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A Scientist’s Take on COVID-19

Questions provided by Fulbright Australia communications; Photo from Google

How has COVID-19 affected your Fulbright Program? How has it affected life back in the U.S?

The COVID—19 pandemic has shortened my Fulbright Program in Australia, which was meant to be nearly a year long, by three months. Since my project was meant to be laboratory-based, this means I missed out on one-third of time to potentially create a new diagnostic tool for an often-misdiagnosed, rare, bone marrow failure and cancer-predisposition syndrome called Fanconi Anaemia (FA).

The pandemic has also affected life now that I have returned to the United States as I have been in isolation for nearly two weeks now after flying back home. All non-essential businesses have closed, and I can’t spend the time with my niece and nephews as I had hoped for at the conclusion of my program.

What is its risk & impact on vulnerable communities, particularly to those whom your work is dedicated?

As a registered nurse, I can tell you that this virus, just as influenza and other respiratory illnesses, will impact nearly every age and health category in our communities. COVID—19 will be harder to fight off for those with pre-existing conditions and compromised immune systems, such as people who live with FA who are pre- or post-bone marrow transplant. This is because chemotherapy is given to these children and adults to suppress their immune systems before receiving stem cells from a donor, in an effort to prevent a reaction called graft vs. host disease, and to maximize positive impacts of obtaining this “new immune system,” which can take up to 100 days to grow to “normal” levels. These individuals are generally placed in social isolation for these 100+ days after the transplant, a similar concept to what all Americans and soon, Australians, are experiencing.

Some families who were nearing the end of their 100 days of social isolation following a successful bone marrow transplant are now having to continue this isolation along with you and me. Think about this—a child, parents, and siblings have already spent over three months largely alone and in their home or hospital room, after a declining illness and stressful hospitalization, and now, they must continue to stay home as long as the virus continues to spread. What perspective this gives in the midst of our struggles with social distancing and learning how to work from home.

How should the Australian and U.S. governments be responding from here?

A great indirect answer to this question which I have been holding on to over the past several weeks is this: we won’t know if we overreact to this situation with drastic social isolation measures and large changes in the way health care is delivered in this time. We will know, however, by the numbers of people dying and becoming critically ill, whether we grossly underreacted.

With that, Singapore has been praised in the media for their response to COVID—19 and how they have expertly managed to contain the spread of the virus. This success, despite being one of the first countries to report detection of the virus and nearing the top of the list by number of confirmed cases in early February, has been attributed to building health care infrastructure capacity, aggressive testing, transparent case reporting, quick and clear social interventions, and frequent and consistent public health communications. Read more here.

How should the Australian and U.S. public be responding?

The past seven months have taught me resilience personally and professionally, as laboratory experiments teach you to expect the worst, and question the best results. I believe the U.S. and Australian public should be responding by learning to become familiar with the unknown and settling into the discomfort that comes with adjusting our day-to-day lives. Listen to public health advisories and take notes from the scientists, health care providers, and experts. As I learned the mindset of managing emotional expectations and resilience related to experiments from research assistants, fellow students, and post-doctoral scientists:

“Maybe scientists have a role to play here beyond the hard work going on to understand this new coronavirus, chasing vaccines and new drugs?

We are comfortable swimming in the unfamiliar,

We know how to float on a sea of uncertainty.

We know it’s OK to say ‘I don’t know’ or ‘good question.’”

From a really great article about how our collective mindset should shift toward becoming more comfortable with uncertainty.

What do we need to do in the future to avoid or mitigate risks of further pandemics?

If we look again to Singapore, a task force was built across several governmental agencies beginning in 2003, following the SARS outbreak, with the aim to coordinate communication and interventions for future pandemics. Collaborations and partnerships across expertise and industries should be prioritized, and creating plans for future disasters of similar scale seem to have highly benefitted Singapore—if I were to hope for the future of our countries and the global health care field, it would be based off of this adaptive, successful model.

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Unexpected and Obscure

“Maybe once you’ve been inside of something for so long, you forget how astonishing it is.

…What if any of these people, in their pursuit of truth, had been motivated by the expectation of reward— where would we be? Or if they listened to what others said, as opposed to trusting in what their own experiments revealed? Or, if they had only been willing to wander 5 years in the wilderness, instead of 10?

Many topics come down to the same issue: how we should act in the world in novel and different circumstances; how we should think about what matters for a profession, or think about those who choose a crooked path. I could go on, but if you are looking for one example to be your guide, start with this one: the grace and persistence of Howard Temin and the Obscure Virus Club.”

The story of the discovery of a human retrovirus and the enzyme reverse transcriptase, which I’ve become all too familiar with during the past six months, and which questioned the central dogma of biology. A story of rejection and curiosity, and the importance of following your intuition and passion, even when it doesn’t fall into the realm of typical.

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On Friday at 1400 Melbourne time, just before midnight on Thursday in IN, all current U.S. Fulbright participants received a strongly worded email from the State Department’s Bureau of Educational and Cultural Affairs regarding a worldwide authorisation for voluntary early departure from our country of assignment.

