone ever told me was going to be a problem became a problem. I was told I would never get a job in nursing when I was finishing this degree in engineering, and I just really needed to think about what I had done to my career and I would probably not be very successful. Nobody else's worries have ever come to fruition for me. 

00:09:52

SP:	What was good about the program at Delaware? 

PB:	Friends. No one has ever asked me that question. That's a great question. 

	I liked living in the dorms. I worked as a resident assistant for several years, so that also picked up part of the money, paid some of my fees for room, board, and tuition. It was unusual at the time for students to start clinical nursing in their freshman year, and we had clinical nursing in our freshman year. We had an awful lot of clinical-- way more than students have now. Two, two and a half days a week. And this is a transition time in nursing education where we were coming from hospital practice where students were not even necessarily supernumerary in the unit. I mean, they staffed the unit-- to college, which was sort of looked at as being not quite as good. And so what schools of nursing would do to stay credible is they would say, well, we have almost as many clinical hours as you'd have if you went to a hospital school. You would have as many over four years as you would have had if you'd gone to a hospital school. So the idea that more hours was better was somehow important. 

	I have great teachers. I can remember becoming personal friends with my freshman chemistry teacher. He ended up marrying a friend of mine who was a couple years older than I, and that friendship continued for 30 years. So there was an ease between faculty and students. That's mostly what I remember. 

	Delaware is also a beautiful campus, and so it was a pretty place to live and it was nice and accessible. 

00:11:30

SP:	So when you got your nursing degree, then what did you do? 

PB:	I worked in the critical care unit for a while. I'd been working as a nursing assistant in this unit. And again, it was a very interesting time because it was the very beginning of open heart surgeries and the beginning of different trauma-focused care. So it used to people, if you were in trauma, you died. And so the unit was a very new unit, very experimental in Philadelphia. And so I got to be part of this unfolding. 

	And I didn't want to do this and it wasn't my first choice. I learned in undergraduate I wanted to be a psychiatric nurse. But you couldn't at the time get into any what we would call specialties in nursing-- psychiatric nursing or public health-- unless you had done a year of hospital based nursing. And so I did my year of hospital based nursing and then got out of it and went to psychiatric nursing. 

SP:	What made you decide you wanted to do that? 

PB:	You know, I don't know. My psychiatric nursing experience was in one of the most horrible places in the world. It was in Delaware State Hospital. It was a time that state hospitals were still very large. They had many, many patients that had very complicated psychiatric problems. 

	Maybe my professor. When I think of it, maybe it was my professor. But I just knew that that's where I wanted to be. 

SP:	And where did you go to? 

PB:	So I worked in, I was still in Philadelphia and I was trying to figure out of inpatient nursing, get into psychiatric nursing. And-- [coughs] excuse me-- there were a couple of state hospitals in the area. But I met a woman, again, met a woman at a party who worked at a psychiatric hospital in Philadelphia called Friends Hospital, which was a Quaker hospital. And she said, do you want to come up and talk to us? 

	So I went up and I met with them and I just was enchanted. It still is a very well respected psychiatric hospital. Very large grounds-- 100 acres-- I mean, everything you'd envision from the movies as psychiatric hospital. Big old building. But it was built on a Quaker philosophy that took the idea that there is-- the Quaker philosophy is stated as there is a bit of god in every person. And that was interpreted to me in the psychiatric sense, there was a bit of health in every person. So I was able to work in a psychiatric facility with very complicated ill persons, but with the idea that every person has a bit of strength, of health in them. So I worked there for several years, four or five years, and I just really liked it. It was a wonderful place. 

00:14:13

SP:	And what made you leave? 

PB:	Graduate school. And now I had friends that say that they remember me talking about, as an undergraduate, that I expected to get a PhD. I don't remember that. But I wanted to go to graduate school. I was married at the time, and my then husband was going to go first. I had this great job, he could go to school. And then he didn't get into school. And so I had to apply very quickly and I got accepted very quickly into a program at University of Pennsylvania. Actually I had a choice between Pennsylvanian and Rutgers. I was accepted at both of them. And got a fellowship, went to school. 

	But I went to school for psychiatric nursing because I knew that I needed to have more advanced skills. And it was at the beginning of de-institutionalization. So that the focus at this program was the transition to the community, community mental health. And frankly, the way we would manage these very, very complicatedly ill persons in a community setting. 

	So I went to a place that was extremely well known for its focus on a kind of psychiatric nursing intervention that was better suited for people who were in the community. Didn't really apply to people who very ill in the community, and so the faculty was working at the time to try to reconcile the two. So we had to take care of community based people who were moderately ill, and we had this rash of people who were seriously ill coming into the community. And so it was a very exciting time because people were trying to figure out, what do you do when you have his complicated person who you don't have all the control over? So it was a interesting time to be in psychiatric nursing, just in time to be at a research intensive university. And it was great. 

00:16:06

PB:	But it was the place where I started working with computers. And that was a very unexpected part of it. I had expected, I was really passionate about urban de-institutionalization, and working with people who were complicated and ill. I had known about computers before. I remember reading in a nursing journal in the '70s-- '75, '76-- about computers and some work that a woman named Margo Cook was doing, who I subsequently got to know and became quite a fan of her work. 

	In my last semester in graduate school in a research course, we had a research professor who wanted us to understand concepts of randomization. And she got us to learn a computer simulation program, which this was back in the '70's, so it was really it was really, really-- but I was enchanted. I was fabulous. It was so interesting. And so I would go and I would study and I would work. And she finally came to me and she said, you're using up all of the computer resource for the whole class. You have to stop. 

	That's where I got my interest in computers. I just thought this was the most amazing thing. And the fit for me was this-- in psychiatric nursing, especially when you're working with acutely ill people, you don't get a chance to make any mistakes. You say something and you have a person who is hallucinating, you have a person who is suicidal, you have person who's in a very serious paranoid state, you use yourself the best way you can. But if you say something stupid, it really can screw up the situation really bad. 

	So people tend to be very conservative in working with people who have that kind of complex illnesses. I wanted to understand better, could you teach people? Could you let them practice? Could you simulate interacting with a person where you didn't have like the silly programmed instructions there, where you just flip two pages and can see what the right answer is. You didn't have control over what the answer was, but you could deal with the consequences of your response. 

	At the time I saw this is a decision making tool. And I saw this with the idea that you could build-- if I was in a crisis situation right now I could consult this little computer, test out what I was going to say and it would tell me, yeah, go ahead. Or, no don't do that. It's a bad thing. So that's what I thought that we could do. And it was through that research course that I was able to learn that. And I'm sure that's not what they wanted me to come out of that program with. 

SP:	What degree did you get, then, when you finished? 

PB:	Masters in this nursing. Master of Science in Nursing. 

00:18:46

SP:	And was the experience with the computer strong enough to have you say to yourself, I want to go on to school and do more of this? Or did you go back out into the workforce for a while? 

PB:	Yeah. then life intervened. I graduated from school around December 15 and I was interviewing at the most prestigious psychiatric facilities in the country. The Menninger Clinic and at the Institute of Living. I was ready to take on the world. And then my brother was killed in a car accident in February. 

	And then it that time my then husband wanted to leave Philadelphia-- had been planning to leave Philadelphia, anyway, that was all in our plans-- but then the only thing they became important to making a job decision was, can I get home for Christmas? And so everything got-- and in nursing, and especially inpatient nursing, no one guarantees Christmas vacation eight months ahead of time. So I knew that any inpatient work was out, I knew that any community based work where I had to have a case load was out, so I went into the academic nursing. 

