On Deciding to be a Second Year HHMI Med Fellow

This has probably been the longest hiatus I have taken from blogging since I started this a few years ago.

The time between February and today has been intense, wonderful, stressful and fun. March was hard. April was better, and May is off to a good start.

Without further ado, how I decided to be a second year HHMI fellow.

The Dark Times

Since the start of my fellowship year, I have known that I could be in the program for one or two years. The thought of two years away from medical school sounded crazy, but at our kick-off meeting in September, I definitely wanted to pick the brains of the students who had decided to do that. Their reasons often took the form of “promising projects” and “prolonged curiosity.”

To be 100, the beginning of my research year was pretty difficult. Learning finicky iPS culture was challenging, but the interpersonal aspects—including technical support/help with my project was even tougher. Honestly, I came right off taking Step 1 (definitely most draining standardized test prep I and many ever experience. MCAT is really cute in comparison), was exhausted, a medical student pretty used to being told what to do—not driving her own research project. I have been curious about sickle cell anemia and the iPS system since the very start but curiosity is not enough to get things done.

So when I saw those second year fellows, in love with science and their projects, I wanted to be them, but just did not feel like I would get there.

 One of my neighbors asked me once what it would take for me to stay another year (very early in the year). I broke it down for her like this:

  1. My project is going well, and I see a publication on the horizon.
  2. An amazing man fell from the sky so I want to stay in Boston longer.
  3. My PI asked me personally to stay.

I definitely thought that number 2 was going to be the most likely option actually. In hindsight, I chuckle. But seriously, I thought 1 and 3 would be VERY unlikely. Especially number 3.

My lab experience really changed course in November 2016. The people in my lab responsible for this know who they are, and I am so grateful to them. Right before my first lab meeting, I remember them staying with me so late to help me squeeze out the last bit of data I could, and I remember just feeling so supported. I felt a part of a team, and that people actually cared about the science that I was trying to do. Moreover, I felt like they cared about me.

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Boston shut down for the February snow storm but not the Daley Lab. Indian food to warm our frozen souls.

A Pot of Risotto

As winter rolled along, I gained more confidence but there was definitely some large barriers I had to making RBCs from iPS cells that could actually model sickle cell anemia. I won’t get into that here but just believe me. After the January HHMI Investigators meeting, my HHMI program officer reached out to me about something and asked how lab was going.

In short, I told her that it has certainly been one of the best years of my life so far, and that is actually saying quite a lot given how difficult it was in the beginning. I love what I am doing. I told her that sometimes I think casually about a second year in the program but since my PI became HMS dean, I was not sure if another year in the lab would be ideal for everyone.

February happened.

My lab has an annual retreat in New Hampshire. There, all of us in the Blood group had to give 15 minute talks. After SO MUCH affliction (think the 7 plagues of Egypt) facing my cell lines (mycoplasma, bacteria and bad luck), I was feeling pretty insecure about my presentation.

Later that evening, I along with a few other lab mates were helping my PI make dinner for everyone in lab. He actually does this, and is surprisingly a good chef! At one point, I had the task of stirring the risotto and for 3 minutes or so we were alone in the kitchen.

And then the most unexpected thing happened. He asked me if I would like to stay and told me he would support me in it! My project could benefit from another year of work he said, and HHMI actually CONTACTED him saying that they would love for me to continue in the program.

I was already a little warm stirring that gigantic pot but was legit sweating after this.

I did not have an answer for him. I did not know what I wanted, and I honestly never thought I would find myself in this situation.

I told him I would get back to him, and I really did not have much time. For one, the intent to apply notification to HHMI was due a week from then (March 1). The application was due April 1.

I needed to decide and SOON.

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Risotto

Soul Searching

A second year will be important in how I market myself as a physician moving forward. Do I want to be a physician-scientist? Do I think I actually could be? Should I even worry about it? True indecisiveness is painful for a very decisive person!

I called my program officer and messaged another fellow just to get a sense about why this may be a good idea again…?

First thing, I knew my parents would give me some push back. They are physicians so they obviously have very informed opinions about careers in medicine. However—not as much academic medicine. My parents want what is best for me. They are immigrants who definitely prioritize, security in regards to career. Delay in anything (I remember I wanted to take a gap year between undergrad and med school and that was not…welcomed) almost appears to be a question of doubt and being unsure. I know what my motivations are in medicine and life, but as parents, they just want me to get that MD as soon as possible so I can stand on my own two feet, and they can worry about me less.

Taking a year off in the first place was a little challenging with them, but it being at Harvard seemed to be very helpful…!

I was the most nervous about telling them about this development. There was some pushback: “what does this mean for your loans?” “Would your PI recommend this to his own child?” “You will be behind.” “You will forget what you learned in your first two years” “what if he asks you to stay another year again? Would you?”

That was difficult, but then another amazing thing happened—I received an email a few days after my first convo with my mom about this from HHMI. I learned that they had nominated me to be a delegate at the the International Achievement Summit. I’ll probably talk about that more in the future, but it’s a big deal. It also gave me a bit more peace. HHMI is an amazing organization, and the people who run my program take a special interest in me and my success. It is very clear. I was accepted as a delegate and will be going to London in October! 🙂

When I told my parents about this, they were excited as were visibly less apprehensive about everything. Truly a wonderful gift to myself as well as to them.

I then talked to my Urban Health pathway advisor from Case Western. You can read more about her role in getting me to HHMI here. But in sum, she is the reason. Out of the blue she called me to ask how I am, and I told her everything. It is almost as if she knew. So much about this decision mirrors what happened over a year ago before I reached out to my PI. Seriously a hint of destiny in everything.

