Disclaimer: To avoid breaching patient confidentiality per hospital policy, names and circumstances have been altered. However, the spirit of the interaction with patients was preserved as best as possible.

a young doctor with a patientAs I sit here typing at 3:23 a.m., my sandpaper eyes can just barely focus on a keystroke before looking yearningly at my bed. But, in just under an hour, I will be heading over to the hospital to begin another full day on my medicine rotation, with chart reviews and studying to follow late into the night. This is the only time I can take a breather to write. But at such an early hour, there is little else that can engage me. So I think of what would make me excited to write. And quite easily, my patients come to mind.

People assume that in medical school, students have incredibly capable teachers and mentors who expertly guide our learning. They’re right; the image of a practiced doctor passing down her knowledge to impressionable young physicians in training is an accurate one. We have excellent faculty who not only meticulously teach us medicine but also serve as exemplars in their everyday interactions with patients. Yet, even after having learned from some of the most brilliant and kindest doctors, I can undoubtedly say that the greatest teachers I have had are my patients.

With every patient, textbook material becomes augmented by people who are able to share their real life story with you. Their presenting symptoms, responses, and physical exam findings become your new foundation for understanding conditions. Also, the gravitas of learning changes; when you miss a question on a written test, there is little consequence. When you miss a diagnosis in a patient with a serious condition, you can never forget. And even beyond the medical facts, you learn how to pause and listen. You learn to look beyond a constellation of symptoms and see patients as people who might be scared — especially the ones who seem so bitter and angry. Every patient tells a story, and our duty as physicians is to respect that fact, and listen.

""Mr. E is a 44-year-old gentleman who comes in about twice a year for extremely painful episodes from his sickle cell disease. A vaso-occlusive crisis, or VOC, occurs when abnormally shaped red blood cells block small vessels and prevent oxygen from being delivered to tissues. In textbooks, the pain from VOC is described as intense and debilitating. In room 409, it is Mr. E curled up in a fetal position — grimacing even as I enter the room.

This is a man who is in more pain than I’ve ever felt in my life, and he somehow has the capacity to warmly wave me closer. When I introduce myself, he turns his grimace into more of a smile. In short breaths, he manages to tell a detailed story of his journey with sickle cell disease. As he speaks, the presentation of VOC becomes firmly affixed in my mind. I also learn that he has a big dog named Beethoven. Afterwards, during the physical exam portion when I listen to his heart, he gives me a toothy smile and explains. “I have an S4 heart sound. Doctors say it’s rare.”

He is right. Until that point, I had never heard something like that outside of an audio recording or simulation. He tells me to let other physicians or medical students know, in case they are interested in hearing it, and grins again when I take another listen. When I thank him for his time, he tells me that he is always happy to have people learn more about his condition — that maybe someone he sees will one day help cure his disease for others.

It is incredible that patients — sometimes in what is possibly one of the worst situations in their life — could be so magnanimous. There are so many other stories besides Mr. E’s that have left me inspired, sometimes heartbroken, but always thankful for the privilege to learn from them. In our time of training, every patient we see is a part of who we become as doctors; their stories are woven into our practice. But, it seems self-centered to only think of my own journey. That is why, at 4:10 a.m., as I begin what will most likely be another very long day, I take a pause to remember patients like Mr. E and wonder how he and Beethoven are getting along. I remind myself to be thankful and feel privileged to meet such incredible people like Mr. E every day.

And then I am refreshed.

After all, today I will learn yet again from the greatest teachers in medicine.

Related Content


No Comments

About the Author

John Choi

John Choi is a lactose intolerant medical student who believes in the power of sharing stories and regretfully loves cheese.

“The best laid schemes of mice and men…” begins the oft-quoted line by Robert Burns, with usually no need to finish with “…go often awry.” Most understand; we as humans make plans, and then life finds a way to complicate them. However, for trainees in medicine and science, planning composes a major requirement of our lives in both the immediate as well as the long term. How do we reconcile this contradiction? Those who can balance this struggle between order and chaos are the ones who do well in careers that require long-term planning as well as short-term flexibility.

planning aheadBut for today, ask yourself this: If I could not come to work tomorrow, what would the consequences be? What about if you could not make it the day after tomorrow? The week or month after? For some of us, this thought experiment is very stressful, yet these questions need to be answered. For others, this experiment becomes reality.

