Tag Archives: STDs

A science project with a missing piece. Where are my shoes?

My sister-in-law Kayla, Sister Athletic Trainer, is an absolute genius at puzzles.

I don’t mean that Kayla likes puzzles, although I suspect she does. I mean that she is literally a puzzle genius. She can walk by a table holding a 12,000 piece puzzle entitled “sky on a cloudy day” and find at least 6 pairs of matching pieces before I can even figure out which way to orient the picture on the box.

I am not being facetious.

Maybe Kayla has just had a lot of practice. She has spent three of our last 11 week long cottage vacations doing puzzles as she recovered from major knee surgery (as good as she is at puzzles, she’s not exactly awesome at keeping her own ligaments from tearing). Maybe it’s a gift from God or something. (Drop Dead Gorgeous reference… anyone?) I don’t know. But she’s real good.

At the moment, I feel like I’m staring at a complicated and beautiful puzzle and all that I have left is one particularly challenging bush or patch of sky or something. Once I get a couple pieces in place, the whole dang thing is going to fall together, but I can’t figure out where to start and I am le frustrated! (The “le” is intentional– I’m pretending that the word frustrated is French.)

Here’s what’s up:

In my job (like my real J-O-B) I work as a scientific research writer, which basically means that I help clinicians and scientists to write grants and manuscripts (and yes, sometimes even eulogies and other speeches and such) about whatever scientific endeavor they favor at the moment. I’ve worked on tons of different things. It’s awesome, really, because as much as I dig STDs, 6 years of nothing but gonorrhea and chlamydia got to be a little bit much. I’m not that into it. In my current job, I get to learn about new and interesting things all the time– oncology, genetics, bioinformatics, cerebral palsy, Alzheimer’s disease, chronic kidney disease, pancreas divisum, diabetes, neuroprostheses, patient navigation, and the list goes on. It’s awesome… like being in school minus the grades plus a real salary. Life is good.

Because I really love science and because nerdiness is my life, not just my job, I get quite invested in the things I do. And it’s all that much easier to get sucked in when I work with really passionate investigators… and so many of these investigators, just wow. These clinicians see a problem in their practice and come to us to either study the problem or solve the problem, and it’s inspiring. I have three projects swirling around in the back of my mind all the time right now. And there’s something about them that’s similar, they are related, they are somehow the answer to one another’s problems, but I can’t figure it out. That’s my puzzle. And it’s becoming my obsession. How can I make these things work together for the good of patients? I won’t know until I can fill in the sky!

Not long ago, I worked with a pediatric nephrologist and learned about Bardet-Biedl syndrome (BBS)– a rare genetic disorder that results in cilia malfunction and many consequent symptoms affecting nearly every organ system in the body. Because the disease is so rare, finding care for these kids, especially coordinated care with specialists who truly understand the disease, has always been a major problem for BBS families. Recognizing that challenge, Dr. Haws started The Treatment Center for BBS at the Marshfield Clinic to provide coordinated, comprehensive care for patients around the country… and even around the world. It is the only BBS clinic in North America and has already served 16 individuals from 14 different families in its 3 clinics to date. I helped Dr. Haws capture survey results from providers and families that participated in the clinics and the comments from the grateful families were overwhelming. I was particularly struck by the woman who blogs here at 71toes.com (polydactyly is a common symptom of BBS and her family of 7 was no exception– how clever!) as she documented her family’s participation in the clinic. So cool!

Coordinated care for kids with special medical needs… it’s a thing that’s done well for many kids at Marshfield Clinic. But what about kids in the foster care system?

I have also spent a lot of time working closely with the medical director of the Marshfield Child Advocacy Center. She is totally committed to creating a Foster Care Medical Home (FCMH) for kids in the foster care system in Central Wisconsin. Medical homes are a really effective and interesting way to make sure that healthcare needs are met in a timely, consistent, and patient-centered manner and it’s something Marshfield Clinic has really embraced in recent years resulting in huge cost savings as well as huge reductions in the need for emergency care and hospital readmissions. We don’t have one for kids in the foster care system, though, and they likely really need it. At the moment, I’m working with Dr. Iniguez to complete an American Academy of Pediatrics planning grant for the FCMH and we just completed our third of four focus groups with foster care providers and past participants. Holy… wow! These families. I mean, I was into it before, I thought it was a great idea… now? I’m smitten! I want this to succeed, to help these families, so very, very badly! I am committed. But how? Where do we find the funding? Whose going to coordinate the care? Can it be like the BBS clinic?

