Surviving the Unthinkable: A Doctor's Story

And I really just, like, couldn't wake up. Like, I felt like I couldn't lift my arms. I didn't feel like I could talk. I think I told my op, Like, I can't talk. And I love talking.

Hi, everybody, and welcome to the podcast. This is Generations md. My name is Stephanie, and I'm joined here by my colleague, Dr. Sarah Davis, who's also my mother. And today we have a very special guest, Dr. Chelsea Romero. Uh, welcome to the podcast.

Thank you. I'm so glad to be here. Thank you for having me.

Well, we are so excited to have you. Um, you came and talked to my class a couple of weeks ago, and you just have an incredible story. Um, and while you were talking, it was just so impactful. And I was just thinking, I want to share your story more. I think it's so important for so many people to hear and just really excited to talk to you today.

Thank you. I didn't mean to have such an impactful story, but some wild things kind of keep happening to me. So the story has continued to expand.

Yeah. Well, backing up. You graduated from medical school that I currently go to this past spring. Before that, before going to medical school, way back when. I like to ask the guests, when was the first time that you thought about being a doctor?

I don't think I seriously thought about being a doctor until I was in my mid-20s, but my dad is a doctor, family practice. Worked ER for a long time. Now also is in concierge medicine. Like you, Dr. Davis.

Very good.

Exciting. I remember being about 10 years old and dressing up as a doctor for Halloween one year. But there's also, like, a picture of me, like, on a set at the ballet studio. Um, so I. I grew up in this really small town in Western Oklahoma, and there was a group of us around my age and a little bit older who were all, like, very intense into dancing. We all went to New York City to study at the Joffrey Ballet School. Wow. When I was 12. And then I continued studying intensively in the summers with American Ballet Theater, Boston Ballet. Went to Europe a couple times and decided to go to New York City when I was 17 to go pursue a career in the arts. I sort of knew that the arts was something I had to pursue at a young age and not something when I was a little bit older. Like, I had to do it now or never. So I went and studied at Alvin Ailey American Dance Theater. They have.

Oh, wow, that's so cool.

Ailey's very cool. So they have a Joint Bachelor of Fine Arts program between the Ailey School and Fordham University. So I was in the BFA program and had had a very, like, ballet focus in high school and switched to modern dance when I was in college. Also got to train with the Martha Graham School, Merce Cunningham with the Paris Opera Ballet, Netherlands Dance Theater. Like, got to train with all of these amazing places.

You had to be so good to be able to do any of that stuff. Like, that's amazing.

But the doubt is always there. I was in all these rooms, but kind of always doubted myself as a dancer. But I. I asked when I was an undergrad, you know, can I double major in pre med? And they said, absolutely not.

That's never been heard of. Yeah, never been heard of pre med.

Not a thing.

Yeah, yeah.

They were like, those are two hardest majors. They happen at different campuses. Like, no, this is not allowed. So I decided to get an English major. So I had double majors in dance and English, double concentrations in choreography and creative writing. And I was like, I'll be a choreographer. I'll be a writer. I was like, very serious in the arse. And I was like, I'll be in New York forever, and this is what I'm always gonna do. And then I was in a car accident immediately after graduation. Had a traumatic brain injury, like, broke my pelvis. Had to do a lot of physical therapy, neuropsych therapy, and sort of danced in some smaller companies that, you know, are pretty obscure, but couldn't move my body the way that I needed to to continue being a dancer. And that also gave me the ability to think about, like, what is it that I want to do? And I realized that I was actually very unhappy in what I was doing. I'd, like, trained and trained and trained and trained and trained, but ultimately was pretty miserable. And, you know, found myself waiting tables, doing the hustle in New York city in about 2015, 2016. And I met this guy who was like, what do you want to do with your life? And I was like, well, I want to be a doctor, but I, like, I don't know. I don't know anything. Like, I don't. I don't know any math or science. And he said, go learn. So I started a postback at Columbia doing, you know, general chemistry, physics, organic chemistry. And I was like, like, what is a proton? Like, I. Like, I had no foundation. But that guy who encouraged me, we're married now, and, you know, I spent two years in the PostBAC program and then took two further gap years after we moved from New York City to Houston so that my now husband could work at NASA. And I wanted to stay to get Texas residency, to apply to Texas medical schools. And I started at McGovern in 2020.

