A radioactive spill on a nuclear submarine could kill hundreds of people. And there aren't allowances made for the fact that the doctor on board is still learning the job or for the fact that she's among the first to break a gender barrier in a traditionally all-male role.
Faced with a radiation accident, Dr. Jean Siebenaler knew what she had to do.
"We had to get dressed up in suits and gloves and I remember trying to irrigate people," she says.
But high-tech gear can pose unanticipated problems for seemingly simple, yet essential, tasks. Navigating the bulky enclosed suits the medical personnel wore posed a challenge.
"There you are, trying to do medicine and it's like, 'Wait a minute. How am I supposed to take a pulse?'," Siebenaler says.
The spill was actually a drill. Being in the U.S. Navy meant constant inspections and drills, according to Siebenaler.
But she saw the reason when a fire broke out on the USS Fulton, a submarine tender to which she was assigned: Everyone quickly performed their duties to get it under control.
"You do it because that's your job and you've been training to do a good job and you just don't think about the danger involved," she says. "It's really neat to watch a system that's been training to do a good job."
Nineteen years later, Siebenaler is taking the pulse of a patient named Hamilton County and diagnosing its needs with the help of her Naval training. Once again she's ready to break barriers.
Siebenaler is a Democrat running for an office long controlled by Republicans. Having never held public office, she's taking on political veteran Phil Heimlich in the race for one of three seats on the county commission. If she wins, Democrats will control the three-member board for the first time in four decades.
'Feminism grabbed me'
Taking chances isn't new to Jean Siebenaler, the oldest of three children born in Sheboygan, Wisc. She wasn't from a family that expected her to be a doctor — or a political candidate — but it was the sort of family that expected her to do her best.
Siebenaler's father was a union painter in the public school system.
"I never remember my father hating work," she says. "My dad was a very proud working man and proud of his skills as a painter. He very much enjoyed helping people. He was kind of a self-made handyman."
Her father was happy to be a provider for his family and continued in that role even when presented opportunities that some wouldn't pass up.
"When he was young, he was an excellent baseball player and he was so good he got a contract with one of the farm teams," Siebenaler says.
Occasionally he'd pull out that old contract and show it to his children, happy he made the choices he did.
"Never with any kind of remorse, just kind of look back and said, 'I was good enough. I was a contender,' not 'I could have been a contender,' " Siebenaler recalls.
Her mother, now in her mid-70s, still insists on doing much of her own yard work.
"She still prides herself very much on her independence," Siebenaler says with a smile. "I think just over the past year she has stopped blowing the snow."
Siebenaler attended Catholic grade school and public high school, excelling as a student.
"I was one of those typical overachievers grade-wise," she says.
Mary Jo Siebenaler of Mankato, Minn., says she always looked up to her sister Jean.
"She always got along with peers," Mary Jo says. "I always remember Jean being kind of popular just because she was so easy to get to know. She is so capable and yet so people-focused. When she decides she's going to do something, she stays with it and does it really well."
As children, the sisters took piano lessons. Jean did well, practicing and becoming her instructor's favorite. Mary Jo excelled in athletics — not exactly Jean's strength. Mary Jo recalls Jean twisting her ankle when she fell off a pair of platform shoes.
"She used to always joke that she was a major klutz," Mary Jo says.
Jean Siebenaler was involved in cheerleading and drama, landing the lead in a high school play.
"I just kind of had to be into everything," she says.
But from the blue-collar part of town where Siebenaler grew up, "everything" for a girl was expected to end with high school. At that point, a girl was expected to get one of those "woman jobs" such as teaching or typing, then get married.
"Basically, back in 1972 when I graduated from high school on that side of town, it was a big deal for a guy to go to college," she says. "And certainly if a girl went on to college, she was going to be a nurse or a teacher."
Her mother wanted her to find a job with good benefits. Her father encouraged her to become good at typing.
But after three years of working as a receptionist and finding it wasn't enough to keep her happy, Siebenaler enrolled in college with the intention of becoming a nurse.
"I became very influenced by the times," she says. "Feminism grabbed a hold of me."
In school, she would often sit next to young men taking the same classes. She asked what their major was.
"These guys, who were clearly no brainiacs, said, 'Pre-med'," she says.
Siebenaler decided if they could do it she could, too.
When it came time to take a chemistry class designed for nursing students, she approached her advisor about taking a tougher course, the one for pre-med students. She was told not to try: If her grade was too low, she might not be accepted into nursing school.
Siebenaler took it anyway, earning an A. Then she took the second chemistry class in the summer, receiving another A. At age 22, she decided maybe she could be a pre-med major.
Siebenaler's father was worried. She had not only given up steady work to go to school, but now she was giving up studies with a definable end point to take a chance at the possibility of medical school.
Siebenaler had proven to herself that she could do things she never imagined, even in a field that was still very much dominated by men.