	I never wanted to be an academic nurse. I never wanted to be an academic. I just thought this was not-- and it was funny to ask me about what got me into psychiatric nursing. It was my professor, but I didn't dislike professors, but I didn't think academic work looked right for me. So I ended up looking for a job in the cities that my then husband was looking for schools that I could get home at Christmas for. And so that's why I became an academic. And that's the thing we probably shouldn't let anybody listen to because nobody know that, that I became an academics so I could have Christmas off. 

00:20:28

SP:	Well, where did you end up? 

PB:	I went to Marquette. I was living in Philadelphia. My then husband was accepted to-- again, didn't get into any of the graduate schools-- but he got on the waiting list to Marquette. And so we thought we'd move to Milwaukee, which we did and I taught psychiatric nursing on the faculty at Milwaukee from like September of '80 until December of '82. Because again, I knew that I wanted to go to graduate school. I wanted to learn more about computers. I thought I was going to-- I mean, I was ready to do something more with these computers by then. 

00:21:11 

PB:	I started in the MBA program at Marquette. And that wasn't it. Although what that got me was to meet a man named Peter Keen who had written a book called Decision Support Systems. And so this fit great. I remembered my clinical practice and how we could help nurses in urgency situation, make a decision, see the consequence. And so I read this book and then I met him. He had come to Marquette's campus. And I thought, this is it. This is what I'm going to go to graduate school for. 

	And so I started to interview people in the area. My husband at the time would have been finished school within a certain period of time, so the plan was I would start at this. We had some friends who were going on for PhDs in nursing. 

	I came out here and I met with Joy Calkin. She was on the faculty at the School of Nursing for about 10 or 12 years. She's an amazing woman. She's really spectacular. 

	She met with me and she said, what are you interested in doing? I said, I want to this and this in decision making and health care. She said, you could study that from a lot of different ways. She said, you could study it from how do people actually make decisions? Psychology behavior. You could study it from how can you make them make better decisions? Engineering. Or you could study from what are the financial structures of their decisions? You could go to the business school. 

00:22:29 

PB:	At the time, I did not realize what a gold mine she was. Because she was highly interdisciplinary in her own research, so she had colleagues in all these programs. And Madison in the '80s was world renowned for the decision sciences that were going on here. Lola Lopes was in psychology, Denny Fryback, Dave Gustafson in engineering. Ray Aldag in the Business School. We just had the most amazing people here. And she was connected to all of them. It was also a great time for health care. And Dave Mechanic was here. It was just an unbelievable time. 

	She help me connect to Dave Gustafson. I did think about looking at other schools in the Midwest. I looked at Michigan, I looked in Illinois, I looked at Minnesota, and I looked at going back to Penn. I'd been offered a doctoral fellowship at Penn before I left to study psychiatric nursing. Didn't take it because of family reasons, so I thought, maybe I'll go back to Penn. But everybody I talked to in the Midwest said, we can't teach you how to do that. Because I'd say, well, I understand about computers and decision making and nursing and we can't teach you that, but you could stay here and study at Wisconsin because of the CIC programs. So I thought, I could stay there and [unintelligible] alway go to Wisconsin. 

	So that's part of why I came. I did not want to come to Madison. This is the smallest city I've ever been in. I thought, I cannot possibly live in this city, it's just horrible. My friends from graduate school still tease me about the fact that for a year I kept saying, it's a horrible city. It's a god-awful place. It's a good school, but it's a horrible place to live. 

	So I met Dave Gustafson and I said I wanted to study decision making nursing computers and this. And he says, oh, that's great. And I said, oh, wow. And he said, and we can teach you how to do that. I'm thinking, this is finally, after talking to a dozen people-- because remember I don't think right like others-- talked to a dozen people and sudden—and in fact, I was just saying, here's the guy who knows how to train me. 

SP:	What department? 

PB:	He was in industrial engineering. He's just retired from our faculty recently. 

	And I'm thinking this is really very strange. So we start talking about it and he says, we can work this out. And you do this and this. You've got to take a year of calculus. And I said, I can't do calculus. I can't math. I was told by my freshman adviser at Delaware, we're going to put you in remedial math, and don't ever take a math course again. You can't do it. I've taken statistics, I can’t—but I said to him you'll have to find a substitute. Because I was like almost 28 at the time, 29. And he said, there is no substitute for calculus. You have to take calculus. 

	So I went back to Marquette, I took a year of calculus, I got through it. And I came and I studied with David. And his attitude was, I'll start your off and we'll figure out along the way if this is right, or if you need to find another adviser, which has been a very profound shaping of my own experiences as a doctoral adviser. 

00:25:10

PB:	So I went through the usual trials that you go through in changing programs. And a lot of math and the engineering. What was I doing here? Lot of pressure from nursing colleagues saying, this is ridiculous. Why are you doing this? This is really nutty. At the same time, I had gotten a federal fellowship. I had applied for it and received a personal federal fellowship for five years of funding, so I funded my own graduate program. And I didn't have to be a research assistant slave anywhere. 

	And sort of towards the end of the program, I realized that David had no idea that first day of what I was talking about. Not a bit. And what I realized that I had this moment of the betrayal. Like, oh, my god. He made me come here and he didn't know what he was talking about. But then what I realized was that he had this belief in me that I could figure this out while I was here. So I did. And I was lucky. And I just had incredible mentors. Really outstanding people-- Steve Robinson from engineering, Denny Fryback-- who became lifelong mentors. And so I felt very privileged. 

	Plus, I also had the most incredible set of friends. I just made great friends here. And friends who are still friends to this day. People from all different programs. A couple of us met up through a statistics class, we brought other friends. And so I think what got me through, in part, was that I think I spent every Friday from about 2 o'clock until midnight on the Terrace. For four years. And that got me through. Honestly. And I look at my students now, and they work so hard. They never go to the Terrace. I think, what's the matter with you? This is where you learn. Our professors would come. It was just a different time. 

	My studies here, they didn't fit again. But it didn't seem to matter to anybody that they didn't fit. I went one time to see Danny in my second year and I said, I've got to leave. I said, I think the only reason you guys are letting me stay is that you need women in this program. And I can't do it. I'm not going to do it. And he said, maybe you're right. Then he said, give yourself another couple weeks. 

SP:	Well now, were there people in the School of Nursing that understood what you were trying to do? 

PB:	No, no. No. I had friends in nursing. I had a couple people-- again, people who became good friends at the time. It was a funny time in nursing here. The School of Nursing did not have a doctoral program until the early '80s. And when they got their doctoral program, they actually were required by the regents to have a joint program with another school. So there was a nursing social psychology program that was set up. Largely, social psychology played the dominant role in this. And for probably four or five years the students got their degrees in-- they got this joint degree, so it was a PhD, but it was largely a social psychology degree. 

	And I took one course in nursing. Maybe two. I don't fit. That's all I can say is I don't fit. I think about things differently. 

	Nursing has been challenged as a science discipline since its inception, but certainly since the '50s when nursing really moved into doctoral education. And the field has responded to that challenge by embracing precision. And so if we're precise, we must be a science. And so it reassures everyone. So precision shows up in highly structured training programs, it shows up in research that is very-- we have colleagues nursing who have spent their lifetimes on an instrument. Developing, refining, ensuring. 

