Meg Figdore, M.D.: It's a Family Affair

Little Meg at around 4 years old

"What do you want to be when you grow up?" the kind lady in church asked the quiet, blonde, pig-tailed five-year-old girl.

"I want to be a doctor," she replied, without hesitating.

The woman looked down at her with furrowed eyebrows and said, "No, you want to be a nurse, don't you?"

"No...I want to be a doctor."

The idea of being a nurse rather than a doctor was foreign to the little girl, now the grown woman, and obstetrician, Meg Figdore, M.D., of York. That brief conversation one Sunday morning took place in 1972 when only about 10% of U.S. medical school enrollment was comprised of women. Perhaps Dr. Figdore’s quick reaction as a precocious and determined child reflected her insider’s view of a life in medicine.

Meg Figdore, M.D.

Meg is the daughter of the late Dr. Galen Kistler. She noted that he was “a wonderful father” who practiced family medicine in Dover and in York. Early in his career, he was on-call every other night and every other weekend. Whenever his patients needed his help after hours he would gladly arrange to meet them in his office.

When Meg and her older sister and younger brother  (each two years apart) were in elementary school their father would “cart his children with him,” said Dr. Figdore. “We would be his assistants. He would tie sutures, and we would take turns as to who would cut off the ends.”

He instructed them carefully, "One-quarter inch, one-quarter inch…"  But Meg's eight-year-old brain would sometimes guide her (future-surgeon) hands to leave a half-inch, or sometimes considerably less than the requested quarter. She can still hear her father’s steady voice saying later, "Meg, I just took a lady's sutures out, and they were too short."

Sometimes the three tag-alongs helped with urine samples and learned to read the dipstick results, but when Meg looked intently down through her father’s microscope at the drop of urine she really had no idea what she was looking at. Reliving this, Dr. Figdore laughed softly, and admitted that she would just “pretend." She was playing the role of a doctor, and “it was great.”

I thought to myself, did this “family” doctoring scene occur in my lifetime?

Galen Kistler, M.D.

But it was not all for fun. The thoughtful Dr. Kistler needed his three children to know how lucky they were in life; that others were not so blessed. So he sometimes took them with him for brief glimpses into the lives of the less fortunate in the community.

For example, the kids were witness to the terrible loneliness in nursing homes. And yet, they saw that these often-forgotten people would “light up” when they visited. They saw the importance of warm human connection. Reflecting on this experience, Dr. Figdore recalled that the simple gift of a single young tomato plant in the spring that fruited in late summer showed that someone cared, and she saw that this act was very much appreciated. This was “eye-opening” for her, and left a “lasting impression.” 

(How is a lasting impression created?  Epigenetics may help with an answer as  environmental factors, including social input, turn specific genes on or off.)

But from where did her father’s humane sensibility originate? "My father learned from his dad, who was the town pastor, about being humble. To be grateful for what you have," Meg said quietly.

On the other side of the family, her maternal grandfather, the son of a physician,  was himself a general practitioner, and Meg and her family often traveled the two hours to visit him.

Mister Rogers

His practice was in his home. She reflected that, “It was neat that he would be playing with us and be ‘grandpop’ until someone would knock at the door.” Then, “like Mr. Rogers,” he would quickly take off his sweater, and slip on his jacket, go into the other room, and become Dr. Scholl. When he was finished seeing the patient he would come back to them, and put on his ‘grandpop' sweater again. "It was fascinating," Meg said.

(Between 1931 and 1974 the percentage of physicians describing themselves as general practitioners declined from 83% to 18%. It is certainly less than that now.)

Her maternal grandfather (‘grandpop’) had lost his own father when in college; he later went to Jefferson Medical College courtesy of his physician-uncle. He lived at home in Green Lane, PA, and took the train 90 minutes to and from Philadelphia daily. He served in WWII and he and his wife, a nurse, were his entire practice until he (very reluctantly) retired at 75.  

Looking even further back, Dr. Figdore can trace her extended family of healers, of doctors and nurses, into the 1800s.

Sadly, her father passed away before she dedicated herself to the pursuit of a medical career. He died when she was a student at Juniata College where she was initially cautious about declaring herself premed. Once she did, however, she excelled. She was accepted to several medical schools and she chose to go to Jefferson. Center City Philadelphia was “a culture shock” but “a good experience,” she noted.

Graduation from Jefferson
Harvey Scholl, Jr., M.D., Meg, Aaron Kistler, M.D., Harvey Scholl, Sr., M.D.

Along the way, she fell in love. She had first met her future husband (Chris) when she was in the seventh grade (he was in the eighth).  They were together in a class for gifted students. She remembers thinking that he was “very cute,”  but they did not get together until the summer after her first year at Jefferson. At that time she was the maid-of-honor at her sister’s wedding and Chris (get this) was the best man for his good friend.  

Her sister and brother-in-law saw something and prodded repeatedly; Meg and Chris eventually gave in. Dating a serious and dedicated medical student isn’t easy, and she said, ”We just made it work.”


For a while, Meg toyed with the idea of going into genetics, but during her third year at Jefferson she “fell in love” with obstetrics and gynecology, especially the obstetrics part. She loved being with the women, and loved delivering babies; there was nothing else that she wanted to do. She took an OB/GYN residency at Geisinger Medical Center.