Two months ago, I was in a severe traffic accident. I am very fortunate that the ambulance driver noticed my ID badge clipped to my pants and took me to The Johns Hopkins Hospital for surgery — the work the care team did there was absolutely spectacular and I’m recovering at home quite nicely today. But the key phrase here is “at home” rather than “in the lab.” Which means out of the blue, I had to answer a number of pressing questions about how to cover my responsibilities, and unfortunately, I was firmly rooted in the group that found the above questions stressful. My boss was exceptionally helpful and understanding, as were my lab mates, who volunteered to cover my various roles, including significant mouse husbandry and other lab duties. The problem of my not planning for this type of situation remains, however; because I was forced to scramble to plug these gaps, my thesis project has been set back significantly and my responsibilities floundered before being saved only by the grace of my lab mates.

'''This has been a hard lesson to learn, but one I hope to need to learn only once: your planning should include a contingency plan for how to cover an unexpected absence. We already know life is full of curveballs, some of which may require stepping away from your job or school for a short or extended amount of time. A medical or mental health emergency, a sickness or death in the family, or even something more benign, such as being stuck out-of-town by a grounded airplane, is always a lot closer at hand than we like to believe.  Having a contingency plan — which is different from the plans you make while scheduling an absence, such as a vacation or prescheduled medical leave — is one way to make sure that when an emergency arises, your research or academic duties aren’t left in a state of disarray. In the case of planned absences, you know specifically when and how long you will be away for, and can make specific plans for that stretch of time. But  a contingency plan covers the unexpected. This should be a dynamic and accessible plan that evolves with your roles and responsibilities, to prevent your job (and your home) from being thrown into utter confusion if you unexpectedly cannot attend to responsibilities.

Unfortunately, it’s a challenge for us to plan for the unexpected and uncomfortable to dwell on the possibilities that might lead us there. However, as our careers advance, our roles and responsibilities increase and diversify as well. As we embrace this increased importance, it becomes more essential to develop proper contingencies, so that we, and the people who rely on us, are not left uncovered and unprepared when the unexpected inevitably occurs.

Related Content

No Comments

About the Author

Benjamin Bell

Benjamin Bell studies sleep and circadian rhythms in mice and flies, and is fortunate the mice understand his semi-nocturnal work schedule. When not actively in the lab, you can find him thinking about research and science-writing on his motorcycle, on the hiking trails, or at any local concert venue.

The author's poster at a conference.

My mentor, Dr. Valle, and I presenting our work on a new rare bone disorder at ASHG 2016

Academic conferences are an integral part of a graduate student’s training. They are not only a window into the life of a professor but also help you to connect with colleagues across the globe. Even better, you get to spend time outside of the lab with your lab mates while still learning new things about your field.

As a second-year graduate student in the human genetics program, I had just settled into my thesis lab after my rotations when my lab mates and I started to prepare for the American Society of Human Genetics (ASHG) conference. Luckily, that year the meeting took place in Baltimore, so everyone in the lab, including me, was able to go. I remember wondering what I would need to do to prepare and how I would even start. Here are a few tips I wish I had known before my first academic conference.

  1. First of all, before anything else, ask to attend! You can talk to your thesis adviser or lab mates, or search the internet to find a conference that is relevant to your field. Most conferences have a website with a list of scheduled talks that you can look at to identify any sessions that would be helpful to your research. You might need to search for additional funding to help supplement your costs, however, if your lab can’t afford to send you. Luckily, for graduate students in the school of medicine, the Graduate Student Association offers travels grants every three months to help students pay to attend conferences. Once you’ve outlined the benefits of attending and have found ways to offset the costs, your professor might be very eager to send you.
  1. Prepare a poster or talk to share your work with the scientific community. Not only did making a poster allow me to share my work with other scientists, but I also received a lot of great tips from other researchers that I met while presenting posters at conferences. This specific feedback has helped me to optimize and refine several experiments before sending that work in for publication.
  1. Attend as many lectures as you can, but make sure to leave time for checking out the exhibit halls. The talks are the bulk of the conference, where most of the cutting-edge research is being presented. However, the exhibit halls are also great sources of knowledge! Usually, you can find a poster that is relevant to your work or an exhibiting biotech company with a new product that might be helpful. If not, you can always grab a free shirt or chat with other graduate students, postdocs and professionals about their science.
  1. The author and friends explore after a conferenceDress professionally. Even though you might wear jeans and a T-shirt to lab every day, at a professional conference you should dress as if you’re going to meet your next supervisor. Chances are good that you might! Conferences are a great place to network, and you want to leave a good impression. You may even find a lab to postdoc in or a company to work for!
  1. Explore! You may be in a different city to attend this conference so you should make the most of it! Leave some time to have fun and sample some of the local cuisine. When I attended ASHG last year in Vancouver, my lab mates and I checked out a local beach one evening after our day of lectures.

