Personal Statement

“AARGH,” I heard him yell. I was in the midst of a 45-mile backpacking trip in the rural Appalachian Mountains when I heard Zach, one of my 15-year-old campers, call from a distance. Zach had been chopping wood for the campfire and inadvertently wedged the ax into his right foot. The injury was not hard to spot; a five-inch cut on the inside of his foot spurted blood, and I could see the tendon connected to his big toe pulsating. I quickly dressed his wound, but it was clear he needed to go to the hospital. With the help of the junior counselor, I carried him to the nearest road. Along the way, I struggled under his weight, and I could tell that he was in serious pain. We delivered a message to the camp headquarters, and at last, when we reached the road, Zach was able to be transported to a hospital.

This was one of my first experiences delivering care and assuming responsibility for the health of another person. It was the beginning of my journey to practicing medicine, which has been built on my foundational passion for life and propelled forward by a love of learning and significant personal growth. Since that moment in the Appalachian Mountains, I have grown to understand the privilege of being a lifelong student, to appreciate the honor to serve and share in the suffering of others, and to recognize the biological, cultural, and societal realities of medicine. Over the years, however, my most important growth has come from developing an expanded understanding of the meaning of care.

Always curious, as an undergraduate, I found myself interested in many academic topics related to health care, anthropology, and the humanities. This lack of focus on a specific path or class often resulted in underperformance in my coursework. After I graduated, I worked in a variety of clinical settings, including a research laboratory that aimed to preserve the fertility of young women and men undergoing cancer therapy and for a clinical trial that compared an internet-based therapy to an in-person physical therapy for patients with osteoarthritis. These years of development were life changing. During this time, I cultivated my goal to become a physician and realized the privilege and opportunity I had in becoming a lifelong learner. The opportunity to apply what I was learning toward helping others was invigorating. I realized that for me, the most meaningful experiences were times spent interacting with patients. For example, I will never forget a young woman beaming over her newborn baby, despite receiving a sterilizing-dose of chemotherapy years prior. As the experiences unfolded and my skills developed, I saw my vision of becoming a physician crystallize. It was with these experiences and this vision that I entered the Masters of Biomedical Sciences program at Duke to further nurture my passion.

Over the past year at Duke, I have applied my love of learning both in my courses and in the clinic as an EMT in Duke’s Emergency Department. In the Emergency Department, I observed as teams of doctors and nurses swiftly and magnificently responded to the most dire of circumstances, with each member of the team working in concert to deliver care to save the patient’s life. I also learned a different aspect of health care through volunteer service in the No One Dies Alone program, which pairs volunteers with patients who are in their waning hours or days of life. For some patients, I learned, providing care does not necessarily mean finding a cure or solving a problem, but rather, being there to offer compassion and empathy. It was through this program that I met Ida, who was about to die. When I walked into her room and introduced myself, she was non-responsive. I told her I was going to sit with her and that I would stay for a few hours. As I sat down, I noticed her breathing--it was irregular, and each breath sounded like she was slowly and painfully drowning. My eyes calmly wandered from her head to her shoulders and along her arms, and then I saw her hands. In that moment, I knew the right thing to do. I reached out and held her hand. Its radiating warmth surprised me. I had expected her to be cold, an embodiment of her appearance. I continued to sit with her; her hand in mine. I gave care with full attention and my full heart. Looking back on this, I realize that Ida may have given more to me than I did to her in those final hours of her life.

My experience caring for injured Zach inspired my journey in medicine; it was the realization of the rewarding feeling of helping another person in their moment of need and my first glimpse of working in concert with the patient and the healthcare team to address a problem. In contrast, my experience with Ida taught me that delivering health care is approaching a patient with compassion, meeting them where they are in that given moment of time. The fact that I could be a part of a team that delivers life-saving emergency care or lends comfort in someone’s final hours gives me immense satisfaction and pride. I know that I can be effective in saving a life as well as providing care at a critical and difficult moment, and in that, I find meaning and purpose.

Advocacy: Describe a situation where you have chosen to advocate for someone who is different from yourself. What does advocacy mean to you and how has your advocacy developed? How do you see it linked to your role as a physician/leader? What risks, if any, might be associated with your choice to be an advocate?

