#thisessaygotmein

Chatter surrounded me in the cafeteria on the first day of school, but I could focus only on the boy sitting alone at the table near mine. How could an upperclassman not have a single friend in this lunch period? He kept his head down and looked at his food, perhaps in an effort to avoid eye contact with a judgmental teenager. Whether having special needs or an awkward shyness, he apparently was not socially acceptable. His look of solitude seemed to intensify in direct proportion to my guilt from inaction.

As I contemplated the plight of this lonely student, I thought of Aunt Gail. My mother’s sister is afflicted with Prader-Willi Syndrome (PWS), a congenital disorder caused by an abnormality of the fifteenth chromosome. As a child, I didn’t understand how missing genes can cause a strange combination of conditions ranging from an insatiable appetite to cognitive disabilities; but I learned at a young age that I need not feel embarrassed in front of my friends when my morbidly obese aunt asked us awkward questions with impeded speech. Aunt Gail seemed to appreciate my confidence to stand by her when others were anxious to escape.

Without further thought, I approached the boy. He seemed surprised by my question, “Would you like to sit at our table?” but readily accepted. I later learned that my new friend Mike suffers from a social disability in the autism spectrum. Although I experienced his awkwardness firsthand in attempted conversations, I welcomed him to our lunch table every day. My friends were often annoyed by his presence and reiterated that I was “overly nice.”

By the end of the school year, Mike trusted me enough to ask a question that caught me offguard: “Would you go to my prom with me?” A sophomore girl should be excited by an invitation to the Junior Prom, but the implications of attending the most anticipated and documented social event of the school year with someone “different” caused me to hesitate.

Thinking again of Aunt Gail, I realized that now was another opportunity to stand with someone whom others avoid. I accepted the invitation and saw for the first time a genuine, uninhibited smile light Mike’s face. I will never forget that moment.

The slow song finishes, and Mike’s social ineptness has disappeared. He seems at ease as he confesses that it took him until the very last day that prom bids were available to get the courage to invite me. As we laugh and dance to a faster beat surrounded by classmates, we are accepted and respected as an ordinary couple at the West Essex Junior Prom. 

Sara Notte is a student at Duke University pursuing a double major in Chemistry and Public Policy. She is currently a summer research fellow at the Institute for Genomic Science & Policy (IGSP) at Duke.

Medicine was appealing because it allowed me to explore my intellectual curiosity, fulfill my need to help others and empower others to want to do the same. In high school, I was fortunate enough to work at two leading medical centres near my home. My first experience was in a developmental biology lab at Cornell studying the effects of Pbx/Hox genes in mouse development. My next stop was at Columbia University studying the genetics of bacteriophages. I learned how to design experiments, and to gather, question and publish my data. This taught me the inquisitive skills I would later need to succeed as a physician and was a giant stepping-stone to the next phase of my education.

In college, I spent three summers at the National Institutes of Health and joined a research lab at the University of Pittsburgh. I helped and mentored 200+ students by teaching organic chemistry and cell biology. I was fortunate enough to shadow a physician and discovered my interest in surgery. Not only did I sharpen my skills as a scientist and delve deeper into the world of medicine, I also became passionate about graphic design and helping people communicate their great ideas. Part of this came from my observation that brilliant researchers and physicians often struggle to convey their ideas to the general public, their students, patients, and even their colleagues. I have learned to use my skills as a designer to turn science from what many people perceive to be inaccessible to something exciting and vibrant.

For me, design was fascinating as it brought together the fields of social science, psychology, and even neuroscience to help people tell powerful stories.

Medicine too, is about telling stories. Each patient is different and each history gives an introspective lens into the human condition. This helps medicine transcend science as it allows us to explore our inherent humanity. I synergized knowledge, storytelling, and humanitarianism when I curated TEDxCMU, an independently organized "meeting of the minds" modeled after the annual TED conference in California. TEDxCMU is a gathering of people who are passionate about the power of ideas and who believe that it is possible to change the world through the sharing of knowledge. I invited eight individuals with world changing ideas to give a talk at CMU.

One of those individuals was Dr. William Gahl, who had a profound influence on my perception of medicine. He is a world expert on rare diseases and sees patients that lack a diagnosis after years of medical attention. Dr. Gahl noted that getting a diagnosis for these patients is tough, but red tape and bureaucracy get in the way of treatment even when we have figured it out.

Why is that? Developing treatments for rare diseases is not economical for drug companies. "There's nothing we can do about that. But there is something we can do!", Dr. Gahl offers. We can use existing drugs off--label, however, even in life or death situations, the FDA adheres to their strict policies and prevents their use. I was mesmerized by how I enabled the powerful interaction between Dr. Gahl and the audience, and after he explained how several of his patients died to these policies, both parties choked up. "These patients want to be protected, but not protected to death."

Combine a powerful story with a powerful audience and something magical happens. After I graduated from CMU, I started work as a research fellow in Dr. Gahl's lab at NIH. Two weeks in, Dr. Gahl announced to a roomful of physicians, scientists, and students that the FDA reversed one of its decision on off--label drug use for rare disease patients. Patients who would have died under the old policy can now receive their life--saving medications. Through TED, I facilitated effective medical communication which can save lives. The audience at TEDxCMU was so moved by Dr. Gahl's talk that they turned those ideas into action, called their congressional representatives and brought the issue before the FDA. "James, you saved a life today", Dr. Gahl told me.

You may or may not agree with Dr. Gahl's stance with the FDA, but that's not the point. I did not want to polarize, but rather to start a conversation and celebrate that all knowledge is interconnected. This made me realize that medicine is at a critical juncture between time-tested practices and new technology.

Patient care is no longer limited to the clinic or operating room. The fiduciary duty of physicians transcends the treatment of just physical ailments — we have to capture and project the voice of the patient. Medicine sums up my love of spreading and applying knowledge, the rewarding experience of helping others, and my ambition to touch lives around the world. I'm ready to use my training as a scientist and my passion for design to bring a unique perspective to the world of medicine.

James Pan is a medical student at Stanford University; in his spare time, he leads a double life as a graphic designer, amateur photographer, and fitness freak.