	And I'm trained in this really messy, sloppy engineering stuff. So I would go to my seminar. Joy Calkin taught one of the seminars that I was taking. And we just thought differently. I keep going back to this idea of thinking differently. And I have to tell you that I'm 52 years old and it was not until I was about 40 that I understood it was OK to think differently. And at the time I couldn't understand why I didn't get it. And they all got it and kept trying to get and trying to get. So now I can look back and say, I know why I didn't get it. I didn't want to get it. I didn't think it was right. Didn't think it was the right way to think about it. 

	As much as my doctoral training was highly interdisciplinary and my cadre of friends were across the library-- School of History, statistics, math-- I was troubled by not being normal. And it just didn't seem right, but it also seemed my lot in life. And I also knew that struggle, struggle all I want, I had a lot of funding for my doctoral program. I had a lot, already was developing a national reputation, I could go anywhere on campus and get anybody to work with me, so it doesn't seem so bad. I didn't have any rules that I had to break, so it was a very freeing time. 

00:30:33

SP:	Now did you find people on the national level who understood what you were trying to you? 

PB:	Absolutely. I have been blessed with the most amazing mentors. And many of them are in nursing. So my sense of nursing comes from this actually international group. 

	In the early '80s when I was still at Marquette I worked on a project around something called nursing diagnosis, which was one of the early terminology structures for nursing, the labeling of nursing problems. And through that I met a woman named Susan Grobe. And through her I was selected for closing keynote talk of the major international meeting in 1984. I was still a student. 

	A couple of years before that, even when I was at Marquette, I was very interested in these computer things. And I worked with a really amazing woman there named Madeline Wake, who is currently the provost at Milwaukee at Marquette. And she said, we're going to get famous together. She said, you know things that I can continue. She headed this continuing education program. And so through her we began to bring in some speakers into Wisconsin who were working at the interface of computers and nursing. Virginia Saba, and then we brought Susan Grobe in. And then through them I got connected to this larger group. 

	And it's not just going to give a talk. In 1984 I was about 30. I was not through my course work, or maybe just through my course work-- I hadn't taken prelims. And I gave a closing talk to 1,000 people in this meeting about decision making and technology and we were going, what possibilities were there. And I don't know if it was good or bad or awful, but what I remember was people understood. And it was so great to have 1,000 people understand me. 

	But I got connected to this community. And I've just come back from our meetings in Seoul, and it's 22 years that I've been working with this community. Partially because of-- I'm not in any way dismissing my own talents, I'm not apologetic about it-- but I could never have done this on my own. When I submitted my first proposal, I had to have people that could read it. And so Virginia Saba was one of the people who read my early proposals. 

	But I've also grown up in an interdisciplinary environment and I've been successful in that. And I've been successful in maintaining nursing's presence in it. And I've been successful in bringing good engineering into it. And I've had these mentors around the country who are the top people in my field. And so whenever I have a question, I call them up. What about this? I'm worried about that. I'm thinking about this. I need somebody, some help for this. And it's reciprocal. So I just feel really well mentored. 

00:33:38

SP:	When you were doing your work on your PhD, did you know at that time that you wanted to stay in academia? That that was going to be your place? 

PB:	You know, that Christmas thing was real important. I don't think I have a question. Except that I kept getting told, you'll never get a job in nursing because you're learning this stuff that no one's going to hire you. 

	I looked at and thought about practice based research positions. So I looked at going back to Penn. They have a very large hospital system. But I think I knew I was going to be an academic. Everyone I had contact with was academics. And the humanities people that I was with really taught me a lot about getting an appreciation for the academy and what the academy brings to society. It's a great thing. No, I don't really think of that. 

	I periodically think about going into industry. And now, I'll tell you that in addition to Christmas, frankly, the security of academia has been very important to me. When you live on the fringe you need to know that you're not going to worry about your job if it fails. So that's why I need academia. I could be very attractive to research and development firms or clinical information systems companies, but I couldn't have the freedom that I have to explore ideas there. 

00:35:11

SP:	You stayed at Wisconsin. 

PB:	No. No. 

SP:	Graduated? 

PB:	No. See, everything in my life is kind of driven by personal things. I graduated and my then husband, who was at the time becoming my not then husband, he got a job in Cleveland and so we moved to Cleveland. 

	I took a job at Case Western Reserve. I was brought onto the faculty of nursing because the dean was a very eccentric, very extreme, high-profile person who liked odd faculty. So I fit perfectly. There was me, there was midwives, there was nurse anesthetists. It was a very strange group of faculty. But it was also-- the '70s and '80s were an amazing time for nursing thinking. So just as we had this anti-intellectualism that led towards precision, we had this expanding breadth of thinking of, what is nursing? Where does it fit in society? What does is do? And the dean of the School of Nursing at Case Western Reserve was one of the leading thinkers in the world, at the time, about nursing as an intellectual discipline. 

	And so I went to work there not realizing at the time that it was so important to go to work there. Because she was-- when you think about the old fashioned ideas of a patron-- she was a patron. She really thought she could get famous by having a famous faculty member. And so everything that I needed to make her famous, I got. And it was everything from access to research support or direct access to foundations. 

	When I graduated-- I spoke of our National Society for Nursing. That is a part of a larger interdisciplinary international society. So the interdisciplinary group was meeting in Washington the October that I graduated. I defended my dissertation and I went out like three days later to this big meeting. And she had a party there for me. And she had a party-- we had 200 people there. She was going to make a big slash-- look, I've hired this weird kid. And then at same time, because I had already begun establishing my reputation with the community, I brought her famous people. So it was sort of this good exchange. It was certainly scholarly, but not only scholarly. So she would do everything from she'd expect you be at cocktail parties and to host dinners, but also expected you to get research grants and write papers and become famous. And that's about what I did there. 

00:37:43

PB:	So I was at Case for 10 years. And I started looking around, actually. I went on sabbatical in '94 and started looking around. Wasn't planning to look around, but actually was in a conversation with someone from Madison-- who turned out to be dating someone from the industrial engineering department-- who called me and he said, I hear you might be moveable. And I said, well, I don't know. And he said, well, why don't you think about coming out here? And I, at the time, was not sure I wanted to come back to Madison, but I did know my work needed to get more technical. But I sort of dismissed it. 

	And then I started thinking about it more and then I talked to another colleague from the medical informatics community, which is my little discipline area, as I think of it. And he said-- he's Vice Chancellor at Vanderbilt now. And he said to me, well, if you know what you want to do and you're not sure you can continue to do it at Case-- because actually, it was becoming very clear that not only was I losing favor with the dean, but the dean was losing favor with the school, so this was going to disappear-- he said, why don't you come to Vanderbilt and just talk with us. Because maybe you can do better. 

	So then I started looking around. That's when I was looking at industry a little bit. Looked at health care. Looked at Boston, looked at Harvard. 

	And I came back here because it was only here that I could get the environment in higher ed that would be the place to live at what was going to be happening in the next 10 years. So I'd lived through 15 years of health care wage and price controls, DRGs, prospective payments, Medicare cut backs. And I saw what was happening in health care, and I saw that being at a premier health care institution is the way to go. You can shape the change, you don't react to it. 

	And I could see that coming into higher ed. It was very clear from the private school that we were coming down off of a big bolus of money, of interest, of resources. And things were going to become difficult. And when things get difficult in a private school, deans get tighter. When things difficult in the state school, you can retain intellectual power. 

