Pediatric Epilepsy Clinical Research Internship at Boston Children’s Hospital

As I begin to wrap up my summer internship, I started to reflect on a few things during my time as a senior pediatric epilepsy research intern. Prior to starting my summer internship, I defined a few learning goals that I set out to accomplish. I wanted to learn the basis of status epilepticus and encephalopathies. I learned this by taking lessons on how to read EEGs, recognizing different classifications of seizures, and learning how to read various EEG reports. Research-wise, I aspired to utilize PowerChart and REDCap and help research assistants enroll patients in clinical studies throughout the summer. By working hard on various projects and seeking mentorship from experienced members of my lab, I was able to achieve all of my goals. In addition to these goals, I was also able to mentor and train the summer interns as well as participate in the fall internship application process. Both of these experiences strengthened my skills in leadership, professionalism, and learning how to stand out among a pool of highly qualified applicants.

As stated in my previous blog post, this internship has reaffirmed my passion for going into medicine. Working at Boston Children’s Hospital and getting to know the patients and their conditions inspired me to take more interest in career fields such as pediatrics and neurology, which I would like to learn more about in the future. While I was able to learn how to conduct various tasks, I was also able to learn more about myself in the process. From this experience, I learned that I like clinical research, leading a team, and learning more about how epilepsy manifests.

If I could give some advice to a student interested in this internship or internships in clinical research, I would advise students to apply to as many internships as they can and not be afraid to ask any questions throughout the process. I find it important to really be involved in a lab that studies what you are interested in! This makes the learning process super fun and motivates you to learn more! While in the process,  is important to be knowledgeable about the internships you are applying to. This means you should read more about what research the lab is involved in so you can demonstrate your interest during your interviews. Some essential qualities to have if you are interested in clinical research those such as having strong leadership skills, collaboration with your team, respect for the patient’s privacy, and being flexible with different changes of plan.  

This summer, I am most proud of learning how to read EEGs, successfully completing multiple projects, and utilizing leadership skills to mentor the summer interns.  I am also very proud of being part of a team that is striving to implement new changes in the lab by advocating for more equitable resources for all backgrounds within the hospital and the academic opportunities currently running. I am excited to have been given the opportunity to continue to work in the lab throughout the academic year and learn more about epilepsy research. I am very grateful to the Loddenkemper Lab at Boston Children’s Hospital, the Hiatt Career Center, and my family for believing in me and constantly supporting me throughout this internship. I am sad this summer internship is coming to an end, but I am so happy to continue to be part of the Loddenkemper Lab and help make a difference in the field of epilepsy research. See you next time!

— Nandini 🙂

Pediatric Epilepsy Internship at Boston Children’s Hospital

Hello Everyone! My name is Nandini Mandaloju and I am a rising senior majoring in Biology and Neuroscience. This summer, I got an incredible opportunity to continue working as a Senior Pediatric Epilepsy Clinical Research Intern at the Loddenkemper Lab at Boston Children’s Hospital/Harvard Medical School. I would like to thank the Hiatt Career Center for awarding me the Social Justice WOW Fellowship and the Loddenkemper Lab for supporting me throughout this internship!

Boston Children’s Hospital

One of the primary missions of the Loddenkemper Lab, led by Dr. Tobias Loddenkemper, is to prevent, predict, detect, and treat every seizure and status epilepticus in children before it occurs. The Loddenkemper lab uses machine learning and predictive algorithms to detect early warning signs of seizures through the Empatica Wristband. The Empatica Wristband is a revolutionary tool in medicine as it measures physiological data such as heart rate variability and electrodermal activity. We combine these seizure monitoring tools into our in-patient clinical studies to best develop epilepsy care in pediatric patients.

My day typically starts at 7:45 am, as I take the commuter rail to Longwood. One of my best friends, Hima, happens to take the same train and works nearby so we usually walk together to our labs and stop for coffee on the way! Upon reaching my lab, I usually like to spend a few minutes settling down before my morning huddles and lab meetings. Then, I train the incoming interns on the project that I worked on last summer. This project studies the effects of anti-seizure medications on the autonomic nervous system. I am currently working on another project that focuses on Sudden Unexpected Death in Epilepsy (SUDEP), where I analyze EEG reports and label different types of seizures. For these projects, I utilize databases such as PowerChart, and REDCap. Additionally, I learned how to utilize medical terminology, read EEGs, and recognize different types of seizures. I also accompany research fellows of the lab and enroll patients in clinical studies.

