Stanford SASI 2022

Clinical Science, Technology and

M E D I C I N E Medicine Summer Internship

In search of curiosity and compassion

Clinical Science, Technolog M E D I C I N E Medicine Summer Internsh

Clinical Science, M E D I C I N E Medicine Summe

Clinical Science, Technology and

M E D I C I N E Medicine Summer Internship

“ People who have that mindset of curiosity — those are the people who advance our society, advance science, and advance medicine. They aren’t afraid to ask the important questions.”

LARRY CHU, MD, PROFESSOR OF ANESTHESIOLOGY EXECUTIVE DIRECTOR, STANFORD ANESTHESIA SUMMER INSTITUTES (SASI)

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Brian BOEHM

From SASI Participant to Medical Student pg 11

Katherine HOURIGAN, MD

A lucky discovery in finding SASI to ignite change pg 23

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Sophia BROTHERS

Opening the door to career possibilities pg 15

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Alan PORTUGEYS

A healthy dose of compassion pg 16

Iaisha SADAT

Reaching underrepresented minorities with cultural competency pg 12

In search of curiosity and compassion

Sara WITHERS

A compassionate future in healthcare pg 19

These are some of our stories.

Clinica M E D I C I N E Medic

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The Stanford Science, Technology and Medicine Summer Internship inspires compassionate careers in science, technology and medicine. We are guided by leading Stanford faculty and empower our participants with skills and hands-on experiences.

Ujwal SRIVASTAVA

Researching possibilities pg 20

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GROWTH AND LEARNING

Curiosity advances career exploration

By Marcia Frellick At one point, anesthesiologist Larry Chu, MD, the creator of the Stanford Anesthesia Summer Institute, or SASI, asked ‘What if?’

What if there was a program to encourage compassionate careers in science, technology and medicine for high school and college students? It’s something he wishes he would have had early in his medical career.

Curious, yet confident about how such a program could impact students, he created SASI in 2016. Though the two-week program has anesthesia in its title, it’s centered on a much broader theme that the best medicine is practiced not by providers telling patients what they need to get better, but by listening to patients’ challenges and working with them to develop solutions to improve their health.

Four years after it was developed, high school and undergraduate students from across the globe apply to SASI. Stanford professors mentor them and they and gain hands-on experience in intubation and IV placement in a state-of-the art simulation lab. They suture and splint “patients” as they learn about specialties such as anesthesiology, internal medicine, critical care medicine and surgery. Students also collaborate in teams to address a simulated airway emergency.

But, a main focus is talking with real patients to see what’s most important to them in the delivery of their health care. Chu says one year students interviewed Syrian refugees to learn what they needed most. The answer 7

was something the students didn’t expect.

The individuals wanted a solution for their loneliness, a way to connect with others and an avenue to address their mental health.

“It’s different when they meet the stakeholder and when they can understand the need and bring that person in to coproduce the solution,” Chu says.

Research soon-to-be published has shown that SASI has measurable effects on the way its participants think about others after they leave it. “Students who come through our program actually increase very significantly their empathy for others,” he says.

Chu adds the increased empathy can help even students who don’t ultimately go into medicine, as the soft skills they learn are important in any career. He emphasizes that though they are called soft skills, they are no less important than any other skill.

“These type of leadership skills need to be taught earlier in our careers,” he says, adding they often get overlooked in formal medical training.

Chu says SASI offers something that most medical instruction doesn’t — an opportunity to explore a career in medicine before life choices have been made. “The health system doesn’t really provide resources for people who are interested or exploring. We often ask for that commitment first,” he says.

SASI draws a diverse group of students, Chu says, adding that about 80% of the participants come from groups typically underrepresented in leadership roles in science and medicine.

Many factors go into selecting applicants, but the most important quality in a potential student is curiosity, he says. “People who have that mindset of curiosity — those are the people who advance our society, advance science, advance medicine,” Chu says. “They aren’t afraid to ask questions.”

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SUCCESS STORIES

From SASI participant to medical student Brian BOEHM, SASI ‘18

George Washington School of Medicine

Brian Boehm’s experience at the 2018 Stanford Anesthesia Summer Institute (SASI) helped confirm that a career in medicine was for him. He had just graduated from the College of William and Mary in Williamsburg, Virginia, with majors in finance and biochemistry, when he attended SASI. He came to SASI in part because of his interest in anesthesia, and he loved what he saw.