I ask my American Society of Hematology career development mentor and he approved! I also consulted a hem attending at Brigham/Childrens who is so wise (her gut was for me to do this) too. My neighbor, a radiation oncologist also told me she took two years off at my stage in medical school and winded up a-okay.

Everyone outside of my lab, was “Go for it!”

Those inside my lab were less enthusiastic. They wanted me to flee, because they know exactly how hard it is to work with the iPS system and how long it takes to get published. Their opinion really mattered because it was actually the most informed. The project just was in a really tough spot and they knew.

But every time they pushed back, I felt bad because I wanted to stay. And, it was then that I realized what I actually wanted.

More than anything, however, I wanted to have peace about my decision to stay and have a plan just in case the project failed.

I met with my PI to discuss my concerns, and he did a pretty good job putting me at ease.

 However, it was a few  fundamental advances in my project that changed everything for me. Modeling SCA, still a lofty goal, came a bit more down to earth. It became possible. I had hope and more support from my co-workers. The stars aligned and I submitted my application (after a few legit all-nighters).

What makes this story beautiful to me is that I kind of took a step out in faith with the decision to stay. I decided aka told my PI before the magical data happened. And, that made the process that much more meaningful. And, I learned more about a passion I had for what I was doing that I didn’t even know was there.

I am so excited for the year ahead. What do I lose? Graduating earlier than expected, will not see some good friends next year. But again, the real friendships stay alive even with the distance. I realized that when I visited Cleveland in April. Super busy third year friends came out of the woodwork to see me, and it really was comforting. Our friendships matter.

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What I can gain with this year is a mystery. I will learn more, I will engage with a question that still intrigues me, and will continue to be supported by a lab environment and medical institute that shares some of my goals.

I’m already off the beaten path. Might as well keep on it.

If I would have left, it would have been about fear. And, I am pretty sure I would have always wondered what this opportunity would have been like. Medical school is there (my deans are super stoked that I’m doing this and so supportive). I sincerely look forward to my return to medicine.

But right now, I want to keep doing this. I enjoy the work, and I’m getting PAID to be curious. PAID to explore in a setting that is safe.

TLDR

It is curiosity that brings scientists to the lab bench and passion that keeps them there. When experiments fail (as they often do) or contradict one another, a scientist must reflect on her internal commitment to what she is pursuing. My commitment is unwavering because my connection to sickle cell anemia is literally in my blood.

I want my work with patients to inform my research in profound ways that will benefit them in the future. The first fellowship year provided me with the intangible gifts of being in a research setting: learning how to troubleshoot, design experiments, ask questions, and actively seek mentorship and support. Completely new to stem cell biology, there is so much I had to learn in this year from culturing iPS cells to using the flow cytometry machine independently. As grateful as I am for the opportunity to grow in critical ways, I am ready now to produce something tangible for the field.

I want to see sickle cell anemia as only a pediatric disease safely cured via hematopoietic stem cell transplant. I hope to dedicate my career medically and scientifically to improving this process for not only SCA patients but also those with other diseases requiring this procedure. This is where I hope to be an expert, still taking care of a panel of patients with hemoglobinopathies while actively engaging in science. Another year learning as well as publishing in a top stem cell laboratory will increase my expertise as well as credibility in pursuit of this goal.

Feel free to ask more questions in the comments if you like! Check out the press release here.

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So much more to update on: especially ASCI meeting! That’s coming soon!

A Saturday Exploring the Ethics of Medicine

Ethics is about making choices using reason.

From 8 AM – 5:30 PM this Saturday, I attended the Abigail Adams Institute Medical Ethics Seminar. I heard about it from my neighbor who is a palliative care researcher after a talk I attended on physician-assisted suicide (or death). The talk was pretty horrible so he suggested this seminar. It was led by Farr Curlin, MD, a professor of medicine and humanities at Duke and Christopher Tollefsen, PhD, a professor and philosopher at University of South Carolina. I had actually met Dr. Curlin while at University of Chicago once about 3 years ago, and he remembered me! Good memory on his part.

After about 6 months in Boston, I feel less of a medical student than I did when I started. I am this wannabe researcher trying to find her place in this weird year of uncertainty, growth and discovery. Therefore, it was an interesting experience to engage the following ideas.

The Purpose of Medicine 

It seems pretty obvious doesn’t it? To make people healthy. But, what does it mean to be healthy? Is health relative? What if you cannot restore that person’s health?

Physicians have gotten rather angsty about their roles in medicine because we can do so much more than we used to do in let’s say 1935. In 1935, doctors could treat trauma wounds, remove diseased organs, do c-sections, blood transfusions and prescribe some early anti-psychotics. Health was so much about survival.

Today, health encompasses the preservation of life (ex. dialysis), beauty (cosmetic surgery), the alleviation of pain, the control of reproduction, the preservation of social functioning (from gender reassignment surgery to anti-depressants), and the end of life.

We can do so much for patients today to the point in which we may question, should we do this? Like Leon Kass, Curlin and Tollefsen posit that conflict arises when we pursue the tenants of health above first instead of HEALTH as a whole. Health defined as, the “well-working of the whole organism.”

Natural Law Foundations of Medical Ethics 

I was told natural law is meant to “uncover what is constitutive and normal for a flourishing life.” One of the big points I took away from this discussion was the fact that there is something lost whenever we make any particular choice. Some “goods” or principles discussed were:

  • health/life
  • knowledge
  • friendship
  • aesthetic experience
  • play
  • integrity
  • religion
  • marriage –> “the state of being married”

Tollefsen suggested that these goods are incommensurable. It’s not like currency where we can say that one is worth more than another by an x amount.

Another point discussed was that sometimes constraining what we WANT to do FREES us up to pursue things/achieve specific aims.

