Jessica Wall Oral History Interview, February 8, 2021

ANDA GHERGHE: Today we have the pleasure of capturing the story of Dr. Jessica Wall. My name is Anda Gherge, and I'm an undergraduate student at Oregon State University. Today is Monday, February 8, 2021 and I am in Corvallis, Oregon.

JESSICA WALL: I am Jessica Wall and I am in Seattle, Washington.

AG: Before we begin, this interview is being video recorded as a component of classwork assigned for the course, "The Hidden History of Women at Oregon State University." Once completed the interview will be deposited into the permanent historical record at the OSU Libraries Special Collections and Archives Research Center. The interview will also be described with a biographical sketch, interview abstract, and detailed index and made freely available to the public through a dedicated web portal. During the COVID-19 era we are asking narrators to provide verbal consent rather than signing paper permission forms. Do you agree to allow this interview to be preserved, described, and made freely available online as indicated?

JW: I agree.

AG: Perfect. Let's go ahead and get started with a little bit about your upbringing, where you were born and raised and a little bit about your family's background.

JW: Sure. I was born in Seattle, Washington. My father's, I think third or fourth generation, from Seattle and my mom had moved up from California. I spent my entire childhood living in Seattle with my family. I don't know, a normal childhood growing up [laughs]. What else are you looking for?

AG: I guess if you want to talk a little bit about your interests in your childhood and if there were any particular experiences from that time in your life that played in a role in your decision to pursue a career in medicine?

JW: Sure, no problem. I was a quintessential tomboy. I played all the sports. I loved basketball. In fact, I thought I was going to go to college on a basketball scholarship. That didn't happen, but I played every sport I could possibly get my hands on. I climbed trees and rode bikes and really didn't hang 00:02:00out with the girls much. Let's see, the biggest things I was interested in, I think, I'm trying to remember what I wanted to be when I was a kid. I think I had a host of things I was thinking about, like lifeguarding or being a professional outdoor something or, I'm trying to remember what else there was in there, but those are kind of what stand out. At one point I think I wanted to be a firefighter, but very much sort of the typical not tomboyish kind of things. I think the other pieces growing up that were really pretty seminal for me would be when I was about 12 I was in a pretty major bike accident and was a trauma patient at Harborview Hospital, which is kind of cool because I now work at Harborview and that exposed to me to EMS. It exposed me to being picked up by 00:03:00the paramedics and taken to the hospital and really kind of put me on the path to medicine longer down the road.

AG: How would you describe your early school years? Your middle and high school years?

JW: I am exquisitely dyslexic, of all things, and I-pretty much kindergarten all the way through high school had normal school, was in normal classes, but also had tutoring on the side to try to help me manage the dyslexia, the difficulty with reading, the difficulty with spelling, the difficulty with keeping my letters forwards. I pretty much was in private school because of that. My mom, who's an educational psychologist, went back to work essentially to support me being in private school because she was concerned that I would have trouble with the public school system at the time, given where we lived in Seattle and what school I would be sent to. I spent kindergarten all the way through high school 00:04:00in private school, at Seattle Country School and then University Prep with tutoring after school as well to manage the dyslexia. It worked out great, but it was a lot of work for my mom. I really appreciate she did it.

AG: How did that translate at all to your college experience?

JW: It did somewhat. When I applied to college and when I went to college, because I had had tutoring all the way through I was kind of used to someone helping me figure out how to manage things and so we built an educational plan for me before I went to college. Then at each school I went to, since I meandered through undergraduate somewhat, I had accommodations for tests typically, though I didn't often use them, that just extended the time because my writing speed was so low. Then for the English literature classes I had to take, I also actually had a recording for the blind and dyslexic. I had books on 00:05:00tape, which now are widely available via Amazon and Kindle but weren't when I was in college. Really the only way to get most of these books was to qualify for this national library and they would send you books on tape. You would listen to them. You would return them. That other accommodation, that's basically how I got through all of my English lit classes and classes that required literature and not reading science textbooks.

AG: Backtracking a little bit to high school, after high school what was the pathway that you took to end up attending the Honors College at Oregon State University?

JW: It wasn't a typical one. When I applied to college initially, I applied to Oregon State. I applied to UW. I applied to a handful of other schools that I don't really remember and then I applied to Whitman College. When I was accepted to Oregon State. It was wonderful that they accepted me. I really appreciate it, 00:06:00but I think at the time I was coming from a fairly, what I would consider, a sheltered environment. I had been in sort of smaller schools. It was the first time I was going to be away from home and I think I was a little worried about being on a larger campus also because my parents had said you don't get your car in college. It stays in Seattle. When I interviewed at Whitman College, it was a much smaller campus. The class size is smaller and it seemed much more manageable in my head. I actually went to Whitman College for the first year and a half to two years, if I remember correctly. I have to do the math...yes, because I took a quarter off in there somewhere...most of the first two years and so I started at Whitman. Loved Whitman College. It was great. But then as predictably, when I got there after about the first six months I realized how 00:07:00small it actually was. Things I wanted to study, Marine Biology for example (Oregon State has a great program in that), Whitman College at the time had one class in marine biology. I started becoming interested in things that I couldn't really study there to the degree I wanted to study them.

Because of that, I then took some time off in between in my second year-this is why I'm trying to remember. I think it was in my second year. I'd have to look at my transcripts to remember, but I took some time off, actually traveled interestingly was out of the country for 9/11. We had set up to go, my best friend and I at the time had set up to go to Thailand to have a vacation for a month: learned to scuba dive, goof off, have a good time, and then go to Nepal and join our research project there for a quarter. We were in Thailand when 9/11 happened and that actually shortened the trip because of challenges around that 00:08:00and traveling and safety in the world. He and I came back to Seattle and at that point I realized I didn't really want to go back to Whitman. That was the deciding moment for me. I wanted to expand. So, I came back, reapplied to college and, God bless Oregon State, they still had all my transcripts and all my SAT scores and everything else. So, when I reapplied, they were like oh, yeah, we already let you in once. We can do it again. You don't get the same scholarship, but that's okay. It made it really easy, since I liked the campus so much, and at that point, quite frankly, my brother had already started college there. I was more familiar with it visiting him as he was pursuing a degree in engineering. So, I transferred and started at Oregon State in the winter quarter, in January.

AG: How has your experience attending and adjusting to Oregon State? I guess 00:09:00more as a non-traditional student or as a transfer student.

JW: Yeah, the transfer student. It actually was, it went so much better than I expected. I think part of that was I had also already been out of school essentially for roughly 2 ½, 3 months because of the events of 9/11 of me being back in Washington, not going back to Whitman, they had already started classes and so I actually worked as an EMT in those couple of months before I transitioned to Oregon State. Then once I got to Oregon State, I mean it was an easier transition than expected. I moved into a dorm. I'd been living in one before. It was actually not bad. The Honors College was nice. They were polite enough to let me back in as well, which was wonderful. Being able to transition back and have one that small kind of group with the Honors College but then also 00:10:00have the larger campus with everything else I was looking at was fabulous. Then ultimately actually I ended up fairly quickly making a group of friends of other non-traditional students that had either been transfers or hadn't gone straight from high school to college and the transition went pretty well.