Now, almost two and a half years later, he will begin medical school in August at the George Washington University School of Medicine and Health Science. He will leave behind his role as a Deloitte management consultant, where he supports the Centers for Disease Control and the Commonwealth of Virginia by promoting health equity in influenza and COVID-19 vaccinations through data visualization.

Boehm, who has always been interested in science, had many experiences as an undergraduate that opened his eyes to a career in medicine. It helps that his brother is pursuing his medical degree at Weill Cornell Medical College and his Ph.D. in computational oncology at Memorial Sloan-Kettering Cancer Center.

“He provided me with quite a bit of guidance on my path to medical school, so it felt incredible knowing that we’re both on our way to becoming physicians,” Boehm says.

But, SASI also played a key role in cementing Boehm’s career choice. Medicine will bring him face-to-face with patients, so he can experience the interactions he seems to thrive on. “SASI reaffirmed my interest in

SASI reaffirmed my interest in “ working directly with patients as a physician, particularly as an anesthesiologist.

Interacting with actual patients and shadowing Stanford anesthesiologists during the program played a big part.”

BRIAN BOEHM, SASI ‘18 GEORGE WASHINGTON SCHOOL OF MEDICINE WASHINGTON, DC

working directly with patients as a physician, particularly as an anesthesiologist,” he says.

“Interacting with actual patients and shadowing Stanford anesthesiologists during the program played a big part in this.”

Boehm recalls the capstone project he and his team of other SASI participants took part in. They were paired with an ePatient, a person who is empowered and fully engaged in making their own health care decisions with their provider. The ePatient shared with the team their health care challenges, and the SASI team brainstormed ideas to solve them.

“We identified three key issues our patient faced — managing multiple symptoms, a lack of patient-physician collaboration, and, Boehm, continued on pg 24

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SUCCESS STORIES

The social and emotional possibilities of health Iaisha SADAT, SASI ‘18 Santa Clara University

By Rachel B. Levin Growing up with a brother with a congenital heart condition made Stanford Anesthesia Summer Institute (SASI) past participant Iaisha Sadat aware at a young age of how health issues and great vulnerability often go hand in hand. Once, when a bad reaction to a vaccine taxed her brother’s heart, she witnessed how his medical team acted swiftly to avert fatal damage. “I saw his cardiologist as a hero that saved my brother,” says the Fremont, California, native.

That heroism inspired Sadat’s desire to become a health care provider. Yet, she also noticed that her brother’s doctors were focused primarily on the biological aspects of his condition and didn’t address the social and emotional ramifications. “I thought if I were to be a doctor, I [would want] to be more than the person who comes in, checks your numbers, and that’s pretty much it,” she says.

Sadat’s interest in approaching health from a more holistic standpoint led the recent Santa Clara University graduate to major in public health science. When she attended SASI in 2017, just before her sophomore year of college, that interest blossomed even further.

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SASI introduced Sadat to the ePatient movement, which encourages patients to become more engaged in managing and making health care decisions. It also encourages clinicians to listen more actively to patient voices. Sadat remembers that Program Director Larry Chu, MD, MS, gave ePatient speakers white lab coats to wear with their names on them. She was struck by what

“ We need to think about cultural competency, we need to be more patient-centered, [and] we have to talk about things that socially impact individuals” IAISHA SADAT, SASI ‘18, SANTA CLARA UNIVERSITY, SANTA CLARA, CALIFORNIA

she says was the implied message to the patients: What you have to teach and what you have to say is just as valuable as what the doctors do.

Sadat became so passionate about supporting the ePatient movement that she made a video about it for her SASI capstone project, completing the program with an award for distinction. Then, about a month after she completed SASI, that award helped open the door for her to join the Ashoka Youth Changemakers Program, which challenged participants to devise design-minded solutions to community health issues.

