Dr. Mamta Jain has come a long way from the studious, shy teen who once felt like an outsider in West Texas and avoided science in college. Now one of UT Southwestern’s top infectious disease specialists, she is leading some of the country’s most promising COVID-19 clinical trials here.
“There is never a dull moment in infectious diseases. Being an infectious disease doctor is like being a detective; you do a lot of digging and put the pieces of the puzzle together,” said Dr. Jain, a Professor of Internal Medicine in the Division of Infectious Diseases and Geographic Medicine.
“During this pandemic, I feel an even stronger commitment to my specialty and patients. We are reminded that new viruses emerge and can spread quickly. We need to be prepared for these infections and develop tools to fight them through nontherapeutic and therapeutic mechanisms, as well as vaccines,” she said.
Patients at William P. Clements Jr. University Hospital and Parkland Memorial Hospital, as well as outpatients served through a recently established clinic at the Paul M. Bass Administrative and Clinical Center, have volunteered for about a dozen clinical studies testing different strategies or therapies to improve outcomes for those infected with the virus. These include trials evaluating the use of convalescent plasma; the safety and efficacy of remdesivir, both alone and in combination with other anti-inflammatory agents; the safety and efficacy of other drugs such as sarilumab or atovaquone; and the tolerability of anti-spike monoclonal antibodies.
Her workweek routinely involves all seven days. It starts with Dr. Jain working with her team to review all new COVID admissions at both hospitals to see who may qualify for one of the ongoing trials. She then follows up with those currently in studies by reviewing labs and monitoring for side effects, making adjustments to medications if needed and ensuring that serious adverse events are recorded and reported. The work spills into the weekend as labs are followed and she meets with patients to discuss the studies so that drugs can be administered on Monday.
Matching patients to the most promising trials is key, she said.
“After reviewing the charts, contacting our primary teams, then discussing the pros and cons of participating in a clinical trial with the patient and family, we repeat the process multiple times between the two hospitals,” Dr. Jain said. “Sometimes these interactions are frustrating, especially when a patient hears the word ‘research’ and just says no without realizing that they may be turning down perhaps the only therapeutic opportunity available.”
The long weeks have turned into months as anxious and ill patients are served by a tired but resilient infectious diseases team.
“When patients do not do well that takes a toll on you over time,” she said. “The carrot that keeps you going is that some hospitalized patients do come off mechanical ventilators or oxygen requirements go down and they are discharged home.”
Dr. Jain’s journey into the world of infectious diseases has been a winding path rather than a superhighway, the result of several “aha!” moments and supportive mentors who inspired her through words and actions.
Born in India, she was 5 years old when her family immigrated to Canada as her father started his internal medicine training in Ontario. After Dr. Bal Khandelwal completed a rheumatology fellowship in Toronto, the family relocated to Texas and soon settled in Midland, where Dr. Jain’s father practiced as a rheumatologist for the next 35 years. In high school, she and her two younger siblings – sister Samta Khandelwal Kundu and brother Dr. Niraj Khandelwal – attended Robert E. Lee High School, a bastion of West Texas oilfield culture where every sporting event is punctuated with enthusiastic fans honoring the Rebels.
“My parents wanted to move to a small town because they were worried about bringing up two girls in a large city,” Dr. Jain explained. “Being in a small town, however, also meant not having access to Indian groceries, culture, religion, etc. I felt out of place in high school because we were Indian immigrants in a place that was not always very trusting or welcoming of immigrants. So, we had to excel at school, and I became a ‘math and science’ student.”
Her high school efforts paid off, as her grades and test scores allowed her to attend Princeton University. Soon at Princeton, though, Dr. Jain was at best treading water.
“Academically, I struggled in classes like calculus, which used to be my strength. I lost a lot of self-confidence that year and began to explore other avenues,” she said.
The call to medicine
By her junior year, Dr. Jain was well grounded but faced another reality: She was on the wrong educational track.
“I began to think about science and medical school again, and after some soul searching, I decided to try medicine,” she said. “However, I was a political science major and had not taken any science classes, so after graduating I spent the next two years in a post-baccalaureate pre-med program at the University of Pennsylvania. Looking back, I’m glad that I stretched myself and received a liberal arts education. I learned to write and think analytically and persuasively at Princeton.”
She earned her medical degree from Baylor College of Medicine in Houston, where she also completed her residency training. During residency, she met an inspirational faculty member who helped guide her to her chosen field. “My interest in infectious disease developed after my rotation with Dr. Daniel Musher, an icon in the field. He is a very demanding attending, meticulous with details, but an incredible teacher,” she said. “I was fascinated by the diversity within the field of infectious disease. I was also considering hematology/oncology, but I finally chose infectious disease because most people with infections improve or are cured.”
During residency, Dr. Jain met and married Dr. Rajeev Jain, who was completing his gastroenterology fellowship at UT Southwestern. She arrived on campus in 1999 to begin her infectious disease fellowship and has never left. Not surprisingly, she found yet another inspiring figure in Dr. William Lee, a renowned liver disease expert and UTSW Professor of Internal Medicine.
“The decision to spend two years doing hepatology research was another turning point for me. I learned a lot about clinical trials from Dr. Lee,” Dr. Jain said.
Fast forward to 2020
Twenty-one years later, all of those sometimes-painful decisions and abrupt educational turns have prepared Dr. Jain for another challenging pathogen – COVID-19. Her daunting work schedule is balanced by early-morning jogs, a strong family unit, and a circle of friends.
“My husband, Rajeev, my sons Anand and Akash – who are 18 and 15, respectively – and my extended family are very supportive. They help keep me going,” Dr. Jain said.
Prior to her 2020 shift to the COVID-19 battle, Dr. Jain spent years conducting clinical investigations into HIV and its comorbidities – hepatitis C, hepatitis B, and influenza. She and her research team have conducted seminal investigations involving the epidemiology, clinical outcomes, and treatment of HIV patients and those with hepatitis C.
Similarly, COVID-19 clinical trials are needed to find new therapies to decrease morbidity and mortality, Dr. Jain said. And although battling this pathogen has provided unique opportunities and challenges, nothing would make her happier than to see COVID-19 finally fade into a distant memory.
“This pandemic is going to change many things in our lives and has already had a devastating impact,” Dr. Jain said. “It is very satisfying to know that in some small way you are contributing to improving patients’ lives and at the same time generating new knowledge that will help others who may become infected in the future.”