This is my workspace in the lab!

One thing I love about my lab is how they encourage their interns to learn more about their goals and broaden their knowledge and perspectives about medicine. I always make an effort to attend the Grand Round Lectures conducted by Harvard Medical School where doctors discuss important topics in medicine such as how to improve the care of children with limited English proficiency. I find it super inspiring to connect with physicians from the hospital and learn more about their perspectives on topics that aren’t often discussed through this lab. I also got an opportunity to shadow my primary investigator, Dr. Loddenkemper in the Outpatient clinic and In-Patient service, and learned how he interacts with pediatric patients with great enthusiasm, intelligence, and care. While at work, I also enjoy spending time exploring the hospital with my fellow interns through activities such as visiting the rooftop garden at Boston

Here is an amazing view from the rooftop garden at BCH!

Children’s Hospital and getting sweet treats such as lemonade and cupcakes. This internship has further solidified my interest to pursue a career in pediatric medicine and I am very excited to continue to build my skill set through this amazing journey!

— Nandini Mandaloju

WOW Blog Post 1- Getting Started at Ariadne Labs

This summer, I have the incredible opportunity of interning at Ariadne Labs’ Serious Illness Care Program. Ariadne Labs is located in Boston, MA and it is an organization made up of 150+ physicians, researchers, and analysts who pride themselves on improving outcomes of patients in health systems. Their work is oriented around quality improvement using universal guides to provide clinicians in order to minimize errors in care. They utilize a system known as the Ariadne Arc to design, test, and spread scalable solutions in health care.

  For example, these solutions include a conversation guide for Serious Illness Care clinicians, a surgical checklist for the operating room, and a BetterBirth checklist to improve the efficiency of the birthing process. 

My specific tasks through this internship will change every 2-3 weeks, however for this first stretch, I am working on sorting qualitative and quantitative data from the implementation of years past. A major focal point of this organization is measuring whether the implementation of programs has benefitted the health systems that use them and improve patient outcomes in the long run. In 2018 and 2019, Ariadne Labs implemented the Serious Illness Conversation Guide to 22 different health systems and trained clinicians to engage in better conversation with their patients through the guide. My job is to help measure whether this implementation was successful for these health systems and gauge whether there was a lasting impact of improved conversation between clinicians and patients. Specifically, I am tasked to sort the 200+ pages of data into a meaningful way to produce a manuscript of our implementation outcomes. So far I have successfully sorted through almost half of the data and will work towards finishing the other half by early July. The impact of my work will allow the organization to gauge whether our guide is able to be used in healthcare settings and if any changes need to be made to the implementation process.

Second, I am also a member of the Patient Guide project team where, upon approval from the Institutional Review Board, I will be able to take notes and even facilitate interviews with Serious Illness patients and families on the “What Matters Most Workbook”. The purpose and impact of this project are to ensure that clinicians are aiming towards patient-centered care and listening to the goals and values of each patient before jumping to treatment options for serious illness. As of now, I am in charge of formatting the workbook so it can be more user-friendly and ensure there are no technical issues with filling out all the important information which is the basis for each interview.

As I embark upon this journey of improving patient outcomes one step at a time, I have three goals in mind. I would like to tackle the issues in health care delivery and how to create scalable solutions to combat inequalities. I hope to prepare for patient interaction as I work my way up to medical school and beyond. This opportunity positions me to prepare for conversations with patients surrounding their medications and diagnoses and generate a human-centered design process for this patient guide. I hope to be more aware of methods of conducting clinical research and tying it to creating notable solutions in healthcare while expanding my network of healthcare professionals. Lastly, contributing to the development of the quality of life for patients battling serious illness would be a tangible goal that I could attain by being a part of this transformative research initiative.