AG: What did you decide to study at OSU? Did you continue with what you were studying at Whitman or did you change paths?

JW: That's a good question. I had studied, I was interested in biology. I love life sciences and biology specifically to me and ecology just by the intricacies of life and how everything from a cellular structure all the way up to the larger organism, how they function and interact and then you look at an ecosystem, which is like almost the same cell on a macro size of all these intricate things that are working together in concert. Because I liked biology 00:11:00so much just continued the biology degree at Oregon State that I had started while I was at Whitman. I also meandered my way into chemistry and meandered my way into zoology. I spent some time taking a couple agriculture classes and considered degrees in all of those things, but when push came to shove I tallied all of my credits. It came down to well I have enough credits for a biology degree now or I could, instead of doing 5 years do 6 and try for something else. That seemed a bit excessive. At that point, I chose to stick with a biology degree, just took minors in everything else.

AG: During your progress as a biology major were there any influential professors or classes that stand out to you looking back now?

JW: Within biology itself, and this sounds terrible, and I don't mean this as an insult, I don't have anybody that really stands out to me from that department. 00:12:00I think, actually, more the things that really stand out to me are really related to the Honors College. For example, my thesis advisors stand out to me just by virtue of, I guess, having much more day-to-day contact with them and then a couple of classes I took through the Honors College, I took a nuclear power class for the non-nuclear engineers and a couple of other things that were absolutely fascinating and really expanded what I think about or was able to think about in college beyond a biology degree. I think those classes stick with me more. Then, Joe Hendricks, who was the head of the Honors College at the time was an absolutely entertaining soul who was wonderful and looked out for me and he really stands out, I think, as someone that was influential in just making sure I made it through.

AG: Wonderful. I know you talked a little bit about this before, but did you have any experiences outside of academics? I know you mentioned EMT, so other work experiences during your time at OSU and I guess what kind of influence those had on you?

JW: Between Whitman and Oregon State, I actually, now that I'm talking this through, I'm remembering the timeline better. I completed my first and second year at Whitman and during the summer between the second and third year before I took a quarter off, I actually went and completed a wilderness EMT at a course in Colorado at the time, in Pitkin, Colorado. Came to Washington and got my Washington EMT and went off on this adventure that got cut short by 9/11. When I came back I'd worked as an EMT in Seattle before I came to Oregon State and then at Oregon State I continued to work for both a company called Tri-Med Ambulance, 00:14:00which is based out of Seattle and then I also worked for Pacific West Ambulance that was based on the Oregon coast as an EMT. I used to commute to both of those mostly on weekends to work. I also took a job at Dixon Rec Center and taught first aid and CPR classes there as well.

AG: How was the balance between those in keeping up with schoolwork?

JW: It probably wasn't smart at times. I had less of a social life and spent a lot of time in the library or studying in my apartment once I moved out of the dorms. I remember at one point taking, as I recall, 25 credits. I had to get permission to do it. I remember after finishing that particular quarter thinking that was a really dumb idea because the classes all went fine, but I studied constantly. I literally had the floor of my apartment with class, here's your 00:15:00books for biochemistry, here's your books for whatever. I just sort of rotated what I was studying hour to hour. Otherwise, the EMT job was pretty, was a good job to have while I was in college because I could study on shift because you're not constantly doing transports, you're on call for a 9-1-1 system. You work 12 or 24-hour shifts and you get to sleep or study while you're not running calls. I was able to keep up with school fairly well. Again, not much of a social life to make up for it.

AG: Going off of that but outside of EMT, are there any other fond memories, maybe more focused on and around the OSU campus that you remember?

JW: I'm trying to think. I'm trying to think of specific fond memories. There weren't huge events that I think I went to. I think the parts that I remember 00:16:00most are dinners with friends off campus or a handful of people that worked at Dixon Rec were in graduate school and so they tended to live in houses off campus, so having dinner at friends' houses, those are the things that stick out most. I really worked and went to school. The thing I remember the most about Oregon State, honestly is my apartment and I remember exactly where I sat in the library and I remember the art on the wall [laughs].

AG: After you graduated from OSU, did you have a sense of your direction for where you wanted to go?

JW: No. Yes and no. I finished at Oregon State, thankfully. My family was thrilled that I actually finished college. I applied directly into paramedic school. I went straight from Oregon State. I had summer off, worked as an EMT 00:17:00and started paramedic school at what is now the Oregon Institute of Technology Program, but at the time was actually the OHSU-OIT combined paramedic program. I moved to Seattle for the summer, worked as an EMT, and then moved back to Portland to start paramedic school. My original plan had been I like EMS so much I'm going to get into this and I'm going to be a paramedic and I also, now come to think of it, I used to, see I talk about it and I remember more things, I did quite a bit of scuba diving as well while I was at Oregon State. I finished my PADI Divemaster while I was at Oregon State.

Also while I was working as an EMT I worked part time for a commercial diving company in Seattle during the summers because it quite frankly paid 4x or 5x much an hour as being an EMT does. I think I had some plans of well, maybe I'll 00:18:00figure out how to incorporate diving into my life and I was making it up. I was young. I went to paramedic school and had a wonderful time doing that. Finished paramedic school, took a job in Washington as a paramedic and then subsequently realized this is not as exciting as I thought it would be. It's cool, but there's a lot more medicine that I don't know anything about. I had thought about medical school but I had never been on the premed track. I never met with a pre-med advisor, conveniently a biology degree meets all the requirements for pre-med, so I didn't have to go back and do a post- bac[alaureate], but I really wasn't seriously, I think, considering it and sure that was going to be my path until I had been out of college for a few years.

AG: Did you ever at any point consider any other careers a bit more seriously outside of medicine?

JW: I don't think so, honestly I think I went to college not knowing what I 00:19:00wanted to do and at one point I thought I could be a vet, and then I realized I probably couldn't deal with animals suffering, so that was not a good plan. I didn't really have a good idea of what I wanted to do. I think I come from a very academic family, both of my parents have Ph.D.s. In fact, my younger brother also has a Ph.D. We're kind of an academic-minded group. I think in my head I thought I'd end up somewhere in academics, though I really had no clue where that was going to be. I think I kind of was leaning towards medicine, but I wasn't leaning as far into it as I could have been in the beginning. It took me a few years to get there.

AG: I guess with that, how was your application process for medical school? How did that go for you?

