Determined. Resilient. Compassionate. There’s no better way to describe Dr. Iliana Neumann, faculty physician at Waco’s Family Health Center. Her path to family medicine was paved with pain and adversity and led her to something more than a career — a human connection that translates to all aspects of her life.
WACOAN: Tell me a little about your job at Family Health Center.
Neumann: I’m a faculty physician, so I teach other doctors. Teaching uses a very different part of your brain. It wasn’t anything that I expected to be doing when I went into medicine. It’s a challenge every day, but I’m fortunate that I get people who are so far along in their careers that they’re very motivated.
WACOAN: Yes, teaching people to do what you do is very different from doing the job yourself. Now are you strictly teaching or are you also seeing your own patients?
Neumann: I do both at the same time. I’m a full-scale physician, so I have patients that I see in clinic. I supervise medicine services at both [Baylor Scott & White Medical Center – Hillcrest] and Providence [Health Center]. I supervise the pediatric service at both hospitals, so I supervise labor and delivery. I also deliver my own patients. I see newborn babies, and I also work on site as a hospitalist.
So I do everything. My job really is taking care of people from the time they’re in the womb —including tons of prenatal care. I deliver them and take care of them throughout their whole life. Adolescents is one of the [age] groups that I really enjoy, children and young people — and also mothers.
WACOAN: So you see older patients, as well?
Neumann: Yes. I take care of everything from diabetes to hypertension. We do end-of-life care, especially in the hospital, inpatient medicine, ICU care. We do it all.
WACOAN: How many residents do you oversee?
Neumann: Our program accepts 10 residents here. The Family Health Center actually started in the 1970s as the McLennan County Medical Society Research and Education Foundation, and it was used to train primary care doctors and family physicians because there’s a huge need for it. We know that communities that have an established primary care health force tend to have [citizens] that are healthier and use less resources. And so we’re training family doctors after medical school to become a specialist in family medicine, which requires three extra years of training. And so that whole group of 30-some residents are always under my supervision in some form or fashion.
WACOAN: Tell me a little about your story and how you got to Waco.
Neumann: I moved here two years ago from North Carolina. My mother was an immigrant from Mexico. She moved to McAllen, Texas, which is where I was born. She wanted to have better opportunities for her kids.
Her father thought, because she was a girl, that school was a waste of time and that she should be home doing the things that women needed to know how to do. But she wanted more for us. She worked really hard at two to three jobs to support my brother and me. We mostly lived in Chicago because she had a sister there, and then we moved to California.
My mother didn’t speak English well, and she didn’t have money or time to go to the doctor. So, by the time she finally went [to see a doctor] because she couldn’t stand the pain anymore, she had advanced breast cancer. She had a complete radical mastectomy.
WACOAN: Oh, no.
Neumann: Then she lost her job, and so she lost her insurance for chemotherapy. The cancer came back in her brain and her lungs, and she died at 38.
WACOAN: How old were you at that time?
Neumann: I was 14 when she was diagnosed, and I was 17 when she passed away. When it came back to her brain, they said she only had six months to live. So I left school my senior year to take care of her.
I worked two, three jobs, starting when I was 15, to support us. My first job was at a donut shop, and then I worked at the school in their print shop. And I also worked at a local department store to be able to pay the bills. We were living in Hayward, [California], which is in the San Francisco Bay area.
WACOAN: That must have been difficult, losing your mom and taking on that responsibility.
Neumann: She died about a month before I graduated, so I had that month to catch up with all my schoolwork and graduate on time.
During all of this, I was determined that I was not going to let all her sacrifices and effort go to waste. I wanted to make sure that I was able to pursue a career and give back to my community, especially to give back to people that had her life experiences and who had the same limitations she had.
I remember going to the high school counselor and saying, ‘Hey, what about these SATs? I hear you have to take them in order to go to [college].’ She said, ‘Honey, it’s not for people like you.’
