Live from SGIM in D.C.

Participating in the world of academic medicine has exposed me to some truly unique patients. I have also been fortunate to work with attendings who value research and innovation and encourage their students to participate. Through this very combination of a unique patient case and a preceptor who believed that I was prepared to engage with the greater medical community, I found myself boarding a red-eye flight to present a clinical vignette at the Society of General Internal Medicine’s national conference in Washington, D.C.

The conference took place at a large hotel in downtown Washington with the theme “Resilience and Grit.” The days were filled with presentations on research and innovation, clinical vignettes, and small group discussions on a variety of hot topics in general internal medicine and health care. Each hour offered dozens of small sessions for special interest groups covering everything from diabetes to the social determinants of health. There was a tremendous emphasis on provider wellness to combat burnout, the non-opioid treatment of chronic pain, and the use of mobile technology to improve patient access and follow up. Significant time was dedicated to better engaging medical students and residents to improve the medical education process. There was an undeniable feminist undercurrent supporting women in STEM. There were many, many lattes.

The hourDC poster-long block of time in which I presented my clinical vignette is what brought me to D.C., but it was surprisingly not the most meaningful part of my trip. Interacting with other attendees in a small group where we were tasked with diagnosing patients with atypical presentations of mystery illnesses underscored the depth of the knowledge I have received in my training thus far. I expected to feel like a timid P.A. student in an sea of qualified and accomplished practitioners and teachers of medicine. Instead I found myself comfortable, almost confident as I collaborated with my future colleagues.

At the conclusion of the week’s festivities I had a half-day to explore Washington D.C. Despite the pouring rain, I laced up my running shoes in an attempt to see as many sites as DC imageI could along the National Mall. In a matter of hours I saw beautiful tributes to Martin Luther King, Jr., Abraham Lincoln, Korean War veterans and several others. It was Earth Day and a large March for Science was taking place at the Washington Monument, complete with guest speaker / childhood idol Bill Nye, the science guy.

Participating in a national meeting of such talented researchers and educators in the field of general internal medicine was an incredible honor. I felt proud of my training and the institution that I represented while in D.C.  I departed the nation’s capital feeling a greater responsibility to participate in medicine beyond my role as a practitioner as well as be an advocate for research and a protector of access to health care for all people. I am thankful for the support of my attending Dr. Jonathan Robbins, as well as P.A. program faculty for allowing me this incredible opportunity that I will not soon forget.

Flow and work

OHSU StudentSpeak is pleased to present this guest post from Gary Josephsen, M.D., an affiliate professor of emergency medicine, OHSU School of Medicine, and student preceptor.

The surprising way the concept of flow can turn our most challenging moments into our best moments

“How we spend our days is of course how we spend our lives.”
-Annie Dillard

The rules of medical education are: never stand when you can sit, never sit when you can lie down, and if you do lie down for a few minutes, never ever ask yourself if this will make you truly happy. Something like this probably happened to the British philosopher John Stuart Mill when he wrote, “Ask yourself whether you are happy, and you cease to be so.”

Mills, although brilliant, was not a particularly happy person, but don’t you deserve to be happy? Not just happy, but even ecstatic on a regular basis? Studies show that we are bad at predicting what will make ourselves happy. Many people overestimate how happy they will be after reaching major goals or even attaining financial success. You are, after all, investing a great deal of money in your education as a medical professional. Measures of happiness do increase with income, but only until it rises just above the poverty line. After that point, more income doesn’t translate into higher levels of happiness. Sure, money can’t buy happiness but should we get a little bump from the added security of solid finances, the privileges of travel, leisure, or even early retirement? When asked what they want to do in retirement, most answer either travel or drinks on a beach, but even then most fall short of “happily ever after.”

image001Why is happiness such a mirage in modern professional life? To answer this question, one might turn to Mihaly Csikszentmihalyi (pronounced just like is looks, |chek-sent’-me-high|), a psychologist most known for his study of happiness across cultures and circumstances. He describes our tendency toward affluent existential angst in his book, Flow: the psychology of optimal experience (Harper, 1990), a treatise on why we can’t “just be happy” and what to do about it:

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Med school life in Zambia

OHSU StudentSpeak is pleased to present this guest post from Malerie Pratt, a medical student in the M.D. Class of 2018 and a Swindells Family Scholar.