And finally, behavioral health. I told you about my big fat $1.5 million HRSA grant? The one that kept me from blogging for over a week, right? What I didn’t tell you was this: due to a “misinterpretation” of the guidelines, the grant was triaged without being reviewed. WTF, right? I know, I’m furious, but trying to be cool about it… because the program is just way too important to let die now. Yes, it was a big mistake. No, I was not at fault (thank goodness, right?!). But dang, do I ever feel responsible… disappointed… dejected even. It was unpleasant news for everyone involved. And now we’re looking for another way. Another way to bring behavioral health services to patients in the primary care setting who desperately need them, but cannot get them due to the provider shortages we face in our area. How does this fit in? Well, you know who else desperately needs behavioral health services but can’t get them? Kids in the foster care system. These kids benefit tremendously from the notion of trauma-informed care… care that keeps in mind, always, that these kids have been through a really stressful, really awful situation and that those traumas subconsciously inform their every single action.

So, in conclusion, I feel like there’s something there… an invisible thread weaving its way through these projects and constantly tickling the back of my mind. It alerts me to the fact that there’s something in common, some answer that I’m overlooking, some person who needs to be contacted or informed or something. I just can’t find what that something is at the moment. I am missing a vital piece of the puzzle– I’ve got to find my special purpose! (The Jerk, yes?)


Two winters ago, my husband’s grandfather set up a card table in the living room and worked on a puzzle all winter to keep himself occupied while it was so cold. He did a bigillion piece puzzle or something and it had a lot of sky in it. Lots and lots of plain, blue pieces spread out on the table. And when he got to the very end? One was missing.

There was one piece of sky that was blank.

And it stayed blank for a while.

Until one day, Ed, my grandfather-in-law, bent down to put his shoe on and found a puzzle piece in it. It was in his shoe! Right there! All along! He snapped it in and the puzzle was complete.

I’ll find the piece. I’ll make the connection. We’ll make the foster kids a medical home and extend behavioral services to the population that needs it.

Where are my shoes?

Better yet… where is my sister-in-law???

Rach and the Dino Hat

It’s so sad for me to sit down at my computer and to log in to Under the Tapestry only to realize that all those ingenious blog posts I wrote in my head never actually made it onto the computer. Fevers’ll do that to you, I suppose. I don’t know what I had and I feel terrible for spreading it (so sorry, my darling, Michele!!) (not sorry for licking the door handle), but I’m finally feeling considerably better. With the exception of the bits of liquefied brain that are clearly trying to leak out of my head through my sinuses, I’m feeling pretty good and my grossness is significantly diminished (P < 0.05).

So onward and upword! First things first: you guys are SO freaking awesome for giving me such a positive response to my STD news. I mean… STDs, right? Ew and stuff. But you totally clapped for the clap anyway and it was awesome! Thanks for that!

But today, what I’d really like to talk about is dinosaurs.

I don’t have enough material for a real dino-focused post at the moment, but I did see a seriously sweet dinosaur hat on a little boy last week and it got me thinking…

At what age do you become “too old” to dance in and out of buildings wearing a dinosaur hat?

I passed a family headed into a building one day last week. It was a family of three. A mom and two sons– one a sullen teen or pre-teen, tall, gangly, peach-fuzz mustache, and permanent scowl. The mom looked beat. But the younger boy? He was grinning and spinning! He was dancing and flailing his arms and having a good old time on his way to the building.

He’s the one who made me light up. It was adorable!

But then I came to my question above. Because had the older boy been doing the same thing, I probably would have affixed my scowl and thought something rude about his immaturity or whatevs. Could he have done anything right? I mean, I was annoyed with him for his scowl in the face of his brother busting a move… but I’d have been annoyed if he’d busted a move himself. He couldn’t win! I was being too much a judge-y jerk!


And I thought about how that made me a total Rachel… like Rachel from Friends. And not in a good way. Rather, in the way she was in the episode where she and Phoebe go running together– Rachel taking little perfect strides, breathing in time, while Phoebe ran all arms and legs akimbo, just having fun with it.


I’m such a Rachel sometimes! (Not in the enviable hairstyle kind of way, more the stick up her backside kind of way.) It would probably suit me to loosen up a bit (I know you’ve been saying that since I was like 8, mom, I know)… perhaps to drop the -el… yes, I think it’s the -el that’s weighing me down.


