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My Quest for a Professional Vocation in Healthcare

By Nicole Gunawansa

Ms. Gunawansa graduated from Washington and Lee University in 2014 with a Bachelor of Science in Neuroscience. Upon graduating, Nicole worked in the Department of Disaster Psychiatry at Tohoku University in Sendai, Japan with populations devastated by the 2011 Great East Japan Earthquake as a part of a Henry Luce Fellowship to Asia. She is now working as an OB/GYN medical scribe in Newport News, Virginia, as she applies to medical school.

There were large periods of my childhood in which I qualified for government subsidized lunches and waited in protracted free clinic queues for annual physicals. I knew my immigrant parents worked long hours and sometimes multiple jobs to support my sister and me, but the sense that we might be “poor” did not completely register at the time.

"It’s a humble idea, at times overlooked when analyzing the behemoth that is poverty, but it is a precious idea that I resolved to incorporate into my future medical career," writes Gunawansa.

“It’s a humble idea, at times overlooked when analyzing the behemoth that is poverty, but it is a precious idea that I resolved to incorporate into my future medical career,” writes Gunawansa.

When I entered Washington and Lee University with a QuestBridge full-ride scholarship, I felt a sense of relief in knowing that I could temporarily relinquish the perpetual trepidation that accompanied my prior fiscal instability. I naïvely thought university was an opportunity to put my impoverished background behind me, but in reality the study of poverty and its reduction—through the Shepherd Program—became an integral aspect of my undergraduate experience.

I decided to take Poverty 101 and the complementary community service course at the end of my freshman year, after hearing praises of the course from countless friends. Not really sure what I was getting into, I thought that I would gain some general insight into such a sensitive and heavy subject. Instead, I found myself learning about people with backgrounds similar to mine. These antidotal stories deeply resonated with me, and forced me to reflect on the privilege that I had obtained simply by having access to higher education. The course not only informed my understanding of how governmental or grass root efforts could help mitigate the adverse affects of poverty, but it compelled me to get more involved and support those who struggle just as I had.

Accepted to Bonner Scholar Program the following academic year, I slowly fell in love with the Lexington, Virginia community through my experiences at the local free clinic, Campus Kitchen at Washington and Lee, and afterschool educational organizations. Initially, my community service work was a source of joy and satisfaction, but also served as a nice break from my science, pre-medically focused academic schedule.

At some point over the next few years, my work with the Shepherd Program shifted from merely being tangential to my degree to becoming a fundamental part of my identity. I was no longer interested in medicine as a general career, but I wanted to pursue the field with the ultimate intent of providing health access to underprivileged populations. When I reflect back on my undergraduate experience, I recognize that my knowledge of what it means to be a physician was primarily cultivated through my exposure to medicine in community service settings. Service work forced me to reconcile health preservations with the realities of living with disadvantaged lifestyle, and constantly challenged me to generate creative solutions in various medical settings, both domestically and abroad.

A pivotal moment for the integration of my poverty and pre-medical studies occur during the summer of 2013 when I volunteered at Kaneshie Polyclinic in Accra, Ghana as a Shepherd Alliance International Intern. Working in the stuffy, rundown rooms of the clinic, I met undereducated patients speaking only their native dialect, witnessed a lack of sanitation due to a shortage of supplies, and encountered the dedicated—albeit tired and frustrated—medical staff who promoted preventative medicine to a population oblivious to the notion of “prevention.” Never before had I felt so moved to assist, yet defeated by lack of training. It wasn’t until I recognized that these individuals were not unlike the free clinic clients back home that I managed to overcome the sense that I was a useless, “obruni” (foreign), bystander. In the final weeks of volunteering, utilizing prior service knowledge, I focused my efforts on prioritizing patient interaction; broken conversations about access to care and holding calloused hands eventually assuaged cultural barriers and demonstrated the astounding power of simply exemplifying hope. It was over the course of this internship that I realized that although poverty manifests itself in different forms depending on the affected populace, the alleviation of social and psychological strain that often accompany such trying circumstances need not be so complicated. Treating people with respect and compassion helps instill a sense of self-efficacy which (hopefully) allows individuals rise above the paucity that plagues their way of life. It’s a humble idea, at times overlooked when analyzing the behemoth that is poverty, but it is a precious idea that I resolved to incorporate into my future medical career.

After graduating from W&L, I spent a year in Sendai, Japan as a Henry Luce Fellow doing Disaster Psychiatry research on mental health in populations affected by the 2011 earthquake and tsunami. My work consisted of evaluating fear-response reduction by microglia in relation to PTSD and conducting a longitudinal psychology cohort analysis. The opportunities I had in Asia stretched far beyond lab work as it was a year of cultural appreciation and personal growth. Collectivistic and private, Japanese society was initially difficult to infiltrate. I once again found the skills that I had developed over the course of my Bonner service and Shepherd Internship to be an asset. Only my experiences with the Shepherd Program had truly prepared me for and equipped me to handle the emotionally draining realities of working with a disaster stricken population. I approached the individuals I met in Sendai with a level of sensitivity and respect that had learned to give to those in vulnerable circumstances, and in doing so, reaped the benefit of constructing meaningful, trust-based relationships that immensely added to my understanding of disaster relief medicine. When it was finally time to come home, I left Japan with a revitalized interest in medicine, a more cohesive comprehension of resilience, and a renewed appreciation of the time I spent with the Shepherd Consortium.

As I move toward my goal of becoming a physician, I have no doubt that my background in poverty studies will continue to aid me in my efforts and amaze me along the way. I am overjoyed to know that the Shepherd Consortium continues to grow so that other students can expand their horizons and obtain newfound perspectives about society and justice, just as I have.  Although I considered myself no stranger to the concept of poverty prior to W&L, truly understanding it and its nuances was only possible through the transformative experiences I have had with the Shepherd Consortium and its passionate, proactive community. I look forward to seeing the positive impact the consortium, and its students, will have on the future of poverty reduction and global service in the years to come.


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