"From that point I became obsessed with doing well," she says. "It was almost as if something had been denied to me in thought and in dream."
Because of her good grades, Siebenaler was accepted to medical school after three years of college.
"And then my dad busted buttons," she says.
In the schools where Siebenaler's father was still a painter, he would sometimes run into the guidance counselors who hadn't had time for her. He would proudly ask if they remembered his daughter Jean. When told she was studying to be a doctor, a look of disbelief crossed their faces.
Intelligence is only one requirement for medical school. Siebenaler still had to come up with the money for tuition.
"I was hit with the reality that medical school was expensive," she says.
She heard about a military health scholarship that would pay her tuition and books and give her a monthly stipend.
"All I had to was pay them back some time," she says.
It was a deal.
Siebenaler finished medical school at the University of Wisconsin. After an internship at Bethesda Naval Hospital in Bethesda, Md., she was sent to the submarine tender, a repair ship with about 1,000 crew members, in Quincy, Mass.
"It was one of the best experiences of my life," she says.
The grueling training of the internship had left her with little sleep or time to catch up.
"It was almost like it was necessary," Siebenaler says. "It was a way for me to reconnect to real life."
The loss of a child
Real life can be unfair, as Siebenaler knows firsthand.
She met her husband, Michael Burba, on the USS Fulton. He had made the U.S. Navy his career.
After they married, she wanted to stay near him as he finished his time on the ship. She ended up working at a naval hospital in Connecticut for three years instead of going back into her residency, which would have forced her to live separately from Burba.
This, she says, gave her more time to think about what she wanted to do. In the beginning, she'd planned to be a pediatrician. But after working as a general doctor in the naval hospitals, she rethought her choice.
At the hospital, the general doctors were the first point of contact for all of the patients, which allowed her to switch from treating an infant one minute to taking care of an elderly person. She liked the variety the work allowed her.
Siebenaler became pregnant with the couple's first child in 1984. Burba, able to fly from his post in Italy for the baby's birth, was supposed to be home permanently by the time the baby, Emily, was 8 weeks old.
But even before he returned for good, Siebenaler could tell something was wrong with the baby.
"Even I denied it as a doctor," she says. "I was just a mother to her."
Instead of progressing and getting stronger, Emily seemed to be getting weaker. Siebenaler took her to a pediatrician, who verified something was seriously wrong, but no one was sure what it was.
Siebenaler pulled out her pediatrics textbook from medical school. In it, she found the answer to the questions they were almost afraid to ask.
"There was a picture in the pediatric textbook of my daughter," she says. "It looked just like her."
The picture showed a baby lying in her crib with her arms behind her, limp, and her legs in a froglike position. The heading was "Floppy Baby" —in medical terms, spinal muscular atrophy, a genetic disorder whose trait must be carried by both parents.
The level that Emily had, the book explained, was fatal. Any future children the couple would have faced a one-in-four chance of developing the same disease.
"A railroad just took off from there and the train just took off," Siebenaler says.
She continued to work at the naval hospital, where she received support from coworkers.
"The one cool thing about the military is it really is a family," she says. "It was just incredible support."
Siebenaler was being exposed to the other end of medicine at an academic institution, as the mother of a dying child.
The couple first took Emily to Yale University and then to Massachusetts General in Boston, where their child became a medical specimen, examined and studied by people trying to get a better understanding of the disease.
Emily died because she just didn't have the muscles to breathe anymore.
"Two months before she died, we had to feed her in a feeding tube because she was too weak to swallow," Siebenaler says.
The couple had to decide whether to put Emily on life support, knowing she would never improve, or let her go.
Siebenaler says the experience shaped her feelings about issues such as abortion and life-support for the terminally ill. She describes them as personal, agonizing, gut-wrenching decisions.
"I became a very strong advocate for these as personal decisions that no one should be in the midst of making for them," she says.
Siebenaler and Burba decided against life-support.
Emily died at 9 months. Knowing they wouldn't be staying in Connecticut, on Christmas Eve 1985 the couple buried their child in Pennsylvania, near Burba's family.
Driving home after the funeral, Siebenaler had a feeling she was pregnant.
"I remember this voice saying it's going to be OK," she says.
Still dealing with grief, Siebenaler had to comfort her family and friends who were scared the same thing would happen again.
"We knew while Emily was dying we were going to have more children," she says. "We tend to be very optimistic people and concentrated on the three out of four chance that everything would be OK."
It was. Her sons Matthew, now 15, and Andy, 13, were born healthy.
'Stop the bleeding'
Following Andy's birth, Siebenaler worked as a family doctor in Connecticut.
"We knew we wouldn't stay in Connecticut because we're both really family-oriented people and we wanted to get closer to family," she says.
So she put her name into a national search engine, hoping to find a place to live somewhere between her husband's family in Pittsburgh and her family near Milwaukee.
