UBC Reports | Vol. 46 | No. 15 | October 05, 2000

Pills of wisdom

Pharmaceutical Sciences Prof. Mary Ensom loves learning

Ask a UBC Pharmaceutical Sciences student about Prof. Mary Ensom's trademark teaching technique and they'll tell you in two words: The Question. Ensom starts most classes with a clinical question and then guides students though a complicated maze of equations and formulae to find the answer.

It's a simple device that links pharmaceutical science and practice and is a key part of a teaching repertoire that earned Ensom a UBC Killam Teaching Prize this year. She also captured all four teaching awards then available to clinical faculty at the University of Kentucky (UK), her alma mater and employer before she joined UBC 's Faculty of Pharmaceutical Sciences in 1997. "I try to put myself in students' shoes," says the advocate of student-centred learning. "They want to know why they need to learn the material. I give them a clinical context." Ensom says she is amazed that she gets paid for doing what she loves to do. "Students' eyes light up when they get it," she says. "It's incredibly rewarding when they come in uninterested or intimidated and leave totally engaged in the subject." In addition to The Question, Ensom encourages active learning by involving students in debate on controversial issues and challenges them to solve problems their own way.

"I let students know that in real life, there's more than one right answer," she says. "My job is to teach them how to approach a problem -- how to learn, not just what to learn."

She teaches clinical pharmacokinetics -- the study of how the body handles drugs -- to both graduate and undergraduate classes.

The discipline combines mathematical and scientific principles with clinical situations to evaluate how drugs are absorbed, distributed, metabolized and excreted. It calls for precise calculations in working out dosages and an understanding of the many variables that affect drug action in the body.

Born in Taiwan, Ensom was seven years old when her family moved to the United States. They originally settled in Virginia where her father earned his doctorate, and later moved to Kentucky when he joined the faculty at UK.

Ensom loved school and explored virtually every subject. She also excelled at music and her violin virtuosity earned her a scholarship to university.

After a brief stint as an engineering student, she settled on pharmacy because it combined science and working with people. It also promised a financially secure job that could be undertaken part-time while raising a family.

She earned both her Bachelor of Science in Pharmacy and her Doctor of Pharmacy from UK.

Her love of learning is evident in a remarkable record of achievement that featured annual inclusion on the UKDean's List with a perfect grade point average and twice being named in Who's Who in Students in American Universities and Colleges.

After 13 years of academic life and 23 years as a pharmacist, Ensom says it's the versatility of her work that keeps her interested.

"I have a unique job because I learn about patient problems as a clinician, research those questions and pass along the learning to my students. It's an integrated cycle."

Ensom's own research, conducted at Children's & Women's Health Centre of B.C. (C&W), looks at how women's hormonal fluctuations influence drug action and disposition. "Women have been under-represented in clinical research studies on drug effects," she says. "Much of my research program addresses this data gap and aims to improve drug therapies for women."

One project looks at the effects of estrogen on asthma symptoms, lung function and airway inflammation, using various urine and blood tests. Previous observations indicated that 30 to 40 per cent of asthmatic women had a noticeable increase in symptoms just before and during menstruation when estrogen levels are low. Ensom explored these findings in a pilot study she conducted while at UK. Research participants were given estrogen to see if it could improve their premenstrual asthma; blood samples were tested in addition to lung function. Results indicated that all 14 subjects had premenstrual worsening of symptoms and most showed significant improvement after estrogen was given.

Working with UBC Respiratory Medicine Prof. Tony Bai and others, she is now conducting a double-blind, random, placebo-controlled study to validate those findings.

Another project, done in collaboration with UBC Obstetrics and Gynecology Asst. Prof. Mary Stephenson, is the first study to systematically evaluate the disposition and action of two types of heparin -- a blood-thinning agent -- before and during pregnancy in women who have experienced recurrent pregnancy loss.

Every year, physicians at B.C. Women's Hospital and Health Centre -- part of C&W -- see more than 400 patients who need blood thinner throughout pregnancy. Many are treated because of a history of clotting -- the most common cause of maternal death in pregnancy. Other mothers need the drug because of an auto-immune problem that causes miscarriage.

Heparin has been used for some time to treat these problems, however, there is little data on how to judge the optimal dose per patient. The study will be useful to maximize the therapeutic effect and minimize drug side effects.

Ensom and Stephenson are also conducting the first study to evaluate the pharmacokinetics of intravenous immunoglobulin (IVIG) in patients with recurrent pregnancy losses.

Although IVIG has been used to prevent miscarriage, detailed information on how the drug is handled by the body is not available. The study aims to gather the data necessary to help doctors prescribe optimal amount of the drug before and during pregnancies.

In addition to her teaching and research, Ensom also serves as a clinical pharmacy specialist with C&W. She supervises students on clinical and research rotations, acts as resource for the hospital Pharmacy Dept. and is involved with staff education and development.

When asked about significant changes in the profession, Ensom points to the field of pharmacogenetics. The emerging area uses a patient's genetic makeup to customize drug therapies, eliminating trial and error or approximate dosages. Ensom is working with UBCPharmaceutical Sciences Prof. Ron Reid and others to bring this discipline into the faculty's research program and curriculum.

Ensom credits her achievements to her parents' encouragement to excel and to her strong Christian faith.

Self-described as a driven person, Ensom's broad range of activities is supported by her organizational skills.

She can, without hesitation, pull out a needed document from the many stacks of paper piled on desk, tables and floor in her office. She also claims a photographic memory for colour and has a reputation in the faculty for her co-ordinated and vibrant outfits.

Mother of 14-year old-Hannah, whose pictures crowd her office, Ensom tries to keep her life in balance with music, drawing, painting and annual Kentucky Derby parties. She also enjoys riding a tandem bicycle with husband, Robin, head of Pharmacy at St. Paul's Hospital.

Described by her colleagues as creative and dedicated with a contagious enthusiasm, Ensom encourages aspiring pharmacists to find a mentor, seek out collaborations and persevere.

And, adds the teacher known for The Question, don't hesitate to ask.