I’m thankful for the faculty at OHSU and Dr. Karen Kwong, my global health research mentor, for all the time and effort they put in to helping me have the opportunity to study and learn about the Zambian medical education and health care system for the last three months. My hope is that sharing my experience will encourage more medical students to collaborate with other medical education programs abroad so that we may learn from each other and form partnerships to continue improving access to health care globally.

I’m really sensitive about medical tourism and was afraid my trip may take more resources from the Zambian hospital than I would be able to give back, but I think this has been the best thing I could have done right now in my education, as it helped me cement my current and future goals. Being able to participate in hospitals internationally as a medical student taught me lessons on adaptability and resourcefulness that I will carry in my future work internationally. Over the last three months I made friends with dozens of African doctors throughout Zambia (many of them Congolese, Zimbabwean and Tanzanian). I look forward to collaborating with them to set up future projects.

Here is a journal entry I wrote about the patients and my time there:

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Final thoughts from the Emergency Department

It is 8 p.m. Two hours remain on my final shift in the Emergency Department. The lobby is full and we are working at a fast pace. My preceptor asks me to go see the patient in bed three. A ninety-something-year-old man with chest pain.* I know the routine. I jot down a few notes, including a differential diagnosis and a list of labs and tests that I will likely order with my preceptor after interviewing the patient. I hop off the counter height stool at the nurse’s station and stride with the confidence of a student on her last day of a rotation toward the patient in bed six.

I draw the curtain, smile, and introduce myself to the patient first, and then to his adult daughter who is at the bedside. I am calculated as I speak more slowly and clearly than I normally would; it is loud in the chaotic ED and this patient is wearing hearing aids.

I interview the patient about his symptoms which are far more vague than the words “chest pain” initially led me to believe. He has been feeling ill for days. He has abdominal pain, nausea, and shortness of breath. His skin is pale and his tongue is dry. He can answer the slurry of questions used to evaluate his mental status, but more specific inquiries about his symptoms are met with “I don’t know.” His daughter looks increasingly concerned, and she begins chiming in to clarify the details of the events leading up to his arrival in the ED.

I conclude my exam and assure the patient and his daughter that I will return shortly. I present his case to my preceptor. This patient is far sicker than he or his daughter realizes. As the results of his studies appear in his chart his diagnosis becomes clear. Just as Occam’s razor dictates, all symptoms can be attributed to a single cause.

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Acknowledge is power

David EdwardsIt’s a common enough thing, the dissertation defense. The seats are packed with students and faculty members, many of whom you haven’t seen in months. The air is crackling with excitement and anticipation. Today is the day that the student—your classmate, your colleague, your friend—becomes a doctor, and everybody knows it.

The head of the student’s dissertation advisory committee stands up, introducing the proceedings and announcing the terms of the defense. Sure, it’s a reminder that you’re technically watching part of an exam, but this bit of formality does nothing to diminish the joyous atmosphere in the room. Then the PI stands up and introduces the student, sometimes with complete sincerity, other times accompanied by embarrassing photos of the student, yet always delivered with an undercurrent of gratitude. You laugh easily, because jokes, even bad ones, are always funnier when spoken in celebration.

And then, finally, the student stands up. They thank their mentor and begin speaking, their voice growing with confidence, first describing their research broadly, comprehensively, then diving deeply into their findings. You stare wordlessly at the presentation, wondering how in the hell you’ll ever produce that much polished, publication-worthy data over the coming months (or years). Then the conclusions, the future directions, the suggestion of experiments that everyone knows the student probably won’t do because, after all, today is transitional. Today is the day they become a doctor.