The job hunters called and asked the family what they would think of Cincinnati.
"It was right after the Reds won the World Series," Siebenaler says. "The town was flying high. Downtown Cincinnati had energy in 1991. In many respects, that colors how I feel today about what's necessary to draw people to this area."
Siebenaler ran against Bill Seitz for state representative in 2000. She lost.
"If nobody else was gong to be out there representing my views, I might as well be," she says.
State legislative races receive less attention than county commission races. During the campaign two years ago, Siebenaler scaled back her office hours at Western Family Physicians, where she was a partner.
This year, taking on a high-profile campaign against former City Councilman Phil Heimlich, Siebenaler has decided to completely give up her medical practice, at least for now.
She takes on the challenge of name recognition with a sense of humor. Her campaign bumper stickers declare Siebenaler the "Heimlich Remover."
Ironically, Heimlich's sister Elizabeth ran Siebenaler's campaign against Seitz.
Leaning on the counter in her kitchen, Siebenaler makes calls asking for permission to speak at a community council meeting. Much of her day, she explains, is now spent on the phone and meeting people.
"When you don't have a lot of money, you have to depend on grassroots campaigning," she says. "I'll be darned if I'll sit back and live in a country where people buy democracy with money and name recognition."
But politics isn't an easy game. At many places where she tries to distribute literature or meet with people, she's told to go away.
Instead of being a way to exercise the will of the people, politics has become regarded as some sort of disease.
"We instead have created an environment where we have allowed it to be stained and people don't want it around (politicians), because they see it as dirty," Siebenaler says. "I really consider this an honor, to the point where somebody would leave their medical practice because it's that important to the community for the greater number of people. I don't agree with really any of the political views of Heimlich, and it's hard to live in a community where your only choice is that viewpoint."
Siebenaler believes now is the time to rebuild a sense of optimism for the area, realizing Cincinnati can return to being a city that people want to move to or stay in.
Building a healthy city — for the county
She thinks the county must keep businesses and work to attract new ones with high tech jobs and higher paying jobs.
She wants to see a county that believes an educated workforce is the No. 1 attraction to an area. Siebenaler says Greater Cincinnati is undergoing a brain drain, with the loss of young people who are growing up and taking their skills elsewhere.
"We have to stop the bleeding, and then you have to figure out how to grow healthy, how to gain strength," she says. "One of the ways we do that is to start showing the world a community that can work as a team to welcome people in."
She believes a closer city/county relationship needs to be forged.
"The fact of the matter is businesses want a quality urban environment," Siebenaler says. "The county needs to concentrate on building up businesses that represent the urban sector. It's not going to be the biggest tax break to attract them."
She also believes the county needs to look at criminal justice beyond police/community relations, examining how the courts treat people and what support is offered once they leave prison.
"Are our juries diverse or are they too homogeneous?" Siebenaler asks. "What are we doing to make sure that people are getting their rights under the criminal justice system?"
Siebenaler says she meets young people in Hamilton County whose parents won't let them go to the city of Cincinnati.
"They're afraid of the city," she says.
Siebenaler believes they're mimicking what they hear: The city is a dangerous place full of nothing to do, yet young people seem to be yearning to go there and find they might have been mistaken.
"I think in general people out in the county are grieving the loss of a healthy city," she says.
Cincinnati City Councilman David Pepper spoke at the kickoff of Siebenaler's campaign on May 24, saying she has a positive vision for the area. Siebenaler could help tackle issues that frustrate city residents but also involve the county, such as housing and transportation, according to Pepper.
"As much as anything, she's just a person of total integrity," he says. "She's someone you trust and is in this for the right reasons. From the time I saw her running for state legislative office, I've always been impressed by her."
Pepper believes Siebenaler will act independently and do what she thinks is right. This means bringing the county and city together to work in cooperation.
"We won't have a productive, healthy relationship with the county without her there," he says.
Not surprisingly, health and safety are a recurring theme for Siebenaler. She hearkens back to her Navy days.
The nuclear submarine force is very serious, according to Siebenaler. Her commanding officer, who was finishing his career on the ship, showed up every day to detail her plans and to make sure they happened.
Siebenaler believes the people at the top of an organization set the tone for the way it runs.
"He didn't like to see people come on board who weren't disciplined," she says.
Siebenaler believes similar attention to detail would benefit Hamilton County, which she says needs more preparation for mass disaster.
"We're woefully lacking when it comes to communications and warning systems," she says.
About 120,000 people in the county aren't covered by the warning system in place now, according to Siebenaler. Many of the sirens don't have a battery backup system in case power is lost. With the current communications system, she says, firemen and police can't communicate well with one another.
Getting this system up to date is something she believes vital.
"It's the least we can do to say we're heading in the right direction for preparedness," she says.
Disaster, after all, doesn't make exceptions for those who aren't ready. ©