A Very Precocious Embryo: The Call of Medicine, and Trying Not to Drop the Glass Balls

A Q&A with Dr. Lisa Zuckerwise, MD

Article written by Laura Edinger

When we look at medical education, it can feel necessary to do all things and be all things. Taking time to acknowledge our hobbies and our loved ones can easily slip down our priority list, in an effort to succeed at our new role- whether that be medical student, resident, fellow, or attending. Medical education can be all encompassing and overwhelming, but looking to others for help can make it all manageable. The skill is in learning priorities and being vulnerable enough to ask for help- often a challenging task. But Dr. Zuckerwise is here to remind us you can’t do it all, and you shouldn’t try. It's enough to simply fill the role being asked of you, and nothing more.

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​​Lisa Zuckerwise, MD, is director of the Maternal-Fetal Medicine Program at UVA Health. She oversees a team of physicians, who specialize in caring for patients with high-risk pregnancies, or a pregnancy when a woman and her baby face an increased risk of complications.

She is committed to working collaboratively with patients to overcome medical challenges and grow their families.

Dr. Zuckerwise comes to UVA Health from Vanderbilt University Medical Center in Nashville, Tennessee. There she helped launch and lead a maternal-fetal medicine fellowship program. She will continue her role as educator at UVA School of Medicine as an associate professor within the Division of Maternal-Fetal Medicine.

At UVA Health, Dr. Zuckerwise will also continue her work in the study of fetal anomalies and pregnancy complications. This includes placenta accreta spectrum. She has extensive experience and expertise in this disorder, serving since 2020 as an active member of the Pan-American Society for the Placenta Accreta Spectrum.

Originally from Westchester, New York, Dr. Zuckerwise received her undergraduate degree from Cornell University before attending medical school at Albert Einstein College of Medicine, where she was inducted into the Alpha Omega Alpha medical honor society. She went on to complete an OB-GYN residency and fellowship training in maternal-fetal medicine at Yale School of Medicine in New Haven, Connecticut.

Fun fact: During high school, Dr. Zuckerwise developed a passion for scuba diving, which she turned into a side gig in college, working as a scuba instructor in New York.

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Note: reproductive rights laws, as touched on in this interview, are constantly in flux. As women’s health providers, it is important to stay informed, and ultimately, keep the goal of comprehensive and empathetic patient care at the center. Views expressed in this interview are independent of the views of the author and the Virginia Journal of Medicine

What is your journey to medicine and why did you choose academia?

“I think it's first really important to say that I was always going to be a doctor.”

With Dr. Zuckerwise, no good day can pass without a little humor. She showed us a little of that good spirit while discussing her journey- from birth to attending physician at UVA. 

“I was a very precocious embryo in that, you know, shortly after being conceived, I decided that I would split and become a monochronic twin. So MFM was always, you know, in my blood. You can include that.”

Maybe she was born with it. Maybe it’s Maternal Fetal Medicine. 

She attended medical school at Albert Einstein College of Medicine in the Bronx, where she worked with patients from diverse backgrounds and varying degrees of medical access. For residency, she attended Yale School of Medicine in New Haven, Connecticut, where she fell in love with obstetrics. 

Like many of us, the choice to pursue medicine was a calling for Dr. Zuckerwise, more than anything else. There was no questioning or plan B. A gut feeling that overtime turned into a dream career, that she was lucky enough to choose. Each life transition became further confirmation that for her, following her gut instinct wasn’t going to lead her astray. Nine years later, she’s able to look back and see all the different paths she could have taken and feel

“equal parts lucky and equal parts wise to have picked the exact specialty and the exact track that was right”

What made you choose Ob/Gyn and ultimately Maternal Fetal Medicine (MFM)?

Crazily enough, MFM was not always the first choice. In fact, Dr. Zuckerwise initially fell in love with Urology and Urogynecology. At the time of her training, Urogyne was a newer specialty, full of complex surgeries and novel research questions, something that thrilled her.

"There was essentially a gaping hole of basic science research and clinical trial research in that world.”

As a fourth year medical student, she joined a gynecology-oncology lab to pursue basic science research and study pelvic organ prolapse, evaluating the uterosacral ligaments in patients who have had hysterectomies. When it came time to apply for residency, she wanted a program strong in urogynecology specifically, but she kept it open ended. All she asked was that they expose her to everything and anything related to women’s health, so that no doors were closed to her. Soon though, her passions shifted.

“Within one month of starting residency, I just fell head over heels in love with the labor floor and obstetrics. And looking back, it had the same draw in terms of there are knowns, but there are so many more unknowns and space for ambiguity, investigation and shared decision making.”