Wow. Just thinking about kind of you had this dad who's a doctor. You knew being a doctor was a, a thing that you could do. And then pivoting kind of away from that and going down this arts path and something that you're so passionate about, was that a difficult decision to kind of pivot again, to kind of do this thing that maybe you felt like you stepped away from a little bit?

I think that I wasn't super serious about the Dr. Pathway when I was in high school. I think it was something that I thought like sounded cool and fun and I liked hearing the stories that my dad always had to tell, especially, you know, from the emergency room. I thought that was really exciting. But I wasn't like on the pathway to go to medical school to do anything in stem. But I was really, really passionate about the arts, so it made a lot of sense for me to pursue the arts when I did. And then when I decided to pivot again and try to go to medical school, I think there was so much that I didn't know that actually benefited me. I didn't necessarily know what I was getting myself. And I think that was probably a good thing.

Yeah. Your story of becoming a dancer and just working so hard at this one thing, all of those things, how do you feel like aspects of that personality, of your personality that have shown up in your dance career, how do you feel like that's paralleled to then medical education?

I think a lot of the perseverance and hard work definitely benefit me being in medicine. I also feel like medical school was not as hard as getting that Bachelor of Fine Arts. That was a very hard four years. And of course parts of medical school were hard. But you know, I was never in tights and a leotard in front of a mirror and I had a lot of mean dance teachers. So I feel like a surgeon can never hurt my feelings. Yeah, you know, definitely the hard work and dedication and I think I had to learn how to shed that self doubt and be willing to be an adult learner, admit that I didn't know a lot of things and then start to soak in that information so that the self doubt that I had as a dancer is not the same thing that I have now in medicine.

Tell us about your medical school experience.

First of all, I loved being in medical School. It was a really great time. I started in 2020 and you know, we were like sitting at home in quarantine in March and April and I started hearing things about public health and sort of got interested in what that might look like and applied sort of last minute for a dual MD and Master's of Public Health program at McGovern and started my public health courses in May of 2020. Really love studying public health. It was very helpful to like learn more things about public health and pandemics during the COVID era. Yeah, I'm sure then, you know, starting, starting medical school, like everyone was still in quarantine. We couldn't come meet each other. We didn't get to have retreats. So we didn't really meet a lot of our classmates until our second year of medical school. It was all. We were at home studying, watching pathoma and sketchy, getting through foundations, trying to figure out how to study for medical school, how to do well on exams, taking all of our exams at home, not really having a built in support network yet because we, we didn't know each other. I did have a small and close group of friends and we would get together when it was safe for study groups. And then as, as time went on, like gotten more and more friends in medical school. A lot of really great people that I got to study with and I got, I started to get like really into women's health and public health and that intersection. Was very passionate about reproductive justice and abortion rights. Got really involved with Med Students for Choice, which is a fantastic organization. I learned a ton from there and really felt myself start to blossom while I was in medical school and felt like this is where I'm meant to be.

What was that initial interest in woman's reproductive health and then on your rotations, on your OB GYN rotations, what kind of like attracted you to that field?

I think it, it probably started when I was an undergrad. I was very invested in telling women's stories, telling LGBTQ stories in uplifting voices. So that is sort of like where I got the bug for advocacy and advocating for women and started going to Med Students for Choice lectures when I was a first year was like, fell in love with everything, learned so much, and then was president of Med Students for Choice at our school during my second year. And that was when Texas Senate Bill 8 was passed, that also known as the Heartbeat Bill, that essentially outlawed abortion at six weeks. And then at the start of my third year was when Roe fell. So we saw like all of these protections and rights disappear before our eyes. And we were getting all of this education about how to take care of patients, what's important in abortion care. And then suddenly, like, none of that care was available in the state where we. Where we were training.

Speaking of, like, reproductive health and all of those things, you also had a child during medical school. So do you want to talk a little bit about your journey with having a kid?