Geisinger Medical Center, Danville, PA

Dr. Figdore and Chris got married in June of 1995, between the second and third years of her specialty training. He did CAD work in York and commuted the 90 minutes back and forth to Selinsgrove. That September, while wearing waders and fishing alone in the shallow Susquehanna, he heard a noise in his head, a noise “like a train.” He made his way out of the river to get help.

He walked, often staggering, about a mile into town. A  man stormed out of his house after an argument with his wife and saw Chris. Quickly figuring there was a problem, Meg was summoned, and the man called for an ambulance.

A devastating bleed

At Geisinger, 25 minutes away by ambulance, the CT scan revealed a bleed “in the center of his brain.” Dr. Figdore, knowing her husband’s “horrible” condition, felt that she was “going to be a widow that night.”  But an emergency VP shunt (draining fluid from the brain into the belly to reduce the critically-rising pressure inside his head) saved his life.

Through this, Meg “learned what it is like being on the other side (of the medical encounter).”  Weeks passed, and Chris made a remarkable and nearly-complete recovery. He was changed but remains “a wonderful person” who makes her laugh. 

After her residency, she joined The Women’s Healthcare Group in York and continues to greatly enjoy the varied practice. She is fulfilled as she cares for women and helps them deliver their babies safely.

"How does your early-life experience affect your practice today?" I inquired.

"My dad taught me the power of touch, and to be a good listener,” she said.  She uses these important lessons every single day. She shakes hands warmly when greeting the women, and hugs them (with permission) when appropriate. She listens closely to their stories to know what they need.   

But today, she noted, "there is a rush to see patients, and (required real-time) documentation on the computer interferes (with face-to-face contact).” Dr. Figdore works around these externally-imposed demands by gently tilting the computer screen away for a while. It takes more time but is certainly appreciated by the anxious mothers-to-be.

Has the practice of obstetrics changed much since her residency? While "the basic process of having a baby has not changed, people have,” she noted.

The worldwide obesity epidemic is one example. This has increased the incidence of pre-pregnancy type 2 diabetes and its associated problems during pregnancy and delivery.  For example, there are many more miscarriages in poorly-controlled diabetics, several times more birth defects (especially of the neural tube), and more babies who are “large for gestational age” (LGA).  Good early (and preconception) control of diabetes greatly reduces the risk of these problems.

Adult Obesity Rates in 2013

The excessive weight gain in the fetus in diabetics increases the risk of preterm delivery, mechanical complications of delivery (due to large shoulders and abdominal girth, not the size of the head), and the need for cesarean section.
Additionally, lung maturity is delayed in fetuses exposed to hyperglycemia in utero. And dangerous hypoglycemia may occur in newborns of diabetic mothers, resulting in brain damage, seizures, and death, if not recognized promptly.

Interestingly, the “metabolic syndrome” (obesity, hypertension, impaired glucose tolerance, and elevated lipids) is more common by age 10-16 in those who were LGA when born. The placental environment alters gene activity in a long-lasting way. 

Obesity itself, without diabetes, makes conceiving more difficult and complicates the monitoring of pregnancy. For example, obstetricians are now obliged to induce labor by 40 weeks if women are over a certain BMI to prevent stillbirths. Inducing labor, rather than letting it start on its own, increases the risk of prolonged labor and the need for a c-section. Wound infections are also more common. 

Yet there are also a few new bright spots in her practice. An infusion of magnesium sulfate, used for many years to treat pre-eclampsia (high blood pressure with a risk for seizures), when given for 12 hours to women at risk of delivering an early preterm baby is “neuroprotective,” she said. This reduces the chance of the baby having cerebral palsy.

Dr. Figdore also remarked that giving the hormone progesterone weekly from 18 to 36 weeks to women who have already had a preterm baby decreases the likelihood of another too-early delivery. This simple measure has resulted in a “really big difference” in her practice, as more babies enter the world at the right time.


Anticipating and preventing problems is vitally important. She spends the time, and she hopes that her careful advice about nutrition (and smoking and alcohol or drug use) during pregnancy is heeded. Too often it is not, and Dr. Figdore regrets that.

Percent of Births to Smoking Mothers 2013

She wants her patients to know how hard their doctors are working, and that they really want the best for them, and that it is frustrating when their counsel is not followed and there is a bad outcome. Good and consistent prenatal care, it must be stressed, greatly improves the chance of a safe pregnancy and smooth delivery.

Years ago, the five-year-old with the pigtails knew who she wanted to be, but only dimly knew why. Without being consciously aware of it, she was part of a genetic lineage with epigenetic tweaking along the way.

(Follow this carefully.)

When a woman is carrying a female fetus, the ovaries of that fetus (with more than six million eggs by the twentieth week of gestation) contain the ovum that will later be fertilized to become the woman’s grandchild.   


So, when Dr. Figdore’s maternal grandmother was pregnant with her own daughter (Meg’s mother), one special egg contained in the ovaries of the fetus was the egg that would be fertilized years later to eventually become Meg. And when she was carrying her daughter Meg was also carrying the ova that may someday develop into her own grandchildren. You see, one inside the other, inside the other…continuing the life journey.

Like nesting Russian dolls, or “Babushka” (i.e., grandmother) dolls.

Babushka Dolls: Fertility, Motherhood, Family

The egg that eventually led to us was formed inside of our mother while she was still a fetus in our grandmother's protective womb. And on and on it goes.

The seasoned obstetrician will be happy to assist in this ever-mysterious process.