— Ayush Thacker, Experiential Learning Fellow 2021

Post 2: Learning and Understanding the Impacts of Socioeconomic Burdens in a Community

It was not until I got to Brandeis until I started to consciously think about socioeconomic issues surrounding different communities. Before my studies as a Health: Science, Society, and Policy major (Public Health), I understood the basic concepts of first- and third-world countries, developed- and developing-communities. While at Brandeis I took classes introducing me to a wide array of global health issues affecting communities in the world. I learned about the impact that Water, Sanitation, and Hygiene (WASH) programs and clean cookstove initiatives can have on low-income developing communities.  I knew since before I arrived at Brandeis that I was privileged to be raised with opportunities that kids my age in Uganda would never dream of having.

My internship with Love4Bukwo Hospital is at a point of organizational development with which they are not at a fully operational point. Although Love4Bukwo is already built and the structure of the hospital has already been created there is still much to do. Working at my internship I have been primarily tasked with working to create policies that will be implemented upon the opening of the fully functional hospital. As I have researched and curated policies administered at the hospital, I have been able to understand how my work will directly impact the people of Bukwo.

At the beginning of my internship, I researched the socioeconomic conditions that people of Bukwo faced. This allowed me to really understand what it is like living there. Through previous courses on campus, I began slowly understanding what sort of socioeconomic differences are typically found in third world developing countries, specifically in Africa. While researching those that affect Bukwo, I learned how these burdens affect the citizens of this rural town.

Before Love4Bukwo began working on building a hospital, on top of dealing with communicable disease burdens prevalent to Africa or the Global South (i.e. Malaria and HIV/AIDS) the people of Bukwo had no way to readily treat health issues they may run into. The organization that I am working with is bringing healthcare to these individuals. Once operational, mothers will no longer be reliant on uneducated neighbors to treat labor complications, workers will no longer have to sacrifice their work for being injured and not treated, community members will no longer be dying during transportation to a nearby hospital sometimes over two hours away in Kenya.

Love4Bukwo Hospital is creating a means to bring first-world solutions to a developing low-income third-world community. The Love4Bukwo organization is not the ultimate solution to address all of the issues facing community members of Bukwo, Uganda. However, being a part of this organization and creating a solution to address even just some of the socioeconomic burdens that face the individuals in Bukwo is satisfying. I know that the research that I do virtually during my time with Love4Bukwo will change the lives of many individuals in the town once the hospital is up and functional. I am happy that although I was unable to travel and experience the culture and what it is like to live in Bukwo over the summer that I am still able to be a part of the initiative that fuels the organization: bringing affordable and accessible healthcare to the people of Bukwo.

Post 3: Finding Power in Coalition Building and Communal Growth

Hey everyone!

This week, I have been thinking a lot about how I define change and progress both personally and within the organization where I am working. In thinking about the goals of my organization–which are very much centered around social justice and health equity– it is always crucial to question where there are areas for continued growth and development, while also acknowledging the big and small strides and positive outcomes. This evaluation is key in assessing what could be the most effective steps to reach our goals as an organization.

With the goal of making equitable maternal healthcare accessible to low-income families, as well as black and brown folks, Ancient Song Doula Services wears many hats as a community-based organization. It is important to note that this lack of access to healthcare, resources, food, and housing stems from a much larger root cause: anti-blackness. Because of this, reaching our goal as an organization is not solely about providing resources to our communities, but also involves taking action around the systems and institutions that first put these barriers in place. Given the immense nature of this multi-faceted goal, what one could consider an “immediate success” becomes difficult to measure, making endurance and consistency key in this work.

At Ancient Song Doula Services, we are constantly multi-tasking, taking on different roles, planning for community outreach events and reaching out to other organizations for support and/or partnerships. We are always looking for different opportunities to spread the word and collaborate with other social justice collectives because it is crucial to identify the intersection of different movements, whether it be birth justice, food justice, or environmental justice. It can be very stressful–especially for a small organization–to take on such a wide range of tasks, but this is why we stress the importance of collaboration and solidarity.   

