To MD or Not To MD: My Existential Crisis

I didn’t emerge from the womb wanting to be an MD-PhD.

I reached that conclusion after two decades of over-thinking, soul-searching, and trial-and-error. Over the past twenty-one years, I’ve reveled in writing, flirted with research, experimented with law, and acquired some truly formidable procrastination skills. Long story short: I was never one of those people who “always knew what they wanted to do with their lives.” So if you, like me, are indecisive, have diverse interests, or want some help navigating this maze we call “The Future,” read on.

My ideological journey wasn’t a “Yellow Brick Road” so much as a sprawling web of distinct, formative experiences – each dedicated to answering a question. The first took place in Cusco, Perú.

“If you, like me, are indecisive, have diverse interests, or want some help navigating this maze we call ‘The Future,’ read on.”

Part I: Cusco, Perú

What makes you feel motivated and fulfilled?

At the end of my freshman year, I traveled to Cusco through the DukeEngage program, a collaborative effort between my university and the Bill and Melinda Gates Foundation. Once there, I was assigned to work at “El Hogar Juana de Aza” (the Home of Joan of Aza), a home for sexual assault survivors. The girls who lived there ranged from thirteen to eighteen years old and hailed from a variety of backgrounds. However, they all shared one reality: someone else made a choice that changed their lives forever.

At first, I didn’t know what to do. I didn’t know how to speak, how to act, or how to cope with the horrifyingly real situation in front of me. So I took a step back. Before I spoke or acted, I observed and listened.

I learned that all eleven girls were violated and bore children at very young ages. Afterwards, many of them were rejected by their families. Some had warm, nurturing relationships with their children, while others struggled to view their babies as anything but the results of rape. “Betty” loved to dance, “Yuliana” wanted to become a doctor, and “Elena” made the most beautiful bracelets from string and beads. Despite their circumstances, all of these girls were determined to overcome their traumatic pasts and pave better futures for themselves and their children.

When I heard their stories, my urge to help them overpowered my anxieties. The home’s directors told me that they were struggling to finance the girls’ education, basic necessities, and medical expenses. Because the young mothers were minors, they did not qualify for government-provided health care – nor did they have any family to help them.

“The most vital aspect of my experience was caring for the girls in a compassionate, personalized manner. I wanted to treat them as unique, capable survivors and not as mere victims of their experiences. That was when I realized I wanted to do that for the rest of my life: work with people and empower them to improve their circumstances.”

In response, I researched and initiated an alternative solution: I negotiated with three local clinics for discounts and exoneration on medical expenses. To finance the girls’ education and basic needs, I created two websites – one in English, one in Spanish – with an online fundraising system to expedite and globalize the donation process. After I left, the girls used those donations to launch their own small business, which they operate out of their home. They make and sell popcorn, chocolate, and potato donuts for a shot at a better life.

The most vital aspect of my experience was caring for the girls in a compassionate, personalized manner. I wanted to treat them as unique, capable survivors and not as mere victims of their experiences. That was when I realized I wanted to do that for the rest of my life: work with people and empower them to improve their circumstances.

Part II: Durham, North Carolina

By whom do you want to be surrounded?

In order to create permanent change, I want to tackle medical issues from multiple angles. After flying back to Duke for my sophomore year, I began engaging in research about sexual assault trauma and coping mechanisms. I perused several books, read countless papers, and reached out to many prominent neuroscientists.

I knew that I wanted to be surrounded by scientific intellectuals, so I joined a lab. Since August 2016, I’ve been sharpening my research and experimental skills in the Patek Lab at Duke. Our lab works mostly with mantis shrimp – stomatopods that are characterized by their distinctive raptorial appendages and remarkable visual systems. Although most of our research is oriented toward biomechanics, I found a way to bring my passion for neuroscience to the lab. I researched, proposed, and am currently conducting an original independent study project connecting the neurocircuitry of mantis shrimp visual systems to their raptorial appendages and predatory strategies.

“I have come to love the community of dedicated, research-driven intellectuals that I found in the Patek Lab.”

