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These 5 Medical Students Have Chosen Neurology—Some At Great Odds: Here’s How They Got There

They are coming to it from different pathways—through EMT training, bioengineering, economics, and a a volunteer stint in a martial arts program for Parkinson's disease patients. But although their journeys through medical school have taken widely divergent paths, these five students have all committed to a future in neurology.

 In this second of a two-part series, four medical students spoke to Neurology Today about the pivotal events that motivated them to pursue neurology. Their comments are excerpted below. [The first article in the series, “Professionalism-For These Future Neurology Residents, Addressing Health Care Disparities Is Personal" appears in the December 17 issue.] 

Luke Moretti, MSY-4, NYU School of Medicine

Luke Moretti had an early interest in neurology. In his senior year of high school, he took night classes to become certified as an emergency medical technician and was most drawn to stroke and seizure calls in a high-volume trauma region. But a diving accident late in his freshman year at Vanderbilt, where he majored in neuroscience, waylaid those plans. He had misjudged the depths of a dive into a lake and sustained a cervical fracture leaving him with an incomplete C5C6 spinal cord injury. Unable to stand, swim or resurface, he soon ran out of air. Friends later told him that when they pulled him out of the water, he was unresponsive and cyanotic. 

After an emergency decompressive laminectomy with fusion and extensive rehabilitation, Moretti gained some function and was able to return to Vanderbilt one year later in an electric wheelchair, more determined than ever to enter the field of neurology. But there were logistical challenges. He needed to live in apartments with elevators and to learn all the curb cuts, ramps, and building entrances on campus that would allow him to get to classes—a  process he would repeat three years later when he started medical school at  NYU.

At NYU, each clinical rotation brought its own set of challenges and workarounds. Surgery required the use of a standing chair with an electrical seat lift to allow him to stand over the operating tables; pedal placement—which varied at each handwashing sink—needed to be struck at just the right time on the way up.  He needed to find ideal-sized sterile sleeves to cover his joystick and armrests, and an OR tech who would help him finish gloving up. For neurology, he had to find the proper tools or modifications for each portion of a thorough exam. A pen substituting for his finger would serve for extraocular muscle testing and pen-to-nose testing, and an extra-heavy Tromner hammer provided him with enough swing and grip functionality to test reflexes.  Good upper extremity proximal muscle strength enabled him to perform motor testing, albeit one side at a time due to his inability to reach the contralateral side from his wheelchair.

These time-sensitive challenges notwithstanding, Moretti also managed to participate in several research projects, author three published papers, present two posters at the 2019 AAN annual meeting, and found a company developing a handheld retinal camera. He has also cofounded another initiative, which will provide all-expense paid nature retreats to individuals with disabilities, among other endeavors.

What drew you to neurology?

My injury solidified my desire on a personal level. My first-person experience with quadriparesis was hugely impactful and it motivated me to help others. I understand those deficits and have practical knowledge that can directly help in treatment.  I experienced a sudden neurologic injury, and with it, a dramatic shift in functioning and normality; as a patient a clear life path became hazy and uncertain in a moment. I went  through the acute and subacute rehab process, dealing with insurance, and navigating the myriad of physical and emotional obstacles.  

Living with neurologic sequelae has enabled me to shift more easily into the mindset of patients allowing for more empathic care and understanding of their needs.  As I prepare to start my residency, I feel grateful for the breadth of experiences I have had and the training that NYU provided me. But I will also keep in mind my experiences as a patient in the ICU and rehab.

 I know the feeling of loneliness that sets in after weeks spent in a hospital room. I know the feeling of guilt that comes with asking for something as simple as a cup of water. Conversely, I know the feeling of happiness when a familiar nurse or physician walks into the room and greets with a smile. I know the feeling of relief that comes from having a clinician sit down and provide an explanation for each sequela experienced. I still believe that there is nothing cooler than the nervous system, from a science/biology perspective.

How has the pandemic shaped your views?

Virtual interviews are cost-saving, but I am unable to truly compare the physical arrangements among the various institutions that would allow me to evaluate the logistical challenges I will inevitably face, at least initially. If I were there in person, I would be able to get a realistic sense of relative level of difficulty for me to circumnavigate those facilities. Despite this, a facility requiring me to take a more roundabout way to get somewhere would not really influence my decision. My two most important criteria are the people (both departmental and residents) and the educational quality and experience.

Roya Edalatpour, MSY-4, Boston University School of Medicine

Coming from a family of engineers which included both her parents, it seemed natural for Edalatpour to pursue her undergraduate studies at the school of engineering at the University of Texas at El Paso. She had always excelled in math and physics and envisioned a career in electrical engineering. But while working on her senior project in bioengineering designing a wireless pulse oximeter, she decided to shadow a few doctors, and that pivotal experience sparked a keen interest in medicine. 

In her first-year neuroscience course in medical school, she realized that there were many parallels between the electrical circuits that she had studied as an engineer and the circuitry of the brain and nervous system. Later, conducting research on sleep in Parkinson's patients, she knew that neurology was perfectly suited to her interests. 

What drew you to neurology?

I never imagined how relevant my knowledge of circuit theory, acquired as an electrical engineer, would be to my study of neurology. Yet, I have had the opportunity to apply this knowledge towards problem-solving both on the wards and in my experiences with neurologic research. I love that I can think like an engineer when analyzing, troubleshooting, debugging and correcting a patient's malfunctioning brain circuitry.

How has the pandemic shaped your views?