” A Day of Solidarity” held at the Schomburg Center for Research in Black Culture. Click on the image to watch the full panel

So, what does change or progress look like for me? Progress, I’ve learned, is very much rooted in and driven by coalition building and communal growth. Recently, my supervisor was a panelist in an event called “A Day of Solidarity” held at the Schomburg Center for Research in Black Culture, where the panelists engaged in a conversation around the recent policies regarding the separation of immigrant families and discussing ways to take action. One of the main topics discussed was how crucial it is for communities to gather in support of each other, stand in solidarity as allies, engage in dialogue and, most importantly, listen to each other. Listening and trusting one another gives marginalized identities agency over their own narrative and experience. At Ancient Song, we often practice this is, as we not only hold events by and for the community in collaboration with other organizations, but also center our workspace around physical and mental wellness. In this way, I’ve learned that, as an organization, listening and building trust and community allow us to constantly assess and reassess the needs of the communities we serve so that we can continue to evaluate our methods for change and be that much closer to reaching our goals.  

There is power in unification, as it is crucial not only for the healing of marginalized identities, but also, in standing firmly against or for a movement and demanding action. This is progress.

One step closer to the world of medicine

This summer, I have the opportunity to work in Dr. Lichtman’s Immunology and Cardiovascular research laboratory of the Brigham and Women’s Hospital Department of Pathology.

Me (right) and my coworker (left)

I have never worked in a lab before. In my mind, I thought working in a lab would be similar to my experience in college’s lab courses. However, the first day I came to the lab, I was amazed by how basic science research can potentially lead to huge development in the medical field in terms of diagnosis and treatments for patients. As the post-doc, Eva, I work with briefly explained to me the projects that were going on in the lab, I realized that I needed to read and self-study much more so as to be able to understand the research and ultimately to be a part of it. My impression about the lab during the first week is that doing research is challenging, but at the same time very intriguing and that I would be able to learn so much from not only my supervisor but also from other talented people in the team. The picture above is me (right) and one of my coworkers who is actually a Brandeis alumni (left).

As I get a better idea of the lab, I have set some goals for this summer:

Regarding academic goals, I want to establish a solid background in basic immune system functions, and how such immune responses can cause diseases. In preparation, I have discussed the basic science underlying this project with Dr. Lichtman and spend a portion of my free time on the weekends reading and taking notes from the textbook he published and recommended to me. I was surprised to learn that the book is also used as a learning tool in many medical schools!

Furthermore, I also aim to master the molecular techniques used in the lab and in day to day research, such as immunohistochemistry and tissue slicing on the Cryostat. This will allow me to not only make progress in my project but to effectively assist other team members in their research by generating accurate data.

Thus, I will learn how to use empirical scientific research in order to contribute to the medical field by learning from the PI and other team members.

Considering career goals, I plan to pursue a career in medicine that includes patient care and clinical or lab-based translational research. As I work in a clinic-based laboratory as a summer research internship, this experience will also allow me to explore different aspects of medicine. As I will attend department conferences and seminars throughout the course of the summer, I will be able to develop a more well-rounded understanding of medicine and the interconnection between its different aspects. I can furthermore establish a professional network at Brigham and Women’s Hospital by meeting with the professionals such as physicians, researchers and educationalists who make enormous impact on people’s lives and on the community in their everyday work.

As for my personal goals, I hope this summer experience will help me to grow intellectually, think scientifically, and be able to contribute to important work relevant to human diseases. I look forward to emerging myself in the Longwood medical area – a hub of biotechnology, of research and ultimately of medicine.

-Phuong Anh (Phoebe) Le-

Post 1: Doulas Crucial in Ending Racial Disparities in Maternal Health

Hi everyone!

My name is Marleny and I am a rising junior and STEM Posse Scholar at Brandeis University. This summer I am an intern and co-coordinator at Ancient Song Doula Services, a Brooklyn, NY-based and low-cost doula service.

As a reproductive justice organization, our goal is to serve families of color and low-income families who do not have access to doula care. Through a collective of several services and resources for parents of color and low- income families, we ultimately aim to bridge racial disparities in maternal health by addressing racial and implicit bias.

In New York City, the maternal mortality rate, for example, is 12 times greater for Black women than for white women. Given that systematic oppression is a social determinant of the high Black infant and maternal mortality rate, shifting tasks and responsibilities down the hierarchy of the healthcare system are both necessary and ideal for the survival of marginalized communities. For these reasons, the most crucial aspect to birth equity is free and low-cost doulas services such as Ancient Song Doula Services.