JW: [Laughs] It was a really unique process because I had had no premedical 00:20:00advising. I essentially, and I never recommend this to any other human being that's going to apply to medical school, because it worked and that was great but it wasn't a good plan-I, in the summer, I think late spring or early summer, I'm trying to remember exactly-got this idea, I should apply to medical school. I want to do this! I took the last possible MCAT slot I could because I was so late in signing up for it that I'm really lucky I actually got an MCAT slot that was going to work. I studied all summer with, because I'd been out of college for a couple of years at that point, I studied all summer with a tutor to get set up for the MCAT, basically just to remind me how to study and get through the MCAT textbooks. Then, I started reaching out to everybody I could to write 00:21:00letters of recommendation. Now, the lovely thing about having a premed advisor is that they help you coordinate your letters of recommendation and ensure they all get mailed to the correct places. I didn't ever have that experience. So, here is me emailing and setting all of these letters up and then literally mailing packages of envelopes, like pre-addressed, stamped, everything, to my letter writers so they could write a letter, print it, and put it in the envelope. They were really nice to do it. Let's just say that. They were very tolerant.

Then, because I was so late in this process, I pretty much sat down with the, I think it's the AAMC comes out with a book every year of all the medical schools in the United States, and just started a couple page summary of what school is about. I pretty much sat down with that book and just went page by page and just earmarked what schools I wanted to apply to, not really knowing much about them 00:22:00besides what the book said. I'm pretty sure if anybody at Ohio State knew that this was the case they'd just absolutely die in shame right now. So, I went through this book, I can't remember, I want to say something like 50 or 60 medical schools, a huge number of medical schools, got all my letter writers up and going, got my personal statement, got everything set, did the application completely by myself without help from other people, and then because I also was so late in the process and my MCAT was so late, instead of applying on the first or second day when the applications open, most of my applications of my application made it close to the last few days before it closed. I was very, very ill-advised in how I did the process, but it worked out. Thankfully, some of them had rolling admissions that hadn't filled up yet [laughs].

AG: With that, where did you end up deciding to go? I guess what factors played into entering that school?

JW: That's a good question. I ended up going to Ohio State University, which is also very entertaining to me, because I have degrees from Oregon State University and Ohio State, so I have lots of OSU degrees on my wall. When I applied, I had never even been to the state of Ohio. I'd actually never entered the state when I applied. As I said, I kind of applied all over the country. I just sort of shot gunned it, because at that point I knew I wanted to go and I didn't want to have to apply multiple years in a row to get in. Uniquely, though, one of the reasons I ended up there, it was a great school. I loved it when I interviewed. The school was now, ironically, flipping from my approach to Whitman College. Ohio State's one of the largest medical schools in the country and so it has a huge hospital, is affiliated with a larger pediatric hospital, it's affiliated with a large cancer hospital, kind of has sort of everything 00:24:00going on there, had a big campus with a great SIMS Center, lots of students, so if I wanted to hide in the crowd and study on my own, I could. It also had at the time two tracks, a sit in a classroom track or a self-study track for your first two years of med school. I just, I kind of loved the interview. I clicked with some of the people I interviewed with. I actually, one of the people who interviewed me was an ER doctor, was a Peds ER doctor who I really liked a lot and she ended up being my advisor. I enjoyed the interview a lot.

Also, not knowing anything about Corvallis when I was accepted to Ohio State, I was not accepted to that many schools, by the way. I actually kept all of my rejection letters. I thought it would be good for my soul. I have them in a folder somewhere, but I did get into the University of Washington and I did get 00:25:00into OHSU. I'm kind of like looking at mostly these three state schools for where to go to medical school and when I looked at funding, because I had worked in Oregon and Washington as an EMT and ironically also because I had bought my car in Oregon while I was in school and then had moved to Washington and switched registration, neither state would give me in-state tuition. I hadn't lived in Oregon in over a year at that point, so I lived in Washington so they said you're a resident of Washington. Washington said, but you bought your car in Oregon and you had a W-2 in Oregon recently so we won't give you in-state tuition, either. I literally was a student without in-state tuition anywhere. And Ohio State as part of their entrance, they have much more lax rules about getting in-state tuition, and they said we can't guarantee it, but assuming you 00:26:00check all the boxes, you'll have in-state tuition in your second year of medical school and we'll give you essentially they pretty much had a scholarship that I was awarded that made up that difference overall. It would have been the equivalent of in-state tuition the whole time I was in graduate school. I think between one, me really liking the campus a lot, and two, me being perturbed that I couldn't get in-state tuition anywhere else, I went to Ohio State and it was a great experience.

AG: How was your experience adjusting to medical school compared to undergraduate?

JW: It was a huge adjustment! Huge adjustment, partially because I hadn't been in school for a few years by the time I got there. The best part is me trying to remember how to study. It had been a long time since I had to study to that degree. That was a solid learning curve. I again made really good friends with the library. I had the same floor. That particular library did not have cool art 00:27:00like Oregon State did, which was sad, but literally the same floor, same handful of tables is where I studied pretty much every night and fairly quickly I made a group of friends, actually through my human anatomy class early on and pretty much developed the habit of I would go to class in the mornings, I would get out of class. I would go, usually I would try to go to the gym and workout just to have some sort of stress relief, most days, not all, and then go home, feed the cat, change clothes, change books, and then go back to campus and study in the library, depending on the day, anywhere from 9:00 to 10:00 at night to 11:00 or midnight. I got really good at having food delivered to the library or going and getting takeout and bringing it back because they would let us bring food in.

The first couple of months were really hard trying to remember how to study. It was like I have always been a good student. I've always had great grades. I graduated with all these honors and stuff and now I'm in med school and I'm not very smart right now. I am middle of the road, bottom of the class kind of thing. Fairly quickly I had to pick myself up and learn how to study again. Ironically I went back to a very old-school technique of making notecards, because if I write things out I remember them. I would take every lecture, every class that I had listened to and take notes in the class and then I would take those notes a second time and put them into flashcards, essentially, to try to study for tests. While that was a very cumbersome way to do it, it worked really well, because I have the ability to remember things, it helps for me to write them a couple of things. If I write it out a few times it just sticks in my head. I developed a whole new way of studying while I was there so I could get through.

AG: In contrast with the difficulties, were there any memorable experiences or lessons that you learned during your time at medical school?

JW: I think, I mean med school, it was really hard but it was a lot of fun. The education was great. The thing, it's funny, because the things that I remember that stand out that were kind of cool for me had nothing to do with med school. Ohio has the coolest thunderstorms. They just roll through. I loved that and it was so much fun just to be able to go stand outside and just watch these thunder and lightning storms just roll overhead. I had never seen lightning bugs in my life. I know! Isn't that cool! I'd never seen them. They're all over Ohio and so there were things like that that were really cool for me to experience just by virtue of living somewhere else.