	And that was when it became very clear that I was more of an intellectual than I was an engineer or a nurse and that I needed to be in a place that valued intellect. And that valuing it from the mouthpiece of a dean didn't matter. It had to be valued at the level of faculty. And so Wisconsin, more so than any other place I had seen, because of the governance structure, because of the Wisconsin idea, because of the expectation and control at the level of faculty of curriculum, this was the place to come. 

	So I went through a little bit of soul searching, lot of negotiation. Terrible conversation with John Bollinger at one point when I said, I want to talk about my salary. And he said, for a woman, that's a damn good salary. I don't think you should be complaining. 

00:40:42

PB:	So I came. And I came here in '96. And I have a joint appointment. I was tenured in nursing and engineering. My tenure is equally held, and so I have the dubious delight, I guess, of being on two executive committees. 

SP:	You were a student in industrial engineering when you left and you came back as a full faculty member. Was there a difference in the culture as far as you can tell? Had things changed in those 10 years? 

PB:	Well, that's a funny question. Part of the reason that I came back is that Steve Robinson worked very hard to get me to come back. And I could, and did for several months, call him with all my concerns. And at one point one of our other colleagues had called me and he said, oh, my god. It's great you're coming back, I heard. And he mentioned another fellow who was at that time supposed to come back-- he didn't come back-- he says, it's going to be fabulous. It's going to be just like it was 10 years ago. And I thought, eww. That's not what I'm coming back for, buddy. 

	[coughs] Excuse me. 

	When I came back, I would say 2/3 of the faculty were the same. Maybe a half, but IE is pretty small-- it's 12, 18 people all together. Gustafson was still here. Robinson. Smith, Suri. Probably eight or nine of them. 

SP:	Any other women? 

PB:	At the time-- When I was a student there were no women faculty. When I came back Vicky Bier was already tenured. Sigrún Andradóttir was here, but on leave and she eventually never returned that leave. Pascale Carayon was here. And there had been some women in the meantime. Leyuan Shi was here. She was faculty from MIT. 

	Part of why I came back is that Wisconsin is great. The department is fantastic. My industrial engineering department is, well, I probably think it's fantastic because it fits with me-- it's odd. I think that it's world class. Everybody in the department is world class. And everyone's expected to be that way. And so you're expected to have a major research program, you're expected to have a major national reputation, international reputation. And if you look down the list of our faculty, the people-- Gregg Vanderheiden and Gustafson and Dave Zimmerman. I mean, these are people who in their area are absolute specialists. 

	So I came into a peership. And I had no sense of, well, you were student and now you’re this. Because I mean, I was old. I came in as a full professor, I came in tenured. I wasn't going to deal with any of that silliness. But I also came into a group of people who worked very, very hard. There's not a lot of tolerance for what you would call the sort of sludge of faculty governance. Our department has had two chairs of the University Committee. We've had five chairs of divisional committees. 

	We do a lot of service. And the expectation is you do service. Period. And we do service internally, we do service externally. This time we've had a chair for quite a while, but at the time we were turning over chairs every three years, like it's everybody's job. I got hired and I was told, you're going to be the chair and this many years. 

	So it was a different environment in the sense that it was more mature, there were a greater number of women, it was a stronger research program, but it was actually not a lot different because there was a lot of the same people and the attitude of scholarship and national prominence, federal funding for work was very common. So it was the same and different. I didn't get back to my old office, but down the hall from my old office, so it's a little weird. 

00:44:46

SP:	What about the culture of the School of Nursing? 

PB:	It's really very different. I have to say, I've made my peace with the School of Nursing, but it was a very long process to do that. 

SP:	Did you want the dual appointment? Did you want the faculty appointment in both schools? 

PB:	Yes. And I won't give it up, actually. And I had to really, really work that one because I've been encouraged to move more of my effort to engineering. I have now. I'm 75% effort and time in engineering. 

	There's a couple of things. So let me try to explain this. When I was hired I was mostly interested in the joint appointment. This seemed like, fascinating. When I got here I was here about 20 minutes and I realized I was the bridge. There was no real interest in having anything along the side of the bridge. The cache of a joint appointment-- perfect. Interestingly enough, IE views nursing as a, if you will, a legitimate vector in health care. So there is no sense of, we'd rather have somebody in medicine but we've got this chick in nursing so we'll stick. There was really a sense of, this is a way to address important health care problems and we have a pathway. Health systems engineering is very important to us, we believe that what is happening with this is very good. 

	Nursing offered me a professorship. That's not a small matter. I feel like with that I have a big responsibility to the School of Nursing. But because of this tradition of social psychology and this very precise approach to research it's been a struggle. It's been a long struggle. And some of the struggle has come from the cultures of the two schools are really very different. 

	The School of Nursing is quite small, and we are a school that is small. So that makes it very confusing. We have to have all the stuff that a school has to have, but we don't have a department chair, a dean as a department chair. And a lot of the infrastructure, the faculty infrastructure that has to be built gets built on a very small number of people. 

	There is a sense in the School of Nursing-- there was a commitment made in the early '90s that I didn't quite understand-- about how research got done. And the belief was if you want to get research done, you have to get people-- 

00:47:25 [End of tape 1, side 1, begin side 2]

PB:	Oh, good. OK. Because I love to talk. 

SP:	OK. Go ahead. 

PB:	The School of Nursing has usually between three and six faculty who have active programs of research. And a lot of other people don't. And people have a different culture about their expectations of their job, their expectations of their work, and their tolerance for differences. And so I've learned over the 10 years that the cultures are very different in their tolerances of difference. So in engineering, no one particularly cares if you are different. But there's no penalty, there's no prize. We expect everyone to be different. We're like a bunch of two year olds with really good parallel play. We do all of our work together, we're friendly in faculty in faculty meetings, we don't undercut each other's decisions, but we frankly don't hang out a whole lot together. In the School of Nursing there's a hope that there will be some congealing around some undifferentiated mass of excitement and scholarship when in fact, we're actually all quite different over there also. 

	So the attention around not being together was something that I didn't understand. And I thought we should be able to get together more. And now I've sort of looked at as we have an outstanding undergraduate program, we have a belief that research and research training is something that everyone can do. Our expectations as a community, our expectations as a group are really quite a bit different than the rest of the campus. 

	And so I look more like this in the campus and the health science end, and that has been a struggle for me. I believe that through some at quirks of fate some decisions were made in my hiring that have advantaged the school and thereby advantaged me. And this is, again-- interestingly enough, I haven't really thought about the issues, how similar this is to what I was working at Case, but--

00:49:22

PB:	We have sort of a pact. You know, I'll keep bringing my research money as long as you don't bug me too much about other things. And I do--I teach in the School of Nursing. I do a fairly-- now extremely limited level of service, for a number of reasons. One of them being that my service locally in my schools is campus wide and nationally-- is really very high. And I've come to the point in my career where I have to be very careful about what I put my time into because there just isn't that many clock hours. But also, I have come to some acceptance that what I can offer is what I offer. It's like when I was in graduate school and I couldn't understand why I didn't understanding things the way other people did. And now, I don't do that type of thing. 

	And I work with terrific administrators there. Nadine Nehls and Barbara Bowers are our associate deans. And Katharyn May. And I've had very frank conversations with them. So what I've been doing the last few years is working with faculty peers to try to strengthen our undergraduate and graduate programs in informatics and genomics, which is things that I know. And so I'm not doing the kinds of things that other faculty do. I'm not sitting on the TA supervisory committee. But I think, why do we have faculty tied up with TA supervision? 