Good luck preparing for your next conference!

Related Content


About the Author

Sarah Robbins

Sarah Robbins is a human genetics Ph.D. student. Her skill at reading recipes has made her able to translate her talents from pies to PCR.

pillsEpidemic. We typically associate this word with infectious disease outbreaks, often outside of the United States. But right here in the U.S., we are in the middle of a unique epidemic: an opioid epidemic. Opioids have long been used for the treatment of short-term pain, and more recently for long-term pain. But rising rates of opioid prescriptions have also been accompanied by an increase in the rate of drug overdose deaths, causing concern in the medical community about the safety of continuing to use these drugs.

What Makes Opioid Addiction So Difficult To Treat?

The use of opioids to treat pain began as many as 5,000 years ago, when ancient Sumerians grew poppy plants, which contain opium. Opioids work by binding to opioid receptors on nerve cells; the resulting conformational change in the opioid receptor stops pain messages from traveling to the brain. Unfortunately, opioids can bind to any nerve cell with an opioid receptor, regardless of the cell’s location, leading to negative and potentially life-threatening side effects. Breathing and heart rate are both controlled by nerve cells in the brain stem, for example, and when these cells are bound by opioids, their function is drastically depressed.

Other key concerns surrounding opioids are their addictive power and the propensity to develop tolerance. In addition to blocking pain, opioids stimulate the release of dopamine, causing a feeling of pleasure; this draws individuals to want to experience it more, causing addiction. Tolerance develops as the opioid receptors in the brain become less responsive to stimulation. As a result, higher doses of the opioid are required to achieve the same pain-killing effect, causing some patients to remain on the drug long after their initial pain subsides.

W""eaning a patient off opioids is not a simple process either. As a patient takes opioids over time, their nervous system makes key changes to overcome the suppression of respiration, blood pressure and activity caused by the drug. When the opioid is removed, these changes are still in place, leading to overactivity of the system. The withdrawal symptoms of jitters, anxiety, muscle cramps and diarrhea present a major challenge to ending a patient’s dependence on the drug.

Two Approaches to Opioid Addiction Research At Johns Hopkins

Addiction, dependence and the potentially life-threatening side effects make the opioid epidemic a difficult one to treat.  The Johns Hopkins Hospital has a Behavioral Pharmacology Research Unit (BPRU), where researchers are working to develop ways to combat opioid addiction and dependence. The BPRU is able to directly test the effects of drugs on human volunteers in a laboratory setting, allowing for tightly controlled studies. The goal is to find a way to help people wean themselves off opioids without experiencing debilitating withdrawal symptoms. Dr. Eric Strain of the BPRU works with buprenorphine, an opioid used for detoxification from strong pain-killing opioids, which helps negate withdrawal symptoms. Work to optimize use of this drug primarily happens at Johns Hopkins. Through his research with buprenorphine, Dr. Strain has improved the way physicians can care for patients facing opioid addiction.

Other researchers have taken another approach, choosing to focus on identifying new compounds to treat pain in a more targeted way as a means to eliminate the need for opioids. Johns Hopkins features a Pain Research Core made up of physicians and basic science researchers who work together to identify new ways to treat and manage pain. Dr. Srinivasa Raja, a principal investigator and member of the Pain Research Core, recently received a large R01 grant from the National Institutes of Health to fund his exploration of pain mechanisms. Dr. Raja’s lab focuses on understanding the roles of the opioid and adrenergic receptors in neuropathic pain. His work helps identify targets for drug treatment that are in the peripheral nervous system instead of in the brain, which would alleviate many of the negative symptoms of opioids and make the drugs less likely to be addictive.

Since the introduction of opioid pain killers, over 100,000 people have died in the United States from using these drugs. As the opioid epidemic becomes more nationally recognized, more research and funding are being dedicated to the problem. As with any other disease, new treatment options will be found to change the lives of those affected by this opioid epidemic, and Johns Hopkins will continue to play a key role in the fight.

Related Content



About the Author

Rebecca Tweedell

Rebecca Tweedell is a fifth-year Ph.D. student in the Cellular and Molecular Medicine program with a strong passion for infectious disease research. In addition to loving anything and everything nerdy and generally uncool, she is an avid runner, rower and random sport participant. Her dream job is to be a Disney princess, singing and performing by day, while writing scientific manuscripts by night.


