Stepping Stones
/I vividly remember walking into my grad school mentor's office, sitting down at the table and chairs, and fretting, "Dr. Schramm, I'm so torn about what to do: do I pursue the post-doc or do I take the position at this start-up in the city?”
I absolutely loved bench research, adored biochemistry, and hated cancer. My thesis research entailed characterizing the mechanism of action of a transition state analog inhibitor as a potential chemopreventive agent in various cancer models.
There was nothing like watching cancer cells die in culture or mouse models. It was intoxicating. Generating data that could be replicated and was statistically significant was the most incredible high. I would have worked 24 hours a day running experiments if some version of sleep wasn’t required daily.
But there was a tangible void. Research left me wanting for so much more. I philosophically struggled with mainly concentrating on one aspect of a metabolic mechanism out of potentially thousands and thousands of others out there. This narrow focus left me hungry for intersectionality and cross-functionality, which my work didn't provide.
As a kid, I faithfully watched Nickelodeon’s Mr. Wizard’s World. I tried replicating a bread mold experiment when I was about 5. It was a huge success (until my mother found the moldy mess under her bed where I had chosen to incubate it.)
As a teenager, I helped too many loved one’s navigate their cancer diagnosis and witnessed immense suffering. I grew up down the road from Hoffman La Roche US headquarters, and every time I drove by there, I remember peering through the back seat window of my mom’s car dreaming about going to go into pharmaceutical research in hopes of developing new drugs for cancer.
Bench research seemed like the way to go until I came across an opportunity while randomly searching Monster.com for positions with a Ph.D.
The words “Medical Strategist” glared at me from the screen. I remember clicking on the opportunity to read the job description. There was no turning back from that job description.
The medical strategy opportunity was a start-up in the heart of Manhattan at a data analytics company building competitive intelligence platforms for Pharma and Biotech.
There were many technical aspects to the work, including query development and natural language processing. I remember thinking at the time, what the heck was natural language processing?! I submitted my resume and cover letter.
I started polling my colleagues, mentors, as well as professors in the coming days on their perspectives: do I leave the ivory towers and pursue an opportunity with a start-up? One of my closest mentors, Dr. John Blanchard, looked at me when I asked for his opinion and laughed out loud as he took a drag of his cigarette. "A start-up? Why the *uck would you go for a start-up?!".
The responses included:
· That's a waste of a Ph.D.
· Scoffing, eye-rolling, looks of disgust.
· It's OK if you can't handle post-doc and need a way out (ouch).
· I guess if you want to have a family, a start-up is a safer choice (double ouch).
· That's career suicide (good grief).
· You'll never get to the National Academy of Sciences.
That last one stung. I had a deep admiration for my boss, Dr. Vern Schramm, who was just elected to the National Academy of Sciences. It was a dream I aspired to one day myself.
In the meantime, I received an invitation for an interview and then an offer for the medical strategy position.
In one final conversation with my boss, I said, “I know nothing about natural language processing, query development, or business strategy.”
I'll never forget what he said, "Say yes to any opportunity that comes your way and figure it out later."
I made my final decision. I traded my white lab coat and post-doc for a new pair of heels that walked me right to my office next to the Chrysler Building.
My life has been a series of unconventional stepping stones to the unknown, where each stepping stone was an opportunity I welcomed with uncertainty accompanied by a determination to figure it out.
The stepping stones haven't been easy. Some stones were in the middle of a flash-flooded Colorado River.
A diagnosis of advanced lymphoma brought my world crashing down in 2008. Ironically the start-up I worked at was a few blocks from Sloan Kettering Cancer Center, where I went for my second opinion. I was able to manage a flurry of incessant doctor appointments, lab work, imaging, biopsies, and eventually video-assisted thoracic surgery (VATS), and recovery from surgery due to proximity and the immense support of my new boss and team.
After four months of all types of care at Sloan, I was discharged post-op and cleared of a cancer diagnosis, now diagnosed with a fungal infection I had gotten on my honeymoon called histoplasmosis. I was stunned by the miraculous news but grappled with why it was me that was spared.
I met so many other patients while at Sloan. Why was I given a clean bill of health and not the mother in the waiting room with two young kids, the grandma trying to make it to her grandson's wedding, or the teenage soccer player in high school? I cried with guilt.
I remember feeling embarrassed when I walked the halls of my hospital floor while recovering from surgery when I ran into other patients walking in the halls, and they asked me what my cancer was. I held back tears and hung my head as I said, "It's not cancer; it's a fungal infection." Each patient genuinely congratulated me. I wished there was a way I could take their suffering away.
I slowly healed and eagerly returned to work, where I was quickly promoted to Director of Medical and Scientific Affairs. Turns out I had a natural knack for medical strategy and competitive intelligence. I became obsessed with data analytics, market landscapes, NLP, query development with the help of an amazing colleague who was a linguist, and helping companies best position their pipeline agents to go through trials and get to market.
One day, I randomly read an article in the New York Times about patient advocacy as a profession. I was intrigued. I had been a patient advocate since I was a kid. You could do this professionally?! I filed this away in my mind for another time.
Fast forward a few months later, my daughter was born and was a colicky baby that had silent reflux, cried for 12+ hours a day, and did NOT sleep like a baby. I quickly learned how little sleep a human body could (sort of) truly function on. An aspiration and scary 911 call ensured I’d never sleep again, constantly checking her breathing each night.
As maternity leave came to an end and the sleepless nights and crying persisted, I knew I couldn’t go back to commuting to the city and my long hours. I resigned from my position. The mix of postpartum blues and exhaustion made the resignation feel, indeed, like career suicide.
The next stepping stones presented themselves: working from home and diving into patient advocacy as a profession. My practice, Enlightening Results, was born. Patients started calling for help.
I've been presented with many stepping stones over my years in advocacy. I've had the privilege of working with countless patients and families over 20 years. I've had the opportunity to represent the patient voice in many collaborations with national organizations and federal agencies.
If I'm faced with a new opportunity, I cross-examine it with:
· Will saying yes help improve the lives of patients?
· Will it bring meaningful change?
I don't take walking out of Sloan Kettering cleared of my cancer diagnosis lightly and intend to use my time wisely and intentionally.
Most recently, I accepted the opportunity to serve on the National Academy of Medicine's Artificial Intelligence Code of Conduct steering committee.
As I approached the front of the National Academy of Science’s building, I couldn't help but smirk as I was greeted by the ivory stairs. I may not have taken the post-doc much to the dismay of my mentors and colleagues, but ironically, I made it to the National Academy of Science through an unexpected series of stepping stones.
As I left what was an exceptional steering committee meeting filled with hours of thought-provoking and illuminating discussions on crystallizing a framework for the responsible use of AI in healthcare, my life came full circle as I crossed the front lawn of the National Academy of Sciences. There I was, face-to-face with a 12-foot statue of Albert Einstein.
My life had come full circle.
I completed my Master's and Ph.D. at Albert Einstein College of Medicine in the Bronx. When I graduated from Albert Einstein, I received an acrylic plaque that is still on my desk. It reads, "A life lived for others is a life worthwhile," a quote by Albert Einstein.
In that moment, as I stood looking at the statue of Albert, I reflected that I still don't know all the reasons why I'm here, but my work brings me joy, and I know I am right where I'm supposed to be.
I'm grateful for all the stepping stones that have led me here. I look forward to the stepping stones still yet to come.
