A moment with Dr Bhavya Allena (Class of 2020)| MEDICUS 2023 Issue 4

Rekindling my passion for research
By Dr Bhavya Allena (Class of 2020), Medical Officer, Ministry of Health Holdings

For as long as I can remember, I’ve been fascinated by the human body, so when as an undergraduate of the UNC-NUS Joint Degree Programme in Life Sciences, I had two opportunities to investigate the molecular workings of the human body, I was truly excited. My first project, I spent in Dr Susan Henning’s lab at UNC-Chapel Hill, where I learnt the basics of lab work and how to conduct research while studying molecular factors and signals that influence the behaviour and regulation of quiescent and active intestinal stem cells. And most of all, it was where I found my love for doing research. However, my passion for research dissipated after a traumatic experience during my undergraduate honours thesis research. Additionally, as much as I enjoyed doing basic science research, I always wondered how I could bring my research into clinical practice.

So, when I had to find my third-year research project at Duke-NUS, I immediately thought about going back to the US. And the major driving force was to rekindle my passion for research. What better way than going back to where you found your passion in the first place?

I had kept in touch with the Susan since my Chapel Hill days, and she put me in touch Dr Katherine Garman, a clinician-scientist at Duke University who was researching Barrett’s oesophagus. I was intrigued to work in the Garman Lab as it offered an opportunity to explore the world of translational research, see how research and clinical work can work in tandem and because of their focus on oesophageal cancer.

There are two main types of esophageal cancer, squamous cell carcinoma and adenocarcinoma. While Barrett’s oesophagus and adenocarcinomas are more prevalent in the West, squamous cell carcinomas are more prevalent in Asia. However, the incidence of Barrett’s oesophagus and oesophageal adenocarcinoma has been gradually rising in Asia. Motivated by this rising trend, I became passionate about discovering the molecular mechanisms driving Barrett’s oesophagus. If this was not enticing enough, the icing on the cake was that Richard, my old colleague from the Henning Lab, was now part of the Garman Lab. Richard and the team were like a second family, so it was also a comfortable choice. And thanks to a Duke-NUS scholarship, I could seriously explore this.

Natalia, Sneha, I and Sabina in front of the Duke-Chapel // Credit: Bhavya Allena

Natalia, Sneha, I and Sabina in front of the Duke-Chapel // Credit: Bhavya Allena

There were four of us from Duke-NUS who went to Durham that September. Sneha and I, Sabina and Natalia, and we figured everything out together, from house hunting to furniture shopping to finding the nearest bank. I still remember sometime during our first week, we googled the on-campus bank. It was a sweltering day but the bank looked 10, maybe 15 minutes’ walk away, so we thought we could easily walk it. We ended up getting lost and did a tour of a good chunk of the campus. By the time we found the bank, we were completely drenched. But it is one of my fondest memories.

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And I loved being back in the lab. I spent a lot of time growing porcine Oesophageal submucosal glands in our 3D in vitro model and exposing them to various conditions, so we could determine how molecular mechanisms (specifically the TGF-b pathway) leads to the pathogenesis of Barrett’s Oesophagus and from there to oesophageal adenocarcinoma. I had to do a lot of troubleshooting during the initial few months. By December, I was rushing for some results to come through so that I could submit an abstract to Digestive Disease Week, the major gastrointestinal (GI) conference. I ended up submitting my abstract on deadline day, thinking, if I’m lucky, I’ll get a poster presentation. But I was invited to talk as a speaker within the distinguished abstract plenary session. I was ecstatic and really, really happy. My two lab mates got a poster presentation, so it was huge for the lab and all of us.

Brainstorming/designing experiments

Brainstorming/designing experiments // Credit: Bhavya Allena

At Digestive Disease Week // Credit: Bhavya Allena

At Digestive Disease Week // Credit: Bhavya Allena

Aside from the lab work, I learnt a lot during the clinical teachings that took place every Wednesday morning when the entire Duke GI team would meet. My mentor, too, would take me to meet patients, talk to them and see how medicine is practised in the US.

No one big thing made my time at Duke special, rather it is a collection of small, everyday moments, like joining some of the on-campus activities that we as Duke-NUS students were also entitled to, or being exposed to US culture by my lab team—whether it was a chilli night, Thanksgiving traditions or going to see a basketball game, they would teach me everything.

Pie night with Natalia, Sneha, Sabina (centre) and friends and relatives of Natalia and Sabina

Sabina, Natalia, Sneha and I would also have our own meetups. We had a Thai night because none of us quite liked what the restaurants offered. We organised a pie night where we all made different pies to get the “American” experience. We celebrated most of our birthdays together. But most often we’d meet in the corridor or at the vending machine downstairs in our apartment block, which had the best hot chocolate.

My time at Duke, in many ways, was eye-opening, in the sense that it taught me that there’s no one way of doing things. You can take an indirect route, and sometimes, taking the long route means you bump into things, or you have a lot of like serendipitous moments that you will treasure, but that also shape who you are.

The Garman Lab celebrating Omar’s (my lab colleague) Wedding (centre, chequered shirt with his wife to the right of him). Susan (seated cente) and her husband (seated left) joined us too! Richard is sitting on the far right // Credit: Bhavya Allena

By working alongside people from different walks of life, I learnt to take a step back and place myself in their shoes. That made me more patient, flexible, understanding and empathetic, which I think is at the heart of medicine. In my current posting to home hospice care provider HCA Hospice, for example, a significant part of my job is managing the anxieties and expectations of patients and their family members. Having had that exposure to dealing with so many different people coming from all walks of life, who experienced all kinds of difficulties, really helps me now because sometimes all they need is a good listening ear and feeling supported.

Looking back at my time at Duke, I loved the experience, even when things were not going so well, when I wasn’t getting the results that I wanted or my cells were not growing. I still loved the whole journey of troubleshooting and trying to figure out what was going on. You’re just being a detective, reading up on papers, coming up with hypotheses and designing experiments. That thrill of just trying to figure it out, putting all the pieces together and the excitement of finding an answer is incomparable. It is what drives me to practise medicine and continue to do research in the future

And now, that I am going through my rotations, I still keep up with research by teaching or participating in journal clubs on posting-related research. Once I’ve picked my residency, I’m hoping to make my research a bit more clinical, so that I can see the effect it has on patients. I want my patients to inspire my next research question.

As told to Nicole Lim, Senior editor.