DLMP Heritage Appreciation - Black History Month

February 10, 2025

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Interview by Kareem Hosny, MD, MPH

We had the pleasure of interviewing Dr. Nicole Jackson for our Black History Month Celebration and learning about her personal journey.

 

Kareem Hosny: Today, I have the personal pleasure of interviewing someone who's very close to my heart in the department. Her presence has made an incredible impact. Her work is fascinating and, honestly, it's endless. She's always doing so much.

Nicole Jackson: Haha – yes!

Kareem Hosny: On many levels, specifically in diversity, equity, and inclusion, she's an ongoing fighter. I am honored to work with her and introduce everyone to Dr. Nicole Jackson. How are you today, Dr. Jackson?

Nicole Jackson: Good afternoon, Kareem. Thank you for having me and for your kind words. I'm doing all right.

Kareem Hosny: Awesome. Thank you for being here. Let's start with what you've been working on recently. 

Nicole Jackson: Oh goodness, I've been busy, as is the norm here. There's a lot I'm working on, particularly in the realm of workforce development. I'm back in academia, where I have resources and opportunities to do what I can to increase our visibility as pathologists. One initiative I'm proud of is the Summer Research Fellowship with Meharry Medical College, a historically black college in Nashville, Tennessee. Their director reached out about creating a pathology rotation—something they didn’t have. With the support of our department, we've funded two students, one of which has pivoted from sports medicine towards forensic pathology. And I’ve been blessed to now serve as her mentor, hopefully for the whole duration of her career. It's rewarding to mentor someone who’s found a new path. I hope to expand this to other institutions without exposure to pathology, much like your informatics observership, Kareem. It’s great to be in a supportive space to create opportunities for those who might not have them.

Kareem Hosny: Hearing about all that you're involved in is exciting. What initially drew you to pathology, particularly forensic pathology and autopsy? Can you tell us about the landscape when you started?

Nicole Jackson: I began in a different specialty, general surgery, but left after a year. I didn't know much about pathology as it wasn't a required rotation. At Tulane, where I went to medical school, pathology was integrated into other courses. I didn’t even know it was it’s own specialty, and certainly didn’t really know about forensic pathology. It wasn’t until I witnessed a complex resection in the OR that I realized my interest lay more with the specimen than the surgery itself.

That curiosity led me to pathology. I also lost my father suddenly at a young age, which stayed with me and highlighted the integral role that we as pathologists play for grieving families and communities. We're a crucial element in the medicolegal death investigations system, public health system, and criminal justice system. It’s a really unique position to serve your community, especially in the forensics community, where often we see overrepresentation of marginalized and minoritized populations in the autopsies that we do. With my background in public health and epidemiology, I saw the importance of our role, especially as forensic pathologists. We serve communities in unique ways, often intersecting with public health issues related to marginalized communities. Being someone families can relate to in times of loss is deeply rewarding. Recently, I testified and had the mother of the decedent express her gratitude for me - it was moving.

Kareem Hosny: That's amazing. Can you tell me more about the state of pathology or forensic pathology when you began your training, especially in terms of diversity?

Nicole Jackson: When I switched to pathology, not much had changed in terms of diversity, and it hasn't improved significantly since. While there are more women entering the field, diversity among some racial and ethnic groups remains low. This is why opening doors for trainees is crucial. My mentors played vital roles; I was fortunate to have two autopsy pathologists in my residency, one of whom was also our program director at the time. Despite differences in our backgrounds and life experiences, they found such meaning in their work, which was infectious. Dr. Melissa Upton also encouraged me, particularly when I doubted my move from the medical examiner’s office to academia. She was in my corner, encouraging me not to doubt myself, and reminding me that I did have the skills to do this job and do it well. Having advocates in your corner is invaluable. 

Kareem Hosny: Reflecting on what you just said, I remember discussing diversity in a informatics conference, and similar questions of how we change the landscape and work on increasing representation came up. With that in mind, how do you view the legacy you're building for future generations?

Nicole Jackson: That’s a good question. Legacy isn't something I think about often. My mom has always said that my approach is more about taking an idea and running with it. That being said, I hope we're leaving a legacy of excellence, compassion, and care. And there are multiple ways to care. Just being excellent in the work we do, making sure we’re giving accurate and timely diagnoses, shows care. But outside of that, showing care for each other in our day-to-day lives is also important. Are we taking time to care for one another, check in, help cover service, or lend a hand in some other way? Justice is also crucial—are we doing right by all? If not, how can we improve? Hopefully that’s the legacy we are all working towards as a department.

Kareem Hosny: I second that. I'm confident we'll achieve it by pushing forward. Would you like to share any struggles or achievements from your journey? 

Nicole Jackson: That’s an excellent question. Perhaps struggles are more relatable. Mine began in undergrad, feeling out of place often. Duke was diverse, but those numbers dwindled when you looked at those studying science or law-related fields, so I often found myself as one of only a few Black people in many of my classes. It's persisted throughout my training. I went to medical school in New Orleans where there were three black students, all females, in a class of about 200. I was the first black female graduate of my residency program ever, and there hasn't been one since. Even when everyone is kind and polite, you can still sometimes feel isolated and like you don’t fit in. Being phenotypically different means you can never fully fit in. Seattle also isn't the most diverse city, which can feel isolating. But these challenges persist, and they shape my journey.

Kareem Hosny: Thank you for sharing that. Let's switch gears a little bit. I know we're highlighting and celebrating Black History Month, but I'd love to know in general, what's your favorite dish, holiday, celebration, or tradition? 

Nicole Jackson: When I think about Black History Month, I think about community, so my answer would be a New Orleans crawfish boil. Having spent a solid 8 years in New Orleans during the course of my training, and reflecting my time there, nothing says love and community like gathering in someone’s backyard and watching your friend cook a giant crawfish boil with potatoes and okra and mushrooms. We’d always gather around a table, throw down some newspaper, crack and peel some crawfish and spend time with friends. It’s a common dish in New Orleans and to me, it captures community and love and coming together. Through heat waves, through hurricanes, through Mardi Gras—you name it—you come together with your people and celebrate and unwind. It's about connection. 

Kareem Hosny: You paint such a wonderful picture, it’s like I can see myself sitting at the table with you all! 

Nicole Jackson: It’s really great. You should come to New Orleans with me sometime—I have a lot of friends down there, and know a lot of great chefs. There’s definitely a lot to experience!

Kareem Hosny: I’ll take you up on that. Thank you for this uplifting conversation. Any final words of wisdom you'd like to share? 

Nicole Jackson: In these trying and uncertain times, be kind—to yourself and others. Extend grace, to yourself and to others. Prioritize yourself and your community, and we will be all right.

Kareem Hosny: Thanks again for taking the time to speak with me, this has been great. 

Nicole Jackson: Thank you.