I think I made some really good friends that have stuck with me and that was huge. I think the part that also helped the most is I had gone to medical school knowing I was going to be an ER doctor. I worked as a paramedic. I wanted to be an ER doctor. I was not too interested in anything else, though as all medical students do in my third year of medical school as I'm going through all these clinical rotations in the hospital I transiently was like I could be a family medicine doctor. I could be a surgeon. I could be a whatever. Everybody thinks about a lot of different specialties when they try them. But one of the cool things that happened to me in med school is I had always found kids, pediatric patients, to be really scary as a paramedic. A sick kid is, we don't see them very often compared to the adult volume you see in the prehospital setting. I was scared of kids, honestly. I thought they were scary, scary little things to treat. And so to get over that I took a job working for Nationwide Children's 00:31:00Hospital on their pediatric critical care transport team as a paramedic. The part about that that was really cool is that kind of set me on the rest of my life path. Going out to all of these community hospitals and, I mean ICUs and the neonatal, they're cute when they're sort of little aliens that fit in an incubator, and the PICU is kind of cool, PICU to PICU, but the part that I love, knowing that I wanted to be an ER doctor, was going out to all of these community emergency departments and seeing these sick kids and then bringing them back to Nationwide Children's.

The piece that was really good for me is, as the paramedic I was sort of the bottom of the totem pole on the team. I wasn't responsible for any decisions. Which is great, because I could just learn. It was fascinating to me to see the variability in how children were cared for in these emergency departments. Some of them would sort of have nothing done and be really sick or some of them would 00:32:00have these full wonderful workups and everything tidied up and ready to go and so that really inspired me to not only be an ER doctor but then to be a PEDS ER doctor. I uniquely when I applied to residency, in my letter to my residency application said I am going to be applying to pediatric emergency medicine fellowship after residency, which you almost never hear from emergency medicine resident applicants. I think that was a really big experience for me. I mean, the other thing that was good for me was while I was at Ohio State, I kind of got connected with a, I never thought about doing research. I never had any interest in research. I thought once I'm going to go to med school I'm just going to be a doctor. I'm just going to go and be an ER doctor and do this. I was presented with the opportunity to take a year off and through an NIH grant 00:33:00funded program get a Master's in Public Health and complete with a dual degree. In investigating that, I kind of was introduced to a couple of really amazing mentors, one of whom ended up being my mentor throughout my master's program and has actually stayed my mentor throughout my emergency medicine career. That was a good experience because quite frankly graduate school, and this is terrible that I'm going to say this, is much easier than medical school, by a lot. Going to graduate school for a year gave me kind of a break from all of the exhausting studying. I mean, I was still studying but not to that degree and gave me some time to work as a paramedic for the peds transport team and get that experience and then also just kind of gave me this really sort of cool background and interest in research and helped me with my nerdy numbers brain that really likes 00:34:00to do statistics.

AG: Have you continued with research since then?

JW: I have. I ended up doing, I did the research study there. I did a handful of studies in smaller things in medical school, oh I'm sorry in residency, and then in fellowship I chose my fellowship based off of the academics. One of the reasons I went there was the academics in the program, also, ironically, because I could get a second master's in clinical epidemiology, which is really fascinating to me. Fortunately, while in Philadelphia in fellowship I was in this very academic group and so it was really good at pushing my research career forward. Having moved to Seattle, the position I took is not research based, and so while I still kind of dabble from time to time, because I think statistics are fun and it's interesting to be able to look at a study or help guide someone a little bit in what they're going to do. My promotional track is no longer 00:35:00research based so I have less time to do it, which is unfortunate.

AG: Then backtracking a little bit I noticed that you did some postgraduate training in California?

JW: I did.

AG: I was wondering how that move was and what that training was for you?

JW: California was residency. I went to the UCLA Olive View Residency. After I finished medical school, in medical school you apply to residency pretty much how things roll. When I was applying to emergency medicine residencies, I did the same thing actually I had done in applying to medical school, is I applied to residencies all over the country. Without really knowing where I wanted to go, I didn't have anybody that was going to be moving with me so I could go where I wanted. I had a dog. That was it. When I interviewed at UCLA Olive View at the program, I was struck by two things, I guess three, is I had never lived in California, and I thought LA would be kind of cool as a city. It was a little 00:36:00scary, little big, little smoggy, but kind of fun and very different than Ohio. The program itself has a kind of, it's called a dual-site program. It means that half of your training is at one hospital and half is at another. The cool part about that is one hospital is a county hospital. It's a Los Angeles County hospital called Olive View. They serve an underserved population. They sort of like getting by with what you got. Then the other hospital was UCLA Ronald Reagan, which is a huge, tertiary, quaternary, academic center with sort of we have every sub-speciality known to man and we do all sorts of crazy things. I liked the ability to train in those two sites, because they're very different and they expand what you're going to do. Then also just meeting the faculty and the residents while I was there had a very family vibe of we all get along, we all support each other, we all care about each other a lot. The gentleman who 00:37:00was recruiting, Mark Morocco, at the time he was one of the program directors, he hosted all of us for dinner at his house and his wife made this amazing, amazing dinner. We all just kind of meandered around and socialized. I was like this is a cool group of people. I want to hang out with them. That's how I ended up in California, because I had also never lived in California before I went there.

AG: From your postgraduate training, I saw you also had a master's degree in clinical epidemiology at University of Pennsylvania. Were there any experiences that prompted that decision?

JW: Yeah. As I had kind of mentioned is when I applied to residency I knew I was going to do a fellowship, so a second kind of round of education in pediatric emergency medicine. That was the plan. In residency, I worked with a guy named 00:38:00David Schriger, who is a very academic researcher at UCLA and a really entertaining guy and so I could kind of, for lack of a better term, we could kind of geek out about statistics. He taught me a lot about the software package called STADA that I was trained to use and not just things that you could do with statistics themselves but graphing capabilities and other things the software could so and that really put me on the path of I kind of want this as a career. I want this research piece. I'm interested in this. When I applied to fellowship in pediatric emergency medicine, I did the same thing again. I applied all over the country. When I interviewed in Philadelphia, a lot of the fellowships in pediatric emergency medicine offer a master's degree but most of them offered a master's degree in public health and I already had a master's in 00:39:00public health. Why would I, I couldn't, I'm not going to do it again. The nice thing about Children's Hospital of Philadelphia, or CHOP, is that they're affiliated with the University of Pennsylvania, and one of the degree options there is this Masters of Science in Clinical Epidemiology. Since my Masters of Public Health had had a lot of epidemiology in it and I knew I really liked it and I wanted to expand that education, that was one of the deciding factors in going to Philadelphia, besides the actual fellowship which was awesome and I really liked them and wanted to train there.

AG: Transitioning a bit into what you do now, what current positions do you hold?

JW: Yeah, so I am titled under the University of Washington School of Medicine. I am an Assistant Clinical Professor of Pediatrics and Assistant Clinical 00:40:00Professor of Emergency Medicine. I'm dual appointed in two departments because I'm trained in emergency medicine and pediatric emergency medicine and then I'm also the Associate Medical Director of Pediatrics for Airlift Northwest, which is our local academic flight program affiliated with the University of Washington. All of that translates into I work as an ER doctor at Seattle Children's Hospital as a Pediatric ER doctor and then I work at Harborview Medical Center, which is our big county hospital that's also our trauma center. I work there as an emergency medicine position and then I spend part of my time hanging out at Boeing Field which is where Airlift is based and doing mostly administrative type things with them.

