Laura B. Vater, MD, MPH is an Internal Medicine resident physician at Indiana University. She plans to pursue a fellowship in adult Hematology/Oncology. She earned a Bachelor of Science from the University of Notre Dame, a Master of Public Health from the University of Pittsburgh, and a Doctor of Medicine from Indiana University School of Medicine.
Dr. Vater’s work is focused on helping patients live the best quality of life possible, even in the midst of serious illness. Her research interests include prevention and early detection of cancer, health disparities, health communication, and clinician well-being. She developed the SMILE Score to help patients and health care providers and patients simplify, prioritize, and advocate for their health. This tool is starting to be used in wellness training programs, clinics, and schools across the U.S.
Here are takeaways from our conversation:
Laura is an internal medical resident at Indiana University and is planning to pursue a fellowship in hematology/oncology. Where you live and where you work affect your health to such a high degree. Laura spent a year in Haiti working in a clinic and worked on projects, which led her to the pursuit of her Master’s in Public Health, then went to medical school afterwards. Laura grew up with a mother that began to pursue her career in medicine when Laura was nine years old. Her mother jokes with her that Laura probably knew she wanted to become a doctor and enter the medical field before she did! Laura recalls memories of going to the cadaver lab from a young age while her mother was in medical school. Practicing medicine in a small town in Indiana, Laura got to experience first hand the personal connection her mother made as a physician with her patients as well as the rigors of medicine.
Laura observed the chemotherapy and surgeries of her volleyball coach when she was in high school who was diagnosed with cancer. Laura was there with her coach when she passed away. This experience solidified her passion for medicine.
Laura knew she wanted to serve humanity and explored opportunities to do so, which led her to Public Health. Laura describes Public Health as being prevention for the population. Public Health and prevention looks at people and targets these questions: “How can we keep people from getting ill? How can we prevent illness? How can we give people the best quality of life possible?” Whereas in medicine, you typically see people once they’re already sick or are in critical care. Laura accomplished her mission by gaining education and combining both Public Health and prevention with medical training, which has given her a diverse experience.
PREVENTATIVE MEDICINE IS WHERE IT’S AT
Laura brings up the analogy of pulling people out of the river- people that are already sick. In preventative medicine, you go upstream and wonder why people are falling in the river in the first place. Both are necessary, but Laura realized that there is a world of good that can be done in the arena of preventative health that can help people from falling in that river, including vaccines, early detection of cancer, lifestyle medicine, eating well, exercising, sleeping well, catching diseases in early stages and reversing them (i.e. diabetes). Laura is an advocate for empowering individuals to implement lifestyle changes and make healthy choices in their lives.
Laura is in the process of applying for a three year subspecialty fellowship. Laura strives to become a leading national expert in cancer medicine, especially focused on prevention and early detection of cancer. She sees herself giving her future patients tangible tools throughout the entire process as soon as a patient is diagnosed with cancer.
Laura talks about centers across the country that specialize in complementary medicines for cancer. They provide alternative healing practices that modern medicine does not encompass. Laura is intrigued by research and aims to maintain an open mind when treating her patients, including providing a personalized plan that works for each other.
PANIC ATTACKS DURING MEDICAL SCHOOL
Laura created a campaign around resilience earlier this year. What inspired her to create this campaign was learning how about other medical experts and providers found resilience in their fields. In retrospect, Laura looked at medical school and realized how all the difficult times of not taking care of her health and feeling exhausted, which negatively impacted her. She wanted to create a resource for people that can help others.
During an intensive part of medical school where Laura recalls taking an exam almost every day, she let go of the self-care activities that grounded her. She found that she didn’t have to get enough sleep, exercise, or go to the grocery store. Laura eventually developed panic attacks, which is something she openly shares about now. The panic attacks occurred while Laura was in class and felt her heart race, chest pain, and lightheadedness. She reached a point in that semester where she developed thoughts of hurting herself. She reached out to her husband that was aware of her thoughts that encouraged her to seek help.
CULTURE OF SILENCE IN MEDICINE
Laura explains there is a legitimate fear about seeking mental health services while undergoing medical training, which as fed into this culture of silence. If seeking help goes on your record, that can impact a future match into a program. Laura shares how there are ways to seek mental health services that are confidential to get around that. Your health matters and it is not a sign of weakness to seek help. People that enter medical school are some of the most resilient and resourceful people. If stressors in healthcare or medicine are overwhelming you, it is a result of working in a system that has enabled all of the high stress to occur. Laura never wants people to think they feel like failure because they don’t feel strong or resilient enough. Your long-term vitality in your practice will depend on how you take care of yourself and seeking the appropriate mental health services when needed.
Laura made a big change after her first semester in medical school and created strategies for coping. Laura identified the important lifestyle practices that positively impacted her mental and physical health, which included:
- Eating nutritious foods
- Connecting with family and friends
- Doing one thing each day she enjoys
- Getting enough sleep
- Maintaining an exercise schedule
- Having a gratitude practice
RESILIENCE AND BURNOUT
Laura defines resilience as being able to learn from adversity and being able to integrate it in her life. Laura talks about burnout being a multi-factorial problem with differing demands (i.e. documentation, hours) of the job that create a burden. With this dilemma of burnout, moral injury, or however you define it- a multi-level solution must be delivered, including at the hospital system level and law-making level. Wellness programs should not be mandatory in Laura’s opinion; however, Laura believes optional wellness programs that organizations pay for can be great additions to one’s wellness plans, but are not all-inclusive as an answer for burnout.
THE SMILE SCORE
Laura created the SMILE Score, which is a daily self-assessment that allows you check-in with your health and to be an advocate for your health. Laura shares how memorizing mnemonics in medical school inspired her to create one for health.
Laura Vater’s SMILE Score.
Laura used this score for her own purposes and recorded her score over time in her journal. Sometimes her score came out to 0 post-call, where she hadn’t slept, made poor food choices, and was socially isolated. Laura found a correlation between a low SMILE Score and low mood and didn’t feel well. This tool helps Laura to refocus her health and make healthy choices even when she’s exhausted. Laura uses this as a rational tool when she isn’t feel good or in a bad mood- she’ll pull out the SMILE Score and realizes that she hasn’t done anything from the SMILE score to take care of herself. Even if she is receiving high scores and she is still feeling off, she will seek additional help. Laura has received such a wonderful response to the creation of this tool. This assessment has helped so many healthcare professionals and even patients across the country and has been adapted to youth as well.
DISCRIMINATION IN MEDICINE
Laura recalls a time when she was pregnant as a third year medical student where she was treated differently during her general surgery rotation. Faced with subtle discrimination, Laura felt she was placed in a ‘maternal category’ and was ignored more frequently than being engaged with. The maternal category means you will most likely leave medicine to start a family and don’t take medicine seriously.
Overall, Laura brings her passion for public health, cancer disparities, and advocacy for preventative medicine to the field of cancer medicine. Laura’s advice to her younger self?
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