Alice Westerman ’21

Weill Cornell Medical Center, New York, NY

I had a wonderful time in the Research Associate Program at Weill Cornell/NewYork-Presbyterian. This program ran from 8 a.m. to 12 a.m., seven days a week, and exposed us to the varying issues that bring people to the emergency department throughout the day. We were assigned eight hours shifts throughout the week, and during the time when we were on shift our task was to screen and recruit patients in the emergency room for clinical studies. This program allowed us to have an autonomous role in the clinical setting, and allowed us to interact with patients and providers as research assistants. I am very thankful to the Alumni Sponsored Internship Program that made this internship a possibility for me this summer.

This program began a few weeks before we set foot in the emergency room. We were required to complete several trainings making us members of the clinical research team and able to participate in human subjects research. We had several course modules on recognizing conflicts of interest, on the ethics and history of informed consent, and on following protocols for clinical trials. All of this made it possible for us to contribute to academic research. These are interesting and marketable skills that prepared us for our time in the emergency department.

Our main task was to continuously screen and approach patients for consent to clinical studies. The study we spoke to the most people for was called AVAST, sponsored by the psychiatry department. The Program for Anxiety and Stress Studies recruits a wide range of people, who have suffered from a traumatic accident or injury or who have experienced symptoms of anxiety, stress, or depression. Our role as Research Associates was to track the reasons why people came to the emergency room, and if they were for a traumatic accident or injury, we could approach them for the study. I spoke with patients who had injuries as small as cat bites to as big as burns from a motorcycle accident, and was able to gain their consent for future contact and offered the opportunity to participate in a clinical trial for PTSD treatment.

Another study we worked on was called MBOSS (Mitochondrial DNA as a Biomarker of Sepsis Severity), a very different type of study that exposed us to blood sample collection and transfer. This purpose of this study is to determine if mitochondrial DNA is an accurate measure of sepsis severity and a cause hospital mortality. Our role for this study was to respond to all pages (yes, we get a pager!) and collect a sample of blood from the septic patient. It was quite fun responding to pages and transporting the samples through the hospital, while also being able to observe the extensive testing that occurs when a hospital patient is declared septic.

My favorite study we assisted on was called CODA. The CODA study is the largest and most involved study that the research associates were assisting on. According to the training for the study, appendicitis is the most common urgent surgical procedure in the United States. In over 97% of patients in the U.S. with appendicitis, they are operated on. The purpose of the CODA study is comparing the outcomes of antibiotic versus surgical intervention for the treatment of appendicitis. The study is also determining if antibiotics are as effective as surgery in eliminated appendicitis, and determining which types of patients are more likely to have positive outcomes if they only use antibiotics.

We followed all patients who came into the Emergency Room presenting with abdominal pain. Once they had been triaged at the front of the ER, they were seen by a provider, and if the patients described their pain as periumbilical (under the belly button), or in the right lower quadrant, the provider would then order a CT of the abdomen. If the appendix was diagnosed as dilated and the case was acute and uncomplicated, the patient was eligible to be screened for the study. The challenge of this study was that most people have the impression that if they have appendicitis, surgery is their only option. Our role is to introduce the idea of antibiotics, and explain that they are safe alternatives to surgery. Many people refused us for this study. But there were some people who were interested in participating in research, and we were able to consent them. In fact, I was able to deliver one person’s treatment course which was a very exciting moment.

We assisted on several more studies, from one about concussions and traumatic brain injuries sponsored by the NFL, to a study assessing what type of anesthesia promotes independence after hip fracture surgery. And when we were not approaching patients for studies, we were assisting on a larger project called the Vulnerable Elder Protection Team. When elderly patients come into the Emergency Room, and it is suspected that they are a victim of elder abuse, VEPT is activated. This is a full social work and medical provider intervention designed to identify, analyze, and remove instances of elder abuse in the community. The social workers and doctors who comprise VEPT received a large grant for the state, but they needed data from their previous patients in order to prove that their program has been successful.

This summer internship provided me with an excellent background in research and tremendously valuable practical experience in clinical research. I loved working at NewYork-Presbyterian since it is such a cutting-edge hospital and there were interesting and boundary pushing medicine being practiced all around us. And I also got the opportunity to work with three other Williams students, which was very fun. I am so very thankful to the Alumni Sponsored Internship Program and the Class of 1972 for making this internship possible this summer.