The rest is history, as they say. 

What is the most fascinating thing you treat or see? 

As a Maternal Fetal Medicine specialist, Dr. Zuckerwise deals in what is known as High Risk Obstetrics, taking care of mothers and neonates with complex medical conditions. It comes with some very highs and some very low lows, and the pathology of pregnancy and its interaction with the maternal body is fascinating. For Dr. Zuckerwise, she is particularly passionate about prenatal diagnosis of conditions, and the potential for prenatal intervention.

"My favorite diagnoses are those that just completely blindside a patient going for their anatomy scan, where we discover that there's something different about how the baby or the placenta formed that in an instant really changes the whole context of the pregnancy.”

For her, she loves solving the puzzle of what can be seen on ultrasound, a limited imaging modality safe during pregnancy, and using knowledge of anatomy and physiology to determine a diagnosis and treatment. Further, she loves interacting with her patients, and using this as an opportunity to educate and inform, while also maintaining her compassion for the family in front of her.

“The most important part is communicating to the patient what's going on in a way that they can understand how it's going to inform their care in that pregnancy, how it's going to inform decisions about timing and method of delivery, and then of course really importantly how it's going to impact their family's life, this child's potential child's life, and how we can support them in the transition.”

She gets to act as the intersection between adult medicine, pediatrics, and obstetrics to, hopefully, guide a complex situation to a positive outcome. 

What is your favorite thing about your job?

"Being with patients faced with something that seems insurmountable, a diagnosis that's really scary, a condition that's really serious, high risk, or poses significant threat to their health, and reassuring them and truly having them come to believe that we can walk this path together, that there is a way forward, and that we will get the patient safely to the end of her pregnancy. But having a patient truly believe me or come to believe me with ongoing counseling conversations and continue to work together that there is going to be a way forward and that we are going to show them a path that although different than they expected when they first found out they were pregnant, is one that is going to equally and meaningfully contribute to their life.”

It all comes back to the patients, and the call of a fulfilling career in medicine. As physicians, we face challenges and meet patients that speak to a deeper part of us each and every day. It's one of the most important aspects of this career. It is, at its core, the art of medicine that calls to Dr. Zuckerwise.

Now, on the flip side, what is the hardest thing about your job?

Like many things in medicine, with the good, comes the bad. While being with patients can be fulfilling and meaningful, it can also be some of the hardest moments- as you sit and hold space with someone receiving life changing news. 

"So probably the same thing that is my favorite thing about my job is the hardest thing about my job- that I am sitting with and being with patients and families in some really hard moments where things can change and expectations can shift and outcomes are different than what they expected.”

Despite the hardship, however, there are ways to grow through these moments.

“I take comfort in knowing that I can be there with them and that I am equipped with the empathy and with the knowledge and with the emotional fortitude to be with them in that hard moment. It continues to feel like a privilege even though it's hard.”His advice? Stay focused on what matters.

OBGYN is a very unique specialty in our political framework. There are very few other specialties where politics plays such a heavy role in what you do and why you do it. For you, how do you see MFM fitting into that framework?

Ob/Gyn is uniquely situated in the framework of medicine. It has been heavily politicized, and the specialty is not above critique, both for current and historical practices. However, comprehensive women’s healthcare remains the ultimate goal for all providers, regardless of background. This is a calling unique to Ob/Gyn that many other providers don’t have to grapple with. It is important to remain cognizant of the reality of medical practice in the modern era, where laws and practice guidelines can intersect and contradict. But above all, Ob/Gyns must find a way to balance the needs of all pregnant patients, individual to their goals, as Dr. Zuckerwise expresses. 

“MFM has to view ourselves as fierce protectors of our pregnant patients and their families. We are exactly at the intersection of medicine, law, and politics in a way that the majority of physicians were not prepared for in medical school”

By nature of their training, Ob/Gyns are well versed in the world of high-risk medicine. Despite this training, there can be fear associated with choosing to do this job, that must be discussed and acknowledged. 

"I will say that the fear for physicians to provide essential, often life-saving or life-preserving care to pregnant patients facing lethal fetal diagnoses, highly morbid pregnancy conditions, and true obstetric emergencies is jarring… it's very hard to do what you know is medically right when a law is designed to scare you away from doing it...as obstetricians, we are people who chose to go into a high acuity, high stakes field…we are not risk averse. We are very risk tolerant when it comes to taking care of patients and when it comes to making good decisions in the moment with shared decision making.  But none of us signed up to also fear criminal prosecution or litigation outside of the medical realm.”

Dr. Zuckerwise was willing to be frank and honest about this aspect of her career- not that it scares her away. Like with many things, it is a complex and multifactorial issue. Choosing for yourself and advocating for preventative medicine, however, will always be the right choice.

