Julia Spiegel (Lee Pellegrini)

With medical school in her sights post-graduation, Morrissey College of Arts and Sciences rising senior Julia Spiegel—a neuroscience major and Hispanic Studies minor—is gaining invaluable experience this summer as a research assistant at Boston's world-renowned Brigham and Women’s Hospital. Through an internship, facilitated by a Boston College Advanced Study Grant, Spiegel is analyzing hospital data on ovarian cancer looking for trends in race, ethnicity, and socioeconomic status. In particular, she uses her Spanish language skills to study data related to Hispanic cancer patients—seeking to determine if, as she hypothesizes, cultural and linguistic factors are at least partially responsible for Latinas being 20 percent more likely to die of gynecological cancers than other population groups.

Interviewed in July, midway through her internship, Spiegel described her experience as “busy but rewarding.” The New York City native discussed how her BC studies led to this opportunity; outlined her project focus, the impact of the COVID-19 pandemic, and the importance of addressing health care inequities; and talked about the potential applications of her research. Spiegel’s work will not only advance her professional formation, but also will benefit the research team in the hospital’s Gynecologic Oncology Division.

Talk about the opportunity afforded you by the BC Advanced Study Grant. How did you determine your area of focus, and what are the potential health care applications for your research findings?

Earlier this year, my Hispanic Studies professor, Elizabeth Rhodes, nominated me to apply for an Advanced Study Grant. I was incredibly honored and grateful, but also overwhelmed by the prospect of proposing a project of my own making. At the same time, I had committed to a pre-med summer internship working as a research assistant at Brigham and Women’s Hospital, investigating ovarian cancer. This prompted me to identify a bridge between my two passions of medicine and Hispanic Studies, and expand upon my internship work through a Hispanic Studies lens.

After doing independent research, I found that there are countless unaddressed health disparities when it comes to gynecologic malignancies like ovarian cancer between Latina and non-Latina woman. This was shocking to me, considering that Hispanics are the largest and most rapidly growing ethnic minority group in the United States. This led to my hypothesis that these under-researched discrepancies are due to an interplay of factors including economic class, cultural dynamics, language barriers, level of health literacy, as well as such influences as environmental racism. I knew I could not address all of these over the course of one summer, and decided to focus my efforts on how language barriers impact the incidence and outcome of ovarian cancer in the Hispanic population. If I am able to prove my hypothesis, the ultimate goal is that it would spark the development of a culturally sensitive communication initiative between patient and provider, based on the specific preferences and needs of the Latino community. If these communication initiatives prove to be successful, this research could help to provide a model for tackling other barriers, illnesses, and other minority groups.

How do cultural and linguistic factors impact the Hispanic cancer patients you're studying? Is the pandemic factored into their health care, and if so, how?

The basic obstacle facing Spanish-speaking Latino Americans—aside from the issue of lack of access to health care—is that they usually do not speak the same language as their provider. Even with an interpreter, patients are often unable to gain a full understanding of their diagnoses or do not feel comfortable asking necessary clarifying questions. If this level of discomfort is associated with the most basic patient-provider interactions, how are Hispanic women expected to receive the preventative care required for ovarian and breast cancer? This was the main question that inspired me to pursue this research project. Not only is the language barrier detrimental to the patient’s experience and quality of care, but the use of interpreters is both expensive and time consuming for providers, which deters their use by health care professionals. It’s clear that the current system leaves both patient and provider unsatisfied, so my hope is to create an initiative that is desirable and convenient for all parties.

The COVID-19 pandemic has magnified these health care inequities and the social, cultural, and economic factors that contribute to them. Statistics show that minority populations, specifically Blacks and Latinos, have been disproportionally affected by the pandemic and are at increased risk for COVID-related deaths and other resulting illnesses. Perhaps one positive thing to come out of the pandemic is that it has raised awareness of the inequities in our health care system—and served as a catalyst for addressing them. My research project is important and timely, and I feel fortunate to have the opportunity to contribute in some small way.

What kind of activity does the internship entail?

The majority of my work is done remotely, but I go to Brigham and Women’s Hospital’s campus once a week to meet with the lab team. My role is to analyze and annotate patients’ medical records, identifying a specific set of variables including demographic information, personal gynecologic histories, family histories, genetic testing, and more. The aggregate data produced from my annotations will reveal any trends in the presentation of ovarian cancer or related conditions across various races, ethnicities, and age groups. I have access to all of the resources that any other BWH staff would have, so I have the privilege to attend virtual lectures, panels, and presentations through the hospital, and Harvard Medical School, as my schedule permits. This is all resulting in an extremely busy but rewarding summer.

What have you found most interesting, and challenging, about the internship?

In searching for a specific list of variables, I sift through a patient’s entire medical history, leading me to discover and learn a wide variety of terms across many fields. This has been both interesting and challenging because, as an undergraduate student, I have had limited exposure to the terms and medical jargon in these records. I am constantly stumbling across new diseases or conditions that I have never heard about, which I find incredibly interesting as it allows me to get a glimpse into other medical specialties outside of obstetrics and gynecology. At the same time, it can be challenging to consume all of this new information while remaining focused on my important job at hand.

I am really enjoying and benefitting from getting a true behind-the-scenes look into many aspects of the medical field, which is really important as I consider medical school and what lies ahead for me.

How have your studies at BC prepared you for this internship—and how will this experience enhance your studies moving forward?

As with any internship, one of the most valuable aspects is gaining experience that cannot be replicated within the classroom, but my BC studies led to these amazing opportunities. I think my research project is a good proof point of the benefit of BC’s education because it allows exploration of various disciplines and encourages students to connect the dots where possible, as I have done with my two areas of study. It also reinforces our Jesuit mission of being men and women for others: always looking for ways to make the world a better place, especially for those in the most need.

Gaining this experience through my internship has been absolutely crucial in confirming what I already knew: that I want to pursue a career in medicine. In terms of my future at BC, this experience has reinforced my passion for the medical field and reinvigorated me as I move into my senior year and think about applying to medical schools.

Your internship combines elements of both your major in neuroscience and your minor in Hispanic Studies. During your undergraduate years, have you found these areas of study to be complementary in other ways?

While my two areas of studies might not hold an obvious connection, my work as a Hispanic Studies minor has added an interesting dimension to my pre-medical studies and my future career in medicine. It can be easy to lose sight of the end goal when on the pre-medical track, but I think being a Hispanic Studies minor gives me a unique perspective and allows me to stay connected to the reasons I chose this field of study and career path—to ultimately help people. I believe being a bilingual health care professional can add tremendous value in many ways, not least of which may be improving quality of care for underserved communities.

Who have been your most influential mentors at BC, and why?

My most influential mentor at BC thus far has been one of my Hispanic Studies professors, Elizabeth Rhodes. What makes Professor Rhodes stand out to me is that she takes time out of her curriculum to connect the dots for her students between our academic work and its broader impact—specifically what is happening in the world and why what we are doing is crucial to making it a better place. For example, this year I took her course “Borderlines: Films of Immigration and Exile,” where we spent time learning about the immigration crisis, an extremely relevant and timely issue affecting our country and our borders in critical ways.

Professor Rhodes also nominated me for this grant, for which I am extremely grateful. I would not have the global perspective or empathy for these underserved populations that inspired me to pursue this project if I had not had her as a professor.

What's next for you after BC?

My professional goals are to go to medical school and pursue a career in medicine. I plan on taking a year post-grad to continue my research and fine-tune my areas of interest in this broad field, of which I have no doubt Hispanic Studies will play a part.

Rosanne Pellegrini | University Communications | August 2021