Cookie jar - Duke - Sample AMCAS personal statement
At ten years old, I faced my first critical decision in the hospital setting: whether or not to give my grandfather a cookie. He never had a sweet tooth before, but Alzheimer’s disease made him unrecognizable as he yelled and pleaded for the dessert in my hand. I froze, unsure of how to communicate, and scared that he would choke on solid food. I knew I wanted to help, but I did not know how. Learning how to help has been the focus of my undergraduate career, and is my drive towards becoming a physician.
These interactions with my grandfather in the late stages of Alzheimer’s disease sparked a lifelong interest in neuroscience. In college, I returned to the hospital to learn more about diseases of the brain. I watched vascular neurosurgeons at Beth Israel resect brain stem cavernous malformations on a young woman, a student my own age. The operation successfully stabilized her neurologic deterioration, and I left inspired by these physicians who prevented permanent disability.
However, I quickly learned that there are times when modern medicine is inadequate. I saw a neurologist, Dr. Steven Arnold, diagnose an elderly woman with Creutzfelt-Jacob disease. I recall being struck by the intense emotional involvement. She let out sobs throughout the exam, and I wondered if she sensed her own insidious rate of decline. When her test results returned positive for prion disease, there was nothing more we could offer her. She passed away in months. By shadowing attending physicians, I felt amazed by life-saving therapies, and disappointed when science fell short of a cure. Both of these feelings are strong motivators for me to pursue translational research.
To better understand the role of a toxic protein, tau, in Alzheimer’s disease, I worked in the lab of Dr. Bradley Hyman at the Massachusetts General Hospital for over two years. I focused on preclinical anti-tau antibodies, and found that targeted epitope significantly affected the ability of the antibody to stop tau aggregation. Tau immunotherapy is a promising new approach at a time when disease-modifying treatments are scarce, and we need to better understand the mechanism of action. However, while I took immense pride in the journey from preliminary experiments to publication, my work tested antibodies in cultured neurons alone. We are years away from bringing the therapy to patients. Much like a physician-scientist who does research for the future while treating patients in the present, I wanted to help people losing their memories to Alzheimer’s, here and now.
My desire to branch out from the bench led me to pursue new roles in clinical research. I am now part of a team coordinating clinical trials for Dr. Arnold, which involves assisting in the outpatient neurology clinic at MGH and meeting individuals being evaluated for dementia. Occasionally, families express an interest in novel treatments, and I have been able to connect them with the first Phase II clinical trial using tau immunotherapy for Alzheimer’s disease. Although the trial uses different antibodies, my research has allowed me to teach patients the basic science behind immunotherapy, and inform them of a clinical trial I truly believe has promise. Being involved with the direct care of these patients has been an incredibly rewarding experience; it gets me out of bed every Friday at six in the morning, excited to see what the day will bring. My clinical experiences allow me to better understand the day-to-day interactions of a physician, and confirm that this is what I want to pursue.
In the clinic, I mostly interact with patients who have mild cognitive impairment. I also wanted to help those like my grandfather, with severe neurodegenerative disease. Research has shown that loneliness can exacerbate the symptoms of dementia, and social interaction may be beneficial to curb disease progression. With this in mind, I founded the first organization at my university to volunteer with the elderly. We work with locations that serve all levels of independence, from assisted living to dementia care, and devote one-on-one time with the residents. In a specialized unit for dementia patients, a former flautist, nearly catatonic, will hum and tap his foot to students playing piano. A woman whose condition prevents her from gardening nearly jumps out of her wheelchair every time we bring in fresh flowers. This patient population presents unique challenges due to both physical and cognitive disabilities, but to be able to provide them these small moments of clarity and joy makes all my work worth it. I hope to find the same gratification as a physician, helping these patients in a more lasting way than I can now.
I will always remember being a young girl, terrified and unsure of what to do in the face of severe dementia. I never want to be in that position again, but I know that there will be many times when I meet the same fear and uncertainty, faced with a far more critical decision. I am prepared to take on these challenges with the same drive and resolve that pushed me to overcome setbacks in the lab, clinic, and volunteering. The road ahead may be long, but I cannot wait to apply myself further, finding fulfillment in the challenges of becoming a doctor of medicine.