It was past 3 AM, but my heart was pounding. I was observing in the resuscitation bay of the Emergency Department as a clinical team swiftly responded to three patients who arrived unconscious because they had overdosed while using heroin. Besides trying to follow the communications of the team and awed by their swift precision, I remember thinking to myself, how could this happen? How could a person get to the point where they overdosed? Why didn’t they stop?

Advocacy means putting yourself in the position of someone else, considering their needs, and then using your own positionality to work towards resolving their needs. In the moment I described above, I failed at the first step of advocacy. I did not understand the context and pernicious nature of addiction. The patients that presented before me were not deserving of my judgment, but rather, they deserved compassion and awareness of the situation in which they exist. This experience helped initiate my journey into learning about addiction, becoming an advocate for greater access to resources, and shifting the focus from prevention through criminalization to reducing harm. This first step in this journey was difficult, because I did not understand addiction. I learned, however, by observing an intimate Alcoholic Anonymous meeting, speaking with patients in recovery, and observing physicians who specialize in addiction treatments. From this, I came to realize how devastating addiction is on the individual level as well as on the societal level, where each statistic is made up of a sum of individual stories.

In ongoing work, I, along with my Bass Connections team at Duke University, are employing a multifaceted approach to reducing the harm of the opioid epidemic. Thus far, we have supported legislation that would increase funding for needle exchanges in North Carolina by writing letters and calling our congressmen; we worked to reduce the stigma of those with addiction by creating a photo essay that will roll out this fall; and we set up a project in the Duke Emergency Department that will distribute naloxone, the opioid-overdose reversal drug, for patients to take home if they present with an opioid overdose. The ultimate goal of the project is to distribute the life-saving medication to those in the community who need it and to stop opioid overdoses from taking lives.

Advocacy work is risky, as it inherently works to change the status quo. As such, those who advocate must be prepared for backlash from those who have found comfort or ease in the system that advocacy works to uproot. In this situation, I discovered an interesting pattern; within the community working to end addiction, there are passionate divisions regarding the best route to solve the problem— in particular, whether to use medication-assisted treatment or an abstinence-only therapy. In order to continue my advocacy, I had to again educate myself and reflect on my values in order to be effective.

Advocacy will always be a part of my life. I believe that there is advocacy like I described above, which can include large projects. But there is also advocacy that occurs every day, by the words I use, the attitude I bring to each day, and the manner in which I treat others. As a future physician leader, I aim to be an advocate for my future patients as well as my future colleagues.

Humbling experience: What has been your most humbling experience and how will that experience affect your interactions with your peers and patients?

There were three distinct conversations. After each one I felt like I could no longer stand. The first conversation occurred when I was in high school and arrived home one evening to find my mother in tears and my father consoling her. My grandmother had unexpectedly died earlier that day. I felt confused and scared because I did not know what this meant, and I had never seen my mom exhibit such grief. The next two conversations were within a few months of each other as my dad’s parents both suffered massive heart attacks and died. In each of these moments, I lost someone that I loved; someone who had been a part of shaping my identity and someone who was a role model for me to grow into. While it was certainly humbling to experience the concept of death and to reflect on mortality, the most humbling aspect was to witness the vulnerability of my parents. To see them unable to stop death, humbled themselves by it, I felt that I was completely powerless. But from the intimate interactions that followed, I discovered that this was not true; I found power and meaning in becoming an agent of compassion in these moments.

These experiences were with me as I started volunteering with No One Dies Alone, a program at UNC that asks volunteers to sit with lonely patients who are in their waning moments of life. Through this experience, I have been pushed to grow; the program has expanded my view of the meaning of care and my understanding of the loneliness within the walls of a hospital. I saw another aspect of this when I shadowed with a Palliative Care physician at Duke. Contrary to some of my previous clinical exposure, we spent around 45 minutes with each patient. With one patient we spent over two hours. The conversations that I observed, which often involved multiple family members, reminded me of those moments with my parents. There were long silences, tears, and frustrations. Throughout, I observed as the physician knelt on the floor, held the patient’s hand, and maintained eye level throughout these long dialogues. Another aspect of shadowing in Palliative Care that I found remarkable was a weekly ritual in which the team of health professionals sat with each other and said the names of the patients who had died in the previous week. Here, I saw how compassionate interactions do not cease with patients, but instead extend to colleagues as they cope with the death of their patients.