	So we've worked out. And there over the years we've added an increasing number of very sharp people. We also have some long-term performers. Sandy Ward has been here since she finished her PhD. She has developed a well recognized, well respected program in informational interventions and understands how to deliver very precise interventions. Karin Kirchhoff has a broad based project in end-of-life care. We've got a wonderful young faculty member-- young in terms of academic years-- Susan Zahner, who does great public health stuff. So we have a really interesting mix of faculty. 

	We have a greater portion of faculty who might publish one or two papers a year, might not have any federal funding for several years in a row, and it's impossible for me to believe you can live that way. I can't imagine how do you get any work done if you don't have any money? But it's a different environment. 

00:51:46

SP:	You said you teach. Do you enjoy teaching? 

PB:	No. 

SP:	No? Why not? 

PB:	Not in the classroom. I think different. It's really hard. You know what? The students go crazy with me. They just can't believe-- one student wrote on my evaluation last semester, if this woman is an engineer, then I must be God. So it's really hard for me to teach. And do you know how long it took me to figure that out? I mean, I try. I work really hard at teaching. In the classroom, I can't. It doesn't come easy to me. I'm better at big classes than small classes, I'm good at bringing ideas in, but I--

	Two things. One of them is that I just don't seem to be able to grok on what students need. I can't give the level of structure they want. I'm much more interested in helping them discover how to learn for themselves. And so Harry Steudel our chairman of engineering, bless his heart, comes to me every semester. I say, Harry, I've got to stop teaching. I can't do this. It's an embarrassment for the department, my evaluations are terrible, you've got to get me out of here. And he'll say, there's that handful of students every semester that just really appreciate you. 

SP:	I was going to say, there must be people out there who think like you. 

PB:	Yeah, there are. There are, there are. That's why I was like, this morning I get this gaper and he says, I want to go to graduate school and study health systems and I think, well, baby, I don’t think [laughs] 

	I'll tell you about my teaching is--what I'm really good at. I'm a great doctoral adviser. And I have the most amazing group of students. And I have graduated 27 PhDs. And a dozen postdocs. I love doctoral students. I love training them. 

00:53:32

PB:	It's very interesting. Very few doctoral students take courses with me. Because I offer such weird stuff. I teach a course in health systems engineering, usually every fall. I teach a course in information systems in health care every spring. I have taught a number of different things in the School of Nursing. I'm going to teach a course in information systems in nursing next summer. So we're trying to reconcile that. And by reconcile, I mean the school has never really wanted a course in information systems in nursing, and that's really all that I've got. So they've had me teaching all sorts of other stuff. And I try to be a good citizen and teach what I need to teach. But if I never went into the classroom again I'd be perfectly happy. 

	Now, I have currently 10 doctoral students, four postdocs, and a half a dozen undergraduates and masters students. So my teaching is going on all the time. Took students to Korea with me. I teach by example, I teach by exposure, I teach by stimulation, I teach by interaction, and my students teach each other. 

	I was just interviewing a new candidate and I said, you're welcome to come and study here, but here's what studying with me means. It means you're part of a team, you should give to the team, you should take back from the team, and you need to be pretty self-directed because you can do anything you want in this group, but it gets pretty overwhelming if you don't know what you want to do. 

	So, yeah. So that's my teaching. It's a sore point with me. There's not many things that I have to keep doing that I don't think I do really well. There's a lot of stuff I don't do really well, but most of it I can say, not going to do that anymore. 

00:55:15

SP:	Could you talk about your current research? 

PB:	My current research is an extension of my original research, which is, how do we use technology to enhance patient care? About the mid '80s I shifted from wanting to do something for nurses to realizing that if we strengthen patients, we would be doing something for nurses. 

	Now, recently I've been doing more about actually trying to bring them back together a little bit more. My research has been to discover, evaluate the use of technology in the home. And there's lots of pieces in that. Our teams have run a series of projects where we would provide computer support in the home that would allow people with complex illnesses to get advice or send messages to each other or to a clinician to get some help. My hope for decision support, which is what 25 years ago I thought I was going to be contributing to-- never actually happened because decision support is really hard, and it doesn't really exist-- but I've done a lot in the area of patience access to health care. So the tag line I use in my work is that I focus on strengthening people's ability to participate in their own care by providing them with technology tools. 

	Along the way I've had to do a couple of things that don't look as directly related to that. Some of them have to do with understanding how nursing care is given, or how team based care is given so that we can understand where strengthening patients matters and where it doesn't matter. So it's really important to help people accept their responsibility for self-monitoring and reporting of symptoms. But it's not necessarily important that they understand all the deep physiology that relates to their symptoms. So that's what I mean by figure out where it's worth doing and where it's not worth doing. 

00:57:18

PB:	I went on sabbatical a couple of years ago-- now three years ago-- and learned more about the structure of knowledge and the structure of knowledge as it's represented electronically. Now, I hope I never have to do any research like that again, but at least I get an under-standing better about if I want to provide-- so my latest kick would be-- if we could have an RFID tag whenever you add every over-the-counter medication in the world, and if your cell phone knew your allergy status, then as you were reaching for a drug that you were allergic to, your cell phone would buzz and tell you, don't take that. You're allergic to it. 

	So I want to build tools like that. In order to do that I have to understand how knowledge is stored. I don't have to make knowledge structures, but I have to learn about that. 

	When I came back from sabbatical I hit one of the those periods that you hit in mid career where I didn't have a new thought for a year. And this was very frightening to me. I had this sense of, I'm going to chair committees for the rest of my life. And they would say, you know, she used to do really good work and now she's great on committees. I love working with her. 

00:58:25

PB:	A whole year. A whole year without a new idea. It was horrible. And then I got a new idea. And I don't know exactly where came from. But what I understood at the time, I'd been working a lot nationally-- I do a lot of national policy work-- and I've been working a lot nationally with a group trying to develop something called the National Health Information Infrastructure. Within that it was really clear that there was a strong business to business orientation and a very strong finance-- can we capture charges? And an even stronger public health-- can we make sure that, I mean, bioterrorism or infection, depending on how you want to look at it. 

	No voice for the patient whatsoever. And I wanted to make the voice for the patient, but I knew patients would not pay for-- we don't pay for the telephone infrastructure, we pay for our access to it. So patients aren't going to pay for this. So I understand a lot more about who was going to pay for it and what some of the issues were about cost and finance. And I got an idea one day-- I have no idea where this came from-- about how we might use economic game theory to apply to the decisions about building or participating in health information exchange. 

	And so I went to Steve Robinson, who I've admired for years, worked with on a lot of university things, but never worked with-- I mean he was on my committee as a student, but I never worked with him until actually as a grownup, So I said, I want to run this idea by you and I want to know if you think it's got any merit and if you might be interested in working on it. I don't know if you know Steve Robinson he's just a character. I have seen twice in 20 years without a white shirt and a tie on. This man if very formal. 

	So he said, well, that's fine. Why don' you send me a couple of pages explaining your idea and we'll chat about it. So we go to lunch and he's got it all marked up and he said, actually, I think it is interesting. I think it's not an idea that he's aware of has been used, but he said, I'm really kind of busy right now. I'm not the right person to work with you on this. But I could help you find the right talent. 