Yeah, definitely. So I didn't start med school with a plan that I was going to have kids while I was in training. But I remember having a lecture very early on in, like, the first week or so of Medical School with Dr. Hilary Fairbrother. And she said, you can build your family when you want to. And that really stuck with me. You know, I was already in my, like, late 20s, like, entering my 30s. While I was in medical school, I was also diagnosed with endometriosis after my first year, had a fallopian tube removed. And the doctor who did my surgery recommended that I I look into egg freezing and fertility preservation because she knew it would be harder for me to get pregn endometriosis and that tubal factor of infertility. So I went through a round of IVF with egg retrieval and embryo creation. At the end of my second year of medical school, like, right after I took step two, like, right after my egg retrieval, I had something called ovarian hyperstimulation syndrome, which is fairly common in ivf. But then I also had this, like, terrible abdominal pain. Went to the emergency room, was diagnosed with appendicitis. Oh, my God. I think I had a, like, mild to moderate case, but it was just confounded by the coexisting appendicitis.

Wow.

Crazy.

Yeah.

I mean, that's absolutely wild. I do want to touch a little bit on just the decision to have kids during medical training. You mentioned that you didn't plan on doing that. And from my experience, what I see is there's some people in my class who are having kids, have kids, but they're all men. And there is very few, if any, woman that I know that are having children during medical training. And I. I feel like a lot of it is you. They tell you, well, just freeze your eggs and do it later. What was your experience in regards to support? Obviously, like having your husband and friends, but just other women that might be going through the same thing. Was it isolating or did you find people?

It was both isolating and I was able to find people. I also did a big research project in my master's of Public health year. I did a five year MD and PH program and was pregnant during that year. But it's, it's very, very common for women physicians to face infertility. If you look at all women physicians, they have double the rate of infertility as the general population, which you guys, I know I've talked about before in this podcast. And then the more specialized and intense your training gets, the worse your fertility outcomes. So I think plastic surgeons have seven times the rate of infertility as the general population. And there was a big study that came out in 2016 by Stents et al. That was sort of the foundation for the research that I did that looked at sort of mid career women physicians and said, you know, like when did, when did you have your children in your training or when, once you were an attending, when did you feel the most support? If you had infertility, at what age were you diagnosed? And the average age of infertility for Women Physicians was 33.7. And that also coincides at the point when a lot of people are finishing training. But if you wait until you're done with training, it might be too late. You might already be facing infertility. I think people need to plan earlier. My research in particular looked at medical students and their plans and their fears around infertility and barriers that they saw or things that they wanted to see change. The Stints et al paper found that people felt the least support in medical school when they had children. They're just like, there aren't really parental leave policies in place. You're taking out loans most of the time to finance your education. Those loans don't increase when you have a family. They don't increase to cover the cost of ivf. And a lot of students like do want to have children when they're in medical school, but there's, there's so few supports for parents or potential parents and like very few like formal guidelines that makes it very, very hard to have children in medical school.

Yeah, I mean we touched on this a little bit. Just the system is not set up for that. In your research or just talking to people, have you and you touched on the barriers of family planning while in medical education, but has anything worked? I know residency programs are now doing egg freezing programs and paying for that, which is great for, but also it doesn't solve the problem of still being able to have children when you want to have children. Are there any sort of policies or kind of quality improvement stuff that have worked to help support women?

Yeah, so there's sort of three aspects of things that are helpful for the fears of infertility for women in medicine. One is having more education. So like more lectures on fertility, specifically the fertility challenges that women in medicine face or LGBTQ plus people face in medicine. So more education, more knowledge, having more fertility education built into the curriculum is one aspect. The other aspect is having access to egg freezing and insurance coverage for that. A lot of residency programs offer it, but sometimes only after the first year that you've been there. You have to do your intern year before those benefits kick in. At the time when I was doing my research, no medical schools provided any sort of fertility coverage, but it's something that's really desired by students. So I did a big push to essentially pressure our university system into covering fertility preservation or IVF in medical school. The third pillar is having other policies that support parenting. So having rental leave, having lactation available, Having like monetary support. Like there's all these other things from a policy perspective that we can do, but very few of those things have actually been tried.