For example, I really love watching films. It’s one of my favorite ways to spend time, and I consider myself a movie buff. It’s relaxing and good fun for me. But, if I pursue this so much, it will certainly limit my ability to engage in other things I want to do. SAYING NO does not mean being LESS free. Sometimes denial is what brings about freedom. 

The Doctor-Patient Relationship 

Definitely relevant and central to medicine. This relationship was broken down into three types:

  1. STRONG PATERNALISM: doctor gives an order and the patient complies 
  2. PATIENT SOVEREIGNTY: patient requests and doctor provides 
  3. PHYSICIAN-PATIENT ACCOMMODATION: doctor proposes and patient consents

There are some benefits to the paternalistic model, the biggest of them is efficiency.  Things are just easier sometimes when people just do what you say and you do not have to think for yourself and just obey. This model also makes physicians the major bearers of responsibility regarding the patient’s well-being. However, it devalues patient autonomy and induces patient passivity.

In the model where patients are sovereign (in my opinion the worst), it is positive that patients have more control of their care, but it also reduces physician responsibility as well as increases physician demoralization. We become technicians, afraid to offer our opinions which are often sugared with experience and years of acquiring knowledge. Sometimes this really can do a patient a disservice.

The last, physician-patient accommodation, I think is the best model. In it, people fall into their appropriate roles. The doctor’s job is not to control her patient. It is to provide her best care which the patient consents. With the physician proposing ideas for the patient’s care, responsibility falls back on her to use wisdom and experience instead of having the patient do their own job. And, the patient is not controlled by his physician. He gives consent if he finds the doctors proposition appropriate. This provides what was described to be enhanced autonomy. 

If you come to a decision you feel certain about, and then can be reasoned out of it, perhaps that was not the best choice for you to make. But, if after given all of the information on what to do about a health decision, as well as your physician’s opinion, and you still hold your position or shifted it slightly, you have autonomy still but it is enhanced in that you have thought more deeply about why you have made your decision. You can make a decision not just informed by facts, but on your physician’s own experiences. If you disagree with your doc, you have still had the opportunity to consider and grapple with your own personal motivators.

DIALOGUE is HEALTHY.

Reproductive Ethics (in this case, “Abortion”)

To start, Professor Tollefsen disclosed that he believed that abortion is wrong/unethical. He then took us through the “personhood argument” as to why.  It’s interesting to me in these kind of settings for a leader to disclose their opinion from the start as well as for a person with a differing opinion to not also share the floor. But, perhaps this was transparent and an honest way to proceed.

His questions/answers:

  1. What are we essentially? Human Beings 
  2. When do human beings begin (developmentally)? Fertilization
  3. Which beings deserve fundamental forms of respect? All 

He described that persons begin from fertilization and that the right of every person is that of fundamental respect (ie not to be intentionally killed). Although, this perspective is certainly not held true in the world (many people are thought to be underserving of this right to life after they are born/many fundamental respects).

It is very clear to me, that the organism of human potential, the fertilized egg, is alive. It is life.

What if this issue is not about whether or not developing embryos/fetuses etc are human beings? 

If we cannot bring ethics into the real world, it is useless. When a woman decides to have an abortion, I think she is entirely aware of a person developing in her uterus. She knows it’s alive. Trying to convince her it is a person and because it is a person has a right to survive may get her to change her mind in some cases, but perhaps not. People have abortions, I think, because in that moment, her right to not have that life supersedes the right we may impose on the fetus to survive. What we are dealing with is an issue of rights of the woman v the right of the fetus and a battle for control.

Is it ethical for the government to block a woman’s choice to choose life or death for her fetus?

How can we discuss this without examining why a person may make this choice? Can we have an absolute, unwavering perspective on the ethics of abortion or is this fluid (is it wrong in every case)? Whether it is a matter of “inconvenience,” unwillingness to have a “sick child” or inability to raise that child in a financially comfortable way, there are real reasons why women make this choice. Unless we grapple with these reasons, it will be difficult to have a practical conversation about it. Abortions are at their lowest in the US since Row v Wade was enacted. Less abortion, is probably linked to increased access to contraception or increased difficulty in accessing abortions. If we live in a world where a woman has a choice to choose yes or no to life for her fetus, and we want her to say yes more, we cannot just say that abortion is unethical. We have to work towards a world where it is easier for her to do this.

The healthiest world, in my opinion, is when a woman becomes pregnant when she wants to be, and when having a child is not a burden she alone must bear.

Clinical Challenges to the End of Life 

This was the original reason for me attending this seminar. What are the arguments for and against physician-assisted death or suicide?

Two cases were presented with young patients with inoperable brain cancer (glioblastoma multiforme).  They both are/were in the twenties and had a prognosis less than 6 months. You do not want this cancer.

Brittany Maynard chose when she wanted to die. She died with her idea of dignity intact.

JJ chose to stay alive for as long as he could. He is still living.

Both of their stories are very much worth listening considering. And, I honestly respect both of their choices. Is PAS absolutely and unwaveringly, unethical? I am currently leaning to the position that like most things in life, it is circumstantial.

Professor Curlin offered, “There is a difference between with holding treatment and making someone dead.”

Palliative care, which entails making someone’s dying process, as comfortable as possible is perceived as an alternative to “making someone dead.” Nonetheless, this is difference is not black and white. Increasing a patients morphine dosage may “hasten death” a very little bit.

This session more than anything, challenges developing physicians to consider their own opinions and what they think to be right. Dr. Curlin calls for solidarity between doctors and ailing patients. The solidarity being the physician attending to her patient’s needs and the patient allowing her to practice medicine that does not violate her commitments as a physician.