The author and his friends celebrating a medical school milestone.

I finished my first marathon last week, a personal mental marathon that took hundreds of hours to complete—my first year of medical school. Our last lecture on that final Friday afternoon was followed by a barrage of claps, applause, cheers, celebratory pictures for Facebook and Instagram photos, and a general sense of urgency to leave the building as quickly as possible. The sunshine outside was beckoning, the air felt lighter, and, in an appropriate fashion, many of us had to run to lab or research meetings to initiate our summer of required research. The feeling of finishing (well, surviving) an entire year of medical education was so overwhelming—overwhelmingly anticlimactic.

I think I expected more exhilaration. “One step closer to earning an MD! MSWho? MS2!” Like a commercial, these were the types of captions I saw scrolling through my social media news feed the past month and a half, as dozens of my friends, and friends of friends, finished their first year of medical school across the country. I stockpiled my stores of adrenaline for the big day to arrive. Yet when it came, I realized that I felt no different than any other day. The moment came swiftly and left without much internal fanfare. Suddenly, I was an MS2, a badge that signified that a year of medical education was conquered and stored in my brain (somewhat), and that I was no longer the absolute rookie in medicine.

gupta-7-3-17The reality is, true joy in medical school doesn’t come at traditional checkpoints. On to the next thing, as the culture of medical school dictates. In the constant whirlwind of a curriculum that offers little time for breaks, typical timestamps of celebration become masked by the onset of the next deadline. The conclusion of one exam is immediately followed by the beginning of a new block or another required assignment, another clinic visit or another research meeting.

Medical students taking a break from the lab to explore the great outdoors.

Johns Hopkins School of Medicine students taking a break from the lab to explore the great outdoors.

As I’ve noticed, however, exhilarating moments do happen frequently in medical school, but more often, happen unexpectedly. Long conversations during 2 a.m. trips to the coffee machine with classmates before an exam, or scouring through dozens of pages of medical literature to satisfy an intellectual curiosity provide me with happiness like nothing else. Having a breakthrough moment in understanding a pathology of a complex disease or listening to a patient share his gratitude towards his medical team brings me a pure adrenaline rush. While passing an exam brings joy and relief, a year in medical school has taught me that hard work is simply the lifestyle—a lifestyle in which true contentedness blossoms from latency not by completing the required tasks, but from the most innocuous of moments, like receiving the trusting gaze of a patient sharing an intimate detail of his or her personal life.

Although I may have not felt any different on Friday, I have been blessed to have received a year-long experience full of accomplishments and magical memories along the way. Each day brings its own opportunities for learning, growth and excitement. Studying medicine, albeit extraordinarily difficult, is truly an honor, and I look forward to seeing what new experiences my second year will provide.

Related Items


About the Author

Pranjal Gupta

Pranjal Bodh Gupta is a second-year medical student who arrived at Johns Hopkins from Vanderbilt University where, over the course of four years, he danced in numerous cultural showcases. Throughout these shows, he learned various routines, including a Japanese fisherman dance (“Soran Bushi”), Indian Bollywood dance, Korean pop, Japanese drumming dance (taiko) and Indian Bhangra. As a side hobby, Pranjal made short films and majored in chemical engineering. His latest adventure includes learning medicine and trying to gain social media fame.

Immunotherapy is rapidly becoming one of the cornerstones of treatment for several types of cancers, and pembrolizumab, a well-known humanized antibody against the checkpoint inhibitor programmed death 1 (PD-1), is again in the spotlight for new expanded use based on patient's genetic differences. In a first of its kind, the U.S. Food and Drug Administration approved use of pembrolizumab based on a common genetic biomarker, rather than the primary cancer location.

Gene Therapy for Cancer Treatment Concept Cancer therapy with T-cell and DNAScientists at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy led a  three-year clinical trial for 86 patients with 12 different types of advanced cancer, including colorectal, pancreatic and prostate cancer. The common denominator was the presence of DNA mismatch-repair mutations in the patients' cancer genomes.