And then just the in residency, just trying to have enough leave to either have maternity leave, but then also, you know, you're a resident and if you have babies or kids, I mean, they get sick, they have issues, and how are you going to be able to be able to, you know, work 24 hours? And it's just. Yeah, it gets really complicated.

Yeah, it definitely does. Issues with, you know, having enough child care. I think the financial strain is the biggest while people are in medical school. Fertility was not covered under the student health insurance plan that I was under. So I had to pay out of pocket for all of my fertility care, which ultimately cost like between 15 and $20,000. It was incredibly expensive.

Wow.

I was living on student loans. My husband was a grad student when we first started, eventually started working and that helped to cover some of the expense, but most of it came out of, you know, like, very careful budgeting and sort of going without a lot of other things. We also spent my third year of medical school, like trying the old fashioned way to get pregnant. And, you know, I was doing really, really well in medical school. I was, you know, acing all of my board exams, acing all of my shelf exams, doing really well in rotation. And then every month I would have a negative pregnancy test and negative and negative and negative. And I couldn't really figure out why I could be so successful in my training pathway but struggle so hard in my personal life to, to build the life that I wanted to have.

Yeah, I mean, I think these. These conversations are so important to have. And I mean, talking about that, just being able to tell people that they do have the option to be able to do this and go through this process and have kids, because I think so many of us just think, oh, well, that's just not an option for me. So, first of all, just being able to just say that this is an option, you're able to do this, people have done this, is important. But then also just talking about the struggles. I know that so many people struggle with infertility. And, yeah, I can't imagine you're like, I can ace every single test. I have never failed a test in my life. And.

Except for the pregnancy test.

Except for the pregnancy test, yeah.

So toward the end of my third year in medical school, I already had the plan to take a research year to finish my master's of Public Health and do all this research that I've been talking about with you. And I really wanted to be able to have a child during that research year. I knew I would get, like, more time at home, wouldn't have to be in the hospital, like, wouldn't have to do, like, overnight shifts during pregnancy. So I wanted to have, like, a calmer, more relaxed period in my life. Started trying to do embryo transfers. In about March of my third year, my uterine lining, like, wasn't thick enough. So, like, it just never really got to the point where I was thick enough to do a transfer. So we had to change up the protocols a couple of times. And then by I think, like, mid April, we finally got the lining to be thick enough and we did our first embryo transfer. I was convinced that it wouldn't work because everything else hadn't worked, but I'm happy to say that it took and I got pregnant. I guess technically we did the. The transfer, like, April 16th or something. I was on my OBGYN rotation as well, so I'd have to be like, sorry, guys got around. I gotta go do an ultrasound across the street. I'll be right back. Like, I. I was so, like, I was so excited that something had worked and I was fine.

Yeah, I mean, that's amazing. Um, your pregnancy was on during. While you were pregnant, was uncomplicated, is that right?

