Anna Meadows was 31 and a mother of three when she wrote to the dean of Harvard Medical School in 1962 about her dream to be a doctor.
His response: Stay home with the kids. A mother with a medical degree couldn't possibly accomplish as much as the younger man he could enroll instead, the dean said.
Happily for the kids - the thousands whom she helped fight cancer and the many more whose battles were eased by her work - Meadows wasn't swayed.
Tuesday night, with a lecture in her honor and a party with friends and family, Meadows will celebrate a 38-year career at the Children's Hospital of Philadelphia.
Now 79, she is an international leader in the study of childhood cancer. Her focus on the long-term health of survivors - even at a time when few were beating cancer - has helped kids grow into healthier adults and reduced the later side effects of many treatments.
Meadows is the "matriarch of the entire field" of cancer survivorship, said Les Robison, an expert in cancer survivorship at St. Jude Children's Research Hospital in Tennessee. "She was stern and rough when she had to be. . . . But, at the same time, she nurtured all the people who are leaders in the field."
A Brooklyn native, Meadows had long thought of going to medical school. But on finishing her undergraduate psychology studies at Queens College at the ripe old age of 20, she said, "I thought I'd be too old when I finished."
In the early 1960s, she was raising two sons and a daughter and teaching night school at Lake Erie College outside Cleveland, where her first husband worked. Meadows met Benjamin Spock, the pediatrician and baby-rearing expert, during his 1962 visit to campus. She told him of her desire to go to medical school.
"He said, 'If we can go to the moon, surely you can go to medical school,' " she said.
After the failed inquiry to Harvard, Meadows was accepted to the Medical College of Pennsylvania, which began as the nation's first medical school for women, and is now part of Drexel.
In 1972, Meadows was recruited for a fellowship at Children's by longtime oncology chief Audrey Evans and Giulio "Dan" D'Angio, then head of radiation oncology at Memorial Sloan-Kettering Cancer Center in New York.
Meadows was charged with scouring the charts of patients across the United States and abroad, looking for physical and developmental problems - the unintended consequences of treatment. She found almost none.
It wasn't that they didn't exist, said Meadows, who, after a divorce, married Alfred G. Knudson, a celebrated cancer researcher, in 1976.
Doctors weren't looking at the rest of the story. For example, she said, girls turned 16 without starting menstruation and no one took note.
"They only wanted to know if the cancer came back," Meadows said.
In the early 1970s, only about two in 10 kids survived childhood cancer, she said. As treatment developed and that rate increased - it's about eight in 10 today - Meadows saw a glaring need for the less flashy work of follow-up, to see what cancer-killing agents did to the brain, heart, and psychology of children as they grew up.
One of Meadows' early patients was Bill Letter, a 9-year-old with a poor prognosis from advanced non-Hodgkin's lymphoma.
With an aggressive treatment that included surgery, chemotherapy, and radiation to the chest and head, Letter survived. During two years of near-daily visits to the hospital, he said, he looked forward most to seeing Meadows. She was warm and enthusiastic and explained things in terms he could understand. "You always felt at ease with her," he said.
Meadows' follow-up with Letter has lasted 36 years. Today, he is a healthy 44-year-old scientist from Richboro. His side effects have been few, consisting mostly of what he called a minor heart problem recently diagnosed.
But at the mention of longtime patients like Letter, Meadows talks with regret. Others have been less fortunate, suffering secondary cancers, organ failure, or cognitive disability.
Very little of the nature of Letter's care would happen now thanks to people like Meadows.
In the late 1970s, doctors knew cranial radiation was dangerous but thought it was a key weapon against the nearly unbeatable leukemia. But evidence was emerging that certain chemotherapy regimens could produce similar success.
Meadows published a study in 1981 showing that leukemia patients who got radiation to the head - then widely used as a preemptive strike against tumors arising in the lining of the brain - suffered significant IQ loss.
"For the first time, she put scientific boundaries around impressions that people had," said D'Angio, now an emeritus professor at Penn.
Meadows' work helped push Children's to stop using radiation in most leukemia cases in 1983 - a difficult step for doctors hesitant to reduce their arsenal.
Meadows used her seat on committees with national oncology groups to advocate a reduction and then an elimination of radiation in treatment protocols for lymphomas.
She was a major force in cutting its use for an eye cancer called retinoblastoma. Meadows lobbied for and led a committee with the Children's Oncology Group, a research collaborative, that developed national standards to treat that rare cancer with techniques that preserved vision and cut long-term risks.
Those efforts were well-served by a defining trait, colleagues said: She's feisty.
"You could always count on Anna to voice her opinion," said Peter Adamson, chairman of the Children's Oncology Group.
Recently, Meadows has focused on caring for young adults who are survivors.
She created the National Cancer Institute's Office of Cancer Survivorship. And in the early 1990s, over lunch at the Four Seasons hotel, she pitched the idea of a cancer survivorship center to representatives of the Lance Armstrong Foundation. (Armstrong wasn't there. "He was riding his bike," she said.)
Meadows secured $500,000 in seed money for what would be the Livestrong Cancer Survivorship Center at Penn.
Childhood survivors are seen there by adult doctors who understand their unique medical history. With the help of an additional $2 million from Livestrong, survivors of testicular cancer receive care and the center provides online support for doctors serving breast-cancer survivors.
Director Linda Jacobs calls Meadows "an incredible mentor to all of us."
Meadows, who plays tennis regularly, officially retired from Children's in December.
Still, she continues to build on work she began nearly four decades ago. She advises a project funded by the National Cancer Institute surveying tens of thousands of childhood cancer survivors treated between 1970 and 1999.
If only the Harvard medical dean - since deceased, she says - could see her now.