“Mismatch repair” refers to an important group of proteins that recognize, excise and replace incorrect DNA bases. Improper DNA bases can come from errors that occur when the genome is replicated each time a cell divides, or from environmental mutagens, such as cigarette smoke or UV exposure. The mismatch repair system is critical for identifying and repairing these mutations, which can otherwise lead to, or exacerbate, the progression of certain types of cancers. Critically, mutations in these mismatch repair genes that impair the system’s ability to correctly recognize and replace incorrect bases have been tied to certain cancers and advanced disease progression, including Lynch syndrome (which accounts for 1–7 percent of all colorectal cancer cases).

This clinical trial enrolled patients who had mismatch-repair defects and had failed at least one other form of therapy. As part of the treatment course, each patient received intravenous pembrolizumab every two weeks for two years. Positive results showed that tumors regressed in size by at least 30 percent in 53 percent of patients, with 25 percent of patients showing complete disappearance of their tumors. The survival rates for these patients with advanced cancers were remarkable, such that 76 percent of patients were alive after one year, and 64 percent were still alive after two years. So far, 11 patients have completed immunotherapy and have shown no disease progression or recurrence. Without immunotherapeutic intervention, it was estimated that patients with these disease profiles would have prognoses of six months at most.

""The results of this trial and the subsequent swift approval by the FDA hold widespread promise. After sequencing 592 genes in over 12,000 patients and 32 different cancer types, it was determined that mismatch-repair defects occur in 5 percent of 11 cancer types. Thus, approximately 60,000 people with Stage I-IV cancers may benefit from drugs targeted at cancers with mismatch-repair defects.

Patients with mismatch-repair defects, regardless of cancer type, are more likely to respond to pembrolizumab. This research could pave the way for future cancer drug research to zero in on the underlying genetic makeup of tumors for better treatment.

Related Content

No Comments

About the Author

Adela Wu

Adela Wu is passionate about making connections between ideas and people, and seeing how her interests in literature, creative writing and medicine play out in that theme. In addition, she also enjoys river and sea kayaking, having recently whitewater kayaked the Shenandoah River rapids.

young hands and old handsIs parabiosis the new fountain of youth? Parabiosis, meaning “living beside,” is a 150-year-old surgical technique that unites the blood vessels of two living animals. One of the earliest accounts of parabiosis comes from the mid-1800s when a French zoologist, Paul Bert, attached the circulatory systems of two animals and demonstrated that fluid injected into a vein of one animal could pass through a vein of the other animal. In 1924, the physician Alexander Bogdanov experimented on parabiosis as a means of extending the lifespan. However, those experiments led to an untimely end when Bogdanov injected himself with blood from a student who had both malaria and tuberculosis; he subsequently died. In the 1950s and 1960s, parabiosis research was briefly revived, as scientists used rats to show the beneficial effects  of this surgical technique on both longevity and improvement in tissue function. However, some experiments also unmasked the potential negative effects of parabiosis, namely, rejection of the donor animal’s blood, cancer or even death. This significantly impacted interest in this method.

Parabiosis is a 150-year-old surgical technique that unites the vasculature of two living animals. It mimics natural instances of shared blood supply, such as in conjoined twins or animals that share a placenta in the womb.

More recently, there has been a renewed interest in this procedure. In 2014, neuroscientist Tony Wyss-Coray reported that injecting only the plasma, as opposed to whole blood, from young mice into older mice could mimic the effects of parabiosis. Similarly, a recent paper published in the journal Nature by Wyss-Coray’s lab, explored the effects of injecting human umbilical cord plasma on memory and learning in old mice, with interesting results.

His team selected mice of different ages, from 3.5 months old (about 25 in human years) to 14 months (about 60 in human years), and injected them with human cord plasma (the straw-colored liquid portion of blood derived from the umbilical cord) every four days. After two weeks, they checked the animals’ hippocampi, the part of the brain responsible for the creation and storage of memories. There was no effect on the hippocampus of young mice. However, in old mice, human cord blood activated the hippocampal neurons. To test whether this change in activity corresponded to actual memory-related behavior changes, the scientists subjected the mice to a common memory test — navigating a maze. The old mice treated with cord blood were able to navigate the maze much faster than the control mice not been treated with cord blood.


Next the team identified TIMP2 (tissue metallopeptidase inhibitor 2) as the specific protein found in cord plasma responsible for this effect. They showed that old mice treated with purified TIMP2 demonstrated the same benefits as those treated with cord plasma. Furthermore, old mice treated with plasma that had TIMP2 specifically depleted did now show any improvements in memory or hippocampal function. Stanford University, home to Wyss-Coray’s lab, has filed for a patent using TIMP2 as a treatment for age-related conditions, and Alkahest, a company cofounded by Wyss-Coray, will develop the therapeutics.