Yeah, it was great. Like, pretty healthy and run of the mill until I hit about 33 weeks. At 33 weeks, I went in for a regular checkup and my blood pressure was in the 150s over 90s. And they said, you're going to go right to OB triage and get checked out. I also had this, like, really deep headache behind my eyes. Felt terrible. Went to triage, stayed in the hospital for about 24 hours. But, like, baby looked great on the strip. All my tests looked good with some bifed. Have been. My blood pressure eventually came down and my headache eventually got better. So I was released on Thanksgiving Day. And at that point we decided, okay with this gestational hypertension. Like, I didn't meet preeclampsia standards yet or criteria. But we decided we were going to start an induction at 37 weeks. So I continued taking nifedipine through the next four weeks. Baby was continuing to grow. I was doing weekly ultrasounds. He looked really good, Always had a perfect strip. My labs were still normal, so I went in for an induction at 37 and 1. I was supposed to go at 37 and 0, but the L and D ward was full, so they didn't have room for me to come in yet. And I woke up the next day and I had a really bad feeling. Like, something felt really off and ominous. And I was like, I think, like, I think something bad is going to happen. And I pulled my husband aside and I was like, here's the password to my phone and my computer. If you need to, like, log into anything to pay bills. If I can't make decisions, like, like, please do this for me. Like, please, please take care of things. Please take care of me. But, like, something like, feels really off. So I went to the hospital for my induction. And another friend who's a medical student as well, he was also there to deliver her baby. It was her third child. She'd had two kids before she started medical school and her. Her third child in med school. We had the same OB gyn. We were on the same floor. We were going to have the same, you know, delivery date. And she got there before me. She's, you know, in sweat, she's standing up, she's got the monitors on, but she's, like, eating food, like, having a good time. I was like, cool, can I have those things too? And they said, absolutely not. Like, I was. I was immediately, like, NPO started on magnesium sulfates. As I was going through the induction, I was so, so, so tired on the mag. I, like, couldn't stay awake. I fell asleep. Knew that I was having contractions, but they didn't feel that terrible. I think probably because I had, like, so many, like, so much pain from endometriosis that, like, labor kind of felt okay. That's crazy. That's crazy. Got an epidural around midnight that night. Then the following morning around 5 or 6am, my OB came to check on me. I was about 5 cm dilated. Baby still looked okay, but I was very, very, very tired. And I really just like, couldn't wake up. Like, I felt like I couldn't lift my arms. I didn't feel like I could talk. I think I told my op, like, I can't talk and I love talking. I wasn't dilating any further. I never got further than 5cm. Ty's strip went from being perfect with moderate variability and good accelerations and no decels to first the axels disappeared. Then he started to get variable decelerations. And, you know, oxygen didn't help. Changing position didn't help. His strip went from having moderate variability to minimal variability, which is really an ominous sign. It doesn't say for sure that something bad is happening, but, like, it's not great and it is a cause for concern. And then I also realized that I hadn't felt him move in several hours. So my OB came to check on me maybe around 2o'. Clock. Strip is category 2. She did an aggressive, like, fetal scalp simulation. And like, he didn't move. We did a bolus of D10 to get some sugar in me and like, he didn't respond to that. So we decided to go for a C section.

I guess just pausing there for a second, as you're in the hospital and I'm not sure if we mentioned that you were currently applying to OBI residency programs. So how was it understanding what was happening as things were happening, as tests were coming back?

How.

How do you feel like that might compare to somebody not in medicine who doesn't necessarily understand the significance of all of these different things? Yeah.

So, like, I was like, pretty fresh off my OB GYN rotation and like, like labor and delivery was definitely like my special interest. So, like, I knew, like, as his strip was changing that like, okay, now we had a category category two tracing. That's pretty ominous. And then like, not feeling him move is also a bad sign. So I actually suggested to my ob, why don't we just go get him? Like, why don't we go for the C section? Yeah, like, I was ready, I wasn't scared. Like, I was in the same hospital where I had done my labor and delivery rotation. And then I went back to have my C section in the same room where I had seen all the C sections and held the bladder blade and been the medical student mostly just watching, but getting to help with some aspects. I knew the teams at the Texas Medical center were really good. I trusted everybody there. So I wasn't scared to go for my C section at all. Like, I was ready. It felt like the right choice to do.

Yeah, I mean, having. Being able to have a more educated decision on what you want to do, I think is. Is cool and beneficial, but at the same time, also kind of scary that you know how bad things could be.

Yeah, Like, I. I knew that things could go really sideways. I think for people who don't have a medical background, it can be very, very scary to go for a C section that wasn't planned. It feels like you've maybe failed in some way, even though you actually haven't. And going from thinking that you're going to have a vaginal delivery to a C section, that decision can be made very quickly. And then it's sometimes minutes between when it's called and when you're, you know, being cut open, like, it's. It's very fast. And I think with less of an understanding of how things go, it can be terrifying to have that happen to you.

That's.

And I was. I was ready. I was like, let's go. Let's make this happen.

Well, I feel like you had.

The terrifying stuff is like, I know how bad this can be if I don't do that. So that's like, you know, you already have that in your head. You're like, c section seems like a much better choice than other things.

I didn't want to, like, sit around and, like, hope I could, like, dilate further. Like, I was like, not, like, I'm not progressing. I've been at five centimeters for, like, you know, six or eight hours. Like, let's. Let's get out of here.

So you go into the or, and then what happens?