AG: As a follow-up, how did you get involved with Airlift Northwest and how has that experience been?

JW: That was pure luck. I had continued, so in residency at UCLA I had taken a 00:41:00position as a flight physician for their pediatric critical care transport team in Philadelphia. I had the opportunity to do the same, but truthfully I worked so much on the side as an ER doctor to keep my adult ER doctor skills, but I didn't do it very much, but I had really liked transport. I really liked EMS. While I was still in Philadelphia had taught a bunch of lectures to local EMS agencies to just keep my hands in EMS quite frankly because I just miss it. When I came to Seattle, Airlift wasn't part of the deal to start a job here. In my mind, I didn't really know what I was going to do, because the position I had been appointed to at Seattle Children's Hospital, which is my primary site, was what's called a non, it's a purely clinical position. It's an academic position, 00:42:00but my promotional track is based on me working and having good teaching skills and teaching residents and teaching lectures. My promotional track is not based on my ability to publish research.

Because of that, I wasn't really sure what I was going to do coming to Seattle. I knew I wanted to come home. I knew I wanted to be back in Seattle. I loved it. I missed it and having a job where I could work both with adults and pediatric patients and I could do that split that I was trained to do was a great opportunity to be able to come home and do that, but at the same time I just didn't really know what I was going to do with myself when I got here besides that because I had been trained as a researcher, and I was like well maybe I'll just research on the side without having it as part of my track. I don't know what I want to do. So, when I finally came back and my current boss actually, we were talking on the phone before I started about I guess career trajectories, the woman who had had my position at Airlift before me had just left. So, he 00:43:00basically asked with your background that you have in EMS would you be interested in taking this position at Airlift. This is basically, for lack of a better term, while Airlift employs me I'm sort of farmed out from Children's. Airlift pays Children's for my time. It's a Children's based position, or Seattle Children's based position. I really remember my response as being, I thought it was going to take me five years to talk you into that, but yeah. I would love to do that. That keeps my EMS hat on. That's how I got the job. I didn't apply for it. I didn't think I was going to get it. I just got handed it, which was really cool. It's been awesome ever since.

AG: Back to your teaching experiences that you mentioned, how has your progression been as a professor?

JW: Well, I'm an assistant professor, so I've not progressed much. But I think 00:44:00the part that I like the most about teaching is, how do I word this? It's taken me a while to figure out my teaching style. I actually took this sort of mini course in how to teach from the American College Emergency Physicians because I wanted to be better at it and it's ironic but you don't, as a doctor, you don't really get taught how to teach. It's not part of the curriculum. I think from a teaching standpoint my perspective is that I initially sort of just made, in residency my lectures, now that I look back on them and I'm embarrassed. They weren't very good. They were pretty bland. They didn't probably impart a lot of useful wisdom. Excuse me, they imparted more of like, well this is what the textbook said. I think now it's been really, and I'm sure my teaching style will continue to evolve over the next decades, but the part that I like the most about teaching, which ironically harder on Zoom, is being able to engage an 00:45:00audience and impart information that isn't just hey this is what the textbook says about this pathology. Because that's boring. You can go read that textbook, but be able to kind of teach a topic in a way that is educational and entertaining enough to stick with a person and to be able to offer, especially for who I teach right now, because a lot of my audiences are mixed audiences, meaning that I'm teaching to paramedics, nurses, and sometimes physicians in the audience all at the same time. Those are very different levels of education. I think the part I like the most is being able to engage the audience, especially a varied audience, on their level and make sure that I'm providing teaching points and tips to them that will be useful. When you see that lightbulb go on or you see that student that suddenly asks a question and you're like oh, you not only got it but you're interested or you want to do better. It's pretty cool 00:46:00to see. I like it. Zoom makes it really hard, though, to do that. I do a lot of Zoom lectures now, and it's always sort of like I'm lecturing to myself on a computer screen and I can see three people in the audience maybe.

AG: I guess that answered my question just about the impacts of COVID-19 but specifically as it pertains to your position as an Assistant Professor. Are there any other challenges that you faced or solutions you've come up with?

JW: Oh yeah. I mean, COVID has changed everything. Covid has changed how we function in the hospital. I've never worn masks and PPE so much. It's actually changed the treatments we're allowed to do within certain parts of the hospital, which is challenging because certain treatments we do, certain types of breathing treatments or breathing support are actually considered to increase 00:47:00the risk of spreading COVID. We have to be creative with can we do them, should we do them? How we function with limitations that I wouldn't expect. I mean, it's added an entire new pathology that has many variations that we have to now be vigilant for as physicians and then the other piece is a huge chunk of my job is administrative and is me sitting, a third of my time is actually sitting in an office and interacting with all of the people in that office space with how are we going to update our protocols at Airlift? How are we going to, do we need to buy this supply? Maybe we need to switch to this piece of equipment. The piece that I didn't realize until COVID hit was how many of those conversations are actual sidebar conversations. They're not conversations that you have like I have a scheduled meeting with you for 30 minutes to talk about something. Actually a huge chunk of where that work gets done and those ideas get generated 00:48:00are really just sitting around the office with a whole bunch of people in cubicles sort of chatting with each other through the cubicle. Covid, I think, stalled that a lot and changed that. I mean, just as it's affected everybody else in the world, it's just really changed how we function as an organization and it's also changed how we approach patients. It's been challenging.

AG: Maybe you're touching on it a little bit now, but how has it impacted physician workload?

JW: Yeah. It's interesting because it's really variable across the country. At the children's hospital, at the pediatric hospital, ironically because of all of the isolation that's going on in the United States, all of the common colds that make kids sick and the flu, which makes kids sick, we have seen almost none of it because kids aren't passing it around. Our volumes, the volume meaning the 00:49:00number of patients that come to our emergency department, have dropped significantly in the Children's Hospital and we've started seeing surges in different types of things. We see more patients with depression and with other psychiatric problems now because of the isolation that I would think and the change in school structure. In the Children's Hospital it's changed how patients present and changed our volumes. It's also changed a lot of the equipment that we're allowed to use or have to use in addition, meaning something called a Capper, which is a helmet with a face shield that has a fan in it that essentially prevents me from being exposed to Covid while I'm out and about in the emergency department seeing patients.