This research comes at a time when Hollywood is obsessed with longevity. A recent episode of the TV show Silicon Valley titled “Blood Boy” explored this issue, in which a rich tech mogul hires a young person whose blood is transfused into his body as an attempt to restore youthfulness. This was perceived as an allusion to the noted Silicon Valley venture capitalist Peter Thiel, who is notoriously obsessed with immortality. In October 2016, Thiel helped fund a Silicon Valley startup called Ambrosia, a biotech company that harvests donor plasma from young people under the age of 25 and injects it into older adults for a fee of $8,000.

Given these recent advances, it appears that parabiosis research may be set to move forward. We might be closer to a day when the science behind “Blood Boy” becomes more accessible to middle-class America and is no longer restricted to rich Silicon Valley venture capitalists.

Related Content

No Comments

About the Author

Monika Deshpande

Monika Deshpande is passionate about science communication. When she was a postdoc at the National Institutes of Health, she was involved in several publications, such as The NIH Catalyst and NIH Research Matters. She is adept at interviewing scientists and showcasing their achievements, and is able to write for scientific and nonscientific audience.

Dr. Stanley Andrisse, was convicted of 2 felony drug charges and sentenced to 10 years in Missouri prison. He is now a postdoctoral scientist in Pediatric Endocrinology and trainee leader at Johns Hopkins Medicine.Still half-asleep, I woke up at 4 a.m. to hit the highway for a four-hour drive. I had retired from “moving weight” (selling drugs) to moving words—ones of experience and inspiration. I was headed back to prison. I had a conversation with my mom the night before about me going “back to prison.” After her initial gasp, she hit me with the Haitian-mom "umpf," showing her concern and doubt, punctuated by "m ap priye pou ou." I told her I'm praying for me too.

As a formerly incarcerated inmate turned postdoctoral scientist at Johns Hopkins Medicine, I had come full circle—From Prison Cells to PhD—and now back to prison to deliver a motivational speech to inmates on the importance of education after release. Obtaining higher education reduces the rate of going back to prison from roughly 70 percent to nearly zero percent (1).  I could not even begin to explain my feelings. I was excited but torn, eager yet uncertain, happy and sad. It’s impossible to capture the emotions. Overall, I was inspired and honored to have the opportunity.

When I entered the prison gates and heard the loud clang of the solid iron door slamming closed behind me, I knew there was no turning back. I was politely greeted by the warden, two assistant wardens and three correctional officers. The warden was an attractive young white lady (maybe 40 years old), wearing a very professional navy suit. She was not what I expected the warden of one of the largest high-security prisons in Illinois to look like. In all my years locked up, I had never met a warden. About 70 percent of prisoners in the United States are people of color. As I walked the prison yard, a black man in civilian clothes with two older white men in suits, three white men in uniform, and the head of the prison, all eyes were on me.

Hill Correctional Center is one of the largest high-security level prisons in the state of Illinois. Roughly 90 of the 1900 inmates have life sentences and will never be released from prison.

Hill Correctional Center is one of the largest high-security level prisons in the state of Illinois.

I arrived at the activity center and was escorted through more locked doors and past more inquisitive faces. I saw a packed room of roughly 200 inmates. I spoke for 2 straight hours and had more attentive faces than any college auditorium lecture I had ever delivered. The room was full of tattooed tears and bodies fully covered in art. It was a room bursting with potential, of listeners deeply eager for a second chance. It was truly inspirational.

I took a tour of the grounds. The air in the yard felt like prison, despite being the same rural country air separated by 20 feet of triple-barbed wire chain fences. There are about 1900 inmates and 10 housing units or dorms. Unlike most visitors, I was permitted to walk through one of the housing units. I saw the cells. I saw the faces I remembered like yesterday. I visited the segregation wing and even hung out in the wardens’ office talking Illinois politics. The entire day was surreal.

Higher Education Reduces Recidivism Nationally, 43% of formerly incarcerated individuals are likely to return to prison within three years of release (65-70% within 5 years). The recidivism rate drops dramatically with access to higher education: Masters: less than 1% Baccalaureates: 5.6% Associates: 13.7%

Even as I have progressed past the prison cell to the lab, my home state of Missouri stated that they still consider me a non-rehabilitated criminal—a difference in politics I guess. Through visits like these, I hope to shine a light on the powerful role of education. Nationally, 43 percent of formerly incarcerated individuals are likely to return to prison within three years of release (65 to 70 percent within 5 years). However, the recidivism rate drops dramatically with access to higher education (1). In fact, the rates drop to 14 percent for those who achieve an associate’s degree, 6 percent for those who get a bachelor’s degree and less than 1 percent for those who get a master’s degree. My goal is to inspire others with similar backgrounds as myself to excel beyond what society and life circumstances have set to be the norm.