The high school I went to closed a few years after I left because it was so poor performing. Only half of us graduated, and only five of us went on to higher education. I was the only one ever to go to a private university. I managed to get accepted everywhere I applied — [University of California] Berkeley, UCLA, Duke [University], Stanford [University]. Except Harvard [University] — I was wait-listed. I decided to go to Duke because I wanted to be far away from California.
My mom has been gone now for 30 years, and I still miss her every day.
WACOAN: During this time when you were working two or three jobs, did you ever feel like, this isn’t what I should be doing at this age? Or was there always that desire and drive to do your part?
Neumann: That thought never crossed my mind. No, no, no.
WACOAN: And that’s just who you are. I can see that.
Neumann: My mom was such an amazing woman. She didn’t let what my grandfather said to her keep her down. Even though she never got past the third grade, [she] read voraciously. She was always pushing herself and always challenging herself. She worked all those jobs, and she never complained. She just always wanted what was best for us, so when she needed me or what the family needed me [to do], of course it was just what I did.
WACOAN: So, you went to Duke?
Neumann: Yes. I went to Duke and, you know, I wasn’t prepared for college. I didn’t go to a school that really prepared me for it, and I had been in survival mode after she passed. I was just trying to keep a roof over our heads and keep us fed. We stayed with different friends until I finished school, plus filling out all the applications for college that no one helped me with.
WACOAN: That had to be overwhelming.
Neumann: Right. Once I got through the whole survival mode, I actually went through a pretty significant depression for that first year. My adviser said, ‘Maybe you’re not college material,’ and really wanted to make me take a medical leave and maybe not come back to school. But a family physician, Dr. Eisenhower, who was at the student center, stepped in for me and said, ‘No, you can’t kick her out. She’s depressed. We’ll work on a plan, and we’ll get her [the] treatment she needs. We need to support her through this.’ It was so inspiring. No one had ever stepped in and helped me out.
That’s still one of my guiding lights as a family physician. It’s not just that I take care of people’s blood pressure or their diabetes. I’m the person’s support system. I make sure that they’re well as a whole person.
WACOAN: That’s what sets family medicine apart.
Neumann: Yes. A big part of our training is to be able to see the person as a whole and to see how they function in their family unit and in their community and keeping them healthy, not just taking care of them when they’re sick. That’s the difference between family medicine and everything else. It’s much more holistic and humanistic, and that’s very important to me, especially after the experiences that I had with my mother.
Dr. Eisenhower, when everybody else had turned their back on me and where I had always felt so alone, reached out his hand to me and helped me stay on track. I came back to school, and I finished on the dean’s list with honors.
WACOAN: So you knew you wanted to pursue medicine at this time?
Neumann: Yes, but many people I went to school with viewed medicine as a prestigious profession and for monetary gain. I didn’t like that. My vision of what I wanted to do with medicine was much more human. I just wanted to take care of people.
So I enrolled in Duke’s physician assistant program. I have a master’s degree in health sciences, and I worked with migrant farm workers through North Carolina Rural Health Association for 10 years and I loved it. [The clinic] was in the middle of this tobacco field. They lived in conditions that are very third-world, in barracks with one source of running water, no refrigeration. And I said, now that’s what I’ve got to do.
We were very busy, and it was one of the biggest clinics for migrant farm workers on the East Coast. And then after clinic I would go out to the fields and see people there and do minor treatments and lots of education on healthy eating and safe sex and avoiding drugs and alcohol.
WACOAN: You had a connection with the people there.
Neumann: Exactly. Being Latina, the way that I looked and the way that I talked, I was able to have much more of a trust relationship [with them]. They were able to share with me things they may not be able to share both linguistically and culturally. So I really felt like I was making a difference and I loved what I did, and I would’ve been happy to continue doing that.
But there was this big population burst in North Carolina from 1990-2000 with a 400 percent increase in Latinos who stayed in North Carolina. And so the healthy farm workers brought their wives and their grandmothers and their children. And I didn’t feel like my training was good enough to take care of them. I felt they were getting the short end of the stick because they wanted to stay with me and I wasn’t as good as I needed to be.
WACOAN: And that’s when you went for your medical degree?