In the adult hospital, it's been the opposite. Covid initially when it hit and interestingly a handful of the first patients with Covid, while were all in 00:50:00Kirkland, which is down the street from Seattle, and a couple of the first patients with Covid not only presented to Evergreen Hospital but also presented to our hospital and we didn't know what it was and we just assumed they're really sick with something. Covid is still in China. They haven't traveled anywhere. These are patients that are from a skilled nursing home. Really quickly after we realized that Covid was rampant all of a sudden we had this huge patient volume. We were seeing a lot more patients than we expected to be seeing and a lot of them were really, really sick. It changed how we approach patients, how we think about it just by adding additional pathologies. We also built tents outside the hospital to try to screen out the what we call "the worried well" the people who really didn't need to be in the emergency department and really wanted a Covid test or are worried about something or had something small because we didn't want people without Covid coming into the emergency department having risk of them being exposed. It basically built out 00:51:00these big disaster plans. It overwhelmed a number of hospital systems, including ours to some degree for a while. It also, again, changed a lot of the equipment. I mean, I haven't seen my nurses, any of my nurses' faces in a year. I see them with masks on. I haven't, it changes how you practice medicine because you can't have the same connection that you often do with, one, the people you work with, but, two, also your patients.

AG: In the same vein, I know that recently the topic of burnout, specifically in the medical field has been really prevalent and I'm just wondering what your perspective has been on that, both before and now with Covid and the work-life balance?

JW: I have many thoughts on that. One of my, because I can't ever have just sit still, so one of the other things that I do on the side is there's an 00:52:00organization called the American College of Emergency Physicians, which is this huge, large national organization of emergency physicians. They have state chapters and I lead the wellness committee for the Washington State chapter. One of the things we're actually talking about right now is how to fix burnout because it's a big deal. I think in emergency medicine burnout exists and always has and will continue without Covid, just by virtue of the fact that there's some things that are blessings about emergency medicine in the sense that I love the fact that if you walk through the door and you're a patient in my ER I have to treat you. That's really cool because I love the fact that I can fall back on that and say well, you're here. It's called EMTALA. I have to take care of you. I don't have to worry about insurance. I don't have to worry about all these, I mean I do later on, but up front I don't have to. I get to treat you no matter what because the law says it. I kind of love that part. I think the challenge is 00:53:00that there's also a huge population that comes to the emergency department, sort of abusing the emergency department in a sense and that is challenging for ER doctors. A lot of them are asking for drugs that we are not going to prescribe them. There's a lot of what we call drug seeking. There's also challenges when you have really sick patients that either don't survive or have really kind of sad stories. I think all of that contributes to burnout, plus an ER doctor is, while you do have the ability that you have to treat everybody that walks through your door, there's a lot of pressure from the hospital, too, about what patients you can admit or maybe this patient is healthy enough they should go home. Even if I think they're sick enough to stay, the hospital may say no. Things like that you kind of get stuck in the middle, and I think that contributes to burnout a lot with ER physicians. At least, those are the stressors that I see in this job.

I think Covid has amplified that tremendously because a lot of hospital systems became profoundly overwhelmed and so you are essentially trying to tread water and keep your head afloat when you have ten pound weights tied to you. It makes it really hard to function in an overwhelmed system because you have sick patients that you want to be treating or you are treating but you don't have enough resources, and that is challenging. I think the other piece to Covid that has really been hard for ER doctors is the work-life balance piece, that you said, is that there's, and I think it's not unique to ER doctors. I think it is consistent with everyone that is exposed to this, but you're, I mean I can't go out for, I mean, I work nightshifts and I'm a nocturnist so I only work night shifts and in the mornings a lot of times we used to take the residents out for a beer or for breakfast, chat about the night. You could socialize a little bit, decompress from your shift. It was really good, especially if you had a 00:55:00difficult shift or a cardiac arrest and someone didn't make it, something like that it was really helpful to decompress in that environment and we can't do that anymore. I can't socialize with my colleagues, which is something that is really helpful outside of work, because there are people on this planet that don't want to hear all the gross stories that happen in the ER, but the people I work with do. You can decompress and be like, hey, what would you have done in this situation? Or this was an interesting patient. You can use that to get some of the stories out of your system that might stick with you otherwise. Then, all of the things that everyone else does to de-stress are the traveling or the going out to dinner or whatever else, all of those things have been removed. A lot of the wellness pieces are gone. You're also working more. I think it's challenging overall. I don't know how to combat it. I don't know how to fix it. 00:56:00There are large national committees that are trying to figure this out. I think burnout has become more prolific in my specialty but probably within the world in general right now. Tensions just seem to be higher.

AG: You mentioned being able to decompress with your colleagues, which obviously that has been taken away. Have there been any replacements with some kind of counseling or other services that can be of help?

JW: There have been. I haven't taken part in them, unfortunately, but no there have been. That's actually something that's pretty cool, is a lot of organizations, including my own, have offered initially up front, especially with sort of the first wave of Covid and the initial shock and stress and what are we going to do, a lot of organizations offered free counseling, other pieces like that. I think the other thing is just finding different avenues to release 00:57:00your stress for lack of a better term. I spend more time hiking outdoors, and I like the outdoors a lot so I'm not complaining, but more than I did before. Apparently all of Washington State is doing the same thing because you can't find any parking if you want to go snowshoeing. All of the parking is full at the parks by like 9:00 in the morning. It's insane. I think it's just finding other things. On a personal level, one of my big stress relievers was my dog. I had a wonderful dog named Cassie, who was a golden doodle who got me through med school, residency, fellowship, moved with me to Seattle and unfortunately died right at the beginning of Covid, which was just horrible timing. And made the first couple of months of Covid really hard, because I was so used to coming home and as much as I love my boyfriend, it's great to come home to him but it was really awesome to come home to her. I think that part was hard. As we've 00:58:00been interrupted several times by them, I now have two puppies to make up for that, which use up a lot of time. I think that's actually been pretty solidly stress relieving and made up for it. I think a lot of this comes down to just finding different ways of doing it. I mean, a number of us host Zoom happy hours now. Apparently it's the wave of the future. My family, I don't get to see my mom nearly as much because I don't want to risk giving her Covid. Because of that, I mean, I Zoom with my mom and my brother. We just catch up, say hi, and we play online board games, essentially, together. I think there's ways to mitigate and get around it.

AG: In that same topic, I was wondering if you could maybe walk us through a typical day or week in your life? Maybe before and after Covid?

JW: Sure! [Laughs] Let's do it! They haven't changed that much except for the 00:59:00location of all the meetings. I, about a year, elected, a little more than that actually I think, chose to become a nocturnist, meaning all of my shifts are overnight night shifts in the emergency department. The reason I'd done that was because with all of my daytime meeting responsibilities with Airlift and everything else and working at two hospitals it had become really hard for me to deal with my schedulers. They're wonderful. Nothing about them, but it had become difficult to essentially figure out when I could work and give them enough availability. About a year ago I chose to become a nocturnist. Really the only reason was because I can pick my nights. That's the benefit of being a nocturnist at my hospitals.

