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Student Spotlight: Meredith Achey

Friday, April 27, 2018

Meredith Achey trained for years to be a professional classical singer. However, when she became a patient, the investigative nature of the medical world convinced her to enter medical school. Now she can often be heard singing along to Dar Williams in the lab of Nicole Calakos, MD, PhD, where she’s investigating the development of neurological and psychiatric diseases. In this week’s “Spotlight” interview, Achey talks to us about this journey, what she enjoys about medicine, lab research, and singing, and how she hopes to keep each of them in her life.

What are your current responsibilities within the Calakos lab? What other duties do you have as a medical student?
I am doing two years of research in the lab as part of my MD. This first year, I have also spent one half-day a week in a clinic of my choosing to maintain my clinical skills. I just finished a very enjoyable 22 weeks with Dr. Jeffrey Baker in his general pediatrics clinic, and I’m excited to be exploring pediatric surgery in a 12-week rotation with Dr. Lisa Tracy.

What is the scope of your medical research project? How do you hope the results will help us treat or understand movement disorders?
My research is focused on the molecular and cellular mechanisms of metabotropic glutamate receptor 5 (mGluR5) signaling as they relate to neurodevelopmental and psychiatric disease. The literature is full of reports of altered mGlur5 signaling in a variety of neurological and psychiatric diseases, from Parkinson disease to autism, and dysfunction in mGlur5 signaling has been shown by our lab to be responsible for the development of an OCD-like phenotype in mice. By enhancing understanding of the mechanisms governing the diverse pathways through which mGluR5 signals, I hope that we can suggest new targets for future therapeutic development.

How and when did you first get interested in neurology? What drew you to work in the lab of Nicole Calakos, MD, PhD?
I have been fascinated by the brain since I was a child, but my first exposure to neurology as a field came after I completed the post-baccalaureate premedical certificate program at Johns Hopkins and was hired to work with Dr. Ray Dorsey at the University of Rochester. Our work was focused on reducing disparities in access to Parkinson disease care by using telemedicine to bring movement disorders specialists to patients in their homes. I also became the Deputy Editor of the Huntington Study Group’s periodical HD Insights, through which I learned about the latest research in the Huntington disease field. I came to know the HD community a bit through my work, and the horrible tragedy of this disease really left an impression on me. I believe it is important that physicians recognize the limits of our medical knowledge, and the gap in our understanding of the biology of the brain, and how to correct it, seemed particularly clear in the case of HD.

When I came to medical school at Duke, I was excited to spend my research year learning to do bench research for the first time. Thinking like a scientist is invaluable to clinical reasoning, since both our ability to test hypotheses about our patients and our ability to evaluate the literature to offer them the best treatments depend on it. Given my interest in the techniques I was reading and writing about, I sought a mentor in the field of neurobiology. When I interviewed with Nicole, I immediately wanted to join her lab. She has incredible energy and enthusiasm for what she does, matched with an impressive intellect and dedication, that is really inspiring to me. And of course, I really enjoy the science!

What has been the most memorable experience of medical school so far? How does your real experience of medical school compare to what you thought it would be?
It is impossible for me to pinpoint one “most memorable” experience. One cliché we are told about medical school is that, “it’s like drinking from a fire hose,” given the amount of information and emotion we process on a regular basis. While there’s some truth to that, I have found that the most interesting and memorable are the moments where I have made an unexpected and deeply human connection with someone. One of my favorite examples of this kind of unexpected human connection happened when I was on a palliative medicine elective this past year. I will forever be grateful to Dr. Galanos, who encouraged me to sing for a patient with advanced dementia and his family. He had all but stopped interacting with the world and appeared asleep when we met him, but after a few bars of “Beyond the Sea,” he woke up, looked at his wife and daughter, and reached out to them for a few moments. The powerful mix of joy, sadness, confusion, and love in that room reminded me that some of the most profound reasons that I am now in medicine are the same as those that first led me to pursue a career in music.

Do you have any plans for what you’d like to do after medical school? If you could have any job in the world, what would it be?

I am planning to pursue a career devoted to the care of children. Currently, I am leaning toward caring for critically ill children and infants, but I remain open to what will surely be myriad experiences in the coming years! I think my dream job will end up involving a variety of different roles and responsibilities, from teaching, to clinical care, to research, to keeping music in my life.

Among other duties, you’re the director of the Duke Med Acapella group. How long have you enjoyed singing? Do you have a favorite genre or style of music to sing?

I actually initially planned to spend my life as a professional classical singer. I studied vocal performance at the Eastman School of Music in Rochester, NY, and began working as a private singing/piano teacher and church musician after graduation. After some vocal problems led me on a medical journey to find out why my voice wasn’t working, I realized that I really enjoyed the process of medical reasoning and decided to become a physician.

I enjoy singing multiple styles of music, but especially enjoy classical art song (particularly French and German nineteenth century song), opera, and musical theatre. I listen to a lot of folk music as well, and if you’re in the hallway outside of our tissue culture room in the evening, you just might hear me singing along to Dar Williams, Meg Hutchinson, or Deb Talan, three very talented singer-songwriters I have on my iPhone at the moment.

Singing and music making are essential to my well-being. I joined Major Groove when I first came to Duke and found a group of friends who also found making music to be a vital part of their development as physicians and as people. I was very proud to direct the group this year. This year, I also joined the cast of the 2018 student-faculty show, a medical school parody of the musical “Grease.” With regard to more classical singing, I have been privileged to sing with the Durham Medical Orchestra (formerly the Duke Medical Orchestra, DMO) in their 2015-2016 and 2017-2018 seasons, and I just recently performed with the Durham Community Concert Band for their 35th anniversary concert. Coming up, I’ll be joining the DMO for their spring concert in Baldwin auditorium on Thursday, May 3rd at 7:30PM.

What other passions or hobbies do you have outside of the Department?
In addition to singing, I enjoy playing board games and spending time with my husband, who is a lutenist and early music specialist.

Photo of Achey above by Brent Arnold.

 

Watch and listen to Achey sing along with the DMO during their 2016 Mother's Day performance.