Profile with Jessica Mellinger

Jessica Mellinger (Wyoming & Trinity 2000) is completing her final year as a gastroenterology fellow at the University of Michigan. Before starting the fellowship, Jessica received her MD from Northwestern University at the Feinberg School of Medicine. She holds an MPhil in Medieval English Literature and a Master’s in the History of Medicine from the University of Oxford as well as a BSc in Molecular Biology and English from the University of Wyoming.

Rhodes Project: Where did you grow up?

Jessica Mellinger: I was born and raised in Sheridan, Wyoming. I grew up and went to high school there. I left Sheridan for college in Laramie, Wyoming, so I basically spent the first 22 years of my life in Wyoming before I went to Oxford. Oxford seemed small to some of the people who were coming from Chicago or New York, but I never understood how they were so bored. I thought it was so big and very eccentric! I didn't know what to expect.

Rhodes Project: What is one of your hobbies and what do you like about it?

Jessica Mellinger: I like to do pottery. I haven't been able to do this as much lately, but in residency I started working with clay and throwing clay pots on the wheel. It's just relaxing. My job is pretty intellectual so it’s nice to have a hobby that allows me to do something creative and with my hands. I enjoy that a lot.

Rhodes Project: When did you first become passionate about hepatology?

Jessica Mellinger: During my intern year of residency. It can sometimes be difficult to know what you want to do in medicine and what direction you want to go in. Figuring out what you are going to fit into is a very maturing and growing process. One of my mentors had told me to pay attention to what I was drawn to and what kinds of cases I found exciting. We had a gastroenterology service at my residency program that only admitted patients with GI or liver illnesses. While I was on the GI service, there was a patient who had liver failure and had been on the waiting list for a long time. When I was on, we got the word that there was a liver coming for her. My attending let me be the one to tell her that she had a liver on the way. Watching her face as we told her - she was just so excited. It was a very formative experience that I will always remember.

That moment sticks out in my mind as one of those crossroad moments where I knew which way I was going. It’s when I knew I was not going to be a rural pediatrician. When I entered medical school I had intended to move back to Wyoming and do what I had seen my pediatricians do, which is part of what inspired me to go into medicine in the first place. But as usual, if you are open to new experiences, you find out what you are really supposed to be doing. What I do now is basically the opposite of rural primary care. I'll be doing very technical work that can only be done at a major hospital in a big city. It combines the biopsychosocial and ethical aspects of medicine all into one, which really suits me perfectly.     

Rhodes Project: What is the most rewarding part of your job?

Jessica Mellinger: I like working with the patients mostly – if you don't like people or patients, you shouldn't be in medicine. Aside from that, the best part is that my job combines so many of the different aspects of medicine that I really enjoy. It combines working with people with being in science and problem solving. Patients with liver disease are some of the sickest patients in the hospital so it requires a lot of thought to take care of them. Then you also get to have long term relationships with them. You get to see them before and after their liver transplant. I already have some long-term relationships from my fellows clinic. They aren't necessarily liver patients, but they are patients with other GI illnesses. I really value seeing patients again and again, seeing how their lives go and being there to help them. I find the whole process very rewarding.

Rhodes Project: What is the most challenging part of your job?

Jessica Mellinger: I think oftentimes, the emotional aspect of it can be very difficult. Particularly when something happens acutely at night and somebody's life is in danger it is very emotionally challenging to be the person who explains what happened to a patient or their family. I sometimes have to tell a patient that we don't have anything else to offer and that they are facing their own mortality. The hope that was there before, of walking out of the hospital, really is not there anymore. It can get even more difficult if you have multiple rounds of it over the course of a couple of bad weeks. You may have a period of time when your role is to help shepherd people through the process of dying. That's very difficult and tragic. Sometimes transplant patients get so sick so fast that, suddenly, they are no longer a transplant candidate. Within 24 hours they can go from being hopeful of getting a liver to being told by our team that we don't have anything else to offer. It's very hard to have to tell people that their loved one is now too sick for a transplant.

Rhodes Project: What advice would you offer to a young woman interested in pursuing a career in medicine?

