One
more Personal Statement, and this time, it’s for her Fellowship application
(for Pulmonary Critical Care). She will complete her residency and start
the fellowship program in June 2019.
I have always enjoyed asking
questions, from abstract to practical, metaphysical to scientific,
straightforward to unanswerable. In college, I loved studying philosophy
because it challenged me to tackle seemingly impossible questions using a
rigorous logical process. It trained me to think critically about data,
deduction, and the means by which we arrive at conclusions. I carried this love
of contemplation with me into medicine: I still seek out the places where
questions are the most difficult, and for me, this is the intensive care unit.
In many ways, the tasks of an intensivist – sifting through a wealth of data to
extract relevant information, making cogent arguments for and against
diagnoses, and deducing a coherent representation of the patient – are
reminiscent of tasks in philosophical thought. These aspects of critical care
led to my love of clinical ICU medicine, but as I’ve become more invested in
clinical care, I’ve also become increasingly aware of the limits of what we can
provide for our patients. Oftentimes, while taking care of the sickest
patients, I found that I had more questions than answers. Through that process,
I learned that one of the most empowering roles of being a physician is having
the unique ability to take these questions from the bedside to the bench, and
actually set out to find solutions.
As an intern, I saw a Vietnamese
patient in the emergency department who had a history of lung adenocarcinoma,
which he believed to have been completely treated in his home country. His physical
exam revealed multiple bony masses suspicious for widespread metastasis, and I
explained to him my fear that his cancer had progressed. He expressed that even
if this were the case, he was certain that we would be able to heal him. I saw
him again two months later in the ICU for respiratory failure, and within 24
hours, he had passed away from complications of his cancer. He had trusted us
to have the means to cure his condition, and this made painfully clear to me
the fact that our current lung cancer treatments remain inadequate. This
experience brought new meaning to my research in the lab, which focuses on
pro-neoplastic and anti-neoplastic factors in lung adenocarcinoma. I have
completed several projects independently using techniques including gene
knockdown, cell proliferation assays, immunohistochemistry, protein
electrophoresis, and RNA analysis. Currently, I am working on elucidating the
connection between exercise and lung cancer on a molecular basis through
investigation of myokines, which I have shown to decrease proliferation of lung
cancer cells in vitro. My time in the lab has taught me how to engage with
basic science, from developing hypotheses based on existing evidence, to
designing, troubleshooting, and executing experiments, to presenting my
findings at national conferences in a way that emphasizes their impact to the
scientific community. Bench science has the ability to decode disease processes
on a cellular level and subsequently guide translational research to develop
new therapeutics that might someday help patients like mine. It has the
potential to significantly broaden the impact that we have on our patients, and
this is why I hope to continue pursuing it as a part of my career.
Outside of the lab, I developed
a quality improvement project to increase use of targeted temperature
management (TTM) following cardiac arrest in our hospital. One of my first
patients in the ICU was a young woman who had suffered a cardiac arrest during
a procedure and subsequently developed diffuse anoxic brain injury and
herniation, resulting in brain death. During our time taking care of her, there
had been no discussion about neuroprotective measures. This precipitated the
question: was there something that I could affect on a systems level in order
to prevent this from happening in the future? In response, I developed a
quality improvement project where I designed and completed a retrospective
analysis of in-hospital cardiac arrests at our institution, which demonstrated
a poor rate of TTM implementation. I worked in collaboration with neurology,
cardiology, critical care, and nursing to develop interventions for
improvement, including incorporation of a neuroprotection lecture in our ICU
didactics. My project was well-received by program leadership and became a core
quality improvement project for junior residents, and I collaborated with a
chief resident to create a morbidity and mortality conference centered around
my data. I will continue this project as a mentor for rising junior residents with
the goal of standardizing post-cardiac arrest neuroprotection and
prognostication for our patients. As this project has unfolded, I have gained
an appreciation for how the moments in which we feel helpless as clinicians can
catalyze meaningful change, and in this way, become empowering rather than
disheartening.
Intellectual curiosity has
always been an integral part of the way that I interact with the world. In
medicine, this has manifested itself as a deep appreciation for the complexity
of pulmonary pathophysiology and critical care. It has also led me to a number
of research experiences, which have taught me that efforts toward discovery and
innovation are absolutely essential to the delivery of optimal patient care.
Going forward, I am looking for a program that will prepare me for a successful
academic career involving basic and translational work in pulmonary disease. I
hope to find a program that will encourage me to ask the right questions, and
strong mentorship that will help me turn those questions into meaningful
research endeavors.