I believe that these intimate interactions occur in many forms throughout medicine such that compassion and empathetic communication are vital skills in my future interactions with patients and my colleagues. I hope to continue learning from these interactions and developing these skills as I continue my training in medical school.

Qualities: What qualities will you bring to the practice of medicine?

I am drawn to medicine because the most meaningful moments of my life have been developing relationships while serving others and sharing in moments of vulnerability. I believe that I have a myriad of qualities and skills that will be my foundation to the practice of medicine. In particular, my strengths of affinity for collaboration, passion for learning, and unrelenting care of others will be the cornerstones of my career.

My affinity for collaboration and skill at communication and leadership will aid me on my path to becoming a physician leader. From small group settings, like team-based learning, to interdisciplinary settings, like policy, education, and research, I believe that I have the aptitude and disposition to be a lifelong collaborator. In my role as the project coordinator for a Bass Connections team at Duke University, I help lead a team that includes undergraduates from many different majors, clinicians, policy experts, as well as basic scientists. In a career as a physician, I believe this skill will encourage communication with broad audiences including patients, nurses, and other doctors.

Learning is what propels me forward. I believe the power of learning and the focus of self-improvement gives my life meaning. Using reflection and journaling to learn from previous mistakes and missteps, I have become a fully engaged student, I have even more passion to learn. This past year, whenever a professor mentioned a book in class, even one unrelated to the subject, I wrote down the title and reserved it at the library. This habit led me down wonderful routes of inquiry into the roles of medicine at the end of life, exploring the humanity in cadaver dissection, and learning of the neurobiology of our behaviors. I believe that as a physician, I will eagerly and continually learn not only about my patients but also about innovative research and changing health policies.

Finally, my compassion and care for others has compelled me to pursue a career in medicine. One experience stands out to me as particularly meaningful. I was serving as an EMT and sitting in the back of ambulance with a young woman as she was transported to the hospital. During the ride, she spoke about her kids and quickly got upset, beginning to hyperventilate. I listened to her and showed her support by calmly telling her that her kids would be at the hospital. I placed my hand on her shoulder, so she knew that she was supported as a patient and as a person. In this experience, I saw first-hand how stressful medical situations can be, and I learned that as a care provider I have the ability to provide comfort as well as medical care. Even though I was only a small part of the care she received that day, I value the opportunity to be a part of the team to support her. My compassion for others carries with it the promise that my heart will be in my work every day as a doctor.

Medicine is my calling because the field matches my core passions and interests and because I have developed qualities that can contribute to the field and be a physician leader.

Coping with failure: Describe a situation where you failed. What did you learn from the experience? Describe at least one functional impact of the experience.

I removed the ovaries from the mouse, isolated the individual oocytes through a grueling microscope-based collection, and began my three-week experiment that would follow these cells as they matured. The next morning, I came into the lab, and checked on the cells that I had worked with the previous day only to find that they were all dead. Frustrated because of the loss of the day of work, I began the experiment again. This time I replaced all of the tools I had been using and changed the filter in the incubator. The next morning, I came into lab, checked on the new set of cells, and again they were all dead. At this point, I felt exasperated; unsure of what I was doing wrong, yet persistent on completing this experiment. I began the experiment again, but this time, I created a detailed checklist of each step required along with the approximate times that I could spend on each step. As I completed each step, I checked it off and moved forward. Sure enough, this process worked, and I was able to complete the maturation of the oocytes and finish the experiment.

While the symptom of the failure may have been the failed experiments, upon reflection, I realized the root cause of the failure was that I had been reactive throughout the process. Instead of starting with the end in mind and implementing a resilient process, I tried to correct the mistakes after they occurred. Since that time, I have come to realize the worth of building proactive habits and organizational skills that ensure the quality of the work that I produce. In this case, that was creating the detailed checklist the third time that I completed the experiment, which could be used in every experiment like this thereafter. In other facets of my life, it takes other forms--outlining what my goals are and working backwards to ensure my priorities are met. This practice has made me a better student, a more effective communicator in team-based settings, and a more productive researcher.