	And that was fine. I felt encouraged by that. And I started talking with my colleagues nationally about what about this, and I'm thinking about that, and getting some early reads on it. And it's going fine. And then about a month later, Steve called and he said, you know, I actually want to work with you on this. I think this'll be good. 

	So then we got Steve and two colleagues from computer science, Michael Ferris and Steve Wright. And we developed a new line of work. We have a whole brand new line of work. We've got federal funds. It's just so exciting. And thing that it's just really, really good, intellectually, it's so stimulating-- I had one of my students working with me as we put this project together-- five people working, the student and the four of us. And the four of us, we're all famous, we're all important. Ferris has a Guggenheim Fellowship and Steve Wright was president of his Computational Society. And we worked week after week to put this idea together. And after the meeting somebody would send back-- here I took some notes, this is what I think we're talking about, or this paper's coming up. Let's put some runs together-- It was an amazing collaboration. 

	We've gotten a lot of good recognition for it. We've got great partners on it. And so this piece of work looks very different than the rest of them because it's all mathematical modeling. But in fact, the mathematical model is a way to make sure that we have a financial structure that doesn't overlook the fact that there are individuals who have a vested interest in this. So the telecommunication system has to be replaced in case we get bombed, but actually, I also have to be able to call my mother. And so being able to have the resources there-- that's how my work fits together. 

01:02:06

SP:	What is-- one of the things I read about when I was reading on the web about you-- HeartCare I and HeartCare II. 

PB:	So HeartCare I was a project that we started at Case Western Reserve that was designed to use the web for post discharge care of people with coronary artery bypass graft surgery. And it was a very successful project in the fact that we learned that by providing people with technology at the moment of discharge in their home that gave them coached, staged information, people got better faster. They don't get better better. Everybody gets better after heart surgery, but instead of having three or four weeks of depression and discomfort, they would have a week. And so they learned how to self-manage better. 

	And this was a wonderful integration of nursing and technology because in order to built a coaching system you have to understand what happens to people and you have to know some way to intervene with that. So we took a nursing model that says people will respond best if you tell them what to expect physically, emotionally, psychologically, and how to manage it. So we took that idea and we mapped out that six months after heart surgery, what can you expect? So that week two, we're telling you what you might expect week three. And here's how to get ready for it, here's how to manage it. So we walk people through this. And the technology at the time-- well, we actually ended up starting it in '96, but we were proposing it in '94-- so it was early web technology and we had to get web accessible devices. So we took this god-awful device called a WebTV that was supposed to be easy to use, let you look at web page on your television. 

	That project was very successful. And then because there's more questions to be answered-- and a parallel line of work that I was doing at the time. Parallel to the HeartCare I project I had gotten some funds from Intel to understand health information management in the home, just to understand, not to intervene. And we learned a whole lot of stuff. We spent a lot of time out in Dodge and Jefferson County making home visits. We took pictures of people's file cabinets and kitchen cupboards and stuff. And we understood that people, most importantly, just want to keep track of stuff. They don't particularly want to know what their last lab values it, but they want to when it happened, they want to know where to get it. 

	And we also, through that process, really began understand the home environment much better. So in my work up until then we had just dropped a computer in the house and said, can you use this? And people could and it was fine, they were happy. But there's so little health care being offered to people that they're desperate-- so they're going to be happy with almost anything. 

	So now we've had to get a little bit better. How do you blend technology and a clinical resource? So in HeartCare II we're working with a different population of patients, people with chronic heart disease. We're working with a clinical care provider group, the Visiting Nurses of Southeastern Wisconsin. And we're using the technology to bridge the two of them. To bring together some resources so that if the visiting nurse needs to teach somebody something, she can teach it to them by sitting next to the computer with them in their home and then the person can go back and review it when they're gone. Or if the patient needs to take their weight every day and record it for the nurse. Well, instead of having the nurse have to come to the house to see the little piece of paper or have the person call, the patient records it on the computer and then the nursing can look at it from her office. So we can sometimes substitute technology based visits for face to face. Or if a patient needs reassurance every day, the nurse can send an email everyday-- how are you doing? 

	So that project is doing two things. One of them is that it's really helping us understand better how to modify nursing practice at these tools are coming in. Because all my work before that didn't look at what nurses were doing. If you've got a smarter patient, you should be able to adjust your nursing practice. 

	And the second thing is that we built it in collaboration with Aurora Health Care systems, so we've got a more sustainable project. In the past, when the problem was done the server was shut down and there was no more resource. And so we have a little bit more sustainability with that. It's a lot harder, frankly, to do it this way. 

01:06:18

SP:	You've mentioned several times you got federal funding for this and federal-- talk a little bit more about the whole aspect of finding funding for what you want to do. How do you go about doing it? It sounds like you've been pretty successful throughout your career. 

PB:	I don't know how you go about doing it. You write proposals. 

SP:	Are you doing a lot of that? 

PB:	I write 10 a year, probably. Not personally. But yeah, you have to. I said one time to a colleague, how many of your proposals that you've written have you gotten funded? And he said, well, one of them. And I think, well I have not gotten all of them funded. 

	David Gustafson taught me early on as a student to understand-- well actually, even before that. I applied for my first grant when I was coming into graduate school for a federal fellowship for training. So I learned about writing grants. But before that, even, my father was a missionary fundraiser, so I knew you had to keep looking places to find money. And I learned that there was this process of applying for grants. I learned early on to do it. 

	I've had proposals that have failed miserably early on. I've had proposals that have been reviewed by people who didn't know what they were talking about and so they thought it was stupid. And when they got better reviewers I got better scores. I need quarter of a million to a half a million dollar project every year because I have a big group to support now. I have to keep things going. 

	So it's part of our work. In order to do this, you have to. So I can get a federal review, or maybe a national review of one of my projects and read it and say, yes, I agree with this or, no, I don't agree with this. But teaching evaluations, I don't do the same thing. I personalize them. I said, oh, but I'm trying really hard, you guys. 

	I recently started working with the Robert Wood Johnson Foundation and I learned that this is a very different kind of funding. I had several dinners and a telephone conference or two and got three and a half million dollars. It's very different way of doing business. And I think money begets money, frankly. I think you get to know as a good deliverer of your grants and so you get more money. I have had the privilege of working with really brilliant people, so that really helps a lot, because my packages look good. 

	I have pretty good grantsmanship skills, so I know how to write in a way that's persuasive. It’s not only that--I can't say that little is known about thus-and-such. So what? Maybe nobody cares. But, because little is known about this, these five things are going to happen to you personally. And so I can engage reviewers. I do a lot of reviewing for the feds, so I get to understand the cultures of the review groups and what seems to sell and what doesn't sell. And I see as a part of my job. It's just you always write grants. 

SP:	What about the other part of writing that you do? The write in publications to get the information out on what you're doing. 

PB:	Well, and now I'd like to tell you that I like that better than classroom teaching. But I don't. But our group writes a lot. I mean, that’s something, you must write. It's only fair to your subjects that you write. I have many things to say. I am a much better public speaker than am I am a writer. It's very painful for me to write. I have to write every day, every single day. I have to, because otherwise I just can't make myself sit down and do it. I write with people a lot. 

	I mean, all my students all the time. We're going to be getting together a little while today to talk about what's going on with writing this summer? Who's writing papers? The students are encouraged to find the right outlets for their dissemination. Sometimes I write with the students. Not always. I don't put myself on everybody's paper or that kind of stuff. I don't think that's reasonable. 