Neumann: Yes. I went back to school at East Carolina University and got my medical degree. And then I went to University of North Carolina [at] Chapel Hill for my training as a family doctor. I stayed on an extra year and did a fellowship in surgical obstetrics so I can do C-sections.
Then my mentor, Dr. Margaret Helton, asked me in my second year as a resident if I had considered doing academic medicine and staying on to train. When she said that, I thought, ‘Who is she talking to?’ because I was somebody who had been told that I didn’t need to even think about college. And once I was in college, I was told maybe I wasn’t college material. Now I was being asked to train doctors.
WACOAN: That’s incredible.
Neumann: At first, I wasn’t quite sure what I had to add. I know a lot of people that go into medicine come from better homes and a lot of their parents are physicians or other professionals. And I remember those Duke pre-med students that I went to school with and how I hadn’t had the same life experiences. And I said, how am I going to relate to these people?
But that’s the point. That’s the reason that I still continue to teach, even though my real love is being with patients. I continue to teach because that’s what I have to add. I have to add the fact that I had this different life experience, and that I have experienced these things very personally. The relationships that I form with my patients are so valuable to me. Each patient that I see, I think about, if this were my mother or if this were my sister. Teaching my residents how to have those humanistic relationships with their patients is what I have to add.
WACOAN: Tell me about your family — your husband, your children.
Neumann: I married my husband, Giovanni Duron, 18 years ago. We met when I was still working in North Carolina. One of my friends wanted to go into Raleigh to salsa night at one of the local hotel bars. I went with her, and as soon as we walked in, I saw him from across the room and I said, ‘Oh, that’s the one.’
That thought was not on my mind because I was very focused on my work at the time. But we looked at each other from across the room, and we danced. He called me every night for the next seven months, and seven months later we were married.
WACOAN: Oh my, it was truly love at first sight.
Neumann: But I told him early on in our marriage, I wasn’t sure I wanted to have children because I was worried again about breast cancer and dying young, and I loved my career and I really felt completely dedicated to it.
WACOAN: How did he feel about that?
Neumann: He was OK with that. We didn’t have babies, and I went back to medical school and I worked hard. And then in my 40s, I thought, well, I made it past 38 and I really love babies so much, so maybe we’ll give it a try. And we ended up having two babies!
Sophia is 5 and was born when I was 42. A year later my son, Leo, was born. I breastfed them for two years while I worked 80 hours a week. I had Sophia while I was doing my fellowship in obstetrics.
They’re the joy of my life. They are remarkable; they make me laugh, and they center me. Every time that I feel like there are too many things going in the wrong direction, I say, ‘I’m just going to have to work harder’ because I want to make sure to leave them the best possible world I can. I want to give them the same example that my mother gave me — somebody who is hardworking and dedicated and honest and has integrity and does the very best she can every day with what she has.
WACOAN: Where do your kids go to school?
Neumann: They go to Waco Montessori School. I love the idea of Montessori education because I want them to enjoy learning. I want them to find joy in their day and what they’re learning. One of the important things about Montessori education is being a good citizen of your community, being a leader for the younger children in the class.
I am a big believer in public education. I couldn’t have gotten here without public education. Through Transformation Waco, I am very dedicated to making sure that the Waco schools are excellent.
WACOAN: You’re on the board of directors for Transformation Waco. Can you talk about its mission?
Neumann: Five of the local schools [in Waco ISD] were not meeting standards. So if they had failed again this year, they were going to have to be taken over by the state and, more likely than not, close. That meant probably that all those kids were just going to have to be shipped off into the other schools.
Marcus Nelson, WISD superintendent, and other people in the community figured out a way for us to be able to take over the schools instead of the state. And so they partnered with Prosper Waco and came up with this charter within the school district. So it’s different. It’s separated from Waco ISD, and it’s a charter school. It was a success, as four of the schools passed. But it’s about our children excelling, not just passing.
One of the things that we’re working on is getting wraparound services. So we’re figuring out other groups in the community that can help us make sure that our children are successful in the public schools. Part of the reason that I’m on the board is to figure out how Family Health Center [can] make sure that the kids are staying healthy.