Thank you to Correctional Officer Justin Bryant and Warden Stephanie Dorethy for the invitation. I must also thank my Hopkins mentor, Dr. Sheng Wu, for respecting my mission. I also want to express my love to my wife and family for supporting me on this mission. It has not been easy to share this part of me.

Learn more about higher education after prison and its effect on recidivism rates:

  1. Changing Minds: The Impact of College in a Maximum-Security Prison 
  2. Prison Education Reduces Recidivism by Over 40 Percent. Why Aren’t We Funding More of It?
  3. A College Education For Prisoners
  4. Higher Education In and After Prison
  5. Benefits of Higher Education – In Prison and After Prison


About the Author

Stan Andrisse

Dr. Stanley Andrisse was convicted of 2 felony drug charges and sentenced to 10 years in Missouri prison. He is now a postdoctoral scientist in Pediatric Endocrinology and trainee leader at Johns Hopkins Medicine.

Science teacher with studentsI recently lost a mentor of mine. Jeff Nye, vice president of neuroscience innovation and scientific partnership strategy at Johnson & Johnson Innovation, passed away in March, due to cancer. I’ve known Jeff since I was born, but it wasn’t until I was in college, seeking a career path, that he became my mentor. Jeff guided me through summer internships, counseled me when I was deciding between science and medicine, and celebrated with me when I was admitted to the Cellular and Molecular Medicine Program at Johns Hopkins, chose my thesis lab and passed my graduate qualification exam.

Losing Jeff made me realize the importance of mentors and how their influence and guidance have contributed to where I am today.

What is a mentor? In graduate school, our primary mentors are our principal investigators (PIs), who guide our thesis work. However, prior to graduate school, Ph.D. students generally have had several other advisers who helped direct them to graduate school and often continue to support them in our post-Ph.D. careers. When Jeff died, I stopped to think of how important his influence had been on my life, on others who led me towards him, and on the people who continue to guide me in his absence.

Science is one of the most selfless careers you can pursue. Beyond discovery and innovation, a scientist’s main roles in training are to learn and to teach. This made me wonder: Besides my parents, who were my first mentors? When did my training as a scientist actually begin?""

I’m reasonably sure it dates back to my 10th grade AP chemistry class, taught by a 7-foot genius named Mr. Grodski. The class wasn’t just 40 minutes out of my day; it became an extracurricular activity, as it required after-school help and weekend study groups with my classmates.

The Wednesday before Thanksgiving break, Mr. Grodski gave us an exam made up of questions from past AP tests. This was extremely challenging, but he encouraged us to take our time, and he meant it—literally. It wasn’t until I took a break that I realized that it was past 5 p.m. (school let out at 2:15). Of course, I had several voicemails and frantic text messages from my parents wondering where I was the day before vacation. Mr. Grodski stayed with the class until 7 p.m., when the majority of us finally finished the exam. He challenged me and believed in me. He also provided me with an environment to explore science, which inspired my passion for discovery.

While most Ph.D. candidates can pinpoint that moment, teacher, or boss that/who inspired them to pursue this path, many cannot. Some find themselves mentor-less or unsure of what a mentor truly is. How many mentors does one need? Can you have too many mentors? When you move on from an institution, does that mentor remain your mentor? I’m still so early in my thesis work and scientific career that I’m still trying to figure all this out. But I do know that mentors can last a lifetime, as was the case with Jeff. I’ve also found that mentors can be individuals you interact with daily; friends whom you admire; or someone you exchange emails with occasionally.

It’s important to remember that mentorship in science must be bidirectional. In the case of the PI-student relationship, it’s easier to see the give and take—I take advice from my PI and deliver data in return. But what about Jeff Nye or Mr. Grodski? What could I possibly give back to these mentors for whom I do not work and rarely see? They trained me and devoted time and effort to making me the dedicated scientist I hope to become. In return, I’ve updated them.

So, when a pivotal event in my career happens, I always share. Whether it’s a publication or passing my oral exam, I want my mentors to know that I credit them for helping me get there. Rarely are papers published with single authors, and rarely are labs run by a single individual. Science is the most selfless career I can think of, and I’m so excited to be a part of it.