She and her group proposed an app called SensiMed, which would put comprehensive cultural information about underrepresented minorities at health care providers’ fingertips. Her group was not only selected as the winner of the challenge, but they also spoke about the app at the Stanford Medicine X conference, which brings together innovaSadat, continued on pg 24

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GROWTH AND LEARNING

Opening the door to career possibilities Sophia BROTHERS, SASI ‘20

Horace Mann School, Bronx, New York

By Rachel B. Levin For Sophia Brothers (SASI ’20) of New York City, her summer 2020 experience with the Stanford Anesthesia Summer Institute, or SASI, broadened her horizons to what her future career might entail. Initially interested in becoming a doctor, the two-week program’s focus beyond those topics have opened new possibilities for her. Now, she’s considering various health care-related roles.

She’s weighing the possibility of working in science research, technological innovation, or in a health care-related nonprofit role.

“There’s a whole spectrum of things you can do within medicine, so I’m kind of figuring out where on the spectrum I want to go,” she says.

Brothers traces her interest in becoming a doctor back to her family tree. Her paternal grandparents are both retired physicians — her grandmother practiced anesthesiology, and her grandfather was an ophthalmologist.

But a group of fictional doctors also rubbed off on her: “I did have a little bit of a Grey’s Anatomy obsession that probably played a role in it too,” she admits.

A senior at Horace Mann School in Bronx, New York, Brothers began volunteering at Memorial Sloan Kettering Cancer Center in Manhattan last year to explore what it would feel like to work in a real-world hospital. She also completed an internship during the summer between her sophomore and junior years, observing heart surgeries in the OR. In doing so, she became fascinated by the role of anesthesiologists.

“ I think this opened up a lot more perspective on other types of careers you can pursue that have to do with health care” SOPHIA BROTHERS, SASI ‘20 HORACE MANN SCHOOL BRONX, NEW YORK

Brothers was first drawn to SASI because of the opportunity it provided to gain hands-on experiences related to anesthesiology. But as her participation progressed, she was riveted by discussions of topics beyond medical science — everything from patient interactions to computer technology and health care management. “I think this opened up a lot more perspective on other types of careers you can pursue that have to do with health care,” she says.

She also became more aware of areas within health care that need improvement. Working with an ePatient with type 1 diabetes for her capstone project opened her eyes to how burdensome the cost of medications and equipment to control the condition can be for patients, particularly the uninsured. “Lack of access to affordable health care, especially in a pandemic, is a huge problem in our country,” she says.

She and her capstone group developed a mutual-aid program for diabetes patients Brothers, continued on pg 24

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CHANGED PERSPECTIVES

A healthy dose of compassion Alan PORTUGEYS, SASI ‘19

Brandeis University, Waltham, Massachusetts FINDING A PLACE FOR COMPASSION AS A CAREER

By Marcia Frellick The Stanford Anesthesia Summer Institute (SASI) helped clarify a few things for Alan Portugeys (SASI ’19) of Mechanicville, New York, in the summer of 2019. One was that his choice to pursue a career in medicine was the right one for him. He is now a freshman premed student at Brandeis University, near Boston.

“I think the program really helped pique my interest in medicine,” he says.

Another item SASI helped clarify for him is that patient care involves much more than the physical restoration of health. Patients may be missing the emotional help from providers that can help them lead the life they want, he learned through the program.

Portugeys had seen the rewards and enjoyment his mother, Katherine Hourigan, MD, received from being an anesthesiologist.

He once witnessed his mother calmly save his cousin from choking at a restaurant by performing the Heimlich maneuver on her when restaurant staff didn’t know what to do. That made an impression on Portugeys and helped lead him to become certified in CPR and then become an instructor, something he wants to keep doing.

“That made me passionate about learning those skills,” he says.

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Hourigan, who practices in upstate New York, had nudged her son to consider a career in medicine, but it was only in recent

“ I think the program really helped pique my interest in medicine” ALAN PORTUGEYS, SASI ‘19, BRANDEIS UNIVERSITY, WALTHAM, MASSACHUSETTS

years that his “no” turned to “maybe,” he says.

The most memorable part of SASI for him were the hands-on activities it included, he says. Students toured the Stanford medical facilities and talked with providers about what led them to medicine and their chosen specialties. They also talked with patients about what was important to them when they received care and recovered from their illnesses.