I have come to love the community of dedicated, research-driven intellectuals that I found in the Patek Lab. We have lab meetings every week, during which we discuss intriguing scientific papers or give constructive feedback on each others’ research. I have tremendously enjoyed taking part in these discussions, learning more about cutting-edge evolutionary research, and being mentored by some of the most inspiring scientists I have ever met. Additionally, I have learned how to structure a research grant proposal, critically analyze scientific literature, and present my findings in an accessible, engaging way.

Part III: Copenhagen, Denmark

What pushes you to work through stress and obstacles?

In Fall 2017, I spent a semester in Copenhagen, Denmark, studying the cognitive neuroscience of consciousness. There, I – along with a team of two other students – pitched, executed, published, and presented an original research project on unconscious arithmetic.

When we were first assigned the topic, we had no clue how to approach it. So I drew from my previous experiences. As in Perú, I took a step back; I did my research, observed the trends, and listened to my mentors. As in the Patek Lab, I engaged in discussions with the intellectuals around me. I initiated team debates and meetings outside of class hours. During those conversations, I always did my best to balance active contribution with open-minded listening. I also took the lead on communicating with our research mentor, Dr. Claudia Carrara-Augustenborg. Every week, I sent Claudia a comprehensive email update and PowerPoint presentation detailing our progress.

Executing the project was not easy. Like most research, our unconscious arithmetic experiment involved countless hiccups, frustrations, and sleepless nights. In the end, we did not obtain the statistically significant results we hoped to find. Nonetheless, I realized that – for me – nothing beats the dopamine rush of working on important, intellectually stimulating research.

Part IV: Durham, North Carolina

How do you fit into the community you’ve chosen?

I am extremely invested in disseminating the fruits of scientific research to the public. As an editor for Neurogenesis, Duke’s student-run neuroscience research journal, I work to bridge the gap between scientists and the general public by providing a platform for students to share their original work and analyze critical neuroscientific issues.

Last spring, I realized that our print journal was primarily tailored towards readers with a preexisting knowledge of neuroscience. Our aim as a research journal was to expand awareness and broaden understanding of neuroscientific issues, but – in my view – we were neglecting a significant chunk of the general public. Therefore, I pitched and spearheaded a new initiative to expand Neurogenesis to an online platform. I created a new website featuring interactive content and “layman” articles, written to inform and engage non-neuroscience majors. Last month, we released our first article: a piece in which the author draws from research and her own volunteering experiences to explore the effects of music therapy on Alzheimer’s patients.

“Throughout the day, I mentored thirty girls, creating interactive games to teach them about brain anatomy, helping them build candy neurons, and drawing from real examples to show them how they, too, could make valuable contributions to science.”

This month, I shifted my focus to in-person mentoring. On February 17, I planned and led a neuroscience workshop at an annual science education capstone event with an audience of over 200 primary school students. Throughout the day, I mentored thirty girls, creating interactive games to teach them about brain anatomy, helping them build candy neurons, and drawing from real examples to show them how they, too, could make valuable contributions to science.

Part V: The Future

What comes next?

My journey’s not over yet. I still have to get through one-and-a-half years of undergrad – and then the process of actually obtaining my MD-PhD. I’m constantly learning more about myself, my abilities, and my aspirations. For every new experience I encounter, I ask myself a new question. For every new answer I fill in, the future starts to look just a little clearer.

When I was in Perú, I learned that helping and empowering other people was what motivated me to get out of bed in the morning and left me feeling fulfilled at night. After returning to Duke, I realized that I wanted to be surrounded by like-minded intellectuals who shared my passion for scientific discussion and debate. In Copenhagen, I discovered that the joy of conducting original, impactful research outweighed any stress associated with the process. And, when I returned to Durham, I found my niche in the neuroscientific community, spreading knowledge through writing and mentorship. Ultimately, I realized that – given my diverse set of interests – I could never be completely fulfilled as either a clinician or a researcher. I had to become both.

So here’s my advice to you: keep asking yourself questions, and give yourself the opportunities to fill in the answers. Good luck with your journey.