Then, finally, the acknowledgements. Thank you, they say, to the core facilities and their lab members and their collaborators; and thank you to their mentors and their committee members; and thank you, most of all, to their friends and their family and loved ones. The slides are filled with pictures of smiling, happy faces, some of which you recognize but all of which clearly represent someone special, someone significant, someone irreplaceable.

Sometimes, at this point, the student becomes emotional, fumbling over prepared words while the audience waits patiently, expectantly. The student, and everyone in that room, comes face-to-face with the realization that this moment is the culmination of years of work, of countless successes and failures, and that today, this very day, is the day that the student finally becomes a doctor.

Yes, it’s a common enough thing, the dissertation defense. But to me, the acknowledgements will always be special. They offer a unique, behind-the-scenes glimpse into the student’s personal life, something that’s never publicly shown. For the first time, the dispassionate façade of the scientific presentation crumbles, and we are all witnesses to the complex, red-blooded emotions that accompany this experience of graduate school.

With the acknowledgements, we are shown photos of get-togethers and vacations and late nights spent drinking, all those necessary moments that, in aggregation, shine a spotlight on the actual person behind the research. Because ultimately, the dissertation defense isn’t about celebrating good science but celebrating a good scientist. We formally recognize someone deserving of the title of doctor, someone who will use that doctorate and will, in their own way, following their own path, somehow improve the world.

I’m thankful for any opportunity to humanize my work. At the risk of appearing tautological, I want to formally acknowledge acknowledgements. Someday (hopefully someday soon!), when I’m giving my own dissertation defense, amid the complicated graphs and the embarrassing photos and the overwhelming sense of relief, I’ll be excited to show my appreciation to all those people who have supported me throughout graduate school. Because those are people who, on that day, will have transformed my common enough thing into something truly special.

What about joy?

The very first day of school, we talked about burnout. Collectively, we nodded our heads, having spent the last six months bracing for an inevitable descent into gloom. I was ready to run the gauntlet, to pop out on the other side haggard and learned; part of the club. I imagined myself, like so many medical professionals I’ve met before, telling war stories of insomnia and humiliation. Earning my stripes.

Weeks went by, and I felt fine. Normal even. Yes, I was working hard. All the time. But it was work I volunteered for. Work I felt privileged to do. The weight of this education did not pull me down, it pleased me, to be buoyed up by this profession, its history, its challenges.

Somehow this had been left out of the pre-matriculation conversation. I started wondering: where was the preface in my GRE book where it said this is a gateway to joy. Why wasn’t there a footnote on my undergraduate transcript that said: congratulations, this is honorable work, and it will enrich you. While applying, why didn’t I hear: you will know felicity, you will feel safe.

What am I trying to say? That no one warned me that I would be happy. And I’m writing this because I wish that someone had.

I want to acknowledge the real problem of anxiety and depression in medical education, and I never want to suggest that those individuals are just “not looking at it the right way.” This is difficult, and overwhelming, sometimes leaving me feeling like I’ve never been good at anything in my life. But I also want to leave room in the discussion for the possibility of cheer.

I always thought that medical education was the trial you stand to offer proof that you are hardened enough to do this work. That medicine will break you if you are too vulnerable. Perhaps, for many, it has been billed that way.

In the coming years, I’m going to try something new: staying soft, gentle, amazed. This education is not a contest of who did the most and slept the least. It won’t impress me if you can leave the hospital unflappable, in the face of terrifying loss and disease. For me, this is an exercise in staying as tender and uncalloused as possible. Learning to be kind to myself, and warm. Learning how to say “this is painful,” and “I don’t know” without fear of appearing weak, and therefore green.

Because, ultimately, I am green. Bright green. Delightfully so.

Finding balance through racing

OHSU StudentSpeak is pleased to present this guest post from Cymon Kersch, an M.D./Ph.D. student in the OHSU School of Medicine and recent qualifier for the 2017 triathlon world championships.