In Philadelphia I was moonlighting, is what it's called. I was working as an ER doctor on the side in fellowship so I could keep my adult skills and the benefit 01:00:00of being a nocturnist in Philadelphia is they actually paid me more an hour to work overnights. I was already used to doing it. I liked it. I don't have that same benefit here, but if my boss is watching this I would love them to consider that benefit. I chose to become a nocturnist because I can pick my shifts, which means while my schedule is really hectic it's fairly consistently hectic. Mondays, being today, are pretty much filled with meetings at Airlift. A lot of those meetings become Zoom when they can be, just to keep too many people from being in the office. But I start about 8:00 in the morning and I have meetings, depending on the day, anywhere spread out until probably around 3:00 or 5:00 in the afternoon. It depends on which Monday we're talking about. I tend to between meetings do a lot of my email catch up, my chart reviews and other things that go along with that, whatever projects I'm working on. Tuesdays are pretty 01:01:00similar that way, though they're not based at Airlift. Tuesdays, it used to be I went to Children's, to my office there, and did all of my work there for the whole day. Now I have the convenience of zooming the whole thing. I pretty much stay home all day Tuesday, which is fun. I start around the same time in the morning sometimes a little bit later, and then work but about half those meetings are really just me listening to stuff that I need to be participating in and the other half are meetings I'm either running or an active participant in. I'm usually on Zoom until about 3:00 or 4:00 in the evening. It was way more fun to do those in person, though, just by virtue of you could see other people. But Zoom is, I'm getting used to it. Wednesdays are a much more variable day. Wednesdays, sometimes I have meetings during the day, sometimes I don't. Then either starting Wednesday night or Thursday night most weeks is when I start my 01:02:00night shifts. This week I'll start Wednesday night. Then, I'll work Wednesday night, Thursday night, Friday night, and Saturday nights. I'll work either three or four night shifts in a row. I intentionally do that string because most of my meetings are Mondays and Tuesdays and that way I don't have to try to go to a meeting in between night shifts. I work a night shift and I like to sleep a lot. I work the nightshift. I come home. The dogs and I go for a walk. I feed them. I have breakfast. I decompress a little bit. If my boyfriend happens to be home, I say hi. If he's at work, then he's at work. Then I go to sleep probably around 9:00 or 10:00 in the morning. Usually sleep until about 6:00 or 7:00 at night. Typically interrupted once or twice by having to get up and let a dog out but other than that I sleep in between my nights, get up, have dinner, go to my nightshift, do it all over.

I do nights all the way through Saturday night and then I have Sunday off to flip back to dayshifts on Monday. That schedule allows me one full weekend off a 01:03:00month to every five or six weeks. While I'm working a lot of weekends, I end up protected with about four or five days, because I'll take essentially a week off of night shifts about every four weeks or five weeks. Then I end up with a little, those people that worry about my work-life balance, then I end up with one weekend in there once in a while to go do something fun and usually I try to get out of Seattle or do something that is unplugged from my computer and my phone just because I spend so much time on it. My clinical shifts, so those night shifts when I'm on, I'm either at Seattle Children's or Harborview. Because those are both academic hospitals, I'm the attending, essentially supervising residents. I had been a resident before and now I supervise them and depending on which hospital I'm at and the time and the day of week or how busy it is, I essentially see anywhere between 15 and 30 patients, probably more 01:04:00than...15 on a slow day, 15 to 30 patients. And the residents go see most of them. I'll see a couple by myself. The residents will go see them. They come present to me. I go see the patients, do that whole thing, provide the best care we possibly can. Occasionally it's punctuated by someone really sick showing up.

AG: A bit about your schedule, I'm wondering how was the adjustment of switching between night shifts and day shifts when you first started?

JW: The reason I stack all of my nights now is when I work a single night it is not a good adjustment. It's actually really hard to flip back and forth quickly for me. But on a week schedule I can do it pretty well. Honestly, the day that I start my series of night shifts I try to have as light a load as possible that day. I can't always do it, but when I start my string of night shifts, I want to 01:05:00be able, usually I can't sleep in because I've flipped pretty well back to days, but I want to be able to not have a lot of stress during the day. Things that are going to make it hard for me to nap in the afternoon. Usually I'll get up. I'll have a couple of meetings in the morning maybe, run some errands, do some grocery shopping, stuff like that and then try to go to sleep in the afternoons, sleep for several hours if I can pull it off. If I can't, then I usually just lay in bed reading, try and relax as much as I can and get up and go to night shift. That flip into a night shift isn't bad. Flipping back is really all about the timing of when you nap. You get home from your last nightshift and I do the same thing. I go to sleep but I only sleep three hours, four at a maximum if I didn't have much sleep between my shifts during the string, get up, have some caffeine, do what I need to do. Right now I'm house hunting. Sundays are when I look at houses. That's what I'm doing on my day off right now. Get up, do my 01:06:00thing, and then usually try to go to bed by 8:00 or 9:00 at night to flip back to days. That works pretty well.

AG: I guess almost closing up, I wanted to touch a little bit on the topic of your experience as a woman in academics and then medicine and if there are any experiences you can speak to about that?

JW: It's really interesting, because I don't think it, for lack of a better term, I don't think I had a great understanding of it early on in my career. I think I had always been a tomboy. I'd always hung out with the guys. I was kind of used to that culture and so I had a pretty thick skin for things. It's not even really sexual harassment, because I don't mean those things but the subtle 01:07:00things that are a little different between the guy and the girl, who gets-I mean little stuff. When I was working as an EMT, who's doing the driving? Ironically, it always wasn't me. Pieces like that that I don't think ever really dawned on me that those are subtle differences that are being called out. There was some frank sexual harassment on occasion where I'd be like why is your hand on my butt? Please remove it. In general, I don't think that I really understood the difference in roles. Even in medical school, in residency I think rarely when I hit fellowship is when I started I think having a better, how do I put this? Starting to even have an understanding of this difference between, what it meant 01:08:00to be a female in medicine as opposed to a male in medicine? Which I don't know if I have blinders on, if I just didn't catch it, if it wasn't that bad. I don't know. Then in Philadelphia, I had this wonderful mentor named Kathy Shaw, and actually another mentor, Tiffani Johnson, who are both very strong women in pediatric emergency medicine. Tiffani actually does research in racial bias and implicit bias and Kathy is one of the founding women in pediatric emergency medicine, so what she overcame decades ago is profound compared to what the differences are now, but interestingly listening to those stories and paying more attention, I actually started catching a little more of it at times. Philadelphia had an incredibly equitable department when it came to men and women, but there are a handful of times where I was working in the hospital or doing something else where I would just be like I can guarantee you would not 01:09:00have this conversation with me in this tone if I was a guy. Being talked down to by people who were my peers. Having, as an attending, having [audio glitches] at the University of Pennsylvania, who was-I'm not knocking them, they're a great place-I mean having conversations where I was like, and it wasn't very often, honestly, it really wasn't but I started catching more of it and being like this is, I'm a young, blonde female. If I was an old white guy, this wouldn't be the conversation. This would be done.