WACOAN: You do so much. How do you fit everything in?
Neumann: I do feel guilty sometimes because I work really long hours.
WACOAN: Can you even put a number on how many hours a week you work?
Neumann: Well, when I’m on call for the hospital and then when I’m attending, we do two-week blocks, so I’m on 24/7 for two weeks in a row, including both weekends.
If you just look at my job, it’s probably around 60 hours and then all the documentation — physicians have to do tons of documentation. I stay up till 2 or 3 in the morning finishing notes and documents and writing letters and looking at labs. And then you surround that with all my work with Waco ISD and my work with the health department, and I’m also now on the board of Planned Parenthood — all that stuff just adds up. And so it’s at least 60, I’m sure.
WACOAN: So it’s a challenge fitting everything in.
Neumann: If I’m working that much, there’s no way. There are so many great moms over at Montessori who have all sorts of time to do wonderful things with their kids. And sometimes I feel guilty, and my kids will say, ‘Oh, so-and-so’s mom came and had lunch with them — why can’t you come?’ Sometimes I’m like, do I need to rebalance?
But the way that I look at it [is] that I’m being a role model for my kids. All the things that I’m doing are to leave a better life for them. That’s my goal every day is to leave things a little better than what they were.
And then the other thing is that when I do have time, it’s quality time. My children are screen-free — they don’t watch TV, they don’t watch phones, they don’t have iPads. We read together every night before they go to bed. We paint. We do play dough like it’s nobody’s business.
WACOAN: So when is your kid time? Your just dedicated kid time.
Neumann: When I’m not at the hospital, I get up early in the morning, and I get them ready. We try to get up early enough so that we can take our time and talk about things.
In the car is definitely an important kid time. I never have the radio turned on, and if they’re quiet, it’s fine. It’s just [as] important to be quiet together. And when they’re talking to each other, I hear their conversations, you know, it’s important to them. They have great imaginations because they are screen-free.
At the table, we never answer phones. If I’m on call, I have my phone on vibrate, and I answer if it’s an emergency.
WACOAN: So dinner time is important to you.
Neumann: It’s been shown that kids do better if you have dinner together. It’s one of the best ways to prevent teen pregnancy and drug use. So I really, really work at trying to have dinner together. And dinner time means we’re sitting at the table and we’re talking to each other with no other distractions.
WACOAN: Do you like to cook?
Neumann: I do.
WACOAN: How do you get dinner ready when you have these long days? Is your husband helpful?
Neumann: I couldn’t do it without him.
WACOAN: What does he do for a living?
Neumann: He does flooring. He’s just the best father ever. He adores the children and plays with them all the time. He is a huge soccer fan, which is actually where we got Leo’s name — Leo Messi. They play soccer all the time.
He helps me get them ready in the morning on busy days. If I have to be somewhere early, he takes them to school, and he picks them up. He is just a wonderful man, and I couldn’t do it without him. And his schedule is more flexible, so he’s able to help me out.
WACOAN: And he’s totally supportive of all you’re doing?
Neumann: He is. But this isn’t what he grew up with. We’ve been together for so long.
Another guiding principle for me is authenticity. I am who I am, take me or leave me. And so he knew who I was all along. Sometimes I think he wishes I would do less. Part of the reason we moved here was that I was working a lot over there, and I didn’t feel I was connected to my community. Here, there is more space in my schedule for other things. I have a little bit more space and especially more time to do things for the community, which is important to me.
And so, you know, he’d always appreciate more time. When I’m with him I want our time to be quality. I try to be home for dinner. In the car, we don’t have radios, we don’t have anything else going. We do lots of games together.
WACOAN: How are you able to get dinner ready when you’re working all day?
Neumann: I do a lot of pre-prep the night before. So sometimes, when I don’t make it home, they can just throw things together.