This is a little story of how I got hooked on triathlons last summer. After racing locally, I competed at the USAT age-group national championships for the Olympic distance triathlon and qualified for the 2017-triathlon world championships. People have asked if I ever thought I would be doing anything like this and the answer is a resounding no, particularly in the middle of an MD/PhD program. But, life is full of surprises, and it’s nice to find that while we are overwhelmed by school, we really can strike a balance between learning to care for others and caring for ourselves.

BEEP! BEEP! BEEP! My alarm clock screams through the dark. That feeling of waking up in a hotel room and being slightly disoriented and confused is instantly replaced by nervous excitement. Game time! Wait… what have I gotten myself into [insert feeling of severe imposter syndrome, usually experienced at school and scientific conferences]. Thirty minutes later, I sit in the breakfast room trying to stomach a packet of oatmeal and a few sips of coffee. I get down what I can, grab my duffle bag and bike helmet, and head outside into the early morning darkness. My boyfriend Trey drives while I sit in the passenger seat, my stomach in knots. These are some next level pre-race jitters. I try to calm my nerves, reminding myself there are zero expectations for today: have fun and race hard. Whatever happens, happens. Still, I am feeling a bit queasy.

IMG_1733Hours later I stand on the dock looking out onto Omaha’s Carter Lake, anxiously eyeing the fluorescent yellow buoys that mark the turns on the swim course. The announcer yells for us to enter the water and goggle-clad women from all over the US splash into the 90-degree lake. The water is so murky I can barely see my hand just inches in front of my face. We are told to start with one hand touching the dock. Over the loudspeaker we hear, “Your fate is now in the hands of the starter!” Interesting choice of words, I think fleetingly, before the crack of a loud gun sounds. I push myself off the dock as hard as I can. The race has begun and my anxiety is quickly replaced with pure excitement and adrenaline that alternates with extreme fatigue over the next 2 hours.

Our 1-mile swim is followed by a 24.8-mile bike ride, which is followed by a 6.2-mile run to the finish, all standard parts of an Olympic distance triathlon. Historically, my strength has been swimming. I’ve been swimming since I was a kid and swam competitively at the University of Puget Sound. After graduating in 2009, I was still figuring out my path in science/medicine, and I entered a Master’s of Science program in entomology to explore laboratory research. Growing up a student athlete, I was accustomed to having some sort of sporty outlet during my academic life and soon found a love for running. Running was simply Cymon-time: time to listen to music and clear my head, time to brainstorm about bizarre lab results, time to contemplate any and everything going on in my life. Over the next several years (bridging over into the MD/PhD program here at OHSU), I ran several half and full marathons. The final of these races was the Boston marathon last spring, which was easily one the worst races of my life. By mile 13, my back and shoulder were spasming so bad it hurt to move. I jogged (hobbled) my way to a very disappointing and frustrating finish line. It was at this point that I decided I needed a change. Around this same time, Trey (an avid cyclist himself) was prepping for his upcoming bike race season. I decided that if I could learn to ride a bike well enough to (semi) keep up with Trey on his easy rides, I could effectively spend quality time with him and also exercise. As any medical and/or graduate student knows, the idea of work/life balance and a precious personal life is almost laughable at times during school, and can require some serious planning. Because I still loved running and had the previous swimming experience, I figured I should see if I enjoy triathlons. I had briefly toyed with the idea of triathlons years before, testing out a sprint triathlon, but decided to focus on pure running at that time.

I completed my first real Olympic distance triathlon last July at Hagg Lake in Oregon. Finishing 1st place out of the women, I qualified for the age-group national championships that were to take place the following month in Omaha, Nebraska. After seriously debating how realistic my participation in nationals was given the demands of school around that time, I decided I’d give it a tri (haha)… bringing us back to the race.