More Rach! More dinosaur hats! More fun! Less judgement!


But baby steps. Because I am not ready to rock a dinosaur hat on my head any more than I’m ready to bust a move on the skywalk between the Lawton and the Laird. (Busting a move in the office hallway? Maybe… so long as I’m not doing it alone.) It is something important to think about though.

Because, clearly, there’s no doing right by me when you’re an awkward teen. The thing that should probably change? My attitude. Less -el.  More blog posts 🙂


Fun fact: I went through a brief period from approximately consciousness through about 8 or so where I hated, hated, hated anyone calling me Rach. And I would totally correct people. Now I totally love it and consider it a sign of natural and unforced intimacy. My sister calls me Rach. My big in grad school (because I sometimes pretend grad school is like a really effed-up sorority) calls me Rach. Some of my super sweet new Marshfield friends call me Rach. I just love it! Granted, I cannot fault those who have known me much longer for not as, to be fair, I would have ripped their heads off over it once upon a time. But now you know.


Not-so-fun fact: I had the same two teachers for sixth and seventh grade– Ms. Fisher and Mrs. Johnson. I adored those two and they had nicknames for everybody, probably because they were absolutely brilliant at making you feeling like you were welcome and loved in their classrooms. They used to call me “Ra-cha-cha” (got to admit, I didn’t love it) and sometimes it would get shortened to just “Cha” (better because my friend Em always called me Racha from the time we were like 2 and 3). One day in science class, we were reading from the textbook out loud in class and Mrs. Johnson was announcing the next reader by name. I heard her say “Chaaaaaa” so I started reading. Loudly. Confidently. Like the nerd I was then and am now.

And it was awkward… super, crazy awkward… because she said “Chaaaaaaad”, which is not even kind of my name, and rather, the name of the boy I’d been crushing on since the moment I’d walked into the Miss Dimitroff’s fourth grade. The horror! I remember the mortification distinctly, the desperation of my hurried explanations in a tiny voice (I thought you said Cha…?) and the extreme desire to disappear.


Fun-ny fact: Chad was not worth the crush. The more you know 😉

Clap for the Clap!

Ladies and gentlemen, the plague is upon us.

It’s upon me anyway.

I haven’t been sick in a while, I suppose I was due. But my goodness– this cold is miserable! Trying to keep a little perspective, though. Thank goodness for drugs (better living through chemistry!) and the snuggles of my sweet pup. I have a feeling I’ll be on the mend in short order and all will be well by the weekend.

It better be, anyway! Because I’ve got PLANS! Book club on Saturday night… Wes Anderson movie marathon on Sunday. I’m pumped about both– so sickness be gone!

So. Are you ready for a forced and awkward segue? Good!

Sickness… diseases… bacteria… bacterial STDs… I studied bacterial STDs in grad school…

And we’re there.

Some seriously good news on the gonorrhea/chlamydia forefront last week!! My old boss emailed to let me know that my coinfection model has been repeated. And not just once, but TWICE. Once in another strain of mice (in case you’re “in the know”… I did it originally in BALB/c mice, another graduate student just did it in C57/Bl6) and once by another group up in Boston (total burn moment for the drunk PIs who tormented me at my poster in Banff– mwuahahaahaha!!). Both repeated my entire first paper– demonstrated coinfection with gonorrhea and chlamydia in female mice (which is ridiculously and unfortunately common in female humans) and increased levels of gonorrhea in mice that are coinfected with chlamydia (which incidentally, has also been shown in women since I graduated… word).

So, all that’s good news… but the really exciting thing to me is that while I was in grad school, I found the freaking mechanism. I did flow cytometry, I made beautiful figures, I wrote a paper and planned to submit it to PNAS (it’s a big deal), but since I graduated in 2011, that lovely piece of work has sat there in my dissertation on a shelf. HOWEVER, now that others have repeated the findings from my original manuscript, my grad advisor feels comfortable getting this second one out there. YESSSSSSS!!!!!

Gonorrhea’s pretty exciting, huh? Better than whatever virus is hanging out in my sinuses at the moment, anyway.

So let’s celebrate– and CLAP for the CLAP!


(Clap = gonorrhea. But I’m sure you already knew that.)

Advent for Thirty: Joy!

