Where We Belong (5 page)

“I knew that eighty percent of diseases in the US are based on lifestyle, so surely that area was already being addressed as a component of the medical school curriculum,” she says. “But when I got to Harvard, I realized,
Actually, very few people are focusing on this angle; there is a big gap to step into
.”

Within months at school, Michelle crossed paths with a man who shared her interest in the link between good health and lifestyle. At an alternative medicine forum she attended, Michelle met David Eisenberg, an associate professor of medicine at Harvard who was hosting the event. He asked each of the attendees to share something about him- or herself.

“I said, ‘I used to be a chef and I’m interested in combining nutrition and medicine,’ ” Michelle recalls. “He said to me, ‘This has nothing to do with what we’re discussing here, but I really want to talk to you about that, so make an appointment with my secretary and come talk to me about it.’ ”

Dr. Eisenberg had the idea of working with the Culinary Institute of America to develop a conference that would teach physicians, registered dieticians, and other healthcare professionals about the combined power of nutrition and good-tasting food. Michelle was not only excited about the project, she was also eager to pinpoint effective ways to motivate people to make healthy lifestyle changes. After extensive planning, a first-of-its-kind conference was held at the CIA at Greystone in St. Helena, California: “Healthy Kitchens, Healthy Lives: Caring for Our Patients and Ourselves.” Michelle was thrilled to be involved with the program as a co-lecturer and culinary educator. But while David’s dream was to educate professionals about nutrition and good health, Michelle was eager to bring the message of prevention to patients, especially in underserved communities.

“When I was a kid, after school, I would let myself into the house and make two microwave burritos with cheese on them and sour cream on top of that for a snack,” Michelle recalls. “I just didn’t know anything about healthy eating at all. It wasn’t something that my parents talked to me about or tried to change. They just didn’t know; they didn’t understand what was going on.”

Ironically, though, medical school was not going to be an easy place to promote prevention. Michelle was shocked to learn that within her four years of curriculum, a mere 4.5 hours of lecture time would be devoted to nutrition, and even then, the material was limited to learning how to recognize vitamin deficiencies and several other basic principles. She also observed during rounds with attending physicians that patients were not being taught that a healthy lifestyle is a key component of disease prevention. When she made the effort to speak with patients about the importance of diet and exercise, some attending physicians discouraged her approach.

“It would almost be a slap on the wrist,” she says. “They would talk down about it and say, ‘It’s not worth wasting your time; no one’s going to make any changes.’ ”

But Michelle silently disagreed, recalling the student success stories at the Pacific Flavors cooking school.

“I thought,
I’ve seen people make changes and not have to be on insulin anymore or on blood pressure medicine. I’ve seen them lower their cholesterol and stop their antidepressant medications
. Clearly these doctors had not seen that.”

The restrictive environment was isolating for Michelle.

“It made me feel like I didn’t fit in,” she says. “It’s frowned upon in med school to do something different from what an authority figure tells you, so I felt like I had to hide who I was and not talk about the things I liked. I had to go through the motions to get through a short rotation so I could get decent grades and eventually go do the things I wanted to do.”

In August 2007, at the start of her second year of medical school, Michelle took the one nutrition course offered. Eager to further explore the topic, she approached the course director about getting more involved with the class and nutrition-related projects. The director listened. Soon after, Michelle was invited to join a committee that linked Harvard’s schools of medicine and public health. Members were tasked with finding ways to increase the nutrition education curriculum for medical students.

“The main theme of med school is not prevention, it’s treatment,” she says. “But you find your group of people and then you feel more comfortable, and you become very close with those people because you realize you’re on the outside.”

In 2009, at twenty-eight years old, Michelle elected to stay an extra year in school to get a master’s degree in public policy and administration from Harvard’s Kennedy School of Government. She felt an MPA would help her understand how to best navigate the politics and social aspects of making change for the better—whatever she determined that to be—on a large scale.

“I realized that to actually make changes that the entire public sees and not just that you do individually in an office with one patient, there would have to be some sort of policy change. A lot of the reasons I wasn’t healthy when I was growing up had to do with lack of education and lack of access to things that make you healthy, like walking trails and fresh fruits and vegetables prepared in delicious ways. I needed to understand politics, how to make policy, and how to inspire people to bring about those changes.”

The burden of funding yet another degree was lifted when she landed the highly competitive Zuckerman Fellowship. The award fully funded her MPA and also provided a $30,000 stipend, money that relieved the financial strain on Michelle’s dad and the guilt she felt for borrowing from him. As a Zuckerman Fellow, Michelle spent the next year attending weekly meetings with a diverse range of professionals discussing effective ways to make positive changes in the world.

“We sat around with all these powerful and influential people and they were saying to us, ‘You guys are the ones who need to figure out solutions to really big, well-known problems,’ ” she explains. “There’s really a burden on me and all the people who’ve been given these gifts and opportunities to try to fix things and make things better in the world.”

The MPA studies exposed Michelle to a network of students from seventy-two different countries, a potentially critical component to broadly integrate whatever positive solution she may develop one day.

“It made my world bigger and allowed me to interact with people I never would have had the chance to,” she says. “Now I can always find someone to reach out to for an answer to a question or to make a connection.”