IMG_1617Running down the final stretch of the race, the noise of the crowd cheering picks up. Cow bells are clanging, music is blasting, and excited faces decorate the final yards leading up to a large arching ‘Finish’ sign overhead. In a semi-delirious state, my swimsuit, and soaking wet tennis shoes I give one final push to the finish. As I cross the line a hand towel soaked in ice water sporting the ‘USA triathlon’ logo is thrown over my shoulders and I am handed a water bottle. I take one quick swig in my mouth before pouring the rest over my head, trying to cool myself down. Big surprise: Omaha is blisteringly hot in August. I wander aimlessly for a few minutes before finding Trey with a giant smile across his face. “Did you hear the announcer?!” he asks. “You came in 6th!” In each category, the top 18 finishers qualify for the amateur Team USA, to compete at the next year’s triathlon world championship. On our 20-hour drive back to Oregon, Trey responds with, “Okay, Team USA” to every comment I make.

Since nationals, I’ve been training with Shawn Bostad (Steelhead coaching) and the Portland Triathlon Club to prepare for the triathlon world championships that will be held in Rotterdam, Netherlands this September. My average week consists of about 10 workouts (various times and intensities) in the three sports and some strength training. Some days, I practice early in the morning before lab, and then again late at night after I leave OHSU. Some days I am exhausted, but others I am energized by the combination of athletics and research. Areas where these seemingly separate parts of my life merge together are also beginning to take shape: functional heart and lung testing, looking at my own spirometry curves, re-learning what VO2 max means. Training during school has been a big time commitment and every so often I wonder if it is worth it or not. But the answer is always a resounding “Yes”.

As students going into medical sciences and practices, we dedicate our lives to the health of others, and it’s easy to become completely immersed in our academic training to prepare ourselves for our careers. This immersion often comes at the cost of our personal wellbeing and life experiences outside the walls of the library, the laboratory, the classroom or the clinical office. But we can and should make time to take care of ourselves, our health, and to enjoy life. My own is one little story about a student finding a little more balance through racing, but stories like mine are shared by current MD and PhD students at OHSU. Ask around and you will find absolutely brilliant future physicians and scientists running 50k trail races, climbing mountains, going on epic backpacking adventures, and being secret champion windsurfers. I am constantly humbled and inspired by these classmates, and am reminded that we do not have to limit ourselves; we can be dedicated students, brilliant future clinicians and researchers, and cherish our lives outside of academics.


Fertile ground for deep roots

Why am I here? I came to OHSU, those many moons ago, because I wanted to be a scientist. I was taught since childhood that “knowledge is the wings wherewith we fly to heaven,” and Science was my passion (that was Shakespeare, by the way). To be a scientist, I needed a Ph.D., and I thought OHSU would be the best place to complete a Ph.D. I never intended to become a student leader, yet here I am. In my first year, I was part of the group of ladies who started Women in Science. In my second year, I acted as representative to the All-Hill Student Council. In my third year, I was elected Graduate Student Organization (GSO) treasurer, my fourth year vice president, my fifth year president, and let’s stop counting and just say I am still president (I am planning on being done July 2017). I have acted as student chair to Research Week, I helped plan the first Women in Academic Medicine leadership conference, and I have seen the GSO renaissance. So you see, I have been around OHSU a while now. I have seen ideas about graduate education proposed, some come to fruition and some cast aside.

Throughout this calendar year, there have been fact-finding discussions on campus, many of led by the Creative IDEAS committee, collecting ideas about graduate education and the School of Medicine. The university is in a unique position to create a future graduate program apart from others, one informed by faculty and current graduate students who are facing the scientific, economic, and job realities of today. Synthesizing the goals and structure of the Graduate Program of Tomorrow began with forums hosted by the Creative IDEAS committee where students and faculty were encouraged to voice their opinions on what works, what doesn’t work, what should change and what shouldn’t change. It was an interesting exercise for me personally, because it stimulated a lot of reflection and introspection. There are a lot of things the School of Medicine Graduate Studies does well and I have always found faculty receptive to student issues. There are a lot of things the OHSU research community does well. As a prospective alumni, I have a vested interest in the continued success of graduate education here. I want it to continue to train successful scientists, with a foot firmly planted on the side of innovation.