I think this looks different for each doctor-patient relationship. In the end, I think we should always return back to the idea of enhanced autonomy. NO physician should make a decision that they believe is unethical. If that situation is presented, it is on them to remove the patient from their care and place them in the care of someone else that can fulfill the role of that patient’s physician. If a patient consents to hearing our opinion on the matter, we should be entitled to share it, but the patient must consent.

At the end of such a day, seldom does anyone leave with more answers than questions. Ethics is about making choices using reason. Often our reason is determined by things that may defy reason like faith, circumstance and experience. These contributors can ebb and flow.

Our conscience judges the moral quality of our own decisions.

 

Saying Yes to 2017: Opera, HHMI, DC, and Marching

What a fantastic January thus far. Truly.

Shonda Rhymes, creator of Scandal, Grey’s Anatomy and more, released a book last September called, Year of Yes. To be honest, I have not read it, but I know the premise. She coaches her readers on how to “say yes” to more of what they experience and how it will really take life to the next level.

When I went on a little dinosaur fossil excavation in college with paleontologist, Paul Sereno and other classmates, his word of advice for us was, “never say no to a good opportunity because you never know where it will take you next.”

I’m going to get real for a moment.

I am an EXTREMELY cautious person. Usually before anyone convinces me out of something, I have already convinced myself out of it already. Because of this, I am pretty wise and deliberate in my choices and have avoided a lot of mess. Perhaps, this is due to my very strict upbringing by busy parents. I’ve learned when to pick my battles and to assess when things really were not worth asking for.

For example, I REALLY wanted to take ballet classes when I was 6 or 7. At that time, my parents were both in residency, and even though I didn’t really know what that was, I had a sense they did not have time to take me. So I just never asked.

But, who knows, if I caught them at the right time, maybe they would have?

Instead, I decided to read the books on ballet my older sister checked out from the library for us. (This is truly a symbolic beginning of my general theoretical knowledge vs experiential knowledge on most things in life…!)

I have mixed views on New Years Resolutions, but I usually try to move into the year with an intentional mindset. For 2017, I want this year to be my year of YES. And, by saying yes to more things–big and small, perhaps the life I live will be more courageous and beautiful.

First Test: La Boheme 

I LOVE opera. My love of opera really began with Cher’s Moonstruck.

This operatic romantic comedy is centered around a woman’s scandalous relationship with her fiancé’s younger brother and the music of La Boheme. When a young Nicholas Cage and Cher finally consummate their passion, O Soave Fanciulla plays on a record player. It was sweeping. Passionate. Dramatic. Powerful. Provocative. And, like that scene, Opera is entirely all of these things. 

In the movie, Cher and Cage see La Boheme at the Metropolitan Opera, and since seeing that film, I have always wanted to do the same! It had been showing at the Met this season since I had moved to Boston, but I kept on putting off until I realized at the end of December that it would be ending the second week of January. I kept thinking: “Wait, who will come with me? Will they like the opera? Where will I stay in NYC? How much should I spend?”

But something happened. When 2017 started, I just decided that I wanted this. I could make it happen. YES.

I bought a ticket to a Friday performance, packed one of my old homecoming dresses and got on a greyhound by myself! It was everything I had wanted. A dream had come true.

I had a whirlwind trip to NYC and returned that same night back to Boston. A few days later, I was off to Washington DC to present my research at the January HHMI Investigator’s meeting.

HHMI Investigator’s Meeting: Poster or Not to Poster? 

This is a really fantastic opportunity presented to us Med Fellows by HHMI. At these meetings you have the chance to meet absolute STARS in science, hear them discuss their research and much more. The meeting was outstanding. Leading up to it, I was not sure if I wanted to make a poster, however. I was worried about not having enough to present so I just put the thought out of my mind until one of my co-fellows suggested we make a poster together. After reflecting on how hard it is to make one by yourself, I figured it may be even harder to combine two projects especially since we don’t work together. And, I really should just say YES to this opportunity to grow/learn.

Words of wisdom from the meeting:

Dr. Charles Sawyers on deciding to be a physician-scientist
I asked him what was the time between him being a history major and his post doctoral time he decided to pursue a career as a physician scientist and what general advice he had for us as we were engaging with this idea. To this he said it has to be a, “conscious commitment to get of the usual track.” We have to be comfortable getting of the train heading in the usual direction. Sometimes that may involve turning down a clinical leadership position during your post doc to instead focus more on your science. Whatever we decide, it has to be an intentional decision instead of coasting.
Dr. Vivian Cheung on mentorship
The Med Fellows had a lunch with her which was really structured and got us to think critically about the differences between a physician and a scientist. She stressed the importance of mentorship and having the right people in our corner to help us protect our lab time when we still have to see patients etc. “You need someone who will pick up the phone and advocate for you.”
Dr. Len Zon on assessing your weaknesses
He told us about how he mentors his trainees. He writes down a big flaw each one has that he thinks will hold them back, and they work on a plan to improve together. Then, we all talked about what we thought could hold us back. Mine was my fear that people would one day discover that although I am passionate about what I do, I am just not as good at the science.
He advised me to act more confident than I feel and that this insecurity is what many feel and something he has struggled with. He said to let it fuel me and motivate me to be the person I want to project to others.

 

I also had the opportunity to visit old friends as well as see some memorials/museums in DC! It was a fabulous trip. The museum of African American History and Culture was a particularly powerful place for me to visit.

Yes to Marching

As wonderful January has been for me personally, it was a very sad week for many of us as a new era of American politics began. This will forever be a stain on our history, and I decided to be a part of the women’s march. I will preface this with, yes I know that 53% of white women in the country voted for Donald Trump. I will not forget that, but as a black woman, I know where I stand. As a Christian black woman I know where I stand.

I choose to stand with the marginalized and to grieve with them and fight with them.