The same year, in July 2009, Michelle built her own website focused on healthy eating. With one foot in medical school, she wanted to plant the other firmly in nutrition. The cyber world seemed lacking in reliable sources on the topic of healthy eating, and Michelle felt she could credibly put the power of prevention in the hands of visitors to her site. She also loved the idea of interacting with people—this time through videos and postings—as she’d done during cooking classes at Pacific Flavors.

Several months into her final year of medical school, Michelle began submitting applications to residency programs around the country through the online Electronic Residency Application Service (ERAS). She decided to specialize in internal medicine, which deals with the prevention, diagnosis, and treatment of adult diseases.

“It’s harder when we’re older to change our habits, so that’s why I decided to work with adults instead of kids. I feel like there’s a big hole there in working with adults on these sorts of things.”

By early 2011, she had already undergone several interviews with residency programs she liked, including her first choice, Cambridge Health Alliance at Harvard Medical School. Michelle wanted to continue her work with underserved patients in CHA’s community clinic system. CHA also allowed for regular rotations in hospitals outside the alliance, which interested Michelle.

The next step required the ERAS system to implement a “best fit” algorithm and match applicants with a residency program.

“Right around March fifteenth,” Michelle explains, “you go to your medical school and there’s a big pile of envelopes waiting. At noon on that day, everyone across the country opens their envelopes and finds out at the very same time where they got into residency.”

Good news was tucked inside Michelle’s envelope. She was matched with Cambridge, her first choice.

One month later, an even more significant match was made, this time in Michelle’s personal life. Over the past year, she had been on dozens of failed dates with men she’d met through an online dating service. Strapped for time and discouraged by the results, she logged into her account in April so she could cancel her subscription.

“I had gone on between fifty to sixty dates and I didn’t hit it off with anyone,” she says. “But then I saw this picture and thought,
Oh, he’s cute. Maybe I’ll look at his profile real quick.
”

The site had saved the best for last—she met Jason Wimmert, who’d recently moved to Boston and worked for Procter & Gamble. Michelle learned that during college, Jason played soccer and built homes in other countries through Habitat for Humanity. Like Michelle, he enjoyed the outdoors, running, and traveling. The two began dating. Within three months, they moved in together.

In May 2011, Michelle achieved her childhood dream and then some. Thirty-year-old Michelle graduated in less than five years with both an MD and an MPA from Harvard Medical School and the Kennedy School of Government, respectively.

Two months later, Michelle Hauser, MD, MPA, began a three-year residency program that included two significant changes: she would receive a paycheck (about $50,000 to start), and she used the word “doctor” when introducing herself to patients.

Throughout medical school and her residency, Michelle worked and trained in four area hospitals and several community clinics. She rotated through a variety of specialties and was drawn to treating patients from underserved communities in clinical settings.

Graduation from Harvard Medical School and the Kennedy School of Government, Boston, 2011
(Courtesy of Commencement Photos, Inc.)

“I knew they must be thinking,
What does this white, blond woman from Harvard know about being a poor immigrant from another country?
But a lot of them worked in a factory or in a field or had to figure out how to get by, so I often found something that we had in common, even through an interpreter, and that put them at ease. I think that being a doctor is more than just knowing medicine. It’s also about making people feel comfortable and confident that you have their best interest in mind.”

By the end of the first year of residency, Michelle began to adapt to the rapid pace of the program, the sleep deprivation, and the pressure of working eighty hours a week.

“I used to have to study where it was really quiet with no distractions, and now I can study next to a jackhammer,” she says, laughing.

In the minimal hours she spent at home, Michelle valued Jason’s consistently caring attitude and calm temperament.

“He’s a solid, dependable, bright partner. He’s also more fun and lighthearted than I am and never gets stressed. That’s exactly what I needed and still do!”

Michelle was thirty-one when she entered her second year of residency. Her role changed dramatically. Instead of participating in rotations as an intern with attending physicians approving her every decision, Michelle was now in charge of teaching and managing a team of interns and medical students.

By 2013/2014, her final year of residency, Michelle was focused on trusting her instincts—
How sick are patients? What care do they need?
The years of intense training were structured to ultimately produce a confident, competent physician who was ready to self-manage her career.

“Someone may barely check in with you during the day, because within a few months you’re going to be on your own as an attending physician yourself,” she explains, “so you need to be able to do the work.”

In the final few months of the program, Michelle worked the overnight shift. Only one attending doctor in the entire hospital was available if she needed help—if there was time to ask. One night, a patient on the floor developed a hole in her lung. Michelle made calls to the attending and the cardiothoracic surgeon, but there was no time to wait. She needed to immediately, on her own, stick a needle in the patient’s chest to release air that was compressing the lung and heart and interfering with the organs’ abilities to function properly.

“I had seen videos and done it on dummies, but never on a live patient,” Michelle says, “but I knew I was able to do it and I did. Luckily, the cardiothoracic surgeon arrived a few minutes later to take over.”

On balance, Michelle found the residency experience both extremely exciting and incredibly taxing. Life for three years was restricted to learning and training.

“You can’t be the type of family member, friend, or partner you wish you could be. You work long hours, the pager is always beeping, you miss holidays, you’re sleep deprived,” she says. “You always feel like you’re failing at interpersonal relationships during residency.”