In the fall of 2019, the prospect of an internship where I’d see patients primarily through Zoom seemed novel, if not a bit niche. “This will be a unique, alternative experience geared toward the future of healthcare…,” I thought to myself.
My name is Ryan, a genetic counseling student with the inaugural class at the Massachusetts General Hospital Institute for Health Professions, located just north of Boston. Born and raised in New England, I decided to view my summer internship as an opportunity to venture outside the northeastern bubble.
When my program coordinator mentioned she had a contact on the west coast, I jumped at the chance to meet with her. That contact was Katie Stoll, the executive director of Genetic Support Foundation (GSF). After our first meeting in January–fittingly via a Zoom video call–I had a feeling that the summer would be special. The nonprofit’s goal to provide unbiased and easy to understand information about genetics and genetic testing to people all over the country, aligns closely with my personal values on healthcare equity. The internship would give me an opportunity to dip my toes into many projects, including writing content for the website, working on a research project, and interacting with many different genetic counselors, both locally in person, and via Zoom all across the country. Plus, my fiancée and I are avid hikers, and an opportunity to spend the summer weekends hiking in the Pacific Northwest sealed the deal.
“The internship would give me an opportunity to dip my toes into many projects …”
In March of 2020, everything changed. The COVID-19 pandemic flipped the country on its head. All classes were moved online, and the majority of my graduate school experiences, from patient observations to post-class happy hours at the local craft brewery, were postponed or canceled. I was certain that my dream internship would at least be restructured to an online only format. However, fortune shined upon us. By early summer, the pandemic panic had waned, and the empty GSF office actually provided an excellent remote counseling set up. COVID-19 rates were declining, and flights were cheap. We decided to throw caution to the wind and try to make the most of the tumultuous summer.
During my time at GSF, I tried my hand in a variety of roles that a genetic counselor may need to take on. On the clinical side, I worked on refining my counseling skills in the context of hereditary cancer. Unsurprisingly, I was exposed to a very different demographic compared to the bustling urban sprawl of the Boston area. Patients came from all walks of life, and each had a unique story to tell. Some were in the midst of their own battle with cancer, many recently diagnosed. Others had lost family the disease, often more than one person and at tragically young ages. Finally, I met with patients who survived their battle with cancer, and wanted the information to help their family members avoid or mitigate a similar circumstance.
Each session came with its own list of challenges tailored to the individual’s needs. I learned first hand how many roles genetic counselors may play in a person’s journey with cancer. They are teachers, explaining complex topics related to risk and genetics. They are also advisors, laying out testing options and treatment recommendations to help patients make the best possible healthcare decisions. They can act as care-coordinators, facilitating screenings and connecting patients and their families to supporting resources. Ultimately, they are there to listen and provide any support one might need in what is often dire and traumatic times.
Counseling in a virtual format comes with its own litany of difficulties. Connectivity issues and microphones cutting in and out add an extra hurdle in successfully engaging with patients. Children and pets divert the patient’s attention. More often than not, people had limited information about the nature of a genetic counseling session. It was our responsibility to connect with the patient, develop a rapport, and guide them through a difficult decision while navigating these challenges. While overall I do feel that genetic counseling is poised to succeed in a remote environment, COVID-19 dramatically complicates patient care and robs many of a needed face-to-face experience. I was inspired by people’s overall resilience throughout these trying times.
“I was inspired by people’s overall resilience throughout these trying times.”
Outside of the clinical realm, I was pleasantly surprised to see how many different lines of work the genetic counselors tackled at GSF. I gladly took advantage of the opportunity, doing my best to jump outside my comfort zone. I contributed to a research project concerning the ethics of privacy policies and terms of service agreements when it comes to genetic testing and I helped develop content for their website geared toward educating the public about neurogenetic conditions.I’m so grateful for my time with the GSF. Their team of genetic counselors are warm and inviting, instantly making me feel like part of the team. I can’t thank them enough for all of the lessons learned and guidance given along the way.
Summers in the Pacific Northwest are truly awe inspiring. Throughout the three weeks I spent there, my fiancée and I hiked nearly 100 miles through the Cascades. We hiked everywhere from the North Cascades to Mt. Hood, passing through the Olympic National Forest, Mt. Rainier, and Mt. St. Helen’s along the way. We saw seals while kayaking in the bay, dozens of marmots, and even two brown bears in Mt. Rainier national park! We enjoyed meadows brimming with wildflowers on our way up to views of endless, snow capped peaks. To top it off, my fiancée and I got engaged on top of the Third Burrow with Mt. Rainier in the backdrop. Olympia will be a special place for me and my family, and I hope to return soon!