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USU Medical Students Practice Life-Changing Medicine, First Hand

Army 2nd Lt. Paige White, left, and Ensign Cat Woodard, recently discuss an upcoming project.
By Sarah Marshall

Army 2nd Lt. Paige White wanted to go to medical school at the Uniformed Services University of the Health Sciences (USU) because she wanted to save lives.  Little did she know that the school would play a part in potentially saving hers.

While in her second year of medical school in USU’s F. Edward H├ębert School of Medicine, White, now a fourth-year student, signed up for the Operational Ultrasound course.  The course was an optional offering given during the summer to students after their first year, and White and her classmate, Navy Ensign Cat Woodard, elected to take it.

The week-long course, sponsored by USU’s Department of Military and Emergency Medicine and led by Navy Capt. (Dr.) James Palma, focuses on the use of ultrasound for specific battlefield scenarios, such as advanced trauma assessment, using an ultrasound to refine triage decisions in mass casualty situations, and using an ultrasound to help make better decisions about evacuation priority in forward-based tactical situations. Palma added that the course also explores topics tailored to global health engagement, such as applications for ultrasound with tropical diseases.

Course attendees took turns performing ultrasounds on their classmates and having the ultrasounds performed on themselves to give each student hands-on experience.  White and Woodard paired up, first with White as patient and Woodard behind the ultrasound wand.

Woodard, who had had some prior experience with ultrasounds, worked her way around to White’s neck, where she noticed an abnormality on her friend’s left thyroid.  She didn’t want to worry White, but mentioned she had found something and wanted to confer with Palma, who reviewed and confirmed Woodard’s findings of a nodule.

“We were still trying to understand that region of our human anatomy,” Woodard said. “I wasn’t sure if it was supposed to be there, but it really didn’t look like it was supposed to be there. We had also been learning about what to look for to identify cancer, such as the size and width of growths like this.  I didn’t want to worry my friend, if there wasn’t a need for her to be worried, and so I asked Dr. Palma to take a look.”

Woodard said she was worried for her friend. And in that moment she truly came to appreciate her training.

“It’s supposed to be helpful, but you never know exactly when it’s going to be – that’s why it’s so important,” she said.

She was also thinking to herself, what are the odds of this happening?

“Things like this only seem to happen on television or in the movies,” she said.

White followed up with her family physician who verified there was, in fact, a nodule growing on her thyroid. A biopsy revealed she had papillary thyroid cancer – a condition that grows slowly and often presents little to no symptoms. It’s also one of the most common types of cancer to affect the thyroid – a gland that sits just below the voice box and produces the hormones that control blood pressure, heart rate, and temperature. Most of the time, these slow-growing tumors can be surgically removed, though some can spread to the lymph nodes in the neck.
Army 2nd Lt. Paige White, a fourth-year medical student, recently on rotation in the procedure room at the Ft. Benning Family Medicine clinic.
Army 2nd Lt. Paige White,
a fourth-year medical student,
recently on rotation in the procedure
room at the Ft. Benning Family
Medicine clinic. (Courtesy photo)

“It was very fortunate that her diagnosis was made early as part of this ultrasound training course,” Palma said. “We do occasionally find abnormalities when doing teaching scans, and we have a university policy regarding how to handle any suspected or confirmed abnormal findings that we encounter while doing the teaching scans.”

The diagnosis was a complete surprise to White who, until that point, did not have any other signs that would have indicated a nodule growing on her thyroid. Fortunately, her prognosis was good and she was scheduled for surgery to have half of the gland removed.

Her plan was to squeeze her surgery in during spring break, then jump right back into her next rotation, not wanting to let anything stand in the way of her school work, she said. She hadn’t mentioned the diagnosis or surgery to her professors, Air Force Lt. Col. (Dr.) Eric Meyer, assistant professor of Psychiatry, who had been helping her with a motivational interviewing workshop, and Army Col. (Dr.) Dana Nguyen, assistant professor of Family Medicine, who was her Family Medicine Clerkship mentor.  However, when they found out she had cancer and was having the procedure, they were very supportive and encouraged her to give herself time to fully recover, not just from the surgery itself, but also emotionally.

“The physical recovery from my surgery was no problem. I was pretty much back to normal activities in three days,” White said. “But the mental recovery is what I didn’t give myself time for, and it definitely caught up with me. I was much more overwhelmed and emotionally tired than I realized. But Dr. Nguyen and Dr. Meyer could see it, and despite my resistance they put their foot down and really encouraged me to take a break.”

Not only did she appreciate their support, she was grateful to have learned an even greater lesson – the importance of taking care of oneself, mentally, as a caregiver.

“Only after making sure we have taken the time to stay mentally healthy can we really do our best as providers,” White said. “When we push ourselves too hard, it is not just us who suffer the consequences, but also those we are caring for.”

Before heading back to the books, White did end up taking some time to rest at home, letting her body and mind heal.

“After having the right amount of time to recover, physically and mentally, I felt ready to get back to the grind and bring the lessons to my practice,” she said.

Two students simulate an ultrasound on another student's neck
Army 2nd Lt. Paige White, a fourth-year medical student, was diagnosed with papillary thyroid
cancer after her USU classmate and friend, Ensign Cat Woodard, found a nodule on
White’s thyroid during an ultrasound class. (photo by Sarah Marshall)

White often looks back on this experience and the irony of it all.

“There were many things that had to fall in place for this nodule to be found – that I was accepted into medical school the year I was … to attend a school that does hands-on ultrasound practice, to be signed up for a course that was optional, and to have volunteered to let my friend practice on me,” she said.

Not to mention the fact that, about a year before her own diagnosis with cancer, her mother was also diagnosed with cancer. At that time, White contemplated taking a year off from medical school to be by her mother’s side. It was hard to balance medical school while worrying about a sick loved one, but she worked hard and made it through.

So, what if she had decided to take the year off? She doesn’t dwell on this.

White credits her faith, and her USU family for carrying her through this time in her life, while simultaneously teaching her a valuable lesson.

“I am thankful and feel blessed by the family and support I have in my classmates and faculty at USU,” she said. “I am also incredibly humbled from learning my lesson about the importance of our mental health as providers.”

The experience has also had an influence on which specialty she might choose, White said.  For years, she had her mind set on Emergency Medicine, having been raised by a trauma nurse.

“I just always loved the personality of the ER,” she said. “However, after seeing a new side of Family Medicine, after this experience, and spending a lot of time in that area, I’m now leaning in that direction.”

For Woodard, who is pursuing a career in Emergency Medicine, the hands-on training has also had a lasting impression. She has seen first-hand how an ultrasound can help better understand what’s happening below the skin.  It also emphasized that if something concerns you, as a provider or as a patient, it’s important to run it into the ground until you’re confident you have done everything possible to understand the concern.

“It really had an impact on me, and I frequently share this story with others,” she said.