I chose to have my body be one of the 125k bodies in Boston and over 3 million around the world demonstrating that she would NOT tolerate a president like Donald Trump.

I considered staying in and sleeping a bit longer. I hoped that some friends of mine could join me, but they could not for their varying reasons. But instead of waiting and saying, “no.” I decided to say “yes.”

You do not need people to come with you.

You can say yes.

You do not need to be affirmed.

You can say yes.

Do what is right for you. Do it in wisdom.

2017 will be my year of yes. How about you?

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“That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or abolish, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness” – The Declaration of Independence

 

 

2016: THE YEAR OF JAMES NORTON

With 2016 nearly over, I now take it upon myself to share the highlights from this crazy year. In 2016, the impossible became possible for better or worse. I don’t remember if it was the year of the cat or dragon, but it certainly has been the year of James Norton.

I FINISHED MY SECOND YEAR OF MEDICAL SCHOOL. This now seems much less exciting as this was months ago, but it’s amazing to think how much I knew of brainstem anatomy about a year ago. I was stressing about tests and examinations, and I can really tell you, med school is no joke. Happy to be done with the first half, and waiting patiently in the suspended animation that is a research year for the journey to continue.

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I SPOKE AT FOOD FOR THE SOUL ON RACIAL AWARENESS & IDENTITY IN AMERICA. You can read more about it in my older posts, The Stuff in the Basement and The Day I Became Black. 

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Photo Credit: Randy Blackford

2016 WAS THE YEAR OF JAMES NORTON. From War & Peace to Happy Valley to Grantchester, 2016 was the year of James Norton for me and many others. Also it inspired me to read Tolstoy for the first time. I suppose I do have time now at days… This actor is one to watch! How can one person play a dashing Russian prince, a sadistic ex-con, and vicar all so convincingly? Well done, sir! Oh and I highly recommend Poldark with Aidan Turner and Eleanor Tomlinson. It has definitely taken over my life and a lot of my emotional energy. Please join me in both obsessing and commiserating. As you can see, I LOVE period dramas.

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I GOT THE HHMI MED FELLOWS AWARD! I have since been on a very excellent adventure in Boston. I talked more about my road to this opportunity in an older post.  Check it out if you are considering a research year.

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I WENT TO THE COLOSSEUM AND RUSSELL CROWE WASN’T THERE. All jokes aside, traveling to Italy was amazing. I share more photos from my April adventure here. The trip was too short, and that is just fine. It just means I have to return once again.

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Colosseum!!

THE DIVERSITY FOCUS GROUP WAS BEST GRADUATE SCHOOL ORGANIZATION. I was so proud of the group I co-led last year for all of our efforts.

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“The group selected has provided and exemplified an inclusive, involved, impactful organization that has committed to the difficult work of pushing institutions and peers to hold themselves to a higher standard. In 2014, this group created the White Coat Die-In, an event to demonstrate solidarity with the Black Lives Matter movement and speaking out against structural racism and bias in medicine. They brought the program back in 2015 to again, stand together and call for increased access to medical care for all people, regardless of race, sex, gender identity, economic status, or sexual orientation. They have also sponsored potluck events and lunches to encourage students from all backgrounds to come together and talk about how to make Case Western School of Medicine a more welcoming place and finally they have implemented several reforms to the first-year medical student curriculum. It is my pleasure to award the The Diversity Focus Group from the School of Medicine as the 2016 Outstanding Graduate Student Organization.”

I WENT INTO AN UNDERGROUND BUNKER TO STUDY FOR STEP 1. It was pretty miserable except for study buddies and Game of Thrones. This was a dark time. Not much more to be said on this front.

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I MOVED TO BOSTON. STOOD IN THE OCEAN AND MADE A LOT OF NEW FRIENDS. This is ongoing. 

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HOME. 

I ROLL AROUND MEETING HEMATOLOGY CELEBRITIES. Everyday in Boston I am constantly challenged not to fan-girl.

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THE OLYMPICS WERE THE BRIGHTEST SPOT OF THIS VERY DARK YEAR. My inner 7 year old and external 24 year old were filled with pride after watching all the black excellence at the Olympics. Note to self: Simone is a great name for a girl…

I HELPED COORDINATE AN HHMI KICK-OFF MEETING. Perhaps a bit more stressful than fun, but undoubtedly very rewarding to be a part of such an amazing community.

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I LIVE IN THE SAME STATE AS HANA ERKOU AND TOLANI CAME TO VISIT ME. Let it be known that my blood relatives still haven’t visited me in Boston…

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Few things are as wonderful as reuniting with dear friends. 
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Lovely ladies in the North End. 

SICKLE CELL DISEASE WAS A KEY FEATURE OF ASH, AND IT WAS BEAUTIFUL. This meeting was dope. Can I just be a hematologist already?

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I PLAYED SANTA WITH MY COMMUNITY. My housemates and neighbors pooled our resources to get gifts for a low income family in Boston that struggles to meet their basic needs. Sometimes I really get fed-up with the angst of buying presents for people who don’t really need them and white elephants and gift exchanges. It really was awesome to instead get things for people who really need them/cannot afford to get much. Hopefully this can be come a tradition for my community as well as yours. Learn more here about Action for Boston Community Development. 

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Delivering presents has never been so much fun. 

2016 has been a year of broken hearts and dreams and also mended and new ones. Go Cavs!! Ugh, go Cubs (I know I was like the only person cheering for the Indians). THE SIMONES. The election…ALL THE PEOPLE WHO DIED. #RIPCarrieFisher

How I feel when people say, “Ghetto” inappropriately.