Given that there have been recent opportunities for reform within maternal health as New York’s governor Andrew Cuomo proposes a state doula pilot program that includes Medicaid reimbursement as well as a Maternal Mortality and Morbidity Review Committee, Ancient Song also centers their work around political reform and advocacy for the marginalized communities it serves. Prioritizing the reimbursement of community-based and culturally-relevant doula services through Medicaid is key to bridging racial disparities in maternal health, so we have been gearing most of our attention towards this lately.

A lot of my responsibilities, as of now, include community outreach, writing testimonies to present to the city council, planning events to gain momentum for our #ourtimeisnow campaign for birth equity, and creating promotional material to share with the community and with other local and national organizations.

Additionally, while we continue advocacy at such a crucial time, I am responsible for coordinating our third annual Decolonizing Birth conference called “Decolonizing Birth: Addressing The Criminalization of Black and Brown People within the Healthcare System,” which is being held September 22-23. This involves looking for sponsors, keynote speakers, and reviewing proposals for prospective workshops. My internship requires a high level of responsibility and I am really enjoying my time at Ancient Song for the second year.

The work I am doing is super important and falls in line with my career goals. By the end of the summer, I hope to have improved my ability to manage my day to day tasks and become more familiar with the policies that have been and will be put in place to address the disparities in maternal health. I am looking forward to sharing my journey at Ancient Song with you all this summer and I am looking forward to what is to come!

Wrapping up

Throughout my internship I have learned so many valuable lessons. The most important one is that you have to be flexible, creative, and reflective because everything is a learning process. Working at a relatively new start-up has also reinforced this. The programs OSW runs are extremely new and depend heavily on the audience. For example, the program we run in downtown Oakland is extremely different from the program that we run in Alameda because there are two different, distinct demographic groups that attend each one. The people who attend these events are receptive to different movement coaches, music, and food, so we have to be extremely aware of what different people need and be flexible enough to change our program to fit their needs while still providing the same support.

At the end of one of our programs last week, my bosses came up to me and said, “We’re never letting you go. You have to stay and become head of HR and our operations director. You can’t go back to Boston.” Honestly, that meant so much to me because it showed me that I am actually making a difference. As an intern, I sometimes feel as though I am learning a lot from the organization and the experience, but that I am not giving back as much as they are giving me. This showed me that I was wrong. Now that I am taking this time to reflect, I think I helped the organization branch out and make connections with different providers in the area, find potential new interns for the fall (to replace me), and create a fluid transition when they shifted their main program to a module system earlier this month.

As I have written in previous posts, my internship is not a typical internship. My bosses push all of the interns to step outside of our comfort zones with projects, be vulnerable with them and each other, and be confident in everything that we do (whether or not we feel that way inside). I wish I had known this about the organization beforehand because I believe it would have taken me a lot less time to open up to them and become comfortable doing these things. I think I would have been a better intern from the very beginning instead of half way through.

My advice to any future interns at Open Source Wellness or people seeking an internship in healthcare or nonprofit work is to be open to new experiences and different types of people. A career in social justice or health care both involve working with people who have backgrounds that are completely different from yours and from each other. Be open to them and what you will learn from one another. Also, make connections and be authentic. Oftentimes, when people are struggling with difficult health issues, they are embarrassed or distressed about their situation. It is extremely important to connect with them on a personal level and share your own story and struggles so they know they are not alone and have nothing to be ashamed of. Finally, be passionate. A career in public health or community health is not easy because change happens slowly. Only people who are truly passionate about healthcare and community health will have the patience to make lasting change.

Here are the only two photos I have at work:

(The interns practicing taking each other’s blood pressure)

(Me taking a patient’s blood pressure during our program)

Thank you for keeping up with my summer journey!

My New Skills

Over the past eight weeks my internship at Open Source Wellness has allowed me to grow and learn so much in a short amount of time. I believe this is mainly due to how small and young the organization is. The OSW staff is composed of the two founders, four undergraduate interns, and one graduate student intern, and officially started running programs in October of 2016. Due to this structure, I am given a lot more responsibility than most interns at larger organizations are given. I have gained numerous skills because of the uniqueness of start-up culture.