I had an epidural in place, so I was able to, like, lay down on the table right away. I was super familiar, like, very comfortable in the operating room, because it's a place that I'd been as not a patient. So, like, I. I knew who some of the people were. I knew what people's roles were. I knew what the steps were going to be. You know, like, knew, like, knew that they were, like, test skin before they, like, did the incision. And I knew the steps of the C section. So having that knowledge was very comforting for me to have an understanding of what's happening next. What I didn't expect was being violently ill during my C section. I threw up so hard the Whole time that they were in my abdomen and just, like. Like, kept throwing up. That felt. That felt very bad. And then, like, baby was out in a couple of minutes. And I didn't really know what was happening with him, but I knew that he was, you know, with the NICU teams that I also really trusted to do a good job and take care of him. And I knew that I needed to focus on myself. So once he was delivered and then hear my doctor say, complete uterine at me. Complete uterine at me. And that's a bad sign. That is when the uterus does not contract at all. So all of these vessels in the uterus that are, you know, raw and open and bleeding, they need the uterine muscle to contract to stop the hemorrhage. And my uterus did nothing. Like, it was, like, totally floppy, like, not firming up at all. And then I started hearing them call for drugs to stop the bleeding. First it was TXA and then hemobate and then methy gene. And I'm turning to my husband being like, these are all, like. These are all drugs to stop the bleeding. And, like, I have. I have high blood pressure. So, like, it's weird that they're. That they're using methrene when my blood pressure's been this high, but I guess it had. It was, like, in the normal range by the time they called for that, so they felt okay using it. And I, Like, I started to get really cold, and, like, I. I knew what was happening. Like, I knew that I was bleeding out. I knew that I was going into hemorrhagic shock. I knew that I was. I. Like, I knew that I was dying. When I was on the table, I wasn't afraid. I was mostly annoyed. I was like, I still have stuff to do. Like, this is very inconvenient and kind of dumb that this is happening to me. I would really prefer to, like, not, like, not be in this situation right now. Like, let's, like, let's get out of this, please. And I'm, like, looking at my wrists and things to see. Like, is there oozing from my IV lines? Like, am I in full bone dic? Like, what's happening here? And I didn't see any oozing. And I was like, that's a good sign. Like, I must. I must be kind of okay. There's a massive transfusion protocol happening. They were squeezing blood into me. Everything sort of, like, faded for a while. And, like, I. I don't remember what happens. I could also hear them say, like, how the. Like, how much blood loss there was. It was Zeno 1800 mils, then 2700 mils, then 3600 mils. I was like, that's. Like, that's a lot of blood. And I could see the flaps stacking up with all of the, like, blood in them, and I'm like, that's more blood than I've ever seen in this room before. Like, that's a lot of blood. And I don't.

Like.

I don't know how much time passed when I was, like, sort of out and, like, not really aware of what was happening, but I eventually hurt my OB set. My OB say, we haven't been able to stop the bleeding. We need to do a hysterectomy. You will no longer be able to have children, but it will save your life. And I said, yes, let's do it. I really wanted to have more children, but I also really wanted to be alive.

Yeah.

So it was very easy for me to say yes to that procedure.

It's just so respectable. Also of the. Your OB gyn, she really did try everything that she could before that hysterectomy. I know that that is, like, such a hard decision to make, but I do think that's really cool that she was trying everything that she could to try to maintain your fertility until it wasn't another option or until it wasn't an option.

Yeah, I think they tried everything to save my fertility, and when that wasn't possible, they were like, we've got it. Like, we've got to save her life.

Coming out, like, do you feel like your perspective on things changed? Kind of. Notice in my peers a little bit, the people who have maybe gone through some serious adversity kind of look at medical training or school a little bit differently than people who haven't. How do you feel? Like, maybe your perspective on school or just life or anything has kind of shifted or did shift after this experience.

You know, after. Like, after my hysterectomy and ICU stay and, like, raging preeclampsia, being very sick, I was very happy to be alive. Like, I was like, I'm just happy to be here. I think it made the postpartum period easier. And then when I went back to rotations, like. Like, I was just so happy to get to come and learn again, to get to be in medicine, to get to take care of. Of people on labor and delivery, help people with REI things. I was just really, really, really grateful. And all of the hard parts of my rotations As a fourth year medical student, just didn't feel as hard in comparison.