No Comments

About the Author

Joelle Dorskind

Joelle Dorskind is a Ph.D. candidate in the Cellular and Molecular Medicine program at Johns Hopkins. When she isn't in lab running experiments, she enjoys reading, playing soccer, running and traveling.

(Disclaimers: Although much of the following comes from my medical education, it should not be generalized to all medical students. Certain details — name, identifiers, complaints — have been modified for privacy reasons.)

7:59 p.m. I am standing outside the patient’s room in the hospital. She has just been transferred from the emergency department (ED).

In my hand, I have a few pieces of information. The patient’s name is Ms. Terry. She is 62 years old, and she was admitted earlier this morning for cough and chest pain. Earlier, I checked our electronic medical record to see if she had any documents on file. Often times, having access to such information can help guide questioning. In this case, though, there are no such records.

senior patient with doctorTaking a deep breath, I knock — twice — and open the door slowly. In about two seconds, I assess the situation. Is the patient sleeping? Is she moaning in pain or is she energetically talking on the phone? In this case, the television is on and Ms. Terry looks over to me with a questioning smile. She is sitting upright in bed with the blanket neatly draped around her. I smile and match my tone to her presentation, emitting a soft but steady greeting.

“Hello, my name is John Choi. I’ll be your medical student during your stay here.”

Sanitizing my hands first, I walk over and shake her hand. She has a strong grip. When I release her hand, though, it takes more than a few seconds to pink back up. I also notice slight clubbing in her nails. My mind reflexively jumps to possible circulation issues and chronic hypoxia (a lack of oxygen in the tissues). I take mental note of my preliminary findings and file them for later.

As part of my introduction, I explain what I will be doing — namely, taking a history and doing a physical exam — and describe what she might expect during her hospitalization. Throughout all this, I continue to observe her, trying to bring together some of the pieces of the puzzles. I note that she is breathing fairly rapidly. I try breathing at the same rate as her and find myself getting short of breath. This is not a good sign. Also, at a certain angle, I notice an elevated biphasic wave pattern on the side of her neck — a probable sign of excess fluid in her system. But again, I place these observations at the back of my mind and instead pull up a chair to the side of her bed. Sitting down, I start by asking her if she could share what brought her to the hospital. In my mind, though, I ask: Can you tell me your story?

I encourage the patient to speak without interrupting her. She tells me that she experienced severe chest pain a few days ago. With just this one complaint, a flurry of worrisome diagnoses flashes into my mind: myocardial infarction, aortic dissection, acute pericarditis, pulmonary embolism, pneumothorax, gastric reflux, esophagitis, etc. She notes an ongoing cough that began a few days prior to the chest pain, and that she has found it increasingly hard to breathe while lying down. A few minutes in, it is easy to jump to one or two diagnoses, but instead I force myself to pause and think: What else can this be?

In Jerome Groopman’s book How Doctors Think, the author explains that one of the most important questions physicians can ask themselves is, “What else can this be?” Forcing ourselves to ask this question prevents us from falling back on the most obvious diagnosis without carefully considering other options. In this case, I resist the urge to ask questions to confirm what might be the most obvious diagnosis and instead continue to let Ms. Terry talk. And she does.

She tells me about her family. She goes into some past hospital visits. She walks me through her allergies and medications with a certain meticulousness that matches her politeness. She tells me about her past drug use and vehemently denies smoking or drinking alcohol. She talks about her hobbies and glows when she mentions her fiancée and home — it is obvious that she already misses both. Slowly but surely, Ms. Terry’s story comes to light. The story is then augmented as I begin the physical exam to methodologically observe and examine different organ systems.

""Through this careful process of history taking and physical examination, I generate a hypothesis as to what is most likely going on. The patient is diagnosed with pneumonia and pre-existing heart failure. I take a step back and retell the story with my medical reasoning, asking if this version makes sense. Afterwards, as sort of an appendix, I think about which labs would be needed to rule out or confirm these diagnoses. Once a probable diagnosis is made, treatment and management begins.

It is necessary to emphasize that paramount to this entire process is the process of learning the patient’s story — both through their words and through the findings on their physical exam. In doing so, medicine has become less about simply identifying disease and more about understanding people. In the words of Sir William Osler, “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.”

Related Content

1 Comment

About the Author

John Choi

John Choi is a lactose intolerant medical student who believes in the power of sharing stories and regretfully loves cheese.