What is the intent of graduate training? Introspection is an interesting phenomenon, and I have had my fair share of fantastic, life altering events and soul-crushing experiences in graduate school. Someone once told me that to pursue a Ph.D. is to resign oneself to semi-annual existential life crises (or maybe I read it in a comic…?).  Experiments work, experiments don’t work. It’s your fault, it’s not your fault. Your future is in your control, you have no control whatsoever. You work too much, you work too little. You want to finish, there is no end in sight. Your mentor wants you out, your mentor won’t let you go. Your mentor is a bully, you are too emotional. But ultimately these bipolar seesaws are OK because you will finish, you will be successful and you will go on to have a life. But then you hear that one story about that one student who did not graduate that one year and, in a panic stricken moment, you conclude that could be you.

I was once told by a faculty member that, in graduate school, I should be eating, sleeping and breathing SCIENCE every day, every hour. On the bus I should be reading articles. With my friends I should be talking nothing but science. While being told this prescription, I imagined a proverbial pilgrim from the Middle Ages, clothed in brown sac-cloth, crawling barefoot along the dusty path to some tottered monastery having been told it housed an ancient relic, let’s say the thumb, of a saint and that if touched would cure his blindness. While telling me to forget TV, forget movies, forget books, forget my friends and family, all I kept hearing was forget yourself. Is this what graduate education meant – that I was required to forfeit myself? Is this what Science demands – that it exists in a bubble devoid of life? And what about the University – surely it has responsibilities to me, the student?

What is a Ph.D.? A quick Wikipedia search tells me the modern iteration of the Ph.D. was first defined in Germany in the early 19th century, but its roots go much, much deeper than the 1800s. They trace back to the early Christian church, where the word Doctor was used to describe the apostles and early church fathers who taught and interpreted the Bible. The Latin word doctor means, simply, teacher, and thus the ancient doctors were religious leaders charged with saving people’s souls. According to Wikipedia, it took a papal act to allow the first non-sacred doctoral degree to be awarded in Paris somewhere between 1150-1200. With the Age of Enlightenment starting in the early 1700’s, and the emphasis on reason as the primary source of authority and legitimacy, scientific progress was reborn. Thus, the Ph.D. of today is a child of reason, of liberty, and of science. To me, a Ph.D. means I have furthered human knowledge. And while a Ph.D. says I have reached the level of teacher, it does not mean I will teach.  But the Ph.D. is the final product of the journey, not the journey itself.

How should Ph.D. scientists be trained? Einstein once said that most people think “it is intellect which makes a great scientist. They are wrong: it is character.” He said he never taught his “pupils, [he] only attempt[ed] to provide the conditions in which they can learn.” Conditions. Any human knows that living conditions directly affect mood, performance, and health. Any lab dweller will tell you tools and conditions are important, be it incubator temperatures, humidity, light cycles, media, pipette tips, cage sizes, or antibodies. If OHSU wishes to produce Ph.D. scientists who rigorously discover and innovate, then it needs to mandate a training environment that supports, hones, directs, and challenges the candidate. Supports does not mean coddle or micromanage. Hones does not mean break down or limit. Directs does not mean rebuild or change. And challenges does not mean prevent, impose, or ostracize. I did my undergrad at Scripps College and on the wall by Honnold Gate is carved a quote from Ellen Browning Scripps, reminding the college that its paramount obligation “is to develop in its students the ability to think clearly and independently, and the ability to live confidently, courageously, and hopefully.”  Fifty years ago, to go to graduate school in research science meant you were going to become a scientist. It still does. What has changed is not the product, but rather the market that buys the product. The University has an obligation to recognize the changing times and adjust its training accordingly.

These ruminations are not to say that our training is necessarily lacking. I have taken my fair share of required classes, elective classes, classes I did not have to take but that were necessary for my research, and totally pointless classes. Some faculty are fantastic educators (I could list 10 here right now off the top of my head), some faculty are not. Here’s the thing, the bottom line: I did not come here to take classes, I came to become a scientist. I have yet to see data showing a direct positive relationship between hours spent in class and successful scientific endeavor.