One of my favorite dishes is arroz con pollo, which is rice with chicken — super easy and really healthy. You just get a bunch of vegetables, whatever vegetables are left over in the fridge usually. My favorites are zucchini and yellow squash and asparagus and red peppers. I usually have a lot of those at home, but I’ll leave them all cut up the night before. Then you just take chicken breast. You can bake just a regular chicken breast or you can get it already cooked and shredded.
WACOAN: Pre-cooked and shredded chicken breast from H-E-B is a game changer, for sure.
Neumann: For those of us who are balancing mom and work, that makes a big difference. If I have that, it makes a huge difference. If I don’t, I just get my chicken and saute it a little bit and then add the vegetables. I add the chicken and vegetables to some saffron rice, cook for 20 minutes and it’s done.
Neumann: So that’s it, and you’ve got your carbohydrate, your vegetables and your protein all in one plate. My other favorite dish is a little bit fancier, but it’s really not that much harder. It’s shrimp with a lemon basil sauce over angel hair pasta.
WACOAN: Oh, that sounds good — but easy?
Neumann: It’s super easy. You just get the shrimp, and you saute them. Then take them out of the pan and put in a little bit of white wine and chop up a little bit of fresh basil and stir it in there. Then get a little bit of cornstarch. This is the hardest thing, but it will make it a little thicker. And then once you’ve got the sauce, you throw the shrimp back in and boil your pasta. Just put in a little bit of butter and a little bit of Parmesan cheese over the shrimp and pasta. And it takes like 15 minutes.
WACOAN: Your family meals definitely are not suffering due to your busy schedule.
Neumann: I may not have as much time with my children as I’d like or as other moms have all the time, but in the time I have, we’re eating good food. We’re talking and snuggling.
WACOAN: Some of life’s most basic necessities.
Neumann: Exactly. It’s okay if we don’t have every weekend, all day long. The time that I have, it’s quality time.
WACOAN: Do you even think about balance in your life? Is that something you have to try to work for or does it just happen?
Neumann: People who know me probably would say that once I’m into something, I just became so dedicated and so invested in it — keeping all the different balls up in the air — they wonder, are you doing it all OK? Do you need to rebalance? But again, the fact of the matter is that maybe I don’t have as much time for me. So maybe no, I don’t have a bunch of time to sit around and go get my nails done.
WACOAN: I was going to say that you look very put together.
Neumann: My niece did my nails for these photos. She didn’t want me to embarrass myself. [Laughs.]
But other than that, you know, I don’t get to go to the salon a lot, and I don’t have time to go shopping for clothes and those sorts of things. But it’s OK. I don’t mind.
WACOAN: It’s not something you’re missing.
Neumann: I’m not missing that in my life. I really, honestly — I’m not just saying this — I feel blessed, so blessed to be able to do other things to contribute to my gorgeous family. I mean, I’m pinching myself. Is this really me? How did I get so lucky?
WACOAN: Considering everything you’ve been through —
Neumann: What got me through all that and what keeps me with this attitude is gratitude. When my mother died and I had that really bad depression that went on for — I actually struggled with it for about five years — there was a book that I read. I don’t remember the name of it right now, but it was a cancer survivor and she talked about gratitude. Her recommendation was every night you need to write down three things you’re grateful for. And I did that, and it just really changed everything for me.
Joy just comes from that because you’re not thinking about what you’re missing or what you don’t have. So I still keep it kind of a practice in the back of my head every night. I am so grateful today it didn’t rain because I fixed my hair for the photos. I’m so grateful today that Leo used the toilet. Every day there’s something to be grateful for and focusing on the gratitude makes you feel that you have abundance. Yes, I’m grateful every day for everything I have.
WACOAN: You’ve been able to let your mom’s illness and death become a light that shines in your life.
Neumann: All that pain that I felt is in the past, and it’s something that I really came to peace with, but still I miss her every day. And everything that I do is with her somewhere in the back of my mind. I think, ‘Mama, if you were sitting right here, this is how I would want someone to treat you.’ If you let negative and bad things in your life make you resentful and make you bitter, who gains from that? Take whatever bad experience life gives you as a way to learn.