A highlight for Portugeys was working with a patient who had chronic obstructive pulmonary disease (COPD). As part of their capstone project at the end of SASI, teams of students worked with patients to find solutions to their health care concerns.

The patient Portugeys was assigned to was recovering well. “But, he said he was really depressed in the hospital and didn’t receive enough emotional care,” Portugeys adds.

The experience helped him understand how much compassion is necessary to treat the whole patient — an aspect is sometimes Portugeys, continued on pg 25

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GROWTH AND LEARNING

A compassionate future in health care Sara WITHERS, SASI ‘19

Saint Francis School, Mountain View, California

By Rachel Levin When Stanford Anesthesia Summer Institute (SASI) past participant Sara Withers was in first grade, her grandmother was diagnosed with leiomyosarcoma, a rare type of cancer that affects smooth muscle tissue. Though Withers was too young to understand the science behind her grandmother’s treatments, she remembers being fascinated by how doctors prolonged her life.

“Seeing them all work together to not only give us more time with her, but to make her as comfortable as possible, was really influential,” says Withers, of Saratoga, California. She and her family were able to enjoy three additional years with her grandmother.

Withers fondly remembers spending time her, while bonding, learning to sew and baking cookies.

Today, as a junior at St. Francis High School in Mountain View, California, where Withers swims and plays water polo, she has her eye on a career in medicine. She began exploring this interest during her sophomore year as she volunteered at the local Good Samaritan Hospital. In doing so, she learned her favorite moments were the conversations she had with patients while they were discharged them. “I don’t think people realize how much you can learn about another human in 10 minutes,” Withers says. “It was really great to hear their stories.”

Because of her interest in medicine, Withers applied for SASI, where this past summer she discovered how significant it is to listen compassionately to patients. She learned this through the program’s lecture series,

“ I don’t think people realize how much you can learn about another human in 10 minutes,” Withers says. “It was really great to hear their stories.”

SARA WITHERS, SASI ‘19 ST. FRANCIS SCHOOL MOUNTAIN VIEW, CALIFORNIA in which health care providers, researchers and other stakeholders discussed pressing issues in medicine. Lectures about health care providers’ bedside manners drove home the importance of caring for patients emotionally as well as physically. Withers was fascinated by how powerful a simple act of kindness can be: “Human interaction is a huge part of the healing process and keeping others healthy,” she says.

Withers linked the mind-body connection she was learning about in SASI back to the behavioral psychology class she took during her sophomore year. She became so riveted by the relationship between physical and mental health that she decided it is something she wants to focus on going forward.

This year, she’s taking AP psychology and envisions studying cognitive and neurological sciences in college. With her sights set on medical school, she says she may want to specialize in psychiatry, but is open to other fields as well.

Withers, continued on pg 25

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SUCCESS STORIES

Researching possibilities Ujwal SRIVASTAVA, SASI ‘18

Stanford University, Stanford, California

In a few short years, Stanford Anesthesia Summer Institute (SASI) past participant and Stanford University sophomore Ujwal Srivastava went from being uncertain about his career choice to deciding to enter medicine and publishing an article in the peer-reviewed BMJ Open Quality.

The open-access medical journal published a report in August 2020 that he authored with SASI Associate Director Amy Price, DPhil, and its Director Larry Chu, MD. The paper examined the effectiveness of patient interviews conducted by volunteer patient and family partners rather than hospital staff.

“I think before [we published the paper] I always thought research was this impossible mystery that was really confusing and complicated, but I have learned that with guidance and mentorship it is very accessible,” says Srivastava. “I still have a lot to learn, and I am very excited to embark on that journey.”

His relationship with Chu and Price, as well as his 2017 SASI experience has — and is — helping him understand his future. After Srivastava completed SASI, he asked Chu if he could intern for him in his Stanford Anesthesia Informatics and Media (AIM) Lab. Srivastava says he is grateful Chu said, ‘Yes.’

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Srivastava has also been a teaching assistant for SASI. He adds that when he attended SASI as a participant, he was trying to decide if a career in health care was right for him. “I really enjoyed the hands-on, clinical activities that we did, such as intubation, ultrasound and crisis-resource management,” Srivastava says.