Essentially, this meant I was to make arrangements to come home as soon as possible, or stay in Australia. Staying against this advisement would risk the possibility of not being supported by the Fulbright Program and Australian-American Fulbright Commission to return home at the end of June, as I originally planned, due to the rapidly evolving situation surrounding the COVID—19 pandemic and extraordinary protective measures being implemented globally which are effecting universities, public gatherings, and movement across boarders. Because of the fluid, unprecedented nature of the situation, I decided to use the generous travel stipend from my Fulbright grant to return home to Indiana within 36 hours of booking my flight at 2200 just two days ago. I was also aware in making this decision that on March 11, 2020, the U.S. Department of State issued a level 3 travel advisory (reconsider travel) for all countries. Because any further advisory advances would make getting home immensely more complicated and unpredictable than it already is, and although I am immunocompromised and therefore at much greater risk of struggling to recover from this coronavirus if I were to get sick, I feel confident about my decision to travel on the most direct route home to Indiana, with lots of hand sanitiser, disinfectant wipes, soap, and hot water along the way.

The AUS-US Fulbright Commission has also given us notice that upon return home, we will not be supported by the Fulbright Program to return to our host country to finish our projects, as we will immediately assume Fulbright alumni status. We are encouraged to assess what work we can continue from home and of course, to maintain our academic connections and friendships formed during our programs to continue supporting the vision of U.S. Senator Fulbright to foster mutual understanding between the United States and Australia.

The above reflection about Malcolm Gladwell’s Revisionist History podcast, season 4, episode 10, is a great supplement to what I have to say about the abrupt, unexpected, and atypical ending to my program. I am devastated that my time in Melbourne was cut three months short, yet I’m at peace knowing I spent 6.5 months absorbing the excitement and challenges of medical research, biochemistry techniques, and Australian sights and experiences. More than anything, I’m beyond grateful to St. Vincent’s Institute of Medical Research and the Genome Stability Unit team for being such an incredible community with an exceptional work culture, and for welcoming me with open arms from before day one back on September 3, 2019.

As far as my next steps, I’m looking forward to embracing my family and friends Stateside in just a few hours, and will continue advocating for my laboratory research project to advance the search for a new detection reagent for Fanconi anaemia. I’ll continue my work to plan the AUNZ family meeting for October as a board member of Fanconi Anaemia Support Australasia (FASA), and look forward to beginning recruitment for a research study I’m very excited about, which has just received ethics approval from the Children’s hospital to investigate a new early detection method for head and neck cancer for individuals with DNA-repair and cancer-predisposition disorders, such as FA. More details about that will be published soon to the FASA website our team has developed over the past few months.

I feel honoured to be able to do this work, and have all intentions of continuing in any capacity I can— regardless of my geographic location. Just a year ago this week I found out that, despite my doubts, I was awarded a U.S. Fulbright Future Scholarship to Australia for 2020. Words cannot describe how thankful I am that I did the hard personal and professional work to get to Australia earlier than anticipated, and I’m looking forward to seeing where this adventure called life will take me next. If I’ve learned one thing through my time as a Fulbrighter, it’s this: we must trust His Plan, as it is always much greater than our own.

Fulbrighters in the ACT

Just a week ago I returned home from the official Australian-American Fulbright orientation program held in Canberra in the Australian Capital Territory (ACT). After a quick 45-minute flight from Melbourne, I settled into listening to everyone’s 30-second introductions and learned there are 141 AUS + US Fulbright scholars in the Aus-Am cohort for 2020– the largest Fulbright Program cohort in the world!

This post will mostly be quotes from other people who spoke at our orientation program. During the first morning, Executive Director of the Aus-Am Fulbright Commission and retired U.S. Ambassador Thomas Daugherty shared: “you were selected for your innate capacity for empathy because senator Fulbright believed that in selection of the emerging leaders of our countries, it was important to bring that knowledge and empathy back to our communities. This comes with a weight of responsibility, as you are the new ambassadors for the Fulbright program and alumni who have walked in your same footsteps.” This quote truly set the tone for the week as I embraced networking opportunities after hearing each Scholar’s intriguing story, project summary, and trying my best to remember which AUS Fulbrighters I wanted to chat with about their projects and their destination in my home country!

This first day took place as the National Strategic Action Plan for Rare Diseases was introduced in Parliament House just across the street. This plan was advocated by Rare Voices Australia and is a huge leap toward equity as we prepared to celebrate Rare Disease Day on February 29th, the most rare day of the year– yay for leap year and showing our stripes as the global rare disease community.

I learned at our first night’s informal dinner that the first treaty between Australia and the United States was to establish the Australian-American Fulbright program over 70 years ago and my passion for maintaining these lifelong bilateral relationships was refreshed.

During our final day of orientation, we enjoyed a great breakfast buffet at our QT Hotel Canberra and prepared for our Fulbright Gala later that evening after a tour of Parliament House. The theme of the day’s speakers including Fulbright and Rhoades Scholar alumna Carolyn Evans, Vice Chancellor of Griffith University; as well as rare disease mom, author, journalist, American and now Australian, Sara James was making beautiful things out of the ashes. To quote Carolyn, “it’s been a hard summer: fires, floods, fear. But think about the fires from which the Fulbright program was founded.” And to quote Sara,

“In the world of rare disease, I’m Jackie’s mom. It’s my double helix. We need to kick some goals here.

Fear. Its absence can diminish memory’s truth. How do we take that sense of alarm and turn it into something good? How do we take it and remind us not to repeat it?

A senator from Arkansas had a great idea: where we introduce each other, send our best and brightest, and instead of starting an inferno, we get together and blaze a trail.

It’s easy to forget fear. It’s easy to forget why we send you out to do what you do. Because this is how we make the world a better place.