I wasn’t really sure what to write about joy. But I got home from work one day last week and had a package waiting for me on the counter. It came all the way from Alaska and this is what was inside:

Treat yo self! In cross stitch! omg!!
Treat yo self! In cross stitch! omg!!

My friend Aimee (yes, that Aimee!) sent me a treat yo self cross stitch! I’m so in love with it! It’s just genius! And it brought me a ridiculous amount of joy! Such an awesome and unexpected surprise!

I sent my sister a picture right away (she was super impressed and super jealous, as anticipated) and then set about deciding where to hang it. I wanted to see it pretty much all the time and to be awake while near it… so I settled on my office. Right by my monitor.

I hung it there. It made me smile– and does so again every time I look at it. And then I realized, in my office, I’ve surrounded myself with little items that bring me joy!

Surrounded by joy... in my office!
Surrounded by joy… in my office!

You can see my treat yo self cross stitch to the left of my monitor. Above that is a line from the Mumford and Sons song Roll Away your stone about grace. The best picture ever of my niece and my puppy makes up the background of my desktop. Other family photos (including one of four generations including me, my mom, my grandma, and my great-grandma) are above. To the right is the super clever science clock my brother made me when he was in high school… apparently my sister picked up on my love of science at some point too and the stuff gonococcus (the bacteria that causes gonorrhea– do STDs bring me joy? Yeah, little bit…) on the left is from her. I’ve also got a Michigan Tech husky pup and lots and lots of pictures from the UP (also taken by Aimee). What you can’t see are all the other microbiology and squirrel jokes I’ve got tacked up, the hand drawn pictures made by another Aimie’s kids, the framed fall leaves from my grandma’s house, or the quilted pine tree with an inspirational message sewn on the back (I can’t even talk about it– it makes me cry every time) that my friend Jess’s mom made for me that hangs by the door.

(I’m suddenly noticing a severe lack of dinosaurs and Harry Potter… will have to do something about that.)

Work can, of course, be tough at times. But the environment I have created for myself is one that is jam packed with joy. And when I thought about that, the more I realized that my house is the same way. So many reminders of the things that bring me joy in my life!

Things like my family. All of it!

The whole big Vonck-Stankowski-Drengler-Krueger-Space clan!
The whole big Vonck-Stankowski-Drengler-Krueger-Space clan!

There has been no greater joy in my life thus far than the day I married Seth and got to celebrate with all of our family and friends! All in one place! So much happiness! It was perfection!

And books, so very, very many books. I love books and they are everywhere in my house.

So many books... in so many places...
So many books… in so many places…

Apparently, some things never change. When I was really little, I didn’t sleep with a stuffed animal or a blankie– I slept with a book under my arm. For me, reading books is a huge source of joy!

And of course, these two, they bring me joy every single day!

My snugglers!
My snugglers!

The way my husband and my pup snuggle just kills me– it’s the sweetest!!

And there are a million other little things that bring me joy…beautiful dishes (especially Polish pottery), when it snows so lightly that you can see each individual flake perfectly formed on your mitten or your windshield, when my puppy tries to catch leaves in her mouth, connecting with other Michigan Tech grads, tinsel, making someone else laugh, and I could go on and on of course, because the list of things that bring you joy should be a long one!

Despite my long list, there are definitely times when I simply cannot find joy… in anything. In fact, it happened most recently at the end of September– we talked about that here. Intellectually, I know that there are a lot of things that should and usually do bring me joy. But I’m not always capable of feeling it.

I am doing well right now as I approach 30. Joy comes easily and I’m feeling pretty good. But I can hear the voice of depression inside me. It’s suggesting we perhaps try to go drug-free… which at this point in my life I know is as ridiculous as a type 1 diabetic listening to their pancreas tell them that they need to go without insulin. Nice try, brain. It’s just not going to work for me.

I was trained in chemistry, then in microbiology, and now I work in medicine. I know better than to think I can outsmart my brain chemistry… and yet those insidious thoughts sneak in, hell bent on robbing me of my joy. But at 30, I’ve finally learned that I cannot let that happen– because what’s life without joy?!

Thanks to Advent for Thirty for convincing me to reflect on that! Advent for the win!!

Ripples, Spirals, and, of course, STDs

As an undergraduate, I worked as a coach in the Michigan Tech Writing Center.  It was pretty much the greatest place on earth I could possibly have worked and I’m relatively certain that I learned as much from working there as I did from every other class I took and experience I had during those four years combined.  It was a truly incredible experience, thanks in large part to the most amazing boss and leader I could every have imagined– Sylvia Matthews.  She is a quietly brilliant and beautiful woman, inside and out.  Her inability to be anything but genuine and sincere was, quite frankly, breathtaking, and I enjoyed every single moment I spent working for her.

