ANN ARBOR, Mich. — Dr. Hope K. Haefner credits her time in northern Michigan at the University of Michigan Biological Station, specifically a lichenology class, for altering the course of her pioneering medical career.
“The lichen niche really made my career,” Haefner said.
Haefner travels the world giving talks about one of her specialties: lichenoid diseases of the vulva.
This fall alone, the Harold A. Furlong Professor of Women's Health at the University of Michigan lectured in Slovenia in September and next travels to India in November to teach dermatologists and gynecologists.
The OBGYN physician and researcher traces her journey of success back to her experience at the research and teaching campus along the shores of Douglas Lake at the U-M Biological Station even though she didn’t pursue the path of a botanist or field scientist.
Haefner was introduced to the world of lichens in 1979 when she was an undergraduate student at the University of Michigan. Lichens are plants that are a combination of a fungus and an algae that grow on rocks and trees.
Haefner had taken a semester off and needed to make up science work in the summer to be able to graduate on time. The Biological Station provided that opportunity
“My family had a place in northern Michigan for years, so I had heard about the Bio Station but never actually visited it,” Haefner said.
UMBS is located near Pellston, about 20 miles south of the Mackinac Bridge at the tip of Michigan’s lower peninsula.
Founded in 1909, UMBS is one of the nation’s largest and longest continuously operating field research stations. Laboratories, classrooms and cabins are nestled along Douglas Lake’s South Fishtail Bay, making up a small portion of the 11,000 acres that UMBS has stewarded for more than a century to support long-term science knowledge and education.
Haefner took two courses that summer: Vertebrate Ecology and Lichenology. While she enjoyed both courses, it was her study of lichenology with course instructor Dr. Howard Crum that had the most lasting impact on her future career in medicine.
“Dr. Howard Crum was a renowned bryologist as well as an expert in lichens. He was a great mentor and a patient person,” Haefner said. “His course was part of a long-standing tradition at the station, where students engage in hands-on research in the diverse ecosystems of northern Michigan.”
Crum’s then teenage son, Roger, helped Haefner with one of her projects that summer. After Haefner learned in the course that many species of lichens contain compounds that can be used as natural dyes, Roger helped his father’s student dye wool different colors with lichen extracts. Then, as a budding wood worker, Roger made Haefner a special box to contain her dyes for presentation at the end of the summer.
“I collected a lot of different lichens and would extract some of the dye and put it onto wool pieces,” Haefner said. “It wasn’t medically scientific, but it ended up as a 20-page report of various lichens with dyed wool next to them. I’ve kept it and Roger’s box with me at home for years. There was one particular lichen that I traveled to the Upper Peninsula of Michigan to get because it would dye the wool purple. I was so happy when I found it.”
Jogging her memory, she believes that particular lichen was most likely Parmelia saxatilis or a species from the genus Ochrolechia.
After that summer, Haefner often visited Dr. Howard Crum in his office in the University of Michigan Herbarium in Ann Arbor.
“Dr. Crum had a major influence on my life,” Haefner said. “I often share a humorous story during my gynecology lectures about his course I took on lichens at the Biological Station. After that summer, I told Dr. Crum, my remarkable mentor, that I had always planned on becoming a physician, but after having studied lichens, I was considering a career as a lichenologist. He paused, scratched his chin thoughtfully, and then said, ‘You should probably become a physician. There aren’t many lichenologists in the world.’ Little did he know that I would go on to study, research and treat ‘lichens.’”
But the lichenoid diseases that Hope treats today have nothing to do with the complex life form of the lichens that grow on rocks and trees.
“The lichen diseases I study are named for their resemblance to some lichens found in nature,” Haefner said.
There are three skin conditions that are common in her area of expertise as a vulvar disease specialist: lichen sclerosus, lichen planus and lichen simplex chronicus.
“We see these skin conditions weekly in our clinic,” Haefner said. “They’re pale and shiny and even thickened with a crinkly surface, similar to what you see on trees or stones with lichens.”
“These diseases can be miserably itchy and painful. The architecture of the genitalia goes away. Unfortunately, up to 5% of the women with lichen sclerosus develop skin cancer.”