It really is true: we can fight fire with fire.

In conclusion, the highlight of this whole experience for me was finding the Kinghorns in the midst of Parliament House at the Gala to say a simple thank you for funding my Fulbright Future Scholarship. Their humble character is sincerely furthering the well-being and relationships between AUS + the US. Thank you.

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Now, more than ever, William J. Fulbright’s words resonate with me:

We must dare to think unthinkable thoughts. We must learn to explore all options & possibilities that confront us in a complex and rapidly changing world.

 

Great Barrier Reef. Tasmania. Rottnest Island. Lorne.

Oz has treated me very well so far in 2020. Shortly after my last update, I was able to spend the week between Christmas and New Year’s Day with my dad, stepmom, her mom, and my little sister in Melbourne and in Cairns, Queensland. We did it all: I showed them around Melbs, including St. Kilda [pretend to be shocked] and Queen Victoria Market. We went to Cairns for a whirlwind 48 hours that began snorkeling and SCUBA diving Moore Reef in the outer Great Barrier Reef and ended on the Skyrail Cableway above a beautiful rainforest and Barron Grove National Park.

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SCUBA Diving the Great Barrier Reef

We landed back in M town just as the fireworks went off over the city and we officially entered a new decade. The trip wouldn’t have been complete without showing them the kangaroos and koalas at Healesville Sanctuary, having some wines at De Bortoli Winery in Yarra Valley, and catching some waves during a surf lesson at Ocean Grove. It was sad to see them go, but I had another visitor just after they left!

Matthew flew into Melbourne on his birthday and I surprised him with a trip to Perth, Fremantle, and Rottnest Island in Western Australia the next day. We had an amazing few days in Freo enjoying Little Creatures Brewery and meeting up with a family facing Fanconi Anaemia who we both knew from Camp Sunshine in Maine, USA. We also spent an afternoon checking out the Perth Zoo [highly recommend]. The highlights of his trip here by far included cycling, snorkeling, and taking quokka selfies on Rotto. We watched a movie from the beach and experienced the international, interactive art exhibit called the Rain Room. See evidence:

I went back to work after returning from Rottnest Island, and began more attempts at my laboratory research project and refinements to our FA research study ethics application.

After a quick few days of normalcy, I ventured down to Tasmania to do a little weekend road trip around the state with some other Fulbrighters. We visited Hobart, glow worm caves, Queenstown, Cradle Mountain National Park, Russell Falls, the MONA, I did the Moorilla winery tour, and then we flew home:

After returning back to Melbourne [again], I won free tickets to another Mov’In Bed screening on the beach, and went for a gal’s night. I finally got back in the dance studio and learned some killer moves:

I was also able to attend a cocktail hour at the US Consulate General’s house and network with current Fulbrighters and Australian-American alumni.

Last but not least, I have been fortunate to attend the Lorne Genome conference on the beautiful Great Ocean Road, just two hours outside of the city. This beachside town hosted scientists from all over the world this weekend, and I felt so thankful to be a part of it. Here are some beautiful sights… find me on twitter @xoxohannahlily to read about the amazing presentations.

I couldn’t end this post without acknowledging the severe bush fires that affected many regions of Australia in the past few months, and summer is only beginning. Not to end on a sad note, but a piece of reality, here is a recent photo from a nurse friend of mine, Nicole, showing the difference in the city, hundreds of miles from the fires:

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Holidays

December has been filled with joy and memory-making. From the Luna Park rollercoasters, to a Friendsgiving potluck, and even a music festival, it’s been great to enjoy the sunshine during this holiday season. I joined a pilates gym a few weeks ago and have been taking barre, pilates, yoga classes, and enjoying city views while stretching and foam rolling sore muscles. I enjoyed exercising my brain and making new friends at Kin North’s second Puzzles + Pinot event. I’ve Facetimed into family holidays and had chats with NICU nurse researchers in the city about opportunities to get back into the clinical setting while I’m here. I received some amazing birthday gifts including $521 donated to the FA Research Fund through my FB birthday fundraiser— wow! Thanks, friends. Though it was my first birthday away from my twin sister, this time I finally got to be the eldest twin (for 16 hours). More birthday celebrations took place at bounce (Oz version of sky zone— indoor trampoline park), and with orange almond cake at work for morning coffee. Dinner and drinks on the river with friends closed out my day! 

I heard a live saxophone play in the club, and enjoyed our lab’s Christmas party in Warragul. I went skydiving over the city and St. Kilda beach wearing my Aria’s Army shirt because she overcame nearly every expectation medical professionals had for her little life, but nobody said she couldn’t fly.IMG_3667.jpgI enjoyed the Institute’s rooftop Christmas party, did my first protein purification, and initiated Melb’s first Taco Bell. I attended my first summer night market and some fabulous halloumi fries, and enjoyed my last tap and jazz classes of the year. During my last work day of 2019, my cousins club gift exchange present was delivered in the Aus post from one of my little mini-mes! I can’t wait to put my “somebody in Muncie loves me” mug to good use.

The last few weeks of trip planning for upcoming travels kicked off with a solid week in New Zealand on its South Island with another American Fulbrighter with whom I’ve been sharing the joys of Melbourne. We flew into Queenstown on the 17th, hiked to Bob’s Cove and to the Routeburn Flats huts in Glenorchy, and stopped at Bennett’s Bluff Point at the head of Lake Wakatipu and the Isengaarg Lookout (to capture a scene from Lord of the Rings) on the way. Lots of suspension bridges, waterfalls, and steps on that second day in NZ… 33,000 to be exact. The natural beauty there is simply breathtaking! 

