Many people say they always dreamed of becoming a doctor, but few people can say that their dreams guided their career as a physician. Biljana Novakovic Horn is one such person. The story began in Cleveland, where Horn, a pediatric resident in a neonatal intensive care unit, had returned after spending several weeks in Thailand. One night, she dreamed about a hematological oncologist from Thailand and upon waking, wondered about the impetus behind her sleep-induced memory. Only later did she recall seeing a notice of a pediatric hematological oncology fellowship at the National Institutes of Health (NIH). The deadline for applications had passed the day before.

Horn called the NIH and asked if she could still apply. They agreed and sent an application, which she dutifully filled out, placed in an overnight envelope and promptly put in the wrong mailbox. "I had to stand there waiting for the mail pickup to get my application back." Horn ultimately got it to the right box, and later got the fellowship. It would not be the first time that this native of Croatia had persevered, a trait that has served her well at UCSF Children's Hospital, where she specializes in pediatric bone marrow transplants and in treating advanced cancers in children.

Growing up in Croatia, Horn seemed bound for a future other than medicine. In Europe, students are set on a specific track very early. They start medical school right after high school, and the decision about whether they will go into science or social science occurs even earlier, affecting what high school they will attend. Horn was placed in a high school that specialized in linguistics and social sciences. "It was difficult to apply to medical school from that background." Nonetheless, by studying 12 to 16 hours each day she was able to catch up to her peers and then excel. She finished medical school in record time, taking five years for what would normally have been a seven-year stint.

"I think there is probably an advantage to getting a more general education right after high school [as in the US]," Horn says. "I think it's too young to specialize, there's no flexibility, although the US system is more expensive and lengthy than the European system."

Horn did not find that being a woman made medical school more difficult, partly because even at that time, in the late 1970s and early 1980s, women represented more than half her medical school class. "Under socialism women had rights to do a lot of things, and it was normal for me to go to medical school." Still, she concedes that her experience might have been colored by her chosen specialty. "Pediatrics is so female and family oriented, and I never allowed anyone to treat me differently for any reason," she says. "Perhaps if I had been in surgery, I would have had a very different experience."

In time, Horn decided to come to the US to take a pediatrics internship at the Rainbow Babies and Children's Hospital in Cleveland, and later became a resident there. Horn soon observed that physicians worked harder in America, but that the extra time was mostly spent on paperwork. "In Europe there is much less administration and charting, so the extra work that doctors do here is not spent with patients." After three years at the NIH, Horn went to work at nearby Georgetown, before deciding on California as her next destination. She came to UCSF for a neurologic oncology fellowship, and when that ended, she was asked to become a member of UCSF's pediatric bone marrow transplant program.

Horn is now involved in two major research pathways. In the first, she is studying ways to reduce the toxicity of pretransplant chemotherapy and radiation therapy, since children are particularly vulnerable to the regimen. In the second research endeavor, she is seeking to understand how to best use growth factors to improve and increase the stem cells collected for transplantation.

Horn has two children, ages three and five, and enjoys working with pediatric patients, even though the news she often has to deliver is bad. "When you're with children you work not with one patient but with whole families," she says. Horn now has her dream job at last.