Who are the scientists of the future? We all recognize that the world is being populated by Ph.D.’s in research science who are using their skill sets in environments apart from the lab.  The School of Medicine has already started to recognize this and The Career & Professional Development Center has done a fantastic job in helping students seeking both traditional and non-traditional jobs post-graduation. But this November I went to my very first Society for Neuroscience meeting. On the first night of the conference, I found myself sitting at a round table with my mentor (science father), his mentor (my science grandfather) and his wife (my science grandmother), and a PI who has been trained in the lab where my mentor did his post-doc (my science step-uncle?), and two other students. Thirty years of science, of stories about the people of science, the evolution of science, the future of science, sat at this table. I imagined we three students not continuing on, of slowly backing away from the table. Would these moments end? How will the culture evolve? Science is more than the bench, but the bench propels it forward in a wonderful symbiotic relationship. Graduate education should aid this evolution, facilitate it, and it allow it to grow.

To be good is to be great

Wychus Creek - 4I feel like I have been sucker-punched. I am sitting in my patient’s living room on the morning of November 9, trying to listen to him describe his low back pain, but all I can think about are the results of yesterday’s election.

During my family medicine rotation at OHSU’s Rural Campus in Klamath Falls I had the opportunity to be involved with the I-CAN project. This project brings together students from across OHSU’s professional programs to provide inter-professional care coordination to the most vulnerable of patients. The patients who chose to participate all have complicated medical histories compounded with huge social problems. We helped them navigate the healthcare system, expanded their health literacy, and acted as their advocate with other healthcare professionals. Our main job, though, was to sit and listen to people who feel they have been systematically pushed aside.

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Island at heart

OHSU StudentSpeak is pleased to present this guest post from Kelsi Chan, medical student in the Class of 2019. She and several OHSU colleagues organized OHSU’s first-ever lu’au in November 2016.

ohsu_luau_2016-030-lI am no stranger to living far away from home. Hawai’i is at least five hours away from land in every direction. As a young girl I often traveled to the states for various soccer tournaments, but I always had my people by my side, whether in the form of parents, family, friends or teammates. Trips were always fun because it felt like I was in a new place experiencing new things, but I always, always was in the comfort of being with people who knew me and understood me.

When I was a junior in high school, a Massachusetts recruiter saw me play in a tournament held in San Diego, California. It was my ticket to four years of higher education. When the day came for me to leave to start my freshman year, like many previous times before, I packed my bags and said good bye to Hawai’i, only this time, I would be thirteen hours away and for many months at a time. By then, I had seen snow. I had built a snowman. But I never knew what living through a Boston winter was like. It took a few months to get my footing, quite literally. I eventually joined the Hawai’i Club and immediately felt at home. I was a part of the school lu’au every year and loved sharing my culture with my non-Hawaiian classmates. Even though I was the furthest I’d ever been from that little rock in the middle of the Pacific, I found a home. I found the people who understood me and knew me without having to explain anything about myself.

Fast forward ten years, I am now a second year, soon-to-be third year medical student at OHSU. I am not ashamed to say this wasn’t my first application to medical school. After taking the years off between applications to make myself a more competitive applicant, I was finally able to get into several medical schools. I ended up choosing OHSU for many reasons, one of the most important being it was the closest to home besides the medical school in Hawai’i. At the time, I wasn’t quite ready to go home for good and OHSU as an institution was too renowned to pass up. When I got here for my first day, I was shocked to find in my class of approximately 140 students, I was the lone Native Hawaiian. At a school in Oregon.

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Ever wondered what life is like as a student at OHSU? What does it take to become a researcher? Just how gross is gross anatomy? Welcome to the blog that answers these – and many other – questions. It’s students writing first-hand about their commitment to careers in science and health care. It’s honest about the challenges as well as the joys. It’s not always pretty. But it is our story. Thank you for sharing it with us. And please, let us know what you think.

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