The 24/7 Guiding Star: An Homage to Dr. Karen Jean Marcus

The 24/7 Guiding Star: An Homage to Dr. Karen Jean Marcus

Guest Commentary

Aug 11, 2022

Dr. Tara Rajendran headshot"I think the greatest thing we give each other is encouragement... knowing that I'm talking to someone in this mentoring relationship who's interested in the big idea here is very important to me. I think if it were just about helping me get to the next step, it would be a lot less interesting." —Anne Sweeney

By Tara Rajendran, MBBS, MFA

Author’s note: Karen Jean Marcus, MD, FACR, the director of Pediatric Radiation Oncology at Dana-Farber/Boston Children's Cancer and Blood Disorders Center, retired in July after 33 years (1989-2022) at Dana-Farber Cancer Institute (DFCI).

The human form of warmth in a maternal hug! This is my one-line expression for Dr. Karen Jean Marcus. In the last 5.5 years that we have known each other, her emails would easily be the highlight of my day—sometimes the entire week! Why? Because her emails are a form of sunshine that instantly light up the day with kindness! She retired in July 2022 as chief of the Division of Pediatric Radiation Oncology at Dana-Farber/Boston Childrens Cancer and Blood Disorders Center, 33 years after embarking on this extraordinary journey that impacted countless lives! While she is retired from full-time work, she will continue attending the pediatric tumor boards, giving lectures to the residents, and discussing cases with the ones who will be caring for patients on the pediatric radiation oncology service.

In March 2017, I sent an email seeking an observership opportunity with Dr. Karen as I was finishing my 1-month hands-on clerkship stint in the hematology/oncology department at Beth Israel Deaconess Medical Center. While Dr. Karen did not have an observership position to offer, she warmly invited me for a meeting. That was our first conversation. The outer door to the Pediatric Oncology offices is locked to visitors, and when I arrived at 10 in the morning, she was already waiting outside with her gentle, childlike infectious smile to let me in. As we concluded the meeting, she gave me a tight hug! Early 2017 was a low phase in my life, and her warmth and kindness provided a sense of belonging. When I met her, I was in my final year of medical school pursuing my first international elective, and she has been a pillar of strength since. We met over hot chocolate every time I visited Boston. She became my unending source of support, from sponsoring my ASCO abstracts to supporting competitive fellowship applications. Even when I chose to pursue a non-traditional career pathway—doing a PhD in classical music—she was incredibly encouraging, which empowered me!

Dr. Karen has a distinctive career trajectory, with expertise in not one specialty but two. In 1983, she completed her residency in pediatrics at the Childrens Hospital of Philadelphia, and in 1986, she completed her pediatric oncology fellowship at the National Cancer Institute. She then went on to pursue a second residency in radiation oncology at the then Joint Center for Radiation Therapy, Harvard Medical School, with the goal of becoming a uniquely trained pediatric radiation oncologist; subsequently, she joined the staff of Brigham and Women’s Hospital/Boston Children’s/DFCI in 1989. Dr. Karen has been a pioneer in developing techniques for using radiotherapy as a palliative treatment choice for pediatric patients with late-stage, incurable diseases. She is the founder of the Supportive and Palliative Radiation Oncology-Pediatric (SPROP) Service, an outgrowth of SPRO, and a member of the Pediatric Advanced Care Team. With the support of the child life specialist and nurses and care team, she provides her young patients the opportunity to enjoy games and music on virtual reality goggles while lying inside a linear accelerator to alleviate their stress and fear, and far fewer of them need sedation or anesthesia to stay still during their procedures.

Her research niche has been the treatment of children with advanced malignancies receiving palliative treatment and end-of-life care for pediatric patients; over the last three decades, she led novel clinical trials and authored over 150 scientific publications. She often discusses how, unlike in earlier days, thanks to major technologic advancements, many patients no longer require radiotherapy and the late effects of radiotherapy have been reduced. In her commentary “Intracranial Germinomas: Can We Improve Upon Our Success?,” she suggests that outcomes for children with germinoma are excellent using standard radiation therapy. She advocates, however, that despite the high cure rate, oncologists must always strive to minimize toxicities along with maintaining cure rates. She recommends that the goal of oncologists is to avoid radiation therapy when possible. Her work has notably influenced the field and led to improved survival and quality of life for children affected by cancer.

Dr. Karen built a premier pediatric radiation oncology program at DFCI. As an internationally acclaimed pediatric radiation oncologist, Dr. Karen’s leadership is highly sought after by prominent professional organizations, including the American Society for Radiation Oncology, American Board of Radiology, Childrens Oncology Group, Connective Tissue Oncology Society, International Society of Paediatric Oncology, and Paediatric Radiation Oncology Society where she recently she completed her 3-year presidential term. In 2018, she was honored as a Fellow of the American College of Radiology, the highest honor that the American College of Radiology bestows on a member. Multiple awards have been conferred on Dr. Karen in recognition of her excellence, such as the Exemplary Care Award from DFCI, the Partners in Excellence Individual Award from the Dana-Farber/Brigham and Women's Cancer Center, and most recently, the Distinguished Clinician Award from the Brigham and Women's Hospital. She was recognized in the top-doctors lists of Boston magazine and Castle Connolly over the last several years.

Aside from her many incredible professional accomplishments and awards, Dr. Karen is admired for her devotion and commitment to her patients and her team. Among her colleagues, she is popularly known for her 24/7 availability to answer any emergencies. In the years I have known her, I have never received a holiday out-of-office response from her—emails are always answered almost instantly. In our recent conversation, Dr. Karen shared how strange it feels to spend her first Friday in decades without a beeping pager!

It is fitting that in Zoom meetings, she always chooses the virtual background of stars; this precisely mirrors her role as a guiding star to the department and all her mentees.

Dr. Tara Rajendran and Dr. Karen Jean Marcus

Dr. Rajendran and Dr. Marcus in 2017.

My dearest Dr. Karen, congratulations on cementing an indelible legacy with Boston Children’s/DFCI that will serve and inspire generations to come. We celebrate you and your three decades of impeccable service! My hearty congratulations as you prepare for the exciting next phase of a life that has provided outstanding and compassionate care to thousands of patients. I am eternally grateful for your unending support, encouragement, and, most importantly, your irreplaceable company. Thank you for seeing something in me that I couldn’t see for myself. Your encouragement and trust in me have cultivated tremendous confidence. You are not only a mentor and a supportive friend to me but also a mother figure; being your protégée continues to be the privilege of a lifetime!

Lovingly yours!



Dr. Rajendran is a physician-musician, author, and TEDx speaker. She is pursuing a PhD in classical Indian music at Annamalai University, Chidambaram, India. She is the founder of "Oncology and Strings," a leading advocacy lecture-concert program advocating the importance of inculcating music into palliative oncology infrastructure. Follow her on Twitter @TaraRajendran. Disclosure.


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