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Bob’s Cove

We were watching a live counter of the impeachment vote and acknowledging the third impeachment of a U.S. president as we witnessed the newest chapter in history books unfold before our eyes, while over 10k miles away. Remind me to write a post about navigating polarizing conversations as a representative of the States in another country, especially during this political climate…

 

On day three, we drove from Queenstown to Te Anau, stopped at the Devil’s Staircase, ate some killer nachos, drove up toward Milford Sound and hiked to The Chasm and some of Lake Marian track. It was pouring rain but the dozens of waterfalls on the mountains were gorgeous with the extra volume. Back to the Airbnb we went with our car karaoke & lots of rain, and we slept to the sweet sound of thunderstorms with the added bonus of a heated mattress, which seems to be the norm in NZ. 

The next morning we woke up bright’n’early to begin day four at 0700 for attempt #1 at the half-hour Te Anau Lake cruise to the glow worms in Aurora Cave. Unfortunately, the caves were flooded from a few days of rain (it rains 200+ days per year there), so we went back to town, bought some postcards, and got comfy at a café to write some it’s-almost-Christmas-and-we’re-10k-mikes-from-home notes to loved ones. We then hit the road and headed toward Milford Sound— it was such a joy to get to sit behind a steering wheel again and blast my favorite music! It has made me grateful that I have experience driving in the left hand side of the road in the U.S. Virgin Islands while visiting my grandma on St. John. 

Two hours and an awesome tunnel drive through the mountains later, we arrived at the end of the road [literally] with the intention of hiking the Milford Foreshore and finding WiFi at the ONLY café in a two hour radius of the “eighth wonder of the world.” No WiFi was to be found, which was a blessing and a curse— we couldn’t execute our plan of judging the last dem debate of the year in between sightseeing, but we did manage to stay disconnected for nearly 12 hours. Sometimes that’s more than necessary, and we’ll catch up on the highlights tomorrow.

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Milford Sound from the foreshore

So, off we went to get our steps in (just 20,000 this time) on another short hike to the Milford Lookout followed by enjoying a delicious berry smoothie. It was almost time for our beloved and much anticipated cruise, and the dreaded rain began. Just when I had lost all hope for experiencing the true beauty of the famous Sound, the storm passed; and as we pulled away from the boat dock, the clouds quickly cleared and we were beyond pleasantly surprised at the views. We saw dolphins flipping for joy, rode some ocean waves in our boat, watched friendly seals climb a slippery rock to sunbathe on, squinted our eyes as far as we could upon hearing we were looking straight into the Tasman Sea toward Melbourne, and captured a double rainbow after getting soaked by a waterfall. Take a look for yourself at our wander of the wonder of Milford Sound… there are no words, except that we were truly somewhere over the rainbow (see featured image).

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Milford Sound

But, that’s not all! After the two hour drive back to Te Anau, we were on for take two of GLOW WORMS: a claustrophobia-inducing challenge for the history books. It was well worth the moments of impending panic as we ducked under cave boulders and around waterfalls to see the little 3-5cm wrigglers above our heads as they glow from their tail’s bioluminescent light, equivalent to one nanowatt of brightness. The light is used to attract an insect snack which is then drawn into their sticky mucus sack or “wee hammock” in which they’ve suspended themselves from the inside of Aurora Cave. Here are some glowing fun facts:

 

  • There is only one species of glow worm in New Zealand, called Arachnocampa Luminosa, and it can only be found in New Zealand. 
  • Aurora Cave is only 12,000 years old and its biggest stalactite [slow calcium drips from the top of caves often seen as large appendages hanging down], dubbed “Percy,” is 400 years old and literally only an inch long. #BabyCave
  • The glow worms are so territorial that the old ones eat the “wee” ones if they get into their space. Ha!
  • They spend 6-9 months in the larva stage as a glow worm. The females lay up to 150 eggs and the first one to hatch will eat the rest in the cluster to try to get the energy it needs to start its life cycle. After a few days, the adult Fungus Gnats die of starvation because they have no digestive tract. Lights out. #ImPunny

The next morning, we hit the road for our second to last drive on the Te Anau-Milford Sound road, this time to stop at a few lookout points including Hollyford Valley, Mirror Lakes, and Cascade Creek and then to hike three hours and 919 meters in elevation to the Key Summit. This is just the other side of the Routeburn Track hike we did a few days prior from Glenorchy, which is a several day hike to do from start to finish. #WalksForWimps 2/2 recommends doing it our way. These views and the on-top-of-the-world feeling and view of Lake Marian were nearly as great as skydiving. 

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Leaping above Lake Marian at the top of the Key Summit

Listen— I’m not an outdoorsy person in any way, shape, or form. (Shocker, I know). In fact, I’m a self-declared city girl through and through. To top it off, thanks to psoriatic arthritis, I was designed for anything but what I love most: moving this body. Yet at this point, I had spent more than eight of the last 72 hours hiking and taking in gorgeous views of NZ, thankfully pain-free. And I wouldn’t change a second of it, let alone the 919 meters to the top of the Key Summit. 