In lichen planus, the skin loses its surface covering and it can become stuck shut. Haefner is one of the few people in the world who operate on lichen planus. It’s a surgery she started doing over 20 years ago.
“I give talks on a variety of topics, but one is titled ‘Learn to Like Lichens,’” Haefner said. “A lot of providers don’t know how to treat these diseases. I give them special recipes of what to do, such as formulation and dosing of topical steroids to add to their regimens to help their patients feel better.”
Why did she choose this medical niche? The answer is a combination of timing and her fascination with the lichens found in nature sparked by her time at UMBS.
First, the timing of the Women’s Health Initiative (WHI). WHI was a series of clinical studies initiated in 1991 by the U.S. National Institutes of Health to address major health issues in postmenopausal women. The findings significantly decreased the use of hormone replacement therapy, creating a problem that Haefner’s work now addresses.
“When physicians had women with lichen sclerosus stop using estrogen, their lichen sclerosus actually flared. Estrogen keeps that disease at bay,” Haefner said. “The Women’s Health Initiative brought lichen sclerosus to the forefront.”
This was right after Haefner finished her obstetrics and gynecology residency at the University of Michigan and went on tenure track after completing a pathology fellowship where she focused on gynecologic pathology.
“I wanted to find a research and clinical niche that was small, and there were at most 150 vulvovaginal disease specialists in the world at that time,” Haefner said.
With the increase in lichenoid diseases, Haefner reflected on the connection between one of her favorite courses during her undergraduate days and the direction her career would take.
“The lichens were beautiful,” Haefner said. “They live together so well as these combinations of fungi and algae. I just found them fascinating. They have a mutually beneficial relationship.”
Nearly half a century later, Haefner remains in contact with friends she made at the Biological Station including Dr. Crum’s son.
Dr. Roger Crum, himself a University of Michigan graduate, is a professor of art history at the University of Dayton where he specializes in Italian Renaissance art and has served as a liaison for global and intercultural initiatives.
“In no small measure I am a college professor because I appreciated the inestimable joy my father found in teaching students like Hope Haefner,” Crum said. “For Daddy, Hope was that kind of rare, prized student who was the complete package: notably smart, naturally curious, gregarious and generous of spirit with her fellow students, and intellectually flexible in translating her foundation in botany into health benefits for women the world over.”
Haefner said she learned important communication lessons about social interaction and learning in community at UMBS.
Three decades earlier, in 1946, Howard Crum, newly discharged from the Army Air Corps after service in North Africa and Iran, learned those same lessons.
“What Daddy gave Hope in teaching, mentorship and life guidance was not unlike what he himself had received at the Biological Station as a young man from his own mentor and eventual Ph.D. advisor, William Campbell Steere, himself a storied faculty member at the Biological Station,” said Roger Crum.
Crum and Haefner believe these interactions make real differences at the moment and for years and decades thereafter.
“As an undergraduate student on campus in Ann Arbor, it isn’t easy going up to a professor who is teaching 500 students in a large lecture hall. But after spending time at UMBS, you became a lot more comfortable approaching professors,” Haefner said. “The personal attention at the Bio Station was incredible. The classes were small, and we’d all go on these van rides to work in the field. We packed lunches and ate together in the woods. You regularly met one-on-one with your professor and received valuable tips on your future career. You often sat at the same table with your professors in the dining hall.”
Haefner’s time at the field station in northern Michigan also gave her a lasting understanding of the importance of taking time to be outside.
“UMBS helped me realize the beauty of nature and understand the co-existence of plants and animals that are here and throughout the world,” she said. “Now I make time to walk every day, whether I’m here in Ann Arbor or with my family at our place on Torch Lake, just a couple hours south of UMBS. I’ve only made it back once to visit the Bio Station, but my experience there with lichens and Dr. Crum, now many years ago, is always with me. It’s a great place. Still is. We’re lucky to have such an influential place in such a beautiful part of the world.”
If you are a UMBS alumni and would like to share how your experience at the field station in northern Michigan impacted your life, please email Chrissy Billau at cbillau@umich.edu.