	I'm writing more judiciously now than I used to. I used to write to anybody who would listen to me. And now I write very carefully. And I don't write book chapters anymore because they're too inaccessible. The only reason that I actually will write a book chapter is when I've got a young colleague who is trying to get started. And they'll try and put a book together and I'll help them out with that. 

	I probably have written too much. I probably should have written fewer papers and better papers. As it is right now, I probably have 150, 200 papers, and there's probably 25 that are really good. And then the rest are [dismissive sound effect]. 

01:11:07

SP:	Talk about your involvement in faculty governance and committee work and other campus activities. I know you said you don't do a lot in your department anymore, but I know you're involved campus-wise. 

PB:	Oh I do. What I said is I'm careful about what I do. My department sets up-- in nursing there's committee to the tons. So first of all, I think governance is not just committees. Governance is what we do every day in our work. But we express a lot of it formally through committees. And a lot of what I do, frankly, is related to divisional committee, getting packages ready for tenure, helping with tenure appeals in my schools. 

	Again, I had great mentors. And I got here, met Rima Apple when I was interviewing, and she was on Committee on Committees. And I was here a couple of months and I got appointed to the Committee on Women and started serving that. And Terry Millar, who is Associate Dean for the Physical Sciences in the Graduate School. He really, and you talk about an advocate for women on this campus, he is a big one. And he got me involved in the research committee early on, which is wonderful because you get to meet all these interesting researchers in your areas and understand the breadth of research. 

	So I've served on some level committees that are more on the scholarly end of work here, but I've also served on a number of committees that have addressed the campus as a whole. The Committee on Women is one of those. Also, the University Committee. I work well in committees, I like committees. I know how to get work done in an hour or two. I've worked very hard on trying to ensure that the conversation with administration stays open and pleasant. And that's not always easy. Some of our work makes us challenge some things that are administratively more efficient, and so you're better doing that as a committing than is a person. 

	My most important contribution to governance I think has been shepherding the response to UWS 7 and the regent's proposal for faculty discipline. And that required keeping out of the way of some people that needed to be able to go forward. I was president of my national society a few years ago. And the fellow who came in after me came to a couple meetings before I stopping being president, a couple board meetings. And he said, I can't do it like you do. He said, you don't get to say anything in the meetings. You're always asking other people what they think. You're always trying to restate, to help. He said, you never get to express your opinion. I thought, when you're the chair, it's not your job. You've got another job. 

	So that's how I chaired the University Committee. It's not my job to have the opinions, it's my job to make sure the opinions get expressed and then get melded into solutions. 

	And it's the same with the Committee on Women, frankly. There are personal issues that I would have taken on differently on the Committee of Women, but at the time the things that we needed to do, we put it in a scope statement. Now every building have to have a statement about the consequences to safety for workers and childcare and things like that. We work with committees to get those done. 

01:14:29

SP:	Committee on Women is a good introduction to the next question. If you would talk about the climate for women here. And how does it help or hinder the participation and advancement of women on campus? 

PB:	Well, that concept about climate that I like the best is the idea of micro climates. And there are micro climates on the campus. I came from a department that is one of the best environments for women on the campus. That's not necessarily everyone in the department would agree to. That I only hid it at the times that it was good, maybe. Or was I enough like the others in the new department that I didn't disrupt it? Perhaps. 

	I think that the climate for women is something I couldn't give you a couple sentence appraisal on. It's a hard place for women here. I think it's a hard place in the sense that you have to be a superstar. You cannot be an ordinary woman here and succeed. That does not speak well of the climate. Some of the issues that women raise concerns about-- women raise concerns and identify as climate issues-- to me are hard to understand because, in fact, there is an interplay between a dominant culture, a desire do something different, and a strategy for making that request. So I'm not sure how I would say how I would address that aspect, except to say that I sometimes believe that the issues that we've taken up in terms of equity on the campus tend to be shaped by the desires of individuals and not necessarily by the needs of the whole. And I think the needs of the whole are really important. I don't work in the basic lab sciences. I have heard horror stories about some of the things that have happened in labs. I find that very distressing. 

	My colleagues in engineering broadly are very interested in expanding the number of women in the college. But they're necessarily interested in expanding the way we think about engineering to bring women's ways of thinking in. And I believe very strongly that women think about things differently. And so I have said on occasion that I would not encourage women to come until I saw a greater openness to the ideas of diversity, not to the numbers of diversity. 

	Something just walked through my mind and I wanted to make sure I talked about it. 

	The most important-- and probably why I really let the UWS 7 issue dominate our work this year-- most important issue to me is the persistence of harassment and the inability to have it dealt with effectively. And I don't even know what that means anymore. What I know it that in circumstances where an individual is unwilling to raise a charge, a suspected perpetrator may get away with an awful lot and may be allowed to quietly leave when they shouldn't. And there's no easy way to intervene in that. I was appalled at the Barrows situation. Not because of what the chancellor did-- I was completely in support of what the chancellor did-- but because of the way innuendo and race and lack of public awareness-- and I don't mean everyone has to know the story-- but the lack of public awareness led that to get completely out of hand. And I don't know what to do about that. The fact that that still goes on I think is very frustrating. 

	I think that Denice Denton's suicide is a message that we need to really be mindful of. It's a horrible thing. She may have been a terrible administrator-- this is not a question, I think she was great and it should not-- but what she was experiencing as with the harassment from the students, with the pressure from the students, in all that you see in the writings about her, you never once see her deans, her fellow chancellors, or her wards say we are with you in public way. 

	Actually, when I look at what Wiley has been through in the last year with Barrows I'm not seeing the deans, the boards say we are with you in a public way. There's something troublesome still. I wish I could be more positive about that, but I'm not. 

SP:	Will you be one the University Committee? 

PB:	No. 

SP:	You’re off. How long a commitment? 

PB:	Three years. I'm an elder statesperson now. 

01:19:13

SP:	I see. Would you talk about the professional organizations to which you belong and the extent of your involvement? 

PB:	I'm most involved in something called the American Medical Informatics Association. It's a 3,000, 4,000 interdisciplinary society of the research and development end of IT and health care. I have served them in lots of ways. I've been on the board, and president, I've been a program committee chair. Most of my professional service goes through them. And then through them to other things like professional testimony, policy, and what. 

	I'm a member of the American Academy of Nursing. That's a honorific society. The work that I do with the academy and nursing is probably very specialized around informatics and not broadly. Whereas my work in AMIA, although it was for a specialty society, was broad across not just my own research area. 

	I'm an elected member of the Institute of Medicine. And through that, my major activities right now have been to bring more people into the Institute, to nominate more people. But I've recently accepted an appointment to a national research committee council as an IOM representative. And I'll be on the board of mathematical sciences. So I tend to work on the policy end of boards. 

01:20:40

SP:	Could you talk about some of the honors and awards that you've received. 

PB:	The biggest one is the IOM. That's a big deal. That's a really nice one. 

	This arises in part from the mentorship that I've had. I got a call one August afternoon from a woman who was at the time the Vice-chancellor for Information at Maryland-- she's not a nurse-- and she said, oh, I'm so excited. She said, you just got elected to the Institute of Medicine. This was like five years ago. And I didn't know I was nominated. So this was really surprising. 

	So I tracked back through that and found that in my society, my Medical Informatics Society, people look out for each other. And so one of the senior women said it's time for Brennan. She pulled my stuff, put the nomination together, arranged it without my knowledge at all. Now, this is a little bit of a guy thing. They don't like to embarrass each other if you don't elected. 