After a total of five hours of driving to land in Albert Town, my glass of strawberry-passionfruit hinted rosé was well-deserved. Hiking onward in Wanaka was on the agenda for day six! #HannahHikes 

We completed our hardest and longest hike to Roy’s Peak lookout, 1,578 meters in elevation, which was not a #WalkForWimps. My payoff included finding #ThatWanakaTree (even though it was nearly underwater), curly fries, 2 liters of water, a two hour scenic drive through Lindis Pass from Wanaka to Lake Tekapo, and a celebratory glass of riesling while soaking in the hot springs. I spent the scenic drive trying to stay connected on my first conference call as a board member of Fanconi Anemia Support Australasia, and was rewarded with a gorgeous sunset upon arriving at the night’s Airbnb in Ashwick Flat. 

Our last full day in NZ consisted of nearly seven hours of driving to squeeze in a three hour hike through Hooker Valley and racing back to Queenstown to finally go white water rafting and have my first ice bar experience! Our color-coordinated schedule had to be altered a bit upon arrival as the rainy days forecasted didn’t line up with our original plan. Though this resulted in some driving-heavy days, it all worked out fabulously and I got in plenty of car singing time. 

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Rafting on Shotover River in Queenstown

White water rafting in class 3-5 rapids on the Shotover River was exhilarating. The drive down the canyon to the starting point was on a historic highway, and the most dangerous road in NZ. I volunteered to sit up front and then to lead the team through a dark tunnel to drop off of a waterfall. I would highly recommend rafting!

Our final day in NZ also happened to be Christmas Eve, so we returned our rental car and headed to brunch at Yonder in Queenstown. We chillaxed by the waterfront and enjoyed some rooftop weather before returning to the airport for our flight back “home” to Melbourne. We landed with just two hours left to Christmas in the Southern Hemisphere, and I achieved my goal of being in my warm, cosy bed before midnight. 

Homesickness is not something I’ve experienced in waves during my stay in Melbourne, but it’s hit twice, hard. Once, the day after thanksgiving here, when all of the family celebrations were taking place at home; and second, upon celebrating my birthday without my twin for the first time in 22 years. It’s not so much that I’m homesick to be back in the States— it’s that I wish more than anything my people were here in Melbourne. I’m beyond thankful to have dear new friends here in this big city who have become my home away from home, and who have made the bad days easier, and the good days just that much more fantastic. This Christmas, I hope wherever you are, you have people like that near and far. I couldn’t imagine this experience without them! 

If you are looking for an incredible cause to support this season of giving, look no further. Aria’s Army has a new initiative called the 2020 Birthday Campaign Leadership Circle. The Leadership Circle helps create a matching fund to maximize the impact of campaign participation, celebrates Aria’s would-be ninth birthday, and will ultimately help to fund research on Fanconi Anemia and support families facing FA. With the goal of raising $20,000, we hope to celebrate the completion of the campaign on January 11th, 2020, Aria’s birthday. If you feel moved to be a part of the Leadership Circle, you can learn more here and donate today. Merry Christas in the stars, Sweet Aria. 💞

Feeling like a nursing student, again; aspiring for always

IsLET Myself Inquire

This month began with the exciting notification that the Islet Isolation Facility at the O’Brien Institute, a part of St. Vincent’s Institute just on the other side of the hospital from the lab, was to receive and process a pancreas from an organ donor. Our job is to quickly isolate the islet (insulin-secreting cells in the pancreas) cells, evaluate their viability for transplant, and either prepare them for transplant into the matching recipient or process them for research. Excitingly, these islets were 89% confluent and therefore we were able to prepare and take them to the hospital for transplant(!) On November 1st, I was fortunate enough to be a part of the final tests for this process and to walk the cells across the street to the hospital. Here’s where the nursing student feeling comes into play: alongside some of my “mates” from the Genome Stability lab, an undergraduate premed student, and the islet isolation program manager, Dr. Loudovaris, I was able to deliver the islet cells to the operating room in the radiology department and observe the whole procedure!

The actual transplant is pretty uneventful, as it is pretty similar to an intravenous infusion – a cannula (plastic tube) is used to infuse the islets through the portal vein (large vein in the liver). Asking questions of the transplant interventionist Dr. Vrazas, and the clinical nurse coordinator Kathy Howe, was a real de ja vu experience. Making my own learning opportunities from the professionals around me is a bit I learned from nursing school.

As we left the hospital at 11 PM that Friday night, it was great to hear Dr. Loudovaris comment that he was glad I was there, as he felt the other team members from SVI wouldn’t have learned as much if I hadn’t been along to ask so many questions. An interesting bit was that most recipients actually receive several islet transplants. To take a step back, I will point out that eligible recipients have type I diabetes coupled with severe hypoglycemia. Being a small part of the type of research work that meets clinical care and improves patient outcomes in such a direct way was truly exhilarating. The whole experience also made me thankful for organ donors and for the willingness of medical staff members who have consistently gone above and beyond to teach me, as a nursing student at home and now as a new scientist and nurse here in Melbourne. I can’t wait for the next pancreas to call the team to the isolator! Side note: the isolator is an incredibly remarkable and complex set of equipment. See the photo below for reference, and note that we have to wear sterile scrubs, hairnet, shoe covers, etc. I also had to pass an aseptic technique assessment to join the team, though I will say it was a breeze since ya know, nursing prepared me pretty well to execute sterile technique… The cells can be seen in the next photo as well. The green cells are alive, while the orange ones are dead. I actually guessed just by looking through the microscope, which is the view you can see, that they were 90% alive. The computer program confirmed 89% of the cells were good to go – I guess estimating the percentage of wound dressing saturation in nursing school has prepared me well for islet isolation.