“Reproductive health has to start like in the home.”

What characteristics and values have been pivotal to your success on your journey to MFM?

“The easy answer is you have to be resilient, you have to care, you have to want to be a physician, you have to love those challenges and feel comfortably uncomfortable in that learning space…we are all works in progress and holes bleed"

Some outcomes, like bleeding during surgery, are inevitable. At the end of the day, it's how you prepare for those outcomes, step up to the challenge, and take ownership. Medical education is all about realizing how little you know. But medicine is also about being able to learn and improve.

“The most important thing that has served me well is a growth mindset.”

Learning to love learning keeps learning lovable.

I think this is an awesome time to pivot into how we accumulate information, aka medical research. Can you briefly touch on your journey to becoming involved in research and any tips you have for students wanting to get involved? 

The art of the cold email or simply asking the question is something learned early in many people’s education careers- putting yourself out there, and getting face time with the individuals you want to work with. Dr. Zuckerwise did just that- as the precocious medical student she was- she had a question she was passionate about and sought out those who could help her answer it, bringing together two teams who otherwise might not have collaborated.

“I think that you have to be present in order to get involved. So you have to put yourself out there…as a medical student, I wanted to know how the uterosacral ligaments were different in patients with prolapse versus those getting hysterectomies for non-prolapse surgery…And so I talked about it with the gynecologic surgeon who was like... I can get you the ligaments…And then I went to someone in a Gyn-onc lab and was like, I know you don't do urogyne research or benign research, but do you think we could look at these tissues together? And she had the technology…And so I was able to kind of bridge those two people together to do that.”

She has a unique journey; not every student needs to dream up a question and solve it on their own. Students can still learn from this however - sometimes, it just takes a bit of extra elbow grease to get involved, just a little industriousness and a creative spirit. 

“My advice to medical students would be to truly see themselves as an asset…My research that I do is so much better because of the med students involved, because of the residents involved, because of the fellows involved. So you just have to ask about it and be there and reach out to people in a field that you're interested in.

In summary? Embody the precocious embryo. 

Do you currently have any projects you're working on that you can share with me?

"I have a lot of interests. I would say my primary research focus to date has been on the diagnosis of placenta accreta spectrum disorder which is an abnormality of placental implantation often into a cesarean scar defect in the uterus… it is acutely life-threatening, often requires cesarean hysterectomy, and is associated with really high risk of maternal hemorrhage and need for transfusion. My research focuses on both how to measure and characterize severe morbidity and clinical outcomes in placenta accreta spectrum so that we can start studying it in a universal language and then also on outcomes related to placenta accreta spectrum management with different surgical approaches…my goal for the placenta accreta world is that in the near future, meaning the next five years, we would have a national multi-center randomized trial of hysterectomy versus non-hysterectomy management of placenta accreta spectrum and that my institution would be a recruiting member of that… I'm really excited about bringing clinical trial research to UVA… So that's coming up. Very, very exciting.”

What are some of the major hurdles you feel you face doing research?

"I would say that my education and training has really been as a clinician educator…I don't have formal statistics training. I don't have formal research methodology training. I think when I was a junior attending, I saw that as a real weakness and something that I was insecure about until I met a colleague who was extremely knowledgeable about research. She had a master's of clinical science and investigation and she was a very generous colleague and mentor of her time and her expertise. Over the course of the almost eight years we worked together, it became this situation where I was the idea person and the boots on the ground. And she was the brilliant mind behind how to answer the question that I wanted to answer. And so through that collaboration, I learned that you can't be amazing at everything. You can't be an expert in everything, but medicine is a team sport and research is a team sport….asking for help is a superpower and a sign of humility, not a sign of weakness.” 

Working in academic medicine, you work really closely with fellows, residents, and med students. Do you see yourself in a mentorship role?

“Yes, definitely. My primary goal when I wake up every day and go to work is to demonstrate that MFM is the best possible career choice for everyone. And so it is my pleasure and my privilege to warmly welcome anyone who might possibly be interested in obstetrics and show them the light…In my role as division director at UVA, the position of also being a mentor for my faculty has been a really great new challenge to take on.”

And what kind of strategies do you use to be an effective mentor?

Even our mentors didn’t wake up one day just knowing how to teach and lead. Like with many valuable skills in life, these skills had to be learned and practiced. 

“In the last year and a half, I had the privilege of doing the UVA Center for Faculty Development's joint mentee/mentor course…where I and one of our newest faculty members attended as a mentor pair…and where I've learned even more about how to be a good mentor as well as a good mentee.