In this year, the Year of 2016, the most important lesson I have re-realized is that I cannot control the choices others make. The more I do this, the more miserable I am inclined to feel. I am responsible for what I choose, how I live, and what I can do with myself while I am adventuring on planet earth. This world can be so nasty, but instead of complaining with no action, I can do something about it. Sure, let’s lament over the things that stink. That is healthy. But, let’s be brave enough to choose what is right for ourselves instead of waiting for others to do it for us.

The world collectively mourns the trials of 2016…from Haiti earthquakes (can that island catch a break, Lord?) to the election…to the continued unrest in Syria. But, what makes us think 2017 will be even better? I cannot know this.

But what I know is that I can make choices for myself to better the world I live in.

Has your heart been broken in 2016? It will mend with time.

Have your dreams been yet to been realized? Keep pushing on. 2017 may be the year. And who knows, maybe there will be better dreams.

 

 

Dead Ends are New Beginnings

These past weeks have been the most exciting ones I have spent in the lab. They also have been the weeks where I have worked the hardest and most meaningfully.

I started this HHMI experience discussing the issue of an “imposter” complex. I almost could not believe I made a decision to take a year off in a new place, and wondered why anyone would give me this opportunity. When I came into this new environment, it was a struggle to acquire the basic skills to carry out some experiments. I really was starting from ground zero in stem cell research even though I had research experience. iPS culture is so finicky. The cells take forever to grow, and red blood cell differentiation protocols take about 3 weeks. But, as time wore on, I learned a bit (LIKE BASICS OF USING LSR FORTESSA). However, my skills beyond basic iPS culture did not feel like they were growing. Cells kept on dying during my RBC differentiation protocols as I was trying to get the hang of them, and it really seemed like it would be nearly impossible to model SCA at all this year.

Then my iPS lines stopped growing. I went to pick up some new ones, that seemed to be growing well, but were actually mycoplasma positive, and had to start over once again.

By early November, I had much more time than cells, floundering, and unsure of how I would practically get to where I needed to go. Oh, and I also had to give a 1 hour talk to my entire lab + PI in a month. **COLLAPSES**

With the help of amazing mentors, old and new, within my lab, I started to shift focus and start working with a different iPS cell system that is more amenable to doing experiments in a shorter time frame. Deadlines can be the worst, but also the best way to pull yourself together and rally people to work alongside you. At first, I was just dreading the prospect of a formal lab meeting, but by the time it happened, I was so grateful for the opportunity to share what I had accomplished with my laboratory in the past 5 months or so.

I spent a few nights in lab until very ungodly hours, and I was not alone. And, together we pulled off some really incredible experiments with amazing results (which of course must be repeated) but SO EXCITING.

Most of the time, things in lab do not work, but when something does, it’s such an exhilarating feeling. It’s difficult to describe, but it’s those small victories that drive people to do what they do. I had my first during these crazy weeks of hell.

Now, I am so incredibly thankful that my cell cultures were dying. If not, I probably would have continued doing the same thing, and perhaps may not have been as open to trying something new. And, I had more time to devote to a new iPS system. Progress is often born out of some frustration. I thought I was at a dead end, but it was really just a new beginning.

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After 2.5 hours of sleep the night before, I gave the lab meeting, and I think it went well! Somehow, I was able to take all the seemingly disparate experiments and weave them together to tell a story.

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After lab meeting, I thawed some cells for a new experiment and dashed off to San Diego for the American Society of Hematology Annual Meeting!

I stayed at the Horton Grand Hotel, which felt very old and wasn’t the ritziest place I’ve lodged, but after a surprise UPGRADE (complimentary of course), I got in the largest room I’ve ever slept in on my own. With a king-sized bed, two flat screens, a kitchen, desk, seating area, two large closets, and a fire place with a real fire in it, I had more than I certainly needed. I was bummed that my mom and sister didn’t come with me this year because of all this space! I watched a lot of The Crown on Netflix (HIGHLY RECOMMEND by the way) and felt Queen Elizabeth and I were practically the same person!

ASH was amazing, just like last year. I did not present this time, which made this meeting a different experience. I was able to take the meeting in and just enjoy it instead of being stressed. I was able to meet up with old friends and mentors as well.

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I want to be part of the Heme Team!
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I got to see my PI give a pretty big talk at the meeting.
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Attended lectures that all were of great interest to me. I focused on the hemoglobinopathies, red cell disorders, and selected topics on stem cell biology. Some of them changed the way I thought about SCA.
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With some past and current HHMI med fellows!

I attended lectures that all were of great interest to me. I focused on the hemoglobinopathies, red cell disorders, and selected topics in stem cell biology. It was at this meeting where I started to think more deeply about how I have differentiated as a young scientist. A few years ago, I do not think I would have felt as comfortable sitting in the talks that I did here at ASH. I knew I was interested in sickle cell anemia, but was still unsure of how to approach it or how I’d like to make an impact. I’m still figuring that out, but it’s clear that my basic science muscles are bulking up. One of my friends, also interested in sickle cell outcomes research, kept telling me during the conference, “You’re such a basic science person” as I would chose those talks over epidemiology of SCA and etc. It was strange for me to hear, because I didn’t quite believe it, but as I attended these lectures I kept on thinking: How can this inform my research in the lab? And, perhaps this is something I’m actually becoming. We all fall on some kind of spectrum. In my lab, I am clearly the “medical person” while with my peers in medicine, I am the “science” person. It’s really interesting how your environment impacts how you are received/understood.

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You can’t go to southern California without having some sushi! This is the “Shogun” from Sushi Deli #2. Went here with some heme/onc fellows.