I Learned LFS Lingo

Rewinding to a few days before islet transplant day, I want to share a nugget from a psychosocial genetics PhD candidate’s final seminar on the care and experiences of individuals with Li Fraumeni Syndrome (LFS), another DNA repair disorder and inherited cancer predisposition syndrome. LFS is similar to Fanconi anemia (FA) if you recall that individuals with FA are hundreds of times more likely to develop cancers when they are aged decades earlier than the general population. LFS is essentially this manifestation of FA (minus the bone marrow failure that comes with FA), due to a genetic mutation in a tumor suppressor known a TP53. That Friday afternoon, 4 PM presenter was Rowan Forbes Shepherd, and the session was held at Peter MacCallum Cancer Centre, a beautiful new-ish building decorated in various shades of purple geometric designs located right in the middle of the city. Because Rowan’s PhD studies have been centered on psychosocial genetics, it made sense that his qualitative research methods have included interviewing individuals with LFS about their genetic counseling and their lived experiences through their own and their relatives’ cancer diagnoses and treatments. The results of his research included various groups of young people with LFS, some who had undergone genetic testing to confirm their TP53 mutation and increased risk for cancers, and some who knew they were a likely carrier of a mutation due to their parents’ or siblings’ characteristic cancers.

It was especially impactful to hear quotes from patients my age who have experienced multiple cancers themselves and who have lost parents and siblings to cancer before even graduating from university. It was also eye-opening to hear Rowan’s mentor and advisor comment on how he had grown throughout the process of conducting this research, as emotionally processing some of the quotes he shared had to have been beyond challenging for any professional, let alone a student.

This was a concept that resounded strongly with my experiences over the past year while conducting my own research and speaking with parents of the newborns suffering from drug withdrawal, or neonatal abstinence syndrome, in the neonatal intensive care unit back home [I would be remiss if I didn’t add that our study has officially enrolled over 75% of our target number of participants]! To be able to listen, process, and respond professionally in the moment to people who have lived through things you could have never prepared to hear, takes a lot of self-awareness and empathy. It was an honor to hear from Rowan and learn about this research into another rare disease, LFS, which is so similar to FA and is taking place just a short walk from SVI.

Nurses Near Newly Nourished Research

The Monday after this visit to Peter Mac to learn about LFS, I just so happened to be in St. Vincent’s hospital trying to track down an ENT specialist to be a collaborator on our ethics application. As I remembered what it was like to step into a hospital and share a small space and short time with people on the best and worst days of their lives, I glanced at the poster in the elevator— the inaugural SVHM nursing research symposium was taking place this week! So, that Thursday, I made sure to catch the end of the symposium, taking place around the corner from my lab in SVI. I specifically enjoyed the Q&A panel that concluded the symposium titled “pathways to research – perspectives from the field.” Resounding responses to my question for best advice to a new nurse wanting to establish a dual career in research and clinical work included: 

• say “pick me!” over and over, until you are where you want to be;

• figure out who the rockstars are in your area and ‘stalk’ them until you become collaborators (I think I already completed this step, rockstars: Dr. Renee Twibell, Dr. Deans, etc.); and

• be a “can do” researcher… and to echo, a “can do” grant-getter. 

What a day of sincerely feeling like I’ve settled into this role of a nurse and a researcher. It is interesting that I found myself asking the question above as if I have not already been working on collaborative research efforts in the nursing world. In reflection, I realized that I never want to stop feeling like a nursing “student,” as there is always more to learn in our ever-evolving field. How exciting that nursing research is becoming more relevant, encouraged, supported, and widespread.

Ethics Effort en Route

I am thrilled to share that our ethics application has been submitted – woohoo – and 24 hours before our deadline, after having to make 8 hours worth of intense close-to-last-minute edits after peer review. My first thoughts were, ‘my work here is done…’ (not nearly true). This sentiment is a reflection of two-ish months of conceptual and collaborative hard work which is all [hopefully] about to turn into something a lot more exciting. I will celebrate with the 15 colleagues on our application while we patiently await ethics and governance approval and move toward a start date. Crossing the border of clinical and laboratory research is oh so exciting to me, if you didn’t already know from previous posts and the above stories. I am so glad to work with people who understand the value of working under the advisement of both perspectives.

This week, my 5th, 6th, and 7th PCR reactions didn’t work for a still unknown reason, after the first went perfectly…but I’ve learned in my short time here in the lab thus far to take each success and failure with a grain of salt. Or, in the words of a card hanging above a colleague’s desk:

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If at first you don’t succeed, try two more times…

…so that your failure is statistically significant.

I am paying close attention to the wisdom that in time, the reason for these experimental failures will surface and things will progress as planned, with just that much more insight.

Dance, Dream, Do

In between these work-related events, I have spent the last month in pursuit of dance classes, socialization, and some much-needed city escapes. Don’t get me wrong – I’m a city girl through and through – but I found myself falling back into the habit of moving ten million miles a minute over the past few weeks with no relaxation time outside of the dance studios. I spent two consecutive Wednesday evenings at Jon Bellion and Shawn Mendes concerts with girl friends, and the others at the Wednesday night events at the Queen Victoria Market across the street from my apartment. I spent a Friday evening at a vermouth tasting event, and a Thursday evening sipping more grape products and putting together pieces of a spherical rainbow at a puzzles and pinot (gris) event hosted by kin north. Kin is a brand created by a woman with a passion for reminding people to enjoy rest and human connection among the hustle of life.