I don't think it really struck me until I was in fellowship and then coming to Seattle as an attending, Seattle I think probably is not as liberated in some of these thought processes at times, which is disappointing having moved back to this city. Because when I left I was naïve to these things. I was young. I didn't catch it and didn't know. But it's really fascinating to see how 01:10:00conversational patterns are different depending on who I'm talking with, whether it's a consultant or-and usually it's people that are my peers. Occasionally, it's actually junior residents. Honestly, every once in a while there's that young, male resident that is going to be right no matter what. I'm like, that's great but I'm the attending. We need to figure out how to have this conversation a little bit better because we need to not do your plan. I think I didn't catch it until recently. It's been eye opening. It's been a learning experience. There are definitely some times when talking with Kathy, she's been like I hate to tell you this but I think you're just going to have to suck it up and deal with this. You can't change this person. You can't fix this. You're just-and she's like it pains my soul and it pains my soul, too, but I'm going to figure out how 01:11:00to accommodate that kind of bias because it's easier than trying to bulldoze through it, which is a sad statement. I think there are also some benefits to being a female in medicine. There are some profound benefits to how I interact with my patients, how I'm able to bond with my patients. Interestingly, there's also times where it really doesn't matter. I mean, I kind of joke I'm a bull in a china shop and so if we have a really sick patient comes in the emergency department we have to do a major resuscitation, I'm pretty good at being a loud voice in the room, like you guys here's step one, step two, step three. Here's the plan. Here's what we're doing. There's definitely no limitation by being a girl in that setting. It's not all the time but there are definitely moments where I'm like, oh yeah that'd be different if I was a guy. I think I try to 01:12:00look at them with a sense of humor. I'm not going to be able to fix those people. I think I try to navigate it and use whatever skills and ways that I have to try to get around it. I mean, part of this also, I mean there's huge amounts of bias in sort of everything that we do, which is unfortunate. It's the way of the world and hopefully it gets better. It seems to have been, hearing historically. I think it just takes time.

AG: You mentioned that the difference between being a man and a woman in medicine, the difference doesn't seem as stark anymore as it used to?

JW: No. Yeah [Agrees with AG].

AG: Besides that, are there any other changes that you've noticed in medicine or maybe even changes since you first started?

JW: That's a good question. I think there's a lot of ways you could think about 01:13:00that. The actual practice of medicine has changed profoundly, obviously, over decades and continues to. There are things that I learned to do in medical school, or residency, that are now out of favor as far as we don't really do them for clinical practice anymore. I think those pieces have changed a lot. I mean, I do actually think it's better. I think medicine, especially with everything that has happened in the last year around police brutality and Black Lives Matter, which are profound movements and there are huge pieces in medicine that exist with that, too. Those need to be called out. Racism in medicine needs to be called out. Sexism in medicine needs to be called out. Bias in medicine needs to be called out. I think that part has never been, such a light shone it as it has in the last year. My hope is that that will generate momentum as it 01:14:00already has started to, in both research and how we practice and just practice patterns in general and being aware of it. I hope over time that will move forward. I think the other piece is that physicians as a whole are feeling a little empowered to stand up with these movements that we think are right. Physicians have always done that to some degree. They've always been advocates for many public health things, but I think, and I'm very young in this profession, so I'm sure things cycle around. You go back to the '60s I'm sure this was there, too, but I think there's definitely a voice being generated in medicine more recently that is hopefully going to be really beneficial moving forward.

AG: Going off of that, is there any advice that you would have for young students interested in pursuing a career in medicine?

JW: Don't do what I did [laughs]. Yeah. I do. For both men and women that are applying in medicine, there's a lot of, I feel like because of the burnout quite frankly that we see in some physicians, I feel like there's a lot of push to go into PA school or nursing school and be a nurse practitioner. I don't want young students to be deterred and think that they shouldn't go to medical school, that it's going to be too much work or too much time, lack of reimbursement, you're not going to make money. None of those things, those are all navigable and those are not true necessarily. They're kind of blown out of proportion. I think my advice is do well in college. Don't feel like you have to be perfect, because clearly I wasn't. If you're thinking about medicine, really reach out to that premed advisor. That will help you a lot [laughs]. That will really help you a 01:16:00lot. But I think it's a great career path and me and a huge number of other physicians are wanting to advocate and find people that want to join us in this career and so reach out and find those people to help push you and show you what it can be like that will allow you to shadow in the hospital or in the clinic or let you volunteer as a research assistant, whatever pieces you can do. I think the other piece of advice I give you is it is completely reasonable to take a couple of years off before you apply to medical school.

A lot of students are non-traditional. I actually am biased towards those students because I was one, but I also think it adds a lot of life perspective so when you apply to medical school, I mean when I was in medical school a lot of the students who had gone straight through are panicked about every test and every test is a huge deal. It's a big deal. For me, I had a fallback career. I 01:17:00could go be a paramedic and the guy, Phil, I studied with, he and I, we studied every night together. We had this running joke of, and he is also non-traditional, have we hit the point of no return yet? If this test just totally we blow it, and we get booted out, like is the world over? At what point have we accumulated, quite frankly, so much debt that we really got to finish this? We really never hit the point of no return, actually but I mean it added perspective, because while the first few months were me learning how to be a student and I wasn't good at it for a while, and I got there. Then it also added this perspective of there are other things outside of medical school, which made it less stressful when it came down to test time. It's fine if you don't know you want it. It's fine if you take a couple years off. Do something worthwhile with those years. Don't be a bum on your mom's couch, because that's probably not going to look great on an application, but it's a great field. I would 01:18:00encourage anyone to join the field of medicine and not be daunted by the loans that you have to take out to do it or by the workload. I think it's worth it.

AG: Lastly, I was just hoping to wrap up with some of your thoughts on your future direction and your future?

JW: I don't know yet. That's a really good question. I don't know. I like where I am right now. I tend to pick up projects, lots of them, and so I have my finger in all of these other little pies and meetings and educational things, which are fun but are a little scattered in what I do right now. It's really hard for me to say no to anything. I keep saying yes and keep doing more. I think in my short term career, I mean I like where I am. I want to stay where I am. My long-term career, I think I will probably stay here in Seattle. I would 01:19:00like to figure out how to reincorporate research back in, but I also like everything that I do clinically right now and everything that I do for Airlift, so it's hard. I couldn't reincorporate research in now without dropping something else. I don't really know. I mean, where I'm going to go. I enjoy picking up a new project and seeing where they take me. I think ironically the biggest thing that I want in the next five to ten years really have nothing to do with my career. They have to do with adulting, learning to be an adult, like buying a house and working on having kids and things like that. All of that work-life balance, the life part that I have probably put on hold longer than I needed to, but you know that's the way life is and so I think those are the parts I'm most looking forward to in the next few years and then continuing to 01:20:00have my scatter-brained million projects. Then hopefully at some point, drilling down a little bit more on what I want to focus on for the rest of my career. Kind of a broad answer.

AG: No worries. Any answer is suitable for that. I want to thank you for your time. It was really nice to get to know you a little bit, and I really appreciate you taking the time to speak with me a little bit.

JW: My absolute pleasure. Thank you so much for doing this. It's a very cool project and I'm truly honored that you selected me to do this. Thank you.