What I loved the most about this meeting, and ASH in general was it’s focus on Sickle Cell Anemia. ASH has started a SCD coalition with the goal of curing this disease in a few years. It’s the first disease-focused initiative they have done! There are certainly some drugs (particularly p-selectin) inhibitors in the pipeline as well. People are making this disease a priority, and I am very much looking forward to entering into medicine at a time when more can be done for these patients. This is why I want to be a hematologist, and it’s a very exciting time to be one.

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This meeting gives me more hope that we could find some real solutions to SCA in my lifetime.

There you have it. An orthodox blog post. I’ve gone off topic for a few weeks. I’ve processed the election, interpersonal struggles, as well as challenged you to think about the value you put on particular metrics for success. Thanks for your patience, and thank you so much for reading!

Make Your Own Checklist

I hesitate to say this precisely because it may go along with the whole, “she’s just bitter” narrative and stereotype, but I gotta say it because after a long holiday weekend like this one, some brother or sister of mine may need to hear this.

We are fed several narratives during the course of our lives.

The first is “hard work, a good education and a career is what makes you a valuable person.”  Congratulations! You got into this university or that medical school! Your life is together. Live long and prosper.

The second, “okay, you can go to college. That’s fine, but can you get married?” As a single person, you just do not have as much to contribute to the lives of others. Is it because you are too picky, selfish or just undesirable? Clearly something is amiss.

Third, “since you do not have any children, you do not know or understand what it means to sacrifice your time for someone else.” If you are unmarried and childless, you probably do not even know what love means.

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I wish we could spend more time diving into the value that resides in each person instead of waiting for them to enter into a life phase that may never happen—waiting for them to reach the fullest potential of what it means to be a complete and full human being.

I believe that as human beings we are made in the image of God. NOW—not when we get that job or degree or husband/wife/relationship or child is when our lives can mean something. Stop waiting to check items off of someone else’s checklist. Be fabulous now.

As a nerd, romantic and future pediatrician, I find so much value in education, love/marriage and children. Please understand. But, I also have the presence of mind to see that these things itself a person does not make.

If you sideline people just because they do not have these things or desire them, for shame! If you have been sidelined, sorry! We are all missing out on something really beautiful.

Life is not just a series of checklists: job, marriage, offspring.

And, if  you are going to implement some (especially if you are type-A like myself), for heaven sake, make your own checklist.

P.S. I promise, a medical post is coming soon! Lab meeting, exciting new experiments and the American Society of Hematology Annual Meeting! Get ready. Get pumped.

5 Things I See Amazing People Do

I am learning how to be a scientist. Observation is one of the first skills you must develop in this area,  I have found. As a student of stem cell biology as well as life, I have not only observed my cells differentiating and proliferating, but also the behaviors of different people. Intelligence and conveying one’s intelligence is of great value where I am and perhaps where you are. But, what is even more striking to me is when I see someone balance emotional intelligence with their profound wealth of knowledge.

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These are 5 things I consistently see really amazing people do. These people are also emotionally intelligent, and I thought I’d share. A lot of this is “common sense.” But, as my mother says, “common sense is not common.”

A normal science/medicine post is coming soon, but for now, here we go….: 5 Things I See Amazing People Do

  1. They do not expect everyone to think the same way they do. These people appreciate open-mindedness. They often question: is my “normal” right? Or is it just normal to me? Does it matter? Way less conflict happens when we get out of our own perspectives.
  2. They do what they say they will do. Flakiness is the worst, worst, worst. And, you want to be the person others can depend on. It’s better to under-promise and over deliver than never following through.
  3. They take time to explain things to people in a way that empowers them—not belittles them. They come off as smart, kind and confident. That’s because they are.
  4. They are aware of nonverbal cues. This means they have to not only listen to people, but look at them and consider how they are feeling in the moment. Emotionally intelligent people really get this. And, it’s been said that 90% of what we communicate doesn’t come out of our mouths.
  5. They communicate directly but diplomatically. Do not skirt around an important issue just because you are afraid of what may happen. Sometimes we have to be the first to extend the olive branch or confront a problem. This choice does not only make you mature, it makes you amazing!

I hope I am not being too much of an obvious Oliver, but clearly there is a shortage of these kind of folks around, and often the people I admire the most have these qualities. These observations combined with our default intelligence or intuition really does take our personal interactions to the next level. And, my goal moving forward is to consistently grow in these areas (especially number 5!!!!)!

Getting it together one day at a time.

The Danger of Likemindedness

It is incredibly comfortable to sit down and talk to someone when you know they are on your side.

Your insight is unquestioned.

In fact, it is celebrated.

Your reason is unquestioned.

In fact, it is admired.

It is a privilege to hold another person’s gaze, knowing that you have their respect and their attention. But, this lovely thing is not always and forever.

I am a black woman in science/medicine. As such, I constantly play a game in which I try to qualify and validate my presence to other people.

When I walk into a room, I need to be as intelligent, calm, yet as non-threatening as possible. And, it is a tiring business.

When you hold a minority opinion or experience, it often falls on you to educate the majority, and that again is also a tiring business. Can’t they all just read a book?

So of late, I have tried to minimize these conversations.

 You think #BlackLivesMatter activism is dangerous and anti-white? Okay, I cannot have this conversation with you. 

You think women are just not cut out to lead a nation? Well that’s sexist and unfounded.

Women who have had abortions should in fact be punished for these offenses. Hopeless. 

Islam is incredibly dangerous, and we should have less Muslims in this country. We will be more safe. Insanity. 

I have been writing people off because I have lost faith in their capacity to change. So this is what I can do, folks:

I can stay in Massachusetts or never leave Cook county. Surround myself with people who think like me, and bite my tongue instead of having a difficult conversation with that person I vehemently disagree with. I can save my energy, have them like me, and keep the peace. YOU CAN DO THIS TOO.

