Experience as a patient shapes student’s future as a physician
Like all Medical School students, Rachel Lundberg ’15 has some good stories to tell. Like the one about the obstetrics rotation she did last year in St. Cloud. “I worked with an awesome doctor, and in one 24-hour shift we delivered 13 babies!” she recalls with wide eyes and a big smile, still amazed by the accomplishment. “I think it actually made the news.”
But Lundberg also has a different story to tell — one that sets her apart. It’s the one from her first year of medical school when, over the course of a few months, she went from being a student to a patient.
Lundberg was halfway through her first year when the pancreatitis she had been battling intermittently since her freshman year of college finally got the upper hand. The decisive attack came just before midterms. Despite excruciating pain and a trip to the emergency room, Lundberg managed to complete her exams.
But at the end of the school year, Lundberg would undergo a total pancreatectomy and islet auto-transplant (TP-IAT), a radical approach to treating chronic pancreatitis that was pioneered at the University of Minnesota. Her operation took nearly 12 hours. She spent the next several days in the hospital and then about four months recovering at home.
For Lundberg, the hardest part of the whole experience was coming to terms with the need to take time off from medical school. The athletic and otherwise healthy young medical student was eager to get on with her life. “I’m a pretty determined person,” she says.
Lundberg credits her Medical School mentor, the late Ted Thompson, M.D., with helping her to make this difficult decision. She had gone to see Thompson for a heart-to-heart after completing her midterms. To her surprise, he scolded her for taking her exams while experiencing the debilitating pain that is a hallmark of chronic pancreatitis. “You have to take care of yourself,” she recalls him saying. “We’ll understand.” Then Thompson picked up the phone and called Martin Freeman, M.D., a gastroenterologist and a professor of medicine at the University, to set up an appointment for Lundberg. She hadn’t yet met Freeman but soon discovered — as she puts it — “he’s a world-renowned pancreas guy.”
Specialists from University of Minnesota Physicians performed the world’s first TP-IAT in 1977. Today, the Schulze Diabetes Institute and University of Minnesota Medical Center are home to the largest TP-IAT program in the world. Freeman leads the team.
At Lundberg’s first meeting with Freeman, he assured her that he and his colleagues would investigate all of her treatment options. Tests revealed that Lundberg had a genetic form of pancreatitis. Eventually, the team advised her that a TP-IAT would be the best longterm solution.
Lundberg admits that after the first meeting with her surgeon, she went straight to her mentor’s office and cried. “I’m not a super-emotional person,” she says. “But I was overwhelmed about taking time off from school.”
“A lot of people have been in my office crying about a lot dumber things,” Thompson told her, she recalls. “Don’t worry about it.”
A TP by itself causes immediate diabetes because the pancreas contains the islet cells that secrete insulin to control blood sugar. In the IAT part of the procedure, the islet cells are harvested and then injected back into the patient’s liver, where, if all goes well, they resume functioning.
In Lundberg’s case, the team harvested a lot of islets — more than they were expecting — which is a good predictor of success. She is now among the one-third of TP-IAT patients who are fully insulin-independent.
“It really was as successful as it could have been,” she says.
From the patient’s side of the stethoscope, Lundberg is quick to acknowledge that the things her doctors did that she appreciated most were really simple. “Like sitting down at the bedside and listening. Asking questions and not interrupting. And introducing themselves.”
The experience will certainly influence the way she practices medicine, Lundberg says. It also impressed upon her the importance of medical research. She is considering pediatrics as a specialty and is quite sure she’ll pursue academic medicine.
“I’m working with a pediatric endocrinologist, Dr. Melena Bellin, who’s just amazing at research, and she’s taught me a lot,” Lundberg says. “If I end up subspecializing, it will likely be in endocrinology. I’m really interested in diabetes and think there are a lot of advancements on the horizon.”
By Kristine Mortensen, a writer and editor at the University of Minnesota Foundation