'Why I Do So Much'

Medical student Amalia Lee learned about being a caregiver from her mom, Naomi, a pediatric nurse practitioner at Walter Reed National Military Medical Center and a Lt. Col. (ret.) in the Air Force Reserves. Following her mom's path, Amalia, who serves in the North Carolina Army National Guard, looks forward to caring for children one day.

'Why I Do So Much' click to enlarge Medical student Amalia Osborne. Photo by Max Englund, UNC Health Care.

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UNC medical student Amalia Lee serves both underserved and military communities. Photo by Max Englund, UNC Health Care.

by Zach Read - zachary.read@unchealth.unc.edu

UNC medical student Amalia Lee was in the sixth grade when her mom, Naomi, served as Medical Crew Director of a medical evacuation flight team during Operation Enduring Freedom.

“It was 2003, and Iraq hadn’t been secured yet,” remembers Naomi, a pediatric nurse practitioner at Walter Reed National Military Medical Center and a Lieutenant Colonel (now retired) in the Air Force Reserves. “So, we would fly from Germany to Baghdad, evacuate wounded soldiers, and return them to Germany.”

What the team did next depended on the critical nature of the patient. They were prepared to transport patients to Texas, if necessary, for treatment at Brooke Army Burn Center, with a stop along the way at Andrews Air Force Base. After handing patients off in Texas, they would fly to Ohio, spend the night at Wright Patterson Air Force Base, and return to Germany the next morning

“While I was serving, I’d estimate that we provided care for 640 wounded soldiers, with no in-flight deaths,” Naomi says.

Always Have a Plan

Naomi had done her best to prepare the children for her deployment. Amalia and her three siblings -- Ayanna, Jania, and Enrique -- moved from their home in Waldorf, Maryland, near Washington D.C., to live with their aunt and grandmother outside New York City. It was part of Naomi’s plan for them should she ever be deployed.

Growing up near Andrews Air Force Base (AAFB), the children were accustomed to their mom’s Reserve commitments, which were usually fulfilled in the evenings and on weekends. They even volunteered together at airshows at AAFB, supporting Naomi’s reserve unit.

“The Reserves teaches you to always have a plan,” Naomi says. “I talked a lot with the kids about my service. After I learned of my deployment, I told them I was going to take care of people who were wounded and sick and who needed to come home to their family members. They understood – as well as they could for their ages – why it was important for me to go.”

Amalia recalls trying to make sense of her mom’s experiences.

“It was difficult,” she admits, “but she did a great job of always explaining her commitment to us. We understood where she was and why she was gone. Still, at that age, you don’t fully grasp the length of a deployment, and you certainly can’t understand the circumstances she’s dealing with.”

A Better Understanding

Naomi was on leave for Thanksgiving in 2003 when she underwent a mammogram. Later that month, while in Iraq, she received a call from her doctor. The test revealed a spot that would require biopsy the next time she was home. She returned in February, had the mass biopsied, and three days later, on her birthday, she learned she had breast cancer.

Fortunately, her physician had caught it early. It could be treated and cured.

“I wanted to return to Iraq,” Naomi remembers. “I told my commander it wasn’t serious, pleaded with her to redeploy, but she grounded me.”

At home, Naomi began to feel the weight of what she had experienced overseas. She was used to creating an emotional connection with her patients at Walter Reed, who include pediatric cancer patients and children in need of sedation before procedures such as MRIs and CT scans. Because of the nature of the care she provided during Operation Enduring Freedom, she was unable to follow up with many of her patients the way she does in her civilian work.

“On a few occasions, while visiting Walter Reed between missions, I saw a patient that I’d transported,” she says. “That helped with closure. But overall I had difficulty, especially when I returned to work, because the medical knowledge I had made me more aware of the extensiveness of their injuries -- what their problems were and how intense they were. I found myself avoiding the cafeteria and the hallway leading to it because I would see so many of the injuries I cared for with our flight team. It took me a long time to get over that.”

Amalia and her siblings had finished out the school year in New York in 2004 and returned to Maryland over the summer to live with their mom. During that time, and in the years that followed, Amalia began to understand more about her mom’s experiences.

“Even though she told us she wasn’t in danger, there were times when her flights came under fire,” she says. “As time went on, I began to understand why she would sometimes cry – it was because of the difficulty of caring for injured soldiers. But I also began to think about the effect she had on lives.”

Role Model

As far back as Amalia can remember she has wanted to be a doctor. She recalls times during her childhood when a friend or classmate would fall and skin a knee or acquire some other minor injury.

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Amalia (R) has served in the North Carolina Army National Guard since graduating from high school. Her mom, Naomi (L), is Lt. Col. (ret.) in the Air Force Reserves. Naomi swore Amalia in when she joined the Guard.

“I’d be the first one there offering to evaluate it and get a Band-Aid,” she says, laughing. “My mom was the same way growing up. People say I’m her Mini-Me.”

Throughout her career at Walter Reed, Naomi has encouraged Amalia’s interest in medicine by setting up shadowing opportunities on her unit.

“I was extremely lucky to have that experience in high school and during breaks from college,” says Amalia. “Being in that environment and seeing how she felt about her patients played a big part in developing my interest in medicine.”

While alongside her mom at Walter Reed, Amalia observed the prevalence of prosthetics for injured soldiers. Seeing firsthand the ways technology and medicine can interact to better the lives of patients, she decided that she wanted to attend the biomedical engineering program at North Carolina State University.