Most of us do this, actually, and this is a big reason why red states stay red and blue states stay blue. But, this may also be the reason why we are so shocked by the results of this election. This is the danger of likemindedness.

The facts as they stand are that we live in a divided country with divided opinions. We live with people who are more concerned with the sound of their own voices than, the voices they do not hear.

We talk to ourselves and not to each other.

So, on this day when I want to shut down and de-friend EVERY person I know who did not vote for Hillary Clinton or abstained from voting, I’m going to pause.

Because, the minute I give up on the human capacity to change it all ends, hope dies, and progress is impossible.

So I encourage you, friends to not give up hope on what a conversation can do. I can be changed for the better, we can be changed for the better.

We have our work cut out for us for the next four years. Our voices are needed.

DO NOT retreat. Speak.

DO NOT retreat. Listen.

DO NOT retreat. Act.

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Sugar, Cytokines and Everything Nice…

Sugar, cytokines and everything nice–that’s what RBC differentiation media is made of. $300 dollars a bottle. More expensive than any wine I’d purchase at this time in my life (or ever), but our cells deserve the best.

It’s been awhile! Life has been good.My project is moving forward. This week, I ran a FACS analysis on some cells that I have tried to make in to red blood cells, and it’s really exciting to see that they are well on their way. What a journey these cells have been on. From a terminally differentiated blood cell –> to an induced pluripotent stem cell –> CD34+ blood cell progenitor. I’m patiently awaiting the day they can mature even further and become capable of sickling. Maturation is a journey. And I know that this is going to be REALLY corny and nerdy but here we go…

I’ve been in Boston for 4 months now. I started out as a terminally differentiated 2nd year medical student. And, over the course of months have been reprogrammed into a person capable of becoming something slightly different. At the end of this year, I know that I am not going to be quite the same person. But, unlike my red cell progenitors, coaxed along a certain path of differentiation with the right cytokines, my microenvironment is so varied and exciting.

Let me tell you about my microenvironment of late.

We had the HHMI kick off meeting which really got me excited about this process again! I am one of the regional co-chairs for HHMI (Boston region) so I helped plan the meeting with 3 other fellas. We heard from physician-scientists at different stages of their careers, practiced distilling our science message for different audiences, and even did some improvisatory speaking (Felt like we were on Who’s Line is It Anyway). The keynote speaker was an infectious disease specialist named Bruce Walker. He’s done a lot of really amazing stuff in HIV research as well as treatment/support programs for women in South Africa. He is also a CWRU SOM alumnus! What I found really interesting about his work is the ethics of using a population to advance one’s understanding of science. In a way, in answering a scientific question, you can benefit from another’s capacity for misfortune. Therefore, I think it’s imperative, to give back to that population. If you publish in Science but the subjects keep on dying miserably from HIV, something is really wrong with what you are doing. Dr. Walker was aware of this, and I think that is amazing.

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My fellow co-chairs and the amazing Med-Fellows Program director
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Howard Hughes. I need to watch the Aviator. Thanks, for being wealthy and philanthropic, and having an unclear will so I can have a salary today. Much appreciated.

My PI submitted a proposal for more funding for sickle cell research to the Doris Duke Charitable Foundation. The proposal was essentially my HHMI proposal, and it was accepted! It felt great to get that news from him, because I really felt some ownership of the project. In science we build upon what has been done before us. And, I know so much work has been done before I came here, but it’s exciting to be a part of this process. This week, I and some of my lab mentors are going to share some of the work done on this project/goals for the project with some of our funders.

The flow cytometer (LSR Fortessa for those curious) used to be my enemy but it is slowly becoming my friend.

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Research has been challenging and such a privilege. It was wonderful to meet the other HHMI fellows at the kick-off meeting and to see the impact of HHMI on the career trajectory of so many people. It seems both significant and positive! It was also intriguing to see that about a third of the HHMI fellows are women. In comparison to my medical school class (slight majority women), it is a real difference. While women are gaining access to more spheres of influence, female physician scientists are definitely a minority. Something to take notice of and to think on…

Whenever I start feeling down about this process, I am encouraged to remember how blessed I am to have this opportunity. Like a few days ago! I got to practice doing some intrafemoral bone marrow injections in some mice! It was so exciting. This is what I am here to do–to learn as much as possible. Perhaps I miss interacting with with mammals…!

Other happenings: went to Boston Symphony! Brahms Requiem was AMAZING. The second movement is my favorite. I really wonder if John Williams was inspired by this while scoring Star Wars…especially the first theme. So haunting. Just thinking of the expansive and ominous Empire. Yet it is later mixed in with a sense of hope. (side note, if you haven’t seen the new Rogue One trailer do that now!) I also saw Thomas Hampson again! Last winter, I saw him and Renee Fleming in the Merry Widow at the Lyric Opera of Chicago. Apparently, Hampson made his debut at the Boston Symphony Orchestra singing this very same piece. Witnessed a little bit of history that night thanks to my housemate, Snowy and her HMS perks!

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Boston Children’s Hospital on a rainy Sunday! Went in briefly on the weekend.

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I also visited the Museum of Fine Art on Wednesday! It’s free after 4 pm, and I know I have to go back. Didn’t even see any European art. I was able to see some of the Benin Bronzes which is always a bit exciting for me–seeing art that is appreciated and a part of my culture.

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A Benin Bronze
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NIGERIA

There is so much more for me to explore inside and outside the lab for the next 2/3 of my stay in Boston. Time is flying. Goals as of now: to see La Boheme at the Met and visit the Museum of African American History in DC.

That’s the microenvironment for now.

We are all differentiating into something, and sometimes the hard part is figuring out exactly what that is. Look up and look out. What and who do you surround yourself with?  What is shaping you at this moment? I hope it is something you love or can love.

Until next time.