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Needless to say, I spent that night following the event enjoying deep conversation with my pre-existing friend and a new Melbourne mate, dubbed Little Miss Melbourne.

I have already bought my ticket for puzzles+pinot round two and I can’t wait for revenge on our barely unfinished rainbow sphere… picture for reference.

I spent the long weekend for the Melbourne Cup horse race lunching over the beach and basking in the Peninsula Hot Springs with gal pals. I attended a farewell dinner for a fellow Fulbrighter after watching the end of a game of netball, and have officially established a Friday-after-work habit of having a drink with colleagues before everyone heads off for the weekend ahead. I applied for and was accepted as a one-on-one counselor for my third summer FA camp session at Camp Sunshine, and facetimed Sweet Aria’s little sister, Cosette, in celebration. Unfortunately, I became hooked on the reality show Love Island Australia, which was added to my current Grey’s Anatomy-The Resident-New Amsterdam-Atypical show rotation, and became the background noise for this month’s Stelara self-injection. Stelara is a biologic medication that helps ease my autoimmune symptoms from psoriasis and psoriatic arthritis, and I am grateful that I only have to administer these subcutaneous injections once every three months. I recorded my injection this time to share with you all, and oops – almost dropped it! It’s a simple task, especially as a nurse, but guess my hands are a little out of practice.

It should go without saying, but I’ve been taking as many dance classes as possible, as well. As I carry on the pursuit of breaking in my rose gold and black, royal-designed, triple threat style Miller and Ben tap shoes, I have continued taking tap classes on Mondays (follow the link if you love Billy Elliot) and Saturdays at The Space Dance Centre and Elevator Studios. Both studios are within a 30-minute tram ride of my apartment and both classes are taught by Eden Read, who is a super fun teacher and also taught at the Australian Tap Dance Festival a few weeks ago, where I was able to take class from the director, Winston Morrison. A special Sunday tap class was also added to the planner once a month, beginning two weeks ago, taught by Bill Simpson. This weekend, I took my fourth and final introduction to pole dancing class, and followed through with jumping back into another style of dance. I took lyrical jazz class from Brad Inness, and I’m so glad I did. Brad also teaches barre and reformer pilates classes, which understandably meant I was worn out 15 minutes into his class as we concluded the grueling warm up, and I was equally thankful for an hour break between jazz and tap yesterday. This also meant I was hobbling around today with a sore back like a person much older than me.

As Melbourne has been facing its coldest spring in more than a decade, some of my gal pals decided it was time to break out of the city again today in search of sunny beaches and incidentally, the end to my quest for mozzarella sticks (which are surprisingly hard to find in this city; thanks are due to TGI Friday’s for quenching my hunger for this apparently American delicacy). We rented a car for the day and headed south to walk to the end of the Rye beach pier. We enjoyed iced chais and brunch, put our toes in the sand and ice cream in our mouths at Sorrento beach after a bit of retail therapy, and ended the day at Brighton beach taking your average tourist photos in front of the colourfully painted bathing boxes (see: featured image on this post).

All in all, the past month has been nothing short of jam-packed and fabulous. It’s now been nearly 11 weeks of #HannahofOz (my creative NBN wifi password name) and I’ve had my fair share of loneliness – though I wouldn’t say homesickness [blog post coming soon (?)] – as well as feelings of contentment and bliss. If you’ve read to the end of this short novel-length post, thanks so much for following along on my Fulbright adventures and inquiries thus far.

Here’s to always seeking opportunities to be the aspiring “student” in the room.

The Art of the Sciences through the Lens of Undergraduate Research

I felt so honored to be asked to write a perspective piece for Fine Focus, an undergraduate microbiology journal based at Ball State University. I first drafted this manuscript in January 2019, and I feel that so much has changed since then. Nonetheless, here’s the link if you would like to read my perspective and advice for undergraduate research.

SWAN, Seminars, and Science

If we’re counting, it’s been six weeks since I arrived in Melbourne, Australia, and a month of working in the lab at SVI! I have shadowed almost every member of our Genome Stability/DNA Repair and Recombination lab, ran several experiments, and broken in my lab notebook. My weekends have been filled with dinners with colleagues, city exploring with fellow Fulbrighters and other new friends, good food and coffee, and I finally got around to turning in my Medicare application. Side note: how incredible is it that in this country, even a visitor like me can enroll in Medicare?! Thanks, Fulbright!

I have had a few unique opportunities outside of my lab work and keeping my tap shoes warm (and my heels blistered, thanks to my beautiful and sturdy rose gold and black Miller and Bens) recently that I wanted to share.