“Even though I knew I wanted to eventually go to medical school, I didn’t want to take the traditional route of majoring in biology,” says Amalia, whose senior design project allowed her to shadow labor and delivery physicians at Rex Hospital and Wake Med. “In biomedical engineering and biochemistry, I was able to learn anatomy but also think about building devices to fix problems that exist at hospitals and in health care and to make doctors’ and nurses’ lives easier.”

She followed a similar path to Naomi outside of medicine. Upon graduating from high school, she joined the North Carolina Army National Guard, and while at NC State, she became part of ROTC.

“At first, I joined the Guard to help with the costs of school,” she admits. “But when I went to basic training and learned more about the army and all it encompasses, I fell in love with it. My initial reasons for becoming part of it have evolved and today the values are deeply ingrained in me.”

Once a month as an undergraduate, Amalia performed her Guard duty by spending a weekend at the North Carolina Army National Guard’s Camp Butner Training Center, where she did periodic health assessments (PHAs) for soldiers preparing for or returning from deployment. PHAs include checking vision, hearing, blood pressure, cholesterol for older soldiers, and other important medical evaluations.

“Before soldiers are handed off to their units, they needed to have these medical tests done,” says Amalia, whose Guard commitment also required two weeks of her time each summer. “For me, it was a way to combine my interests in medicine with duty to the Guard.”

On campus at NC State, meanwhile, Amalia’s role in ROTC expanded during her four years. The commitment, she acknowledges, was a challenge. But ROTC taught her how to manage her time. Every day, Monday through Friday, she woke up at 5 a.m. for physical training. She developed leadership and organizational skills, and eventually, as a senior, became battalion commander, overseeing 150 other ROTC students. Through a national ranking system of 4,900 ROTC members, she came in ninth in the United States. The experience, she says, made her a more confident person.

“After commanding a battalion, what do I need to do next?”

'Why I Do So Much'

When she interviewed at the UNC School of Medicine she immediately knew it was the place for her.

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By her senior year at NC State, Amalia had become battalion commander of her ROTC unit. She ranked ninth out of 4,900 ROTC members nationally.

“I had this feeling,” she says. “It felt so family-oriented, the faculty seemed to be invested in me before I’d even enrolled, and there was genuine faculty interest and participation in community outreach efforts. It felt like home.”

Since beginning her career at UNC in 2014, Amalia has been involved in a variety of activities and outreach efforts. She is co-president of a pediatric interest group for students; an advocate for Dimock College, one of the School of Medicine’s four advisory colleges for career and professional development for students; a member of the Bloomer Hill Free Clinic, a student- and community-led clinic for underserved rural populations in Whitaker, North Carolina; and an officer in UNC’s chapter of the Student National Medical Association, through which she leads outreach efforts for minority and underserved children. These activities have enriched her experience and expanded how she views her role as a future physician.

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She managed to complete two majors at NC State -- biomedical engineering and biochemistry -- serve in the Guard, be ROTC, and get into medical school at UNC.

“I came from suburban Washington, D.C., and being able to be a part of rural programs like the Bloomer Hill Free Clinic has helped me develop my relationship with patients and understand the challenges many patients face at home, away from the clinic,” she says. “Additionally, being able to give back through minority outreach programs has helped me understand the importance of reaching out to children about their health and education early in their lives. These experiences will make me a more well-rounded physician.”

Today, with all her educational responsibilities, the Guard doesn’t expect two weeks per year out of Amalia while she’s in school. Instead, they are invested in her becoming a doctor, and they value the contributions she can make to the Guard in the future, after she completes her medical education.

One weekend per month, Amalia continues to give back to the Guard. She wakes up before dawn on a Saturday and Sunday, puts on her military uniform, and drives one of the days to Statesville and the other to Raleigh.

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At UNC, Amalia has found a home -- a place where she can pursue her dream of providing care for patients, serve in the Guard, and participate in community outreach to help those in need. "Here, they take care of the overall person," she says. Photo by Max Englund, UNC Health Care.

“After my experience at NC State traveling to Butner to perform PHAs for Active Duty, Guard, and Reserve, a physician assistant and fellow Guard member and I decided that we should make it easier for soldiers to receive the assessments,” she says, noting how cumbersome it was for the military and the soldiers to have only one location to administer and receive PHAs. “So, we developed a program in which we travel to Statesville or Raleigh once a month and the soldiers who live in that area and require a PHA come to the facility, at which point we provide it for them.”

These new mobile PHAs, as she refers to them, have experienced growth since the program was launched. Today, Amalia is joined by a physician, a third-year medical student from ECU, and recently three first-year students from Campbell University’s D.O. school. She is now Officer in Charge of the mobile PHAs.

“When it was just the third-year medical student and me, I did a lot of the physical exams,” she says. “But now that the program has expanded to include three first-year D.O. students, I’m doing more teaching, showing them what to do. Although the travel can be challenging and the days long, it has provided me a deeper understanding and further developed leadership skills.”

At UNC, meanwhile, despite the rigors of medical education, Amalia has found a culture supportive of her commitment.

“I have friends who have continued their military careers who receive less than optimal support from their institutions or employers,” she says. “Here, they take care of the overall person. There aren’t many places that care about you and everything you want to do in addition to being a doctor.”

As Amalia prepares for her clinical year, which she thinks will ultimately lead her to pediatrics like her mom, she reflects on how her military and educational experiences will guide her through the rest of her education and inform the doctor she plans to be.

“I’ve been on this path since I was a girl,” she says. “Through UNC, I’ve been able to go to communities and see people who look like me struggling. That makes me strive for change by contributing more than providing care, perhaps by offering education to parents and children….It’s very humbling to be here. A lot of people would love to be where I am and I’ll never take anything for granted. That’s why I do so much.” 

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