Effective mentorship often starts with forming a positive connection- recognizing and encouraging the talents and skills an individual brings to the table- and fostering those areas where they need additional support in a collaborative way. 

“I think the key is communication and having clear and shared expectations…I think a mentor mentee relationship could start with what are your hopes and dreams for this? It can be anything, including: I hope to write a paper that makes it to publication together, I want you to be a lifelong resource that I can model my career after, I hope my jambalaya tastes good today when I reheat it.”

The goal is to keep the relationship and its utility centered- it’s about what the mentee needs and what the mentor can provide, and working towards that shared understanding.

So you wear a lot of hats. How do you balance it all?

“I don't let the glass balls fall. When you're juggling, you can picture rubber balls and glass balls. And you got to keep the glass ones in the air and let the rubber ones go so they bounce…I think it's okay to not be 100% into every single thing that you're doing. And so that I guess is a balance. But you can't be 100% everywhere at once.”

Being an excellent physician is more than being excellent at patient care. It means being able to balance all the necessary roles you play and prioritize appropriately as needed. It means being all in when you are at the hospital and all in at home, but not all in on all things, all the time.

What do you consider your greatest accomplishment so far?

Everyone’s ‘greatest accomplishment’ is personal to them- for some, it's a career success, for some it's a personal success. For Dr. Zuckerwise, its creating a positive work environment for all. 

“I'm very proud of the culture I create when I am at work…I hope that I accomplish an environment of curiosity, of collaborative learning, of excellent patient care, and of enthusiastic fun when we're doing happy things, but also just productivity and excellent supportive care when we're doing harder things.”

Dr. Zuckerwise doesn’t want to have to separate her life into two completely independent categories- she wants to bring the personal into the professional. And she wants to be authentic while doing it.

“I stay true to who I am and demonstrate that you can be imperfect, that you can be ridiculously silly, that you can have fun at work, and that you can show pictures of your kids, be proud of your life outside of work, and have other things that are really, really important to you. Life is real.”

By allowing her real self to shine through, she encourages that in others, and helps create the working environment she desires- one of collaboration. She wants her colleagues to know her as more than a physician, and she wants to know her colleagues for more than their contribution to medical care. Like in all things, we are all more than the profession we pursue.

And looking ahead, what excites you the most about the future, both academically and personally?

“Professionally, I'm just really proud of the growth that our division here at UVA is experiencing. When I was interviewing, there were four faculty. Now we have seven. We're hoping to build up to nine or ten. We have increasing numbers of patients and increasing acuity of our patients who need us. Personally, I just want to raise kids that end up being good citizens, good humans, who care about other people and understand very accurately how the body functions.”

Any final closing words for our medical students?

“I would say if it feels hard, it's because it is. But if it feels harder than you think it should be or harder than you think you can sustain, it probably also is, and that's a sign that you can ask for help and ask for support. Every single person that you look at who you think has it all together and you think it came easy to has either been held up when they felt like they were going to fall or reached out and grabbed on for dear life, and that's not good or bad. It just is the truth. So there is no role for being a hero. There's no role for being a martyr. We are all in this together. “

It’s okay to ask for help. You don’t need to have it all together. You don’t need to be perfect. 

Final Thoughts:

Dr. Zuckerwise embodies all that is great about UVA- the collaborative spirit, the drive for excellence, and the ability to balance both personal and professional development. Like with all things, these are skills she has learned through trial and error. The lesson here for all of us is to seek out those we admire and learn to be a little bit more like them- by asking for help. No one is in this alone, even if they come from a very precocious embryo.

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Stay tuned for more interviews from our Expert Q&A series, where we spotlight faculty across surgical specialties working at the cutting edge of surgical care, research, and education.

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Interested in reading more from Dr. Zuckerwise? Check out some of his recent works!

1. Donovan BM, Zuckerwise LC. The Management of Placenta Accreta Spectrum Disorder. Clin Obstet Gynecol. 2025 Jun 1;68(2):251-265. doi: 10.1097/GRF.0000000000000942. Epub 2025 Apr 17. PMID: 40241417.

   
   

2. Zuckerwise LC, Mulhall JC, Thompson JL, Jackson LA, McNeill-Simaan EO, Osmundson SS. Effect of panniculus elevation device on postoperative pain after cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100920. doi: 10.1016/j.ajogmf.2023.100920. Epub 2023 Mar 6. PMID: 36889439.

   
   

3. Conservative management of placenta accreta spectrum: is it time?

   Shainker, Scott A.Zuckerwise, Lisa C.Shamshirsaz, Alireza A. et al.

   American Journal of Obstetrics & Gynecology, Volume 226, Issue 6, 871