IAP Health Reflection: Giselle
Hello! My name is Giselle and I’m a senior in the Biological Engineering department at MIT. I’ve spent the past month an intern at the Autism Program at Boston Medical Center and it’s been a whirlwind of working, learning, collaborating, commuting, and more. I thought it would be appropriate to document some of the highlights here, to try to capture a snapshot of what has been a complex, thought provoking, multi-faceted experience.
I was assigned to the Research Team, along with Kayla and Sahithi. Our supervisors were Belinda and Simone. It was my first experience working a 9-4 office job, and I was honestly surprised by how much I liked it. The office environment was incredibly welcoming and friendly, and they made it clear to us that we were not expected to work outside of work hours. The three of us were working together on two big projects. We all brought different strengths and perspectives to the table, and were thus able to complement each other and work together to produce a better final project than any of use could have achieved alone.
On top of that, I really loved being able to go home at the end of the day and leave work behind. During the semester, the pressure to always be doing something productive is never really off, and I didn’t realize how much stress it added to my life until it was gone! That’s one aspect of this month that I will truly miss—the sense of having a real, healthy work-life balance.
Both of our projects were in areas of research I had previously been unfamiliar with. One was to write up a research proposal to study the Parent Leadership in Autism Network, a program run by the Autism Program (PLAN) that matches parents of kids with autism with trained, experienced parents of children with autism. PLAN has been running for years, but the program has never been rigorously evaluated for its impact, success, and effect it has on parents. Our assignment was to conduct a literature review of all studies evaluating similar programs supporting of parents of children with autism and use the information we gathered to write up a research proposal to evaluate PLAN. We summarized insights from the literature, found validated quantitative measures of quality of life, parental stress, child behavior, and more, and wrote up a list of research questions and how they might be answered. I won’t bore you with the gory details, but we ended up with a ten page research roposal that the Autism Program team can use as a roadmap of options to evaluate PLAN going forward!
Our second project involved another program called TEAM: Teens Engaged in Mentoring. In TEAM, teens with and without an ASD diagnosis mentor younger kids with ASD, going out on monthly outings to promote socialization, leadership skills, and fun 🙂 TEAM was in a slightly different place than PLAN: the Autism Program had conducted yearly focus groups about the participants’ experiences in the program, but were lacking a rigorous way to analyze the transcripts. Simone had recently taken a class qualitative analysis, which aims to identify themes, patterns, and relationships, using “coding” to label and organize qualitative data. Codes are themes such as “leadership” and “adaptability” which are defined in codebooks along with examples, so that different coders can analyze the data in a consistent and reliable way. Therefore, Simone tasked us with creating a codebook to analyze the TEAM focus group transcripts. Our process involved going through the past four years of focus group transcripts to collectively identify themes
We were given free rein to go to whichever talks we wanted, so I and many others in the cohort took advantage. Unfortunately, all the best talks were at 8am. One that I was particularly glad I dragged myself out of bed for was a Case of the Week presentation entitled “New onset psychosis with persistent vital changes”. The senior resident presenting the case began with the patient’s presentation with auditory hallucinations and “bizarre behavior” with hypertension (high blood pressure) and mydriasis (dilated pupils). He then opened up the floor for different audience members to speak, going from the least experienced residents all the way up to specialist clinicians, walking us through the process of diagnosis, treatment, and followup. As a fly on the wall, I loved watching the people in the room pitch ideas and offer insight and discuss the nuances of the case. The case ended up being diagnosed as a case of malignant catatonia secondary to synthethic THC. Watching the differentials get narrowed down reminded me of how extraordinary BMC is as both a teaching hospital and safety-net healthcare system.
We all had the opportunity to shadow one of the clinicians in the Department of Developmental-Behavioral Pediatrics. This experience was a glimpse into the everyday reality of children with developmental disorders and their caregivers. I particularly was struck by a 3 year old girl who came in with her mother, who needed a Spanish-speaking interpreter. Crammed into the tiny room were the nurse practitioner I was shadowing, the patient, her mother, the interpreter, and me. I was sitting on the exam table, while the patient happily played on the floor with a bucket of toys the NP, Christina, had given her. Christina asked a detailed series of questions to the mother, the room filled with three alternating voices speaking Spanish and English, and the constant happy shrieks of the child. She was a boisterous, sweet kid dressed impeccably in bright pink, with bows in her hair and an infectious smile. I soon ended up on the floor with her, stacking brightly colored blocks and and smiling uncontrollably while trying to talk to her in my extremely rudimentary high-school Spanish. Afterwards, I was brought abruptly back to reality when Christina confirmed that she was nowhere near her developmental milestones. I had known on a distant level that it was true, since that was why she had come in, but it felt more personal, somehow, applied to the toddler who had charmed me so effortlessly.
These were just a few of the moments and experiences I had this month—I haven’t written about the adventure of a commute, the friendships we formed, the weekly outreach calls made to BMC parents, any of the numerous projects that the Autism Program has going on that we barely glimpsed. I’ve had an incredible experience and it’s quite bittersweet to be leaving it behind for my final semester at MIT.
Tags: IAP Health 2020