Interview by M. Paige Plumley and Jace C. Bradshaw
Dr. Gina Drobena is an Associate Professor in the Department of Pathology. An Arkansas native, she is board certified in clinical pathology, transfusion medicine, and lifestyle medicine.
What brought you to the field of medicine?
I think my family realized I was bright at a young age. They always told me, “You’re smart enough to be a doctor.” My family held doctors in really high esteem, and because of that, I always thought I might be a doctor. When I got to college and started looking at things more, I was unsure if I wanted to be a human doctor or go to veterinary school. I was actually planning on applying for both—this was sort of like a trial run because it was my junior year. I ended up getting my application to medical school submitted on time but not my application for veterinary school, and UAMS accepted me.
During medical school, what brought you to pathology?
Probably my anxiety. I was afraid of hurting someone; I did not want to harm a patient. I realized that pathologists got to read about the diagnosis, think through the process, and get others’ opinions. That really appealed to me. I knew I did not want to make the minute-by-minute life-changing decisions that I saw in other places like the emergency department. The adrenaline rush is not my game.
During medical school and residency, what struggles did you have, if any?
I struggled. I feel it is important to be honest here: I struggled with anxiety and depression from a young age. I saw my first mental health professional in first grade; I was started on medication as a teenager. I have had more therapists than I can remember. It has been a lifelong struggle for me that was especially bad during medical school and residency. The intensity was so high. I don’t think I would have made it through without the student mental health section at UAMS. They are a big reason I was able to finish medical school.
During my training, [my mantra] was “fake it till you make it.” Over time, it has transitioned to “if you are with your people, you do not have to fake it.” Find your people; find your place. When you have done that, you will know—you don’t have to fake it anymore. As you go into your career, be patient because it might not be the first place you work or the first people you befriend. It takes time to know what really matters.
What advice would you give to medical trainees struggling with mental health issues or the motivation to finish their training?
Talk to people. Find people who are willing to help you, hear your struggles, and advise you. I think we have a fabulous framework for people who are struggling here at UAMS not just for students but for residents and faculty as well. I still use the mental health professionals available on campus; I have been thrilled with the care I have received. I think it is very noble to care for your peers and make sure that they are able to function at their highest level. I would always encourage students, residents, and faculty to reach out whenever they need it. I think one of the things that has helped me over the long term is not ever needing to be hospitalized or needing an escalation of care. Over the years, I have gained the insight to know when I need to reach out to someone. If you don’t have that self-awareness, listen to those around you—they’ll tell you.
Did you develop any role models in the field, especially ones who displayed this kind of vulnerability?
I think that came later for me. During medical school, I was able to go back to my family doctor in Malvern, AR, and do rotations there. I felt encouraged by him, but I didn’t have any real role models. I had family members in healthcare, but none were doctors. My mom actually went back to nursing school when I was a teenager, so I had some exposure to healthcare, but I didn’t really know many doctors.
Can you share how you became interested in culinary medicine and what that has taught you?
That journey is an interesting one. I have always been interested in food, especially food as medicine. I remember telling my mom during medical school that I wish people would pay me to clean out their pantries and get them on track for a healthier diet. Of course, that was usually at the times that I was considering quitting medical school.
During medical school, I would get sick a lot. I would have a cough that would progress to pneumonia or bronchitis. I finally got sick of it. I started reading about common causes of inflammation, and I came across dietary causes in the medical literature. After reading more, I decided to go on a plant-based diet. I cut out meat, dairy, sugar, and alcohol. Shockingly, I felt a lot better. I stopped getting pneumonia and my eczema disappeared.
In 2018, the chancellor of UAMS purchased the culinary medicine curriculum from Tulane. I had just taken the board exam for lifestyle medicine and was trying to find a way to transition from pathology into lifestyle medicine. I immediately volunteered for the culinary medicine program and co-chaired the curriculum committee. I now teach a senior elective in culinary medicine; it is the highlight of my week. It feels refreshing to teach medical students. I give as many CME talks as I am invited to give because it is important to discuss culinary medicine and its impact on Arkansans.
Now I am trying to move the lifestyle medicine parts forward on campus. We are starting an interest group, and I am in the middle of writing a grant to start more interprofessional simulations. Hopefully, we will develop a track so that interested people can participate.
For specialties that might have reduced contact with patients, what is a way to incorporate a couple of small things from what you have learned about lifestyle medicine or culinary medicine into their practices?
One of the easiest things you can do is incorporate some of the screening tools into your encounters. In emergency medicine, screening for food insecurity would be great. It is going to have short– and long–term consequences for your patients’ wellness. If you do this, you will be able to refer these patients to an on-campus or local food bank. Patients also present because they are out of insulin or other medicines. It is important not just to treat these patients but get them in contact with the resources they need. Finally, you should always consider counseling patients who smoke. Just because you are in a setting where your patient follow-up is limited does not mean that you can’t refer these patients to smoking cessation programs.
A lot is going on in the world right now. What advice do you have for medical trainees on incorporating events and problems happening in the world into their patient care?
I think doing a sincere check in with your patient. Not just going through a checklist, but using the relationships you have with your patients to ask how they really are. Try to connect with them on a deeper level because this can have an impact beyond just refilling medication but caring for the whole person. When you have back-to-back 15-minute visits all day, it can be easy to lose sight of that person you are caring for. Also, make sure that you are taking good enough care of yourself so that you can take care of others at this deeper level.
Advocate for the changes that need to happen within medicine. This advice isn’t always feasible, and we need to advocate for a system that allows it. Get involved in things that are on a larger scale. I am a member of the Arkansas Medical Society. Being able to have a way to advocate for my fellow Arkansans is meaningful for me. Some of these changes might not happen on a local level; you might have to go to the state or national levels. It might not be a policy problem at all, so you might have to consider the billing and reimbursement side. Taking part in this process allows you to have a voice and gives you the feeling that these things aren’t just happening to you.