Yeah. How do you feel like it impacted your interest in going into OB GYN and wanting to apply to that residency?

I think it only strengthened my resolve to go into obgyn. And, like, the people who saved my life were also my teachers. Like, the guy on who did my hysterectomy was also, like, my gynon attending. When I did that rotation as a fourth year, Like, I, like, I got to thank all the people who. Who helped save my life. And it felt really meaningful to be able to help save other people's lives. I remember there was another case that was similar to mine. A patient had. She had one living child, and then she had a loss at 20 weeks. And she also had placenta accreta spectrum. So, like, some of the placenta, like, was embedded into the uterus or other parts of the surrounding tissue. And she. She also kept hemorrhaging. She was in the same ICU that I had been in. She was awake and ventilated, terrified. And there was. There was sort of a disconnect between, like, what MFM wanted to do and what gynonc wanted to do. I just wondered, like, who was asking the patient what she wanted. And eventually she was able to say, like, yes, she did want to do the hysterectomy. Yes. She didn't want to stay alive. She wanted to be there for her living child. And then I got to scrub in on her, on her hysterectomy. It was a, like, monster case. She lost another 4 liters of blood during the hysterectomy. There were so many, like, vessels, like, tangled and swollen that were, like, on her uterus and then spreading into the surrounding tissues. But it felt, like, really meaningful to be there. One of the guy dogs who took care of me was also the attending on that case. And she was like, are you okay to be here? And I was like, yeah, I'm okay. Like, let's go. And after the surgery was done, like, the patient woke up and she gave us the biggest hug. Like, she was so grateful to be here. And I, like, I knew. I knew what she felt.

And there's not really anyone else, very few people in the world who understand what she felt. And that is so special that somebody on her care team knew that.

Yeah.

Well, going through this whole event, coming out on the other side, you're. You have a newborn. You're in your fourth year of medical school, you're applying to OB gyn, You're Graduating from medical school. You're looking to your future. Tell us a little bit about that. Kind of like, what happens next.

I thought my brush with death. With death was over, and I was wrong. So I matched into OB gyn And then a week after graduation, I was visiting, visiting my parents in New Mexico. Had terrible abdominal pain, like, 10 out of 10. Like, felt like when I'd had appendicitis. Went to the emergency room, got a CT scan, and, you know, like, the attending was like, okay, your. Your scans back. We don't have the read yet, but do you want to come take a look at this? And I remember, like, taking a video of the scan as he scrolled through, and there was this, like, huge mass on the left side of my abdomen. And we were both like, huh? Like, that's not supposed to be there, but, like, I don't know what that is. I sent it to a buddy of mine who's a radiologist at Mayo, and he was like, holy crap, that looks bad. And he's asking, you know, like, what's the patient's white count? Like, how old are they? And I had to be like, no, like, this is me. Like, this is my scan. And, you know, he's like, you know, it's lymphoma versus sarcoma. There's mets all in the abdomen. So I, like, I knew that I had cancer, I think before the ER Doctor did. I was ultimately diagnosed with a super, super rare sarcoma. It's about a one in a billion diagnosis. It's called desmoplastic small round cell tumor. There's been less than a thousand cases since it was discovered in 1989. It's very hard to treat. It's very aggressive. It's almost always found at stage four because it is kind of a silent tumor. And then by the time there are symptoms, it's already spread. So I was at stage four, did a workup at MD Anderson. When I was first, like, officially diagnosed. My oncologist said, your cancer is really bad, and you need to go make memories with your son. He was 17 months old at the time, and I didn't know that. I would love to see his second birthday hearing that.

Also, just with everything that you've already gone through, I literally can't even imagine or fathom that at all.

Yeah, I was really angry at first. I started chemo, like, a few days after meeting my oncologist, and then it was in my first cycle of chemo that I. I got the official diagnosis of the wor. Like, the Worst type of sarcoma that it could have been.

This is. This was all what this was this last spring. So it's been not quite a year since. Since the diagnosis. And so what has been going on this last year?