Jessica Mellinger: I would say it’s a great field. If you know yourself and really feel like you want to do it, then get some experience with people. Find other physicians to shadow – male or female – and talk to them. It’s very different from “Gray's Anatomy” or other doctor shows on TV! It’s also a very long road, I'm 35 and I still have two years left of training. I've taken a little bit longer route because I went through the Rhodes program, but it is important to realize that it is a lot of training and hard work. Overall though, I think it’s a fabulous career. Even with all the policy changes and changes in healthcare in the US, it's still so rewarding. For someone who wants to work with people and in science, who wants to really have an impact on peoples' lives at the individual level, I don't think there's a better career they could go for.

Rhodes Project: Can you tell me about a favorite past research project?

Jessica Mellinger:  One subject I feel very passionate about – this is coming from a rural area myself – is access to healthcare for people in rural areas. We just don't have the doctors, particularly in the GI and hepatology field. There are a lot of people who need our services on a variety of different levels and it can be very difficult for them to get to a GI doctor or hepatologist when they need one. Part of what I've been working on, which is still in its fledgling state, is looking at innovative ways to extend our knowledge and expertise out to people who need it. We are getting some really interesting things done with distance learning and knowledge networks. We are also working on developing electronic based referrals, where you communicate electronically with referring physicians. It's interesting to look at access issues for patients with liver disease and how we can think more creatively about ways to help them so that they might not have to travel 200 miles to see us. I might be able to talk to a patient’s primary care doctor, hear about the case and give them some input from our experience here at an academic health center so they can try to help their patient where they are.

Even in big cities, access to healthcare is often hampered. People are not able to get in to see the best doctors because they don’t have insurance or the money. A lot of access issues differ depending on where you are. In rural areas there is a lot of poverty, so there are insurance and money issues there, but a lot of it is geographical. Where I grew up, it was six hours south to the nearest major academic health center in Denver. If you had a problem that was severe enough, you had to travel back and forth. We all have stories like that - of driving hours to get to a doctor or being able to tell how sick somebody is based upon what hospital they were in.

Rhodes Project: If you had unlimited resources to address any issue, local or global, what would it be?

Jessica Mellinger: Because transplants are so close to my heart, it would probably be unlimited resources for the development of new transplant technologies. They are doing some interesting new work in adult stem-cell research in terms of growing new tissue. It's very futuristic, but if I had unlimited resources it would be great to be able to fund that and hopefully come up with ways to create organs in the lab so we wouldn’t have to simply wait for other people to pass away to get them.  

Rhodes Project: Can you recall a memorable experience while you were at Oxford?

I think the most memorable part of Oxford was my Rhodes class and the people I met there. I still keep in touch with some of them. The whole experience of being part of that community and being in Oxford itself was very eye-opening. I could study whatever I wanted and there was all of this knowledge available to me. Probably the biggest thing that stood out was that I really felt there was a group of people who were like me. They were very concerned about what was going on in the world. Everybody had their individual area of interest - international relations, law, social policy, medicine, literature – but they were also so engaged with other things that were going on around them. I had the most wonderful conversations with people about various different topics and got all these fantastic perspectives. Rhodes obviously selects for people who care very deeply about the world, but it still made a big impression upon me. I felt like they were all genuinely concerned about fighting the world’s fight and doing it in their own unique and creative way. I’m still impressed by my classmates and what they are doing. It was just a real honor to be included in that group.

Rhodes Project: What inspires you and why?

Jessica Mellinger: My faith is probably my biggest inspiration. It has recently become even more important to me. It has been a real touchstone in my life that keeps me grounded and focused on what’s important. Part of my faith is a belief in service and working to be less selfish by focusing on what you can do for other people – especially the people immediately around you. I think oftentimes we can fall into this belief that a difference we make only counts if it is big, if it gets acclaimed and noticed. But I start to see more and more – and I think this is a direct result of my faith – that the real differences we make are often the ones that are unheralded and that nobody may see or give you an award for. They are the individual micro-differences that we make in each other’s lives on a day-to-day basis. My life becomes so much more full and meaningful when I can remember that. Keeping that connection with my faith and with God allows me to take the focus off of myself and what I want, and direct it toward how I can be of service. How can I help my patients, how can I help my family and how can I be there for other people?

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