My senior year, Sylvia took a couple of us coaches to the Midwestern Writing Center Conference in St. Cloud, MinnesOta, where the theme had something to do with water.  I can’t remember exactly what it was, but we put together a poster-style presentation where we discussed what we termed “The Ripple Effect” and shared some of the resources we had developed for working with international students in our center.

The ripple effect was essentially what it sounds like– like you drop a pebble in a pool of water and watch the waves spread out from that central point, making a change, even in yourself, will spread out from you in every direction and change the minds, hearts, and lives of those around you.  It was such a beautiful and simple idea and we really made it our mission in the Writing Center that year– to continually effect and be affected by change in others.

When I went to grad school, I moved away from writing and focused instead on infectious disease for 6 years, and interestingly, microogranisms seem to promote change in the same sort of way– primarily horizontally.  True, there are some infections that can be transmitted vertically (especially STDs!– gonorrhea? check… chlamydia? check… herpes? check… HIV? check… need I continue?), or from parent to offspring, but the most effectively spread pathogens spread horizontally from person-to-person-to-person… think the common cold, influenza, or norovirus on a cruise ship.  (Or even the primary spread of STDs– its horizontal, no matter how you look at it.  Ha!!)

And I heard the same sort of idea again when I heard Sister Miriam Therese Winter speak at the CTA conference a couple weeks ago.  She talked about ideas moving most effectively through the world in a spiraling pattern… not so much from the top down or the bottom up, but from person to person to person from the center out in a spiral pattern.

Recurring life theme?  I think so.

Sr. Miriam’s point was so beautiful.  She talked about how the divine, the Holy Spirit, the good, whatever you want to call it, is inside everything and everything is simultaneously inside the divine.  Those good things inside you can spiral outward to others, and the good things you are part of can simultaneously spiral back in to you.  Lovely, right?

It’s especially lovely when I think about how this has happened in so many ways throughout my own life.

Let’s start with the Writing Center, shall we?

I met my friend Ming in the Writing Center.  He was a brilliant mechanical engineer working toward his PhD… yet we spent most of our time talking about vegetables.  Vegetables!  Because he knew all the English words for building materials and other fancy technical terms, but he couldn’t match the produce he was seeing in the grocery store to the names on the signs above and therefore, couldn’t tell how much something cost… which was troublesome for a grad student on a budget.  So I brought in pictures of vegetables and we talked about their names, among other things.  It was so much fun!  He told people I saved him from starving to death (ha…), but he taught me a whole lot more than that.  Ming became my friend and accented English stopped bothering me in the slightest.  In addition, I dropped my prejudice against Asian accents, which was important for me… I had a preconceived notion that Asian accents were harder to understand than European accents.  How wrong I was! (Finnish was definitely the toughest for me, by far.)  And that, for me anyway, is true to this day.  Ming and I were both changed.  And I never miss the opportunity to work on understanding a new and exciting accent, foreign or otherwise.  (I live in Wiscahnsin now, dontchaknow!)

Likewise, things changed me and I like to think that I changed things in grad school.  No, I didn’t spread STDs (to any humans, anyway), but I did try to spread my thoughts about the importance of studying STDs for the sake of women’s health.  I remember sitting on the end of a dock on Clear Lake in Tomahawk one summer day with my aunt-in-law whom I barely knew at the time– we were chatting and catching some rays when she asked me about my work.  I talked (at length, of course) about gonococcal and chlamydial coinfection and my model and what it meant and blah, blah, blah and infertility blah… when she stopped me and said, “But if someone had gonorrhea and chlamydia maybe they shouldn’t be allowed to have kids– what kind of mother would they be?”  Or something along those lines… I explained that it doesn’t seem quite right for a responsible woman ready to start a family to have to continue suffering from an unfortunate mistake made at the age of 16.  Everyone makes mistakes, after all.  She liked my point, and I felt really good about making it.

And most recently, Sr. Miriam reminded me to keep it up– to keep dropping pebbles in the pond, to infect infect infect, and to send my love spiraling outward at every opportunity.

Seth helps me make waves these days!
Seth helps me make waves these days!

(Don’t worry– I left the STDs behind in Maryland…)