Boston Children’s Hospital, Biobehavioral Pediatric Pain Lab, Boston, MA
This summer, I worked as an intern for Dr. Christine Sieberg in the Biobehavioral Pediatric Pain Lab at Boston Children’s Hospital. In her lab, Dr. Sieberg studies chronic pain in children and adolescents. The goal of her research is to develop an understanding of the underlying neurological and psychosocial factors contributing to chronic pain conditions in order to identify individuals at risk, work to improve treatment methods, and help patients cope with their pain. This is particularly important for children suffering from chronic pain, as altered neural development during childhood can have significant ramifications that persist into adulthood.
While I had the opportunity to work on a variety of projects during my time at Boston Children’s Hospital, I primarily worked on Dr. Sieberg’s study of chronic pelvic pain, titled Examining Pain, Psychosocial, and Sensory Factors in Adolescents and Young Women with Endometriosis. This study explores how young women with chronic pelvic pain (CPP) secondary to endometriosis function in comparison to healthy individuals. Endometriosis is a disorder in which the endometrium (the tissue lining the inside of the uterus) grows outside of the uterus. A typical form of treatment for endometriosis is to undergo a laparoscopy, a surgical procedure to remove the lesions on the uterine lining. However, this is not always an effective form of pain management, and, for many patients, severe pain persists even after multiple surgeries. As part of this study, we tested postsurgical endometriosis patients whose CPP was not managed by laparoscopy. One aim of the study is to identify possible alternative treatment methods for CPP by investigating the underlying biology and sensory experience of patients with this condition.
Dr. Sieberg’s study of chronic pelvic pain had been going on for about two years by the time I joined her team. As part of my internship, I took over participant recruitment and testing. To recruit participants, we partnered with Dr. Marc Laufer, a gynecologist at Boston Children’s Hospital, as well as the Women’s Health Study: From Adolescence to Adulthood, which is a longitudinal study run through Boston Children’s Hospital that tracks health issues affecting women over the course of their lifespan. The research assistants for the study would give us a list of eligible CPP patients between the ages of twelve and twenty-two, and I would approach them after their appointments with Dr. Laufer. To recruit healthy controls, we hung flyers at local colleges and high schools. This summer, however, I also launched the recruitment of control participants for our study through the Adolescent Medicine Clinic at Boston Children’s Hospital. I would review the medical charts of incoming patients and flag those who would be potentially eligible for our study, as well as for the Hepcidin Study, the Women’s Health Study, the MARSSI study, and the Dating Apps, Relationships, and Well-being Study. It was exciting for me to learn about other research being done at the hospital, talk with the research assistants and doctors working in the clinic, and gain experience interacting with patients.
I also enjoyed running the actual study, which consisted of a quantitative sensory test (QST) and several medical questionnaires. The questionnaires provided a standardized way to assess participants’ medical history, mental health, experience of pain, and feelings surrounding pain. Prior to beginning testing, I was trained in the QST protocol and did background research to understand the history and applications of the methodology. The QST consisted of six different sections designed to measure participants’ sensory perception and pain thresholds by using a brush, Von Frey filaments, a pressure algometer, and a thermal sensory machine. Participants were asked to note at what point they first detected mechanical touch or temperature change in order to establish perception thresholds. They were then asked to say when the sensations began to feel painful in order to establish pain thresholds. All tests were performed on the four quadrants of the abdomen and control areas (the deltoid, thumbnail, and palm) in order to understand how sensory processing functions differently in the abdomen. While administering the QST was daunting at first, it soon became routine, and I enjoyed engaging with the participants. I would also enter the data into SPSS, and it was exciting to see patterns emerge and discuss their meaning with my team.
In addition, I trained other lab teams who were interested in using our QST protocol for their own studies. I also met with other researchers whose work focused on different pain populations and was excited to see the high level of collaboration between doctors at the hospital. One of the meetings I found most interesting was with a team working on developing a new neuroimaging technology designed to assess the perception of pain.
The other major part of my internship was conducting literary research. Dr. Sieberg was beginning to work on a review article exploring the mechanisms of chronic pelvic pain. I compiled possible references for her and wrote about each one. I also researched stress paradigms for one of Dr. Sieberg’s other studies investigating the effect of stress on pain and proposed changes to the current experimental design.
Throughout my internship, I was thoroughly impressed by Boston Children’s Hospital and by Dr. Sieberg. In my initial interview with her, she told me that she values her role as a mentor to students. I would say that she lived up to that and more. Dr. Sieberg went out of her way to create as many learning opportunities for me as possible. She trusted me with a lot of responsibility, and, as one of only two interns, I got to be involved in every part of her lab. It was particularly interesting for me to see all of the work that goes into planning human subject research, such as writing grants and working with the Internal Review Board.
I know that my experience at Boston Children’s Hospital will be incredibly helpful for me going forward, both during the rest of my time at Williams and as I begin a career in psychology or neuroscience. I learned a lot of information specific to my study, such as the neural mechanisms of chronic pelvic pain. But more importantly, I will take with me many general skills and knowledge, such as how to design, conduct, and write about research. I also gained practical skills using data analysis programs and healthcare software.
My experience with Dr. Sieberg will help me decide what career path I want to pursue. Last summer, I worked in a clinical position in a residential psychiatric unit at McLean Hospital, where I counseled patients in dialectical behavior therapy. This summer, I knew that I wanted to do research so that I could get an inside look at another major track in psychology. I absolutely loved both experiences, and I feel much more informed about possible career choices as I enter my junior year at Williams.
Beyond the benefits that I personally received from this internship, I also recognize the importance of medical research. During my internship, I gained a better understanding of just how debilitating and widespread chronic pain conditions can be. More than anything, it made me realize the need for research studies like Dr. Sieberg’s that can hopefully improve the treatment and prevention of chronic pain and other serious health issues.
I would like to thank the Williams College ’68 Center for Career Exploration and the Class of 1972 for facilitating this worthwhile experience! I feel incredibly lucky to have the support of Williams and its alumni.
Megamenu Social