The Children’s CEO

The first job out of college can be life and career changing— just ask Boston Children’s Hospital CEO Sandra L. Fenwick ’72.

Fresh out of college with a biology degree and an enthusiasm nurtured by her four years at Simmons, Sandra L. Fenwick ’72 eagerly accepted an unusual assignment: a stint in Saudi Arabia as part of a team hoping to find a cure for a mysterious illness that caused blindness. 

This was the first of many twists and turns in a career that would lead Fenwick to the position of chief executive officer of one of the country’s premier hospitals, Boston Children’s Hospital. It was in Saudi Arabia where Fenwick first realized she had a knack for leadership. It was where she realized that she was interested in health-care administration rather than direct patient care. There, she met the man who would become her husband. And it was where she met a female Saudi medical student named Tahiya Binhemd—one of those fleeting encounters in life that, nevertheless, make a lasting impression.

Working in Saudi Arabia was not something the girl known as Sandi envisioned while she was growing up in New Britain, Conn., the daughter of a postal worker father and administrative assistant mother. In high school, however, she stood out—she was one of the few girls interested in science. This led her to Simmons—a women’s college with a good science program and “the ability for women to explore what they wanted to do,” as she recalled in a recent interview at her office at Boston Children’s Hospital, which this year marks its 150th anniversary. Poised and elegant, Fenwick answered questions precisely but with emotion. 

She clearly remembers her Simmons days. In 1968, her first year, Simmons required women to wear skirts to class (that dress code was soon changed to allow pants and jeans), but Fenwick liked how the school was trying to hang on to a few traditions during a turbulent time in the country. 

Selected unanimously as chief executive officer in 2013 by the board of trustees, Fenwick now leads a team of 20,000 people.

At Simmons, she found like-minded fellow students and teachers who encouraged her to consider pre-med or other fields in the natural sciences. “Oh, it was incredibly supportive. You didn’t feel like an outlier. You felt like somebody who really was going to get support and acknowledgment and encouragement and camaraderie. And that felt good,” she said. 

She remembers the support of faculty such as Anne Coghlan, who became the chair of the biology department, microbiologist Martha Berliner, and Marie Sacks who taught evolution and fundamental biology. Phyllis Brauner taught chemistry and physical chemistry “which I never thought I would get through, but I actually took a higher-level course with her.” 

She also recalled with gusto her classes in Shakespeare and the Bible; while she thinks today’s university students should identify a focus for their studies, they should also explore other options through electives. College “is an opportunity to really look broadly and maybe understand something that you didn’t think you would pursue but might become a vocation or an avocation,” she said. 

After graduating with a B.S. in biology in 1972, Fenwick decided she wanted to work while she determined whether she would pursue an M.D. or a Ph.D. Professor Berliner recommended her for a job at the Harvard School of Public Health. “If you really are trying to decide on medical school, or go in deep in science, or if you want to do something with public health, this is a perfect opportunity, because this department will expose you to all that,” the professor told her. 

It did. 

In three months, she was asked if she wanted to go to Saudi Arabia to study a disease called trachoma, which was endemic in hot, underdeveloped countries. She said sure, even though she had to find an atlas to determine just where Saudi Arabia was. 

She spent the next two years in the country, collecting blood and cell samples from villagers, gathering demographic data, conducting a clinical trial, meeting with the local emir, and studying Arabic. The team did identify a treatment—it turned out that the common antibiotic doxycycline was effective for what was a strain of the Chlamydia bacteria. Fenwick reveled in the experience; she thought of herself as a pioneer, someone who pushed boundaries. 

And then she met an “incredible woman.” Tahiya Binhemd was a medical student, about Fenwick’s age, who helped with the research. She had to wear a veil, Fenwick didn’t. “She had to sit behind all the men. I sat up at the front. I was able to speak directly to the emir; she was not allowed to speak to the emir. She was never going to be able to take care of men.” 