First, I have strengthened my organizational and leadership skills. During our Tuesday night events, I have been tasked with helping coordinate and organize the event, and with leading the meditation portion for two weeks. Although these tasks were daunting at first, I have seen that I can take on challenges that are typically out of my comfort zone and still succeed. At Brandeis, I am a coordinator for Big Siblings through Waltham Group. As a coordinator, I am in charge of running and leading multiple events. I believe my responsibility to help run OSW events and leading the meditation sessions have helped me gain both the skills necessary to organize the logistical aspects and have the confidence to lead the actual events.

Second, I have strengthened my professional networking skills. One of my main jobs has been to reach out to healthcare providers to form referral partnerships with them. I call, email, and meet with them to explain the program we run at Open Source Wellness, and urge them to refer their patients to us. Through this task, I have gained extremely valuable networking skills. I now know how to speak with professionals on an individual basis, and I have gained more confidence when I speak with people who are much older than I am and who have a lot more experience than I do. This will help me in the future with my networking skills because I will know how to communicate professionally and be Pleasantly Persistent.

Third, I have learned how to understand and relate to people who are different than I am. Many of the individuals I work with live in a low-income, re-entry housing community, and are mainly people of color who have been incarcerated or homeless. This is a very different demographic than I am used to working with and that I, myself, can relate to. Through this experience, I have found ways to connect to people who are extremely different from me. I have seen firsthand that most people struggle with the same health issues, regardless of their backgrounds, socioeconomic status, or ethnicity.

Lastly, I have also learned a lot about myself in the workplace, including my strengths and weaknesses. I have discovered that it is difficult for me to draw boundaries when I am asked to do something that goes beyond my capabilities or job description. I find that when a superior asks me to if I want or can do something I say yes, almost automatically, even if I cannot. I have been pushing myself to stick to my boundaries and communicate with my supervisors when I am unable to do something. Here is an interesting article about crossing boundaries in the workplace. I also found out that it takes me longer than most people to become comfortable in a work environment. It took me a few weeks to get to know the work environment at OSW before I became comfortable, personally and professionally.

Furthering Social Justice

Open Source Wellness officially began running their first event in October 2016 and their second event this past April. Considering it is an extremely young organization, the founders have many goals and milestones they want to achieve. Their main social justice goal is to reach more people in low-income communities.

The organization was founded by two psychologists, Liz and Ben, who came up with the idea behind Open Source Wellness while they worked in different health clinics in Boston. They continuously saw patients who were referred to them by doctors who told the patients that they needed to change their eating habits, exercise more, or reduce their stress to combat the chronic health conditions they were facing. Wealthier patients could hire a nutritionist, personal trainer, or join a meditation group. However, people who lived in low-income communities went back to their same lifestyle because they did not know how and did not have the means to change the way they ate or acted. Through these experiences, Ben and Liz decided to open a “behavioral pharmacy” to help people make major lifestyle changes at little or no cost. Their doctor could write a prescription to go to Open Source Wellness to get support in making lifestyle changes. Even though this is their mission, Ben and Liz have been struggling to reach this demographic.

Below are pictures of Liz and Ben:

 

To combat this issue, the other interns and myself have been reaching out to providers, including clinics, doctors’ offices, and community centers in low-income areas in an attempt to form a referral partnership with them. We have been giving them free spaces that are reserved for their patients in our month-long program upon their referral. By reserving certain spots for their patients, we are creating a scarcity of spaces that they can fill which will incentivize them to fill the spots. Hopefully, once they see how helpful the program is for their patients, they will start sending more people. Some of the clinics we have been speaking with seem extremely interested in our mission, so we started talking with them about running an event in their clinic. These would be solely for their patients or members and would happen in the clinics or centers. West Oakland Health Center and Project Open Hand are two of the groups that we have been meeting with.

If the clinics followed through with their pledge to get their patients to sign up for our July cohort, which starts on July 11^th, that is what progress would look like. It would also include one or more of the new clinics or centers allocating money to OSW to begin an event in their building, exclusively for their patients.

Provider outreach has been my main long-term task as an intern at OSW. I have spent countless hours emailing, calling, and meeting with doctors and administrators to tell them about the program that OSW offers, and to speak with them about creating a referral partnership.