	That's how I got elected to the Academy of Nursing. One of my colleagues called-- and this one I knew about-- but she called me up and she said, it's time and we're going to put you up this year. And my other, a fellow in Medical Informatics, and again, that was another colleague making the initiative. So that's really taught me that you get it and then you give it. And you keep giving. So I do a lot of nominating of people. 

	The other honors that I've received that I've been very proud of have to do with lectureships. So I've given named Lectureships at some places in the country that it's been very important to do that. 

	I tried to get one of my colleagues on the School of Nursing to let me nominate her for the Academy. I said to her one time, let me nominate you for the Academy. And she said, well, why would I want to do that? And I said, well, it's an opportunity to service. That designation after your name and an access to that group, you can really get a lot done in your research area. Because if I need to put together a national panel for something, I've got this ready-made group of experts. 

	So she came back a couple days later and she said, I talked to other people and they don't agree with you. And so I never got to nominate her. She said, my C.V is strong enough without that. And that's not what I mean. I just talked to one of my students this morning. I said, I want you to get in the honors program before you graduate. He said, why do I need that? I said, because it gives you an opportunity to learn and serve in a different way. And that didn't make sense to him either. The honors are an opportunity to serve. 

SP:	What is the Lillian Moehlman Bascom Professorship? 

PB:	This is a wonderful professorship. Lillian Moehlman was a librarian here in Madison and she had arthritis. The only real relief she got was through some therapeutics that nurses devised for her about how to sleep and how to position her hands. So she give this professorship to honor a nurse who was working on information for patients to use. So it's perfect. It's just wonderful. 

01:23:57

SP:	All right. Like after work. Would you talk about your family, how do you balance work and family, what do you do for fun and relaxation when you're not working, how do you keep healthy and energetic? 

PB:	I go to the gym every day. Well, six days a week. I don't know how I got into that. 

SP:	What gym? 

PB:	I go to the YMCA. And I go, I can go any time of day, do anything I want, but I go six days a week. 

SP:	Good for you. 

PB:	I’ve been blessed with a lot of energy, so that I don't sleep a lot. I sleep four, six hours a night. 

SP:	Now, what do you do when you go to the gym? 

PB:	I do the elliptical. I do bike. Sometimes I swim. 

	I'm the mom of a 13 year old son. I'm a single mom. So I do a lot with my kid. Travel and go to the pool, play games, bike rides. 

SP:	What's his name? 

PB:	Connor. Connor Murphy. I married regularly. Not well. [laughing] 

	My first marriage ended shortly after I moved to Cleveland and while I was there I met my second husband, who was the father of Connor. We were married for, we were together for 17, 18 years. And then we're no longer together, but he's here in Madison and is very much a part of our family. So that's really very nice. And Connor stays with him when I travel. 

	I belong to a murder mystery book club. And so I read murder mysteries a lot. I sew. I knit. It I paint. I don't do any of those very well. But unlike some of the things I just drop off, painting is episodic. Knitting is something that I do because I can carry it with me when I'm travelling. And I do tend to sit in a lot of meetings, and so it's kind of nice to be able to knit. 

	Sewing is where my real creativity comes in. I like to match fabrics and look at designs and think about how to solve problems. And it's a whole very difference way, a whole different part of my brain I use about, how do I get this collar to do on properly? I tend to sew for people rather than for myself, although I do make some things for myself and I tend to like them a lot. 

	I am a good friend I think. And that's one of the things I do. I spend a lot of time with my friends. I have a special person in my life, I spend time with him. And because of the nature of my work I travel a lot, but I try to use the travel as a way to keep in touch with other people. 

SP:	Do you enjoy the traveling? 

PB:	You know, when you're stuck at [laughs]--you don’t enjoy it, but by and large, yeah, I do. Half the time when I'm travelling I'm going to a very lovely city and I'm in a first class hotel and there's people that are happy to see me. And I don't pay the bill. It's really nice. 

	Traveling let's me see my family. My parents and my brothers and sisters are all in the Philadelphia area, so I get out to see them. Now my dad's not well, so I get out there about once a month Travelling is a way for me to help Connor see the world. So we were in Asia a couple weeks ago. We went to the Grand Canyon last summer. We travel well together. 

SP:	Do you think he'll go into science when he grows up? 

PB:	I think he might. You know, he's gotten quite interested in chemistry and he went to chemistry camp. He just got an opportunity go to Spring Harbor Middle School. And he's been at Jefferson for two years, and he's decided he's going to go there. And so he's happy. He's looking forward to the science part of that. 

	He used to want to be a truck driver, and then he wanted to be a performer on stage. And I said, well, you know, actually when I think about my career I help people move, I get on stage, I think you can do it. 

	We had this great conversation when we were in Japan. Mom, do you think I'm smart? I said, yeah, I do, actually. I think you're smart. Well, how do you know? Because I got a B in science. I said, well, I know you got a B in science because you figured out exactly how little you had to do to get a B and you did it. And if you had done a little bit more you could have done better. 

	He's a good problem solver. He's a good thinker. Then he said, well, Mom, are you smart. He said, I think you're really smart, but maybe I don't know. 

	So we had this really great talk. What it was like to be smart. And I said, I don't think I think like other people. And I think that's hard sometimes. That that doesn't mean I'm smart, it means I think different. But combining that with the fact that I think I am smart, I'm able to solve problems for people that they couldn't solve by themselves. 

SP:	Good answer. Well, we're finished with the questions. 

PB:	Well, this was really a delight to get me to think about myself. 

SP:	It was really a delight for me. I really appreciated this, really. you have great stories, great work. 

PB:	We do great work. 

SP:	We're so fortunate to have you here on this campus. And that you stayed. Or you came back. 

PB:	Well, you know, it's interesting. I think that everyone at my level in their career gets called to think about other jobs. And so I get called to think about other jobs—no, I don’t want that, I don’t want that. Most of the time people want you to just do what you don't want to do anyway. So they think you do this and they want somebody that does that. 

01:29:20
	
PB:	But I did look at other jobs this year. And I looked at--I put my name in for the provost. And I was a candidate for the Dean of the School of Nursing at University of Michigan. And I was a candidate for the director of a lab at NIH. An information technology lab. 

	And I didn't get the provost position, obviously. Pat Farrell did, who I think is terrific. I withdrew from the position at Michigan because it was really just devolving into just a mess. And it turned out it's a real mess over there right now. And I did not get the position at NIH. 

	But I learned a couple things. I was on sabbatical in DC three years ago and I very much liked living there. So I want to go back there someday. So this was my first exploration to going there. I learned that I don't want to be a dean. I really do like being a faculty member. And I don't want to not be a faculty member. But I mean, I have a great career. And not everybody gets to have the career I have, so I appreciate the fact that some of my colleagues who might be less happy with their work might really not have the same kind of-- if I'm not happy with what's going on in my department I go out to DC for a couple days or I go to going to university and people applaud. 

	Well, I want to say how grateful I am that you're taking the time to develop the history. I read Bill Cronon Sr.'s book and also the-- went right out of my head-- Hanson's book. And I just feel like I'm a part of the most fantastic university in the world. 

SP:	Absolutely. 

PB:	And it's really great that you're taking this attention. So thank you so much. 

SP:	Well, thank you. 

01:31:03	End of First Interview Session.