Yesterday, I attended the inaugural Syndromes Without A Name (SWAN) Australia conference at the Royal Children’s Hospital. SWAN is a non-profit that supports families who have a child with a rare or undiagnosed genetic condition. The conference was titles Exploring the Unknown Through Genetics and Genomics, and featured several genetic counselors, researchers, geneticists and pediatricians, as well as mothers and advocates of these children. One of the speakers commented that the expected audience for the conference was originally families in the SWAN community, and they were surprised by the turnout of professionals, too. The aim of my attendance at the conference was to learn from Jane Tiller, lawyer and genetic counselor, about the ethical implications of research and genetic testing in order to inform some of our work. I also enjoyed hearing from two mothers of children with rare diseases. One SWAN mother in particular spoke about “How Genetic Counseling Helped Me to Make Decisions,” and her journey in navigating the rare disease space. In her reflection, she shared (paraphrased):

“our children are rewriting history, contributing to the future;

they’re all mosaic– they break us apart and rearrange us more beautifully than we ever could’ve imagined;

and they’re all contagious– if you spend time around them, you’ll likely catch some ‘awesome’ just by being around them.”

It’s safe to say this mother (and the whole conference) was a bucket-filler, especially on a Saturday morning at 0900.

I also wanted to talk a little about Tuesdays. At SVI, we are lucky enough to have either an internal expert or an external visitor come speak at each of our Tuesday seminars… plus free lunch for those in attendance. Call it a win-win: feeding our brains and our stomachs in one go! Last week’s Tuesday Seminar was given by Professor Eva Dimitriadis, a National Health and Medical Research Council Senior Research Fellow, Professor in Reproductive Biology at the Department of Obstetrics and Gynaecology, University of Melbourne and Co-Head of the Gynaecology Research Centre at the Royal Women’s Hospital [copied from the SVI promotional flier]. Eva’s talk was titled “The Role of Placental Inflammation in the Development of Pregnancy Disorders,” and she focused mostly on how inflammation contributes to placental insufficiency and preeclampsia.

I was on cloud nine to hear both the clinical and biochemical sides of her research, since this begins to explain the science behind some newborns with intrauterine (fetal) growth restriction and low birth weight– most of which end up with Neonatal Intensive Care Unit (NICU) stays. My two worlds came together in her talk, and I loved every minute of it.

In addition, her research findings, the results of which have been published in over 100 articles, found that inflammation can prevent typical development of the placenta. Since the placenta is how the baby receives blood, oxygen, and nutrients from the mother, and preeclampsia begins with the establishment of the placenta, she has found success in studying the tissues and mechanisms of placentation. Her findings have the potential to be used as novel treatment options for preeclampsia by targeting certain inflammatory cytokines like Interleukin 11 (Winship & Dimitriadis, Journal of Reproductive Immunology, 2017). It was incredible to hear her speak about her work!

Lastly, I wanted to share that I’m eager to continue working on the different projects and collaborations I have going on now that I’m a few weeks into my work. While 10-hour days in the lab are nothing compared to 12-hour nursing shifts, they sure are a similar kind of rewarding. I’m making progress on my research project to find new detection reagents for Fanconi anemia, went through orientation to join the islet (pancreas cells) isolation team for transplants and research, and continue to work an ethics application for an international FA and cancer study that bridges patient-facing and biochemical laboratory research. Of course, I can’t end this post without mentioning that my research study back home— which is exploring the effects of movement and music on newborns with Neonatal Abstinence Syndrome– is moving along well thanks to my awesome team in the NICU!

And with that, the sun is setting on this Sunday night and another week of asking the hard questions in hopes of finding answers, treatments, and cures lies ahead. I missed out on Ball State Homecoming this weekend, which was a bummer after spending this week during the past three years watching the results of our Homecoming Steering Committee planning come to life. I was reminded, however, by my awesome desk name plate– gifted by the best committee advisors– that being a Cardinal is part of why I’ve been able to fly all the way Down Under. Thanks for reading.

 

Settling in

It’s been almost three weeks since I moved to Melbourne and I am loving the city life, learning so much at work, and it’s safe to say I miss my people. I landed on the 3rd of September and a great friend picked my mom and me up from the airport (thanks Kylie!) and helped us shop to fill my studio apartment. For two weeks, mom and I explored, did all of the touristy things, and made sure I was settled and ready to begin working on the 16th. We quickly learned the public transportation system (which is super great and easily accessible) and off we went to the Melbourne Zoo, Eureka Skydeck, Melbourne Star ferris wheel, Yarra Valley’s Healesville Sanctuary and wineries, St. Kilda beach and a tap class, Queen Victoria Market, and a riverboat cruise of the Yarra River. We even went to a networking event hosted by the Victorian chapter of the Australian Fulbright Alumni Association and got to meet Fulbrighters past and present and hear their passion for their project and professions. It was a great few weeks and let’s just say that sending mom back to the airport was not the happiest morning.

This past week, I went to work at St. Vincent’s Institute for Medical Research to begin #fightingFA in the Genome Stability lab. It’s really great to be able to walk 15 minutes up the street and be at work. Up first: learning the ropes of the lab. I’ve had plenty of pipetting and centrifuging experience, and have already learned so much from everyone in the lab. They’re a super helpful bunch and I can’t wait to get into the meat of my project. I’ve had my fair share of coffee (err… chai lattes) during our morning coffee hour, true to Melbourne as this city is known for its crazy amount of quality coffee shops. I’ve also attended several scientific presentations by my lab mates about Fanconi anemia and by guest presenters about different types of clinical trials and research into various cancers. There is a weekly seminar presentation every Tuesday at SVI, which is so exciting!

I reserved a spot in a masterclass at the Australian Tap Dance Festival for next weekend and am looking forward to another great week full of learning at work. Thanks for reading, and I’ll try to update again soon!