My parents—who live in El Paso, TX, where cases have been going up by more than 1,000 a day—both contracted COVID-19 during the beginning of my interview season.  As you may imagine, this created a lot of anxiety and fear in me, but I think most importantly, it put into perspective the magnitude of suffering that this pandemic is causing for families. Being miles away and seeing my father helplessly gasping for air in a secluded hospital room over FaceTime made me feel powerless.  As health care providers, we have seen how much trauma this pandemic has inflicted on our communities, especially on those with diverse populations, like El Paso, and it has shed a light on the flaws and breaks in our health care system.

Abdullah Mohammed Alam, MSY4, The University of Toledo College of Medicine

The summer after Alam completed his freshman year at Ohio State University, he secured an  internship in database development with a researcher; as an economics major, he was familiar with a variety of statistical analysis software and computer languages. But when the investigator invited him to the neonatal intensive care unit to better understand the data collection process for the project, Alam was captivated by the entire medical team. The doctors and health care providers he met that summer ultimately inspired him to pursue medicine—fueled in no small part by the overlap he observed between neurology and economics. Using his knowledge of linear regression and accounting for variability drawn from his economics training, he is currently working on SARS-CoV-2 data, examining the incidence of Bell's Palsy. 

What drew you to neurology?

Both economics and neurology call upon us to play detective, as many things cannot be directly observed. What I love about neurology is how we utilize the physical examination to localize and diagnose disorders. It is similar to how we measure variables in the economy where often, we can't observe the direct variable we want to measure, so we make use of other signs and clues. 

How has the pandemic shaped your views?

One economic therapy poses that when conflict arises, bargaining can lead to the best efficiency. In the case of COVID-19, we have a situation in which health care workers are willing to risk their own health for the greater safety of the public because it is their cost to bear. My greatest hope is that, in return, all non-health care workers will do their best to prevent new infections, so that we all can survive this crisis together.

Brianna Sennott, MSY-4, Rush University Medical College

Like many medical students entering neurology, Sennott had influential mentors.  Several modeled exceptionally compassionate patient care, community involvement, true passion for the field, and dedication to teaching. In her first year of medical school, she heard a presentation by Jori Fleisher, MD, MSCE, about a pilot study involving Kick-out PD—a martial arts intervention designed for individuals with early to mid-stage Parkinson's disease (PD). 

The community-based effort intrigued her enough to sign up as a volunteer.  She was subsequently awarded a fellowship, which enabled her to attend all the karate classes, as well as the pre- and post-intervention study visits, including mobility testing and assistance with focus group facilitation.

Before medical school, Sennott had attended the Johns Hopkins Bloomberg School of Public Health and received a master's degree in public mental health. She had previously enjoyed working with community organizations to implement interventions for patients, and now found it remarkable how much participants in Kick-out PD enjoyed doing an exercise class with a community of other people who were living with PD. She continued her involvement throughout the rest of medical school, and hopes to train to become an academic movement disorder specialist just like several of her mentors.

What drew you to neurology?

The human connection between the neurologist and patient—especially someone with a neurodegenerative condition—is extremely special. You are working with patients whose diagnoses impact how they fundamentally function in the world, and in some cases, affect their ability to process those changes.

How has the pandemic shaped your views?

None of us who chose to specialize in the nervous system could have predicted that neurologists would be responding in the manner we have to an infectious disease.  It was an eye opener. I was on the sidelines as a medical student but hearing about the neurologic presentations of COVID-19 from a loss of smell to stroke to long-term effects, I could not have previously imagined this  scenario. This unpredictability, as well as the many different clinical roles that neurologists were called to fill as part of this crisis response, underscores how important  foundational medical knowledge is as the basis of many subspecialities. I am looking forward to residency to focus on being a neurologist and to becoming a fully functional member of the medical team. ​

Gabriella de Paz, MSY-4, University of Florida College of Medicine

As an undergraduate at MIT, de Paz studied bioengineering with a concentration in literature, while her best friend enrolled in an entrepreneurship and business track.  One day, after long hours working in a coffee shop, both students ran low on cell phone batteries, and in their frustration, an idea was born.  Why not create wearable battery technology infused into fashion accessories? 

Up until then there had been only clunky chargers developed for camping gear, so sensing a market void, they created a startup together.  At the height of the company's success, de Paz was lured to work in a pilot program at the Massachusetts General Hospital to test wearable devices to help manage childhood obesity.  Her interest in medicine developed over the ensuing year and a half and she decided to apply to medical schools. Even then, neurology was the last specialty on her radar, but when she was finally exposed to the so-called “dreaded neurology block" at the end of her second year, she was inspired from the very first lecture. Months later, when she did her clinical neurology rotation, she absolutely knew this was the field for her.

What drew you to neurology?

From the time I heard that first lecture to the time I spent on the neurology wards, it felt very much like a call back to the engineering style of thinking, in which we are asked to fundamentally understand the way a system works in order to deduce what is going wrong and, ultimately, to innovate upon that system.  I loved the importance and robustness of the physical exam because it felt like detective work rather than memorization.  I also was wonderfully surprised when I was introduced to neurologists, these curious, excited, collaborative people, doing so much for their patients and developing a close and personal connection to them.  I felt like I had found my place.

How has the pandemic shaped your views?

The COVID-19 pandemic has made me appreciate the year we spend as interns doing general medicine.  The nervous system interrelates with every other organ system in critical ways, and this has been brought into sharp relief for me by a virus that causes lung and other organ failure as well as hypercoagulability, stroke and myriad other neurologic manifestations. This virus has pulled residents from neurology to COVID floors because that is where patients need us to be. The pandemic has served as a resounding and humbling reminder that neurology cannot exist in isolation, and that our preliminary year of internal medicine is the best introduction we can receive.  Finally, the pandemic has allowed me to consider and appreciate again the role of wearable tech and remote monitoring of patients with neurologic disease.​