Research: What role has research had in your preparation for medicine?

For me, research is both the intellectually stimulating quest of discovery and the altruistic pursuit of helping patients who could benefit from the work.

My introduction to research occurred in Cuba, where I examined infant mortality and wrote an honors thesis analyzing the reasons for the low infant death rate in the country. I then continued the development of my research skills while working in a fertility laboratory, where I was introduced to the experimental side of research. More recently, I was a part of a clinical trial that examined the reduction in knee arthritis symptoms in patients who undergo internet-based therapy. I appreciated this experience because of the multiple layers of potential impact: alleviating symptoms in arthritis patients, reducing the financial burden on the health system, and investigating a new modality of care.

Additionally, I have come to learn the importance of communicating the inquiry so that it can be used and discussed by others and in the community. To this end, I have been an author of five publications and my work has been presented at a national conference as well as two regional conferences. I believe my experience in research has given me a background to understand the steps it takes to make a clinically meaningful change, and I appreciate the opportunity to contribute to our field’s standard of care and to engage in work that is always aiming to improve health and wellness of patients.

Additional information: Please let us know of any additional information that you would like us to consider while reviewing your application

After spending a year in the Masters of Biomedical Sciences program at Duke University School of Medicine, I saw first-hand the abundance of resources and committed faculty at Duke, and as a result, Duke’s School of Medicine is my top choice for continuing my education. In particular, I believe that Duke’s learning environment, clinical opportunities, and chance for extended scholarly exploration during the third year would give me the greatest opportunity to grow into a well-rounded physician and leader.

Over the last year, I was able to thrive in the learning environment at Duke. I valued the team-based setting, which pushed me to grow through learning from the differences and contributions of my peers. In addition, I hope to continue to take advantage of and learn from Duke’s extensive network of resources. For example, this past year, I was able to do an internship at one of the world’s largest human development nonprofits, FHI 360, through the Duke Global Health Institute, and I am a currently a part of a Bass Connections team that brings students and faculty from different disciplines to work towards reducing opioid overdose deaths in Durham. As a medical student, I hope to continue to grow through the wide array of learning opportunities that Duke has to offer.

Through my EMT clinical shifts in the Duke Emergency Department and shadowing at the hospital, I experienced first-hand some of the benefits of completing clinical rotations at Duke. In the ED, I observed a phenomenon that the clinicians called the “Duke Miracle,” which refers to the frequent occurrence of a patient who travels a very far distance to seek out care at Duke because of its sterling reputation. In fact, one patient I was with had driven over 7 hours to be treated at the Duke ED. The physicians I spoke to found this tedious because often the patient’s expectations were unrealistic; but as a learner, I relished in this opportunity to observe and learn from these interesting cases. Further, the location of Duke in Durham provides the opportunity to learn from a diverse patient population, including patients from both urban and rural settings, during clinical rotations. I have witnessed the “Duke Miracle,” and I would be honored to have the opportunity to continue learning in a setting with such an exceptional clinical experience.

Finally, I believe that the third year at Duke presents a unique opportunity to continue a rigorous exploration of scholarly work and lay the groundwork for my future career as a leader. While I would be open to many different paths for this year, one route that would be particularly meaningful to me is to continue my development in health policy by completing a Masters of Public Policy at Duke’s Sanford School of Public Policy. Health policy is a burgeoning passion of mine, and starting in August 2017, I will begin working full-time as a health policy researcher at the Margolis Center at Duke. I am enticed by the opportunity to further my development in this important field, and I believe that this kind of training will make a better, more informed doctor. Duke’s rare third year program would allow me to pursue this passion and allow me the opportunity to learn from the passions of my peers.

Because of Duke’s network of resources, clinical learning opportunities, and unique third year curriculum, I believe that continuing my education at Duke University School of Medicine would facilitate my growth into a physician leader.