“ Dr. Chu brings an unmatched excitement and energy for research that rubs off on others,” Srivastava says. “I am always inspired when I talk to him because I can sense his passion for research.”

UJWAL SRIVASTAVA, SASI ‘18, STANFORD UNIVERSITY, STANFORD, CALIFORNIA

Ultimately, he confirmed he does become a doctor, but is unsure of the specialty. He is also interested in academia. As a pre-med student, he is considering majoring in computer science with a minor in biocomputation.

Srivastava says the most important thing he learned from SASI was the Everyone Included ™ model of collaboration and inclusivity within health care. “ … [It] promotes empathy, trust and open communication between all stakeholders,” he says.

That type of teamwork is also important in research, which he says is an inherently collaborative process. He’s been able to grow his teamwork skills and further realize the importance of open communication within the research setting. He’s also learned technical research skills and how passion can impact the work being done. He sees it Srivastava, continued on pg 25

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PARENTAL PERSPECTIVES

A lucky discovery in finding changing Katherine HOURIGAN, MD, SASI PARENT ‘19 Mechanicville, New York

By Marcia Frellick Katherine Hourigan, MD, an anesthesiologist in upstate New York, had been nudging her teenage son, Alan Portugeys, to consider a career in medicine. But, she says until recent years, her recommendations were not heeded.

She had come from a long line of family members in South Korea who were physicians, and she wanted her son to at least consider the career. He had shadowed other physicians as a hospital volunteer and remained unconvinced medicine was the right path for him.

But Hourigan, who practices at Glens Falls Hospital in Glens Falls, New York, discovered the Stanford Anesthesiology Summer Institute (SASI) in an online search and helped persuade her son to apply to it. He was accepted and attended the program in 2019. And, through it, he decided he does want a career in medicine.

“The [SASI] experience was eye-opening,” she says, adding that up to that point, it was the only exposure to the medical field that had truly engaged him.

Her son told her that at SASI he worked in a patient simulation center and he and his capstone team worked with a patient as part of their project. The patient had chronic obstructive pulmonary disease (COPD) and was depressed because his disease was limiting his lifestyle. The team interviewed the patient and looked for solutions to provide more engagement with his providers, as well as further physical activity.

“ I think we were very lucky to have found this program,” Hourigan says of SASI. “What they’re doing is really valuable and I’m grateful for what they did for my son.”

KATHERINE HOURIGAN, MD SASI PARENT ‘19 MECHANICVILLE, NEW YORK

Hourigan remembers her son also told her about the program’s emphasis on medical ethics and empathy. Through SASI, he started to understand more about how patients feel when they seek health care and what’s important to them. He came to enjoy talking with the patients and learning about what their lives were like before they got sick, she says.

Hourigan says it’s more difficult to teach empathy than it is procedural skills, so she was glad he received that experience at a young age. Empathy has long been linked with increased patient satisfaction and better clinical outcomes, as well as reduced physician burnout, so developing it could serve Portugeys and his future patients well, should he become a doctor.

Hourigan, who started her career in nursing, says she wishes she had had a similar Hourigan, continued on pg 25

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Boehm, continued from pg 11

Sadat, continued from pg 12

most significantly, insufficient control over her own health,” Boehm notes.

tors in health care and technology.

Then, Boehm and his team proposed the use of a multipurpose, wearable watch system that would improve the user’s ability to address multiple symptoms, while promoting patient-physician communication and granting the patient greater control over their health.

Working with ePatients to solve problems is often a favorite activity of SASI participants. Boehm also enjoyed interacting with physicians while in the program, learning about their day-to-day activities. He says he is drawn to anesthesiology because of the perioperative aspect of the job — anesthesiologists prepare patients for surgery, and remain with them as they head to the recovery room.

He had other positive experiences with patients during college, whether through volunteering at the Angels of Mercy Medical Clinic, which provides free care to those in need in Williamsburg, or while doing upper limb prosthetics research and meeting the amputees his work could benefit. Ultimately, however, it was the culmination of all of these experiences that led him to the day he learned the good news about his George Washington medical school application.

“I was happy beyond words,” Boehm says.

“It felt incredible when I received the call from the dean of admissions.”