I am happy to say the treatment has gone as good as it possibly can. So I started chemo. I did six rounds of very, very hard chemo with doxorubicin, vincristine, and iphosphomide. And when I was first diagnosed, like, my oncologist said, like, it's too far spread. Like, you're probably not going to get to have a surgery unless it's just palliative to relieve symptoms. But, like, I'll refer you to our sarcoma surgeon. Like, you can talk to them, but, like, you're probably not going to get to have surgery. I saw the surgeon, he's like, yeah, we could take it out. We can do it for sure. They were able to get all the cancer out, which is also really, really hard to do with this type of tumor. They took out my descending colon, which was where the primary mass was surrounding. It had invaded into the muscularis layer. They took out my spleen. They took out part of my pancreas, my omentum, and then all of these other mets that I had, like deep in the pelvis and some scar tissue. But it's very rare to be able to have a complete cytoreductive surgery with this type of tumor. And I was able to have one. And if you look at the papers, there'll be like 100 patients with this tumor, and five of them lived. And I'm meeting the criteria of what those five other people met too. You know, as far as we know, like, the cancer hasn't come back yet. I still have about an 80% chance of recurrence, but, like, this is the most optimistic I felt in a really long time.

Yeah.

I mean, wow, that's incredible. And also how just through all of these different events, managing optimism and having that grit to persevere, get through it while also understanding the circumstances and still having hard conversations and balancing that, how do you find the middle ground between that for yourself and, like, for those around you as well?

I think the middle ground is so hard. When I was first going through the workup, I was very pessimistic. And I think that pessimism, like, thinking it was going to be the worst case scenario, helped prepare me for every time that it was the worst case scenario. Like, it's not lymphoma, it's sarcoma. It's not Ewing sarcoma. It's DSR ct. Preparing for the worst possible scenario, I think helps me when the reality was the worst case scenario. As I started to do better in my treatment and was responding really, really well to chemo. And it was like, looking at having this surgery, like, it introduced more uncertainty. Like, I. I think I felt more at peace when I, like, felt like I was for sure going to die. Like, that felt like a definite thing that was going to happen. And then like, this little bit of, like, hope was introduced. And I was very uncomfortable with that for a long time. Like, I. I didn't know how to sit with it. I didn't like it. I didn't like the uncertainty of not knowing if I was going to live or if I was going to die. I didn't know how to plan for the rest of my life. Around that time, one of my mentors, also a gyno, said, let's meet. Let's talk about what you can do for your future. That was on a Sunday. And she was like, I think you should reapply to residency, try family medicine. There's an emergency medicine program near you. Apply to that too, and, like, see where it takes you. But, like, I would hate for you to have to wait two years before you can start instead of one. And applications were due on Wednesday. So I like, you know, reached out to letter writers who got really, really kind and supportive letters. And for me, really fast. I got officially released from the OB GYN program I matched into. The deans at McGovern were super helpful. I wrote a new personal statement, had a pretty good story, and ended up applying to nine programs, got interviews at all, nine of them. Getting to think that I might get to have a future has been so helpful for me.

Well, I want you to write a book and put me down on the wait list for a copy and you.

Can come back on here and promote it. From all of these crazy life experiences that you've had and this roller coaster. What advice would you give to, honestly, anybody, but especially just like, students or young people that are, you know, starting on their education path.

Yeah, I would say have your family when you want to, no matter what point in training you are, have your family if that's something that you want to have. And keep advocating, like, be noisy. Like, advocate for yourself, advocate for your peers, advocate for the people who come after you. Like, we are capable of changing systems and making the world better for everybody. Advocate for your patients and the population as a whole. Like, your voice really matters and everyone should use it.

Are you aware where people can follow any of your journey?

Yeah, I. I haven't really, like, shared a ton on social media, but I. I do have an Instagram account at Chelsea Traveler. I guess, like parting words, it's hard to know how much time any of us have on this earth, so follow what you're passionate about and keep going.

Well, that's incredible. Thank you so much for being here. Yeah, you guys know where to find us at Generations MD on TikTok and Instagram and ask generations.mdgmail.com and we will talk to you guys soon. Bye.