Grace Kromm ’20

Massachusetts Eye and Ear Infirmary, Boston, MA

“It usually starts around sunrise and disappears around sunset. It looks like a floating fish, made up of little dots, when I close my left eye. It seems to grow larger every day.” In response to every question from the doctor, the man launched into greater and greater detail about the floater affecting his vision. For this patient, like many others, his vision was inextricably tied to his quality of life—the man was a teacher who had trouble seeing his own chalkboard. For many patients, their experiences of vision were so visceral and personal that the conversations often progressed this way, as the patients were compelled to make the doctor truly “see what they see.”

Standing outside the hospital at the end of my internship at MEEI, which is ranked the number one hospital in the nation for ophthalmology.
Standing outside the hospital at the end of my internship at MEEI, which is ranked the number one hospital in the nation for ophthalmology.

As I listened to this man describe his deteriorating vision, I was reminded why I had taken such an interest in eye care. Growing up alongside a sister with cortical visual impairment has challenged me, as I have constantly wondered how her visual experience of the world compares to mine and how it can be improved. Motivated by this interest, I was lucky enough to find, apply for, and receive a summer internship in ophthalmology research from a renowned institution just nine miles (a quick commuter rail ride) away from my home. It was here that I would be able to meet and listen to patients such as the man with the unusual fish-shaped floater.

This past summer, I was a Research Assistant in the Retina Service of Massachusetts Eye and Ear Infirmary (MEEI), a teaching hospital of Harvard Medical School with locations in and around Boston, Massachusetts. I worked directly under Dr. Deeba Husain, MD, a distinguished vitreoretinal specialist and Associate Professor of Ophthalmology at Harvard Medical School.

Dr. Husain, a fiercely intelligent and compassionate physician, is the Primary Investigator of the study I supported during my time at MEEI. This study concerns age-related macular degeneration (AMD), the leading cause of adult blindness in the developed world. This research has attracted international attention, as AMD is an incurable disease, and the field currently lacks reliable measures to identify patients who may be at risk of developing AMD or progressing to blindness. Utilizing a technique called metabolomics, the study targets biomarkers of AMD in blood and urine samples, with the ultimate goal of using these biomarkers to improve diagnostic and prognostic information and identify possible therapeutic targets. To understand how genetic and environmental factors interact to put a person at risk for developing AMD, the participants fill out several questionnaires about their medical history as well as their diet and exercise habits. To grade their AMD (or lack thereof, for controls), the research patients also undergo several imaging and functional exams. Including the collection of blood and urine samples, each patient visit can take anywhere from two to four hours.

Waiting in the OR before shadowing an emergency surgery, performed by Dr. Husain, to repair a retinal detachment caused by dropped pliers.
Waiting in the OR before shadowing an emergency surgery, performed by Dr. Husain, to repair a retinal detachment caused by dropped pliers.

As the only undergraduate research intern in the Retina Service Laboratory, I was heavily involved with many aspects of this ongoing study. I recruited and consented patients, conducted patient visits, processed blood and urine samples, and performed data entry and analysis. I was also trained and certified to administer visual field and dark adaptation functional tests to patients independently, which is where I spent the most one-on-one time with patients, as the exams took up to an hour and a half to complete. This work, whether in the office, laboratory, or clinic, enabled me to receive practical hands-on experience in the field of medical research.

Throughout my time at MEEI’s Main Campus, Longwood, and Stoneham offices, I have had the opportunity to shadow many other aspects of the medical sphere. I went to weekly Retina Service Conferences, Ophthalmology Grand Rounds, and Resident Lecture Series. I met wonderful doctors, nurses, data collectors, on-site workers, and technicians who are passionate about providing excellent patient care. I befriended two medical students who, over dozens of lunches, answered every question I could think of about the medical school application process and medical school daily life. I observed the ophthalmic photographers and the technicians in ophthalmic ultrasound perform imaging for our study, and I shadowed Dr. Husain’s clinics, including patient exams and routine injections. In the OR, I watched several surgeries and experienced what it means to “scrub in.”

Our research poster at the 2018 Ophthalmology Annual Meeting session. Pictured (left to right): a fellow medical student, Dr. Inês Laíns, MD, another fellow medical student, and me.
Our research poster at the 2018 Ophthalmology Annual Meeting session. Pictured (left to right): a fellow medical student, Dr. Inês Laíns, MD, another fellow medical student, and me.

I am thankful to have participated in an internship so relevant to my career interests and so crucial to my academic pursuits after I graduate from Williams. As an undergraduate student planning to attend medical school, exposure to research and clinical care in a hospital setting is incredibly important. This internship has been immensely personally fulfilling as well. I have gained a sense of the real-world experiences of those in the healthcare sector, a field that was still nebulous in my mind going into the summer. Now, I better understand my future place in the medical system, and I am inspired to seriously consider a specialty in ophthalmology. Additionally, I feel as though I helped address a specific need in our society—the need for more comprehensive care strategies for those who may develop blindness, a potentially devastating disability. Serving these people in my own community by meeting with them in the clinical setting and working in the laboratory on their behalf has been extremely gratifying.

At the end of my internship, I did not feel like an undergraduate intern but like a contributing member to the Retina Service research team. In the last week, I happened upon a particularly interesting and unique case: an elderly woman whose vision was spared due to the heart-like shape of the geographic atrophy of her macula. I approached Dr. Husain about submitting the fundus photograph to the literature with my colleagues, and she confirmed the intrigue of the case and suggested that I submit the image to the Digital Journal of Ophthalmology. I am currently in the process of submitting the photograph and a brief case report for publication. I am so excited to be able to write and submit a contribution to the medical literature, however small.

I would like to sincerely thank the Class of 1972, and the Williams College ’68 Center for Career Exploration for their generosity, without which I would not have been able to complete this internship. I am profoundly grateful for your support.