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Sadat’s SASI and Medicine X experiences helped refine her goals within medicine and shaped her vision about what needs to be changed within the U.S. health care system.

“We need to think about cultural competency, we need to be more patient-centered, [and] we have to talk about things that socially impact individuals,” she says. To those ends, Sadat has decided to pursue a master’s degree to become a nurse practitioner (NP). She’s attracted to the NP model because it encompasses the social as well as biological determinants of health.

She hopes to impact disadvantaged communities by integrating public health and medicine. “SASI really did give me the opportunity to believe that it is something that’s possible,” she says.

Brothers, continued from pg 15 called Reciprocaid, which they designed to help patients share resources needed to manage their disease.

The experience sharpened her desire to further explore issues of health equity.

In addition to taking pre-med courses in college, she plans to major in sociology — a field she says will help her identify the root causes of health care inequalities. “You can’t make change just at the surface level because that’s not going to fix the underlying problem,” she notes.

Whichever direction her career takes her, Brothers believes the lessons she learned in SASI about the importance of empathy and compassion in health care will be applicable.

She says figuring out what patients and communities need the most and collaborating with them on solutions is essential, otherwise well-intentioned interventions may miss their mark. “That kind of mindset applies to everything, whether it be service work or social justice work or just patient care,” she says.

Portugeys, continued from pg 16

Srivastava, continued from pg 20

overlooked. “That’s something I’ll never forget and will take with me,” Portugeys says. “Their emotions and feelings can’t be left behind.”

firsthand when he speaks with his mentor.

His team devised a survey to help identify what was most important to the patient.

Then, they developed a way to give such individuals an opportunity to schedule a one-on-one talk with their providers about their emotional as well as their physical care.

Portugeys says he also discovered how much he values his independence. Because his mom couldn’t stay the entire two weeks with him at Stanford due to her work demands, he stayed in a hotel and drove himself to and from SASI on those days.

“It was a pretty unique experience,” he says. “I think it made me a more caring, open-minded and understanding person.”

He says he hasn’t made any commitments to medicine beyond taking preliminary courses. “But I think I’m on the right track,” he adds.

Withers, continued from pg 19 No matter which direction she heads, the memory of her grandmother continues to motive her. In fact, one SASI lecturer this past summer spoke about a perspective on medicine that resonated with Withers’ experience. He said that as a doctor, the goal is not solely to prevent death, because death is a part of life. Instead, he explained doctors can help make people’s lives more comfortable and manageable as they face illness, and extend the time they have to spend with loved ones.

Withers hopes that through a career in medicine, she can pay forward the kindness of her grandmother’s doctors. “I think being able to help others in a way that someone helped my family is the ultimate reward,” she says.

Through it all, Srivastava is gaining valuable experience — all of which became possible because of SASI. He encourages others with an interest in medicine to consider applying for the program. “You will hear from patients, doctors and mentors about the field of medicine, meet new friends, and have the opportunity to develop various clinical and non-clinical skills that are vital to a future career in medicine,” he says.

It’s an experience he’s fortunate to have had, as it led him to where he is now. “I have always hoped that I could get involved in research and I feel really fortunate that I got this unique opportunity to work with a wonderful mentor like Dr. Chu in high school and as an undergraduate,” Srivastava says.

Hourigan, continued from pg 23 program before she began her medical education. Her only experience before she started her medical career was in a research lab. But, a program like SASI could have given her more confidence in her decision to enter a medical career and a better idea of what to expect, she says.

She adds that what SASI offers is unique, especially as some programs that offer look into medicine only accept local students.

She wishes SASI could be replicated in the East so more high school students could have the introduction to medicine her son had.

And, SASI did help change his mind about a future in the medical field. Portugeys is now a freshman at Brandeis University near Boston, taking premed courses.

“I think we were very lucky to have found this program,” Hourigan says of SASI. “What they’re doing is really valuable and I’m grateful for what they did for my son.”

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Notes

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Clinical Science, M E D I C I N E Medicine Summe

Clinical Science, M E D I C I N E Medicine Summe Stanford Clinical Science, Technology and Medicine Summer Internship 2370 Watson Court, Suite 235 Palo Alto, California 94303 P. 650.723.4671 E. summermed@stanford.edu