“We want to be at the cutting edge of the next discovery for children, the next treatment, the next diagnostic tool, the next therapy, and then, hopefully, the next cure,” said Sandra L. Fenwick ’72.

“I was inspired by her perseverance and her tenacity and her desire to give back to a country that really kept her somewhat restrained,” Fenwick recalled. “Her private world was also going to be incredibly limited, and I realized how different the rest of the world was.” 

Fenwick eventually lost contact with Tahiya, but the encounter strengthened her resolve to continue to push boundaries. Something else happened in Saudi Arabia. “After the main team left, I ran the lab there. And I ran the program in the villages. So they left me in charge.” A dean from the Harvard School of Public Health visited Saudi Arabia, and he and Fenwick had a coffee. “So I see leadership, I see capability, I see opportunity for you,” he told her. “The landscape is changing and there will be a need for health service administration.” 

That conversation would put Fenwick on the path to Boston Children’s Hospital, but not before another few twists and turns. Now married to Geoffrey Fenwick, an engineer from England, Fenwick accompanied him to Houston when—due to the 1974 recession— he could not find a job in the Boston area. 

“I decided to explore medical school, dental school, and master’s in public health. But I realized when I was in Saudi Arabia that what I truly loved was the organizational work, the insights into really how projects got done.” 

She attended the University of Texas School of Public Health where she received a master’s degree in Public Health in Health Services Administration. When her husband was accepted by Harvard Business School, the couple happily moved back to the Boston area. Fenwick was able to find a position at Beth Israel Hospital in a new field called utilization management and quality assurance. Forty years ago, the move to control health care costs and improve quality of care had already begun, she said, adding, “Believe it or not.” 

Once again, Fenwick was a pioneer. “I was the first woman at Beth Israel to be in what was then senior management and senior leadership.” At national meetings, she was one of a few women in such a role at a hospital. (According to The New York Times, in 1981, not a single one of over 60 hospitals in the Boston area—except for one religious hospital—was run by a woman.) From 1976 to 1998, Fenwick served in a number of senior executive roles at Beth Israel in operations, strategy and business development, ultimately as senior vice president of system development for its parent CareGroup. 

In 1999, Fenwick—by then the mother of a 7- and an 11-year old—made the move to Boston Children’s Hospital, considered the nation’s top pediatric hospital. Boston Children’s is home to the world’s largest pediatric research enterprise and is the leading recipient of pediatric research funding from the National Institutes of Health. In addition to the main campus in Boston’s Longwood Medical Area, the hospital includes eight satellite facilities, seven community hospital partners and one community health center. Fenwick was hired as senior vice president for business development strategy but was promoted to chief operating officer within a year. She became president in 2008. 

Selected unanimously as chief executive officer in 2013 by the board of trustees, Fenwick now leads a team of 20,000 people. “Sandi has a fantastic record,” commercial real estate developer Stephen Karp, chairman of the Children’s board, told The Boston Globe when she was selected. “She has the complete confidence of the board, including the doctors on the board, which is critical to success. She understands the cost implication of things, and she’s a strategic thinker. We’ve seen her work in some very difficult times.” 

As a mother (and now the grandmother of three) as well as a Sunday school teacher, Fenwick is keenly affected by her work at Boston Children’s—there’s joy when a treatment proves successful and heartbreak when it doesn’t. “We want to be at the cutting edge of the next discovery for children, the next treatment, the next diagnostic tool, the next therapy, and then, hopefully, the next cure,” she said. She has overseen many expansion projects but, as in Saudi Arabia, Fenwick is still intrigued by research. The hospital has just finished a strategic plan for how to bring discoveries in treatments, cures, and devices more quickly into patient care. 

Throughout her career, Fenwick, like many professional women, has had to strike a balance between personal and professional life. “Realize that your career is a journey,” she said. “It’s not this destination where you’ve got to keep hitting milestones; think about what works holistically.”