Transcript

Chanel: You can use it for, eyeballs to testicles, I mean, you can use it for, for eyes, for thyroid, for breast imaging, obviously, for skin and soft tissue, for musculoskeletal bones, ligaments, tendons, obviously anything in the abdomen, transvaginally too.

It’s funny cause I do put the probes on patients and the joke I'll often hear is, oh, do you see a baby in there? that's what we're traditionally used to. but I use it all the time for many, many different aspects, not just for obstetrics.

John: Welcome to Human Science, a podcast exploring the human element behind the science that shapes our everyday lives. We're powered by Labfront, the go to tool trusted by researchers looking to automate their studies and transform real world data into health insights. I'm your host, John Drummond, and today we're joined by Dr. Chanel Fischetti, who will discuss her role in integrating AI into medical practice, her experiences across different cultures, and the impact of mentorship on her career. We'll also delve into how she balances her personal and professional life, inspired by her mantra, Remember Why You Started. So everyone, please welcome Dr. Chanel Fischetti. What's up, Chanel?

Chanel: Hey, thanks for having me.

John: Well, hey, thank you so much for joining us today on Human Science.

I'm really excited to dive into all sorts of different topics and just kind of see where our curiosity goes, but I was hoping maybe we could begin a bit with a high level backstory I think you started with your undergrad in neuroscience and psychology, but you've really transitioned more into medicine and now focusing on AI.

So at a high level, 10, 000 feet. Do you mind giving us a little bit of that early journey?

Chanel: You know, I think a lot of my journey was, is probably dictated through both just great mentors and, and also just curiosity. And then probably a third of it is just serendipity, like just happening to be in the right place at the right time with the right people.

I mean, I had always wanted to be a doctor. I had known that, from the age of 10. And in college, I, I ended up choosing neuroscience and sociology because they overlapped enough that I could double major.

I found the sociology and like, just like the science of people and, behavior patterns, very interesting. and then I I graduated early from college. I took another year off before applying. And then in med school is where I really met one of my, I mean, he's still my mentor, my lifelong mentor.

And, he really helped both attract me into, the field that I am in now, which is point of care ultrasound, but also, it was just the way he lived his life. Um, he seemed to have a really good work life balance, and so the people I tended to gravitate towards are the people whose lives I really, like, loved or looked up to, both from a personal or professional standpoint, ended up being in emergency medicine.

I, of course, like many med students, loved a variety of different fields and Practices, but, Emergency Medicine, or EM is what we call it for short, just afforded me a lot of opportunities to both take it globally or, you know, to dial down work, dial up work, not worry about the clinical practice,

We could in, in theory move around to different ERs at any time. You don't have a specific set population. and so I love that and then, coincidentally after residency, I ended up doing a point of care ultrasound fellowship and at the time, just serendipity, I happened to be in the right place at the right time and ended up taking a job in Boston at a start up company, at a medical imaging start up company, actually, and the company was great.

It had just gone through YC. I was a really early part of the company, which is an incredible experience to be at a seed stage start up, and, that experience actually led me back into academics,my current chair, Dr. Mike VanRooyen, I think was trying to rebuild the ultrasound division our community is very small, especially in point of care ultrasound.

And I think, they had been trying to kind of integrate, some of the new technology and, trying to bring women back onto faculty,because the division kind of had transitioned a bit. And so, reached out and I just happened to say yes to an interview.

And now I'm, back in academics, but, You know, again, part of my journey has been serendipity and part of it has been good people reaching out to support me in my career or in a transition in between careers.

So, yeah, yeah, I've been really fortunate. And so, right now what I would say my focus is and like how the story has all kind of crafted and blended itself together.

Because it certainly has not been linear, but, I, I love doing point of care ultrasound for low resource settings. Whether that's applications for, for combat or for low resource settings like, Sub Saharan Africa, or, you know, I was just recently in Saudi Arabia, or for space and space medicine applications, it's one of the few modalities that has opportunities in a variety of different low resource settings, and it's one of the few modalities that is portable and affordable, usually with no radiation.

I always joke that ultrasound is my love language because it really can change a patient's care, especially when you don't have a lot to work with.

How I see the AI bridging that is that currently the technology has has really outpaced the education and so it used to be that ultrasound machines were really expensive or like if the probes broke it'd be expensive to fix and now there's so many opportunities to buy portable and affordable machines.

Things like the Lumify, the Butterfly, the Clarius, that there are a lot of providers purchasing them but the rate limiting step now is. the education and kind of the annotation or QAing of those images. So people, even if they feel comfortable acquiring the image, they don't always feel comfortable interpreting it and saying, Oh, this is positive or this is negative, or, you know, I see this and not that.

Where I see the AI bridging is that interim between. the actual hardware and software, the ultrasound, and where the actual operator is and their ability to interpret. AI is like a natural, appendage to where I think medical education and training, will really benefit just from having that part integrated into the software and technology.

It can really close the gap between just, you know, the limitations and, and realistically training everybody up to the level of standard or proficiency that they need to be, and you don't have to be, a board certified ER doctor or, have done an ultrasound fellowship to feel comfortable using ultrasound.

AI has a lot of applications for reaching more people, in medicine in general and for, proselytizing it to other, other places that otherwise also may be limited in their education or, or ability to be educated on it.

John: I love that. It's a beautiful summary, first of all, of your life, Chanel. That was, That was a, well done. AI might have summarized that, just as good as that. But, you know, you know, some, some key kind of words here that I was surprised to hear. I was actually really happy to hear, of course, talking about your mentors.

And I want to dive into that a little bit later in the episode, but, As a med student and kind of how you were looking for your life, you were saying like a balance of your work life. I'm, I am so happy to hear that you cared so much about that because my partner is a medical doctor and there was no such thing as work life balance for her, her early career.

So how did you even, I mean, did you know that from, from med school or from your undergrad that, Hey, I need to balance my work and life here.

Chanel: That's the hard thing. I don't, I do not have it figured out at all. I would say that and there's always exceptions to every rule, you know, but I'll just say in general, as a blanket, the healthcare system in the United States, but I would say even globally, is just so, exhausted.

And everybody is burned out and there's just not enough providers for the volumes of patients coming in. and so I really think that at the end of the day, of course you want to choose something that you're going to be happy in doing and showing up to work every day, but I think traditionally it used to be a little bit more lifestyle dictated, you know, the roads like radiology, orthopedics, anesthesia, dermatology,

They were maybe more ideal for, career longevity and lifestyle. But I really think that in general, the entire medical system is overwhelmed. And so when it comes to work life balance, healthy work boundaries are helpful, but how do you do that when you already feel like you're overwhelmed with the volumes of work or patient care that you're committed to?

I think for me, I need to come to terms with maybe I'm only 70 percent and just make less money, you know, because I, I can't carry a full, Workload and still feel like I'm fulfilling my, obligations just in my personal life. So, yeah, I don't have it figured out.

And I'll tell you, I don't think that anybody really does. I, mean, maybe some people, but I think if people are being honest with you, everybody, feels like they're not balanced. Some of the best advice I got was that sometimes the pendulum swings, sometimes you're a great mom and sometimes you're a great doctor, you know, just for the workload or, or what's going on at home.

And sometimes it changes and, I think that's life. I don't think it's unique to medicine. everybody probably feels that in a lot of different fields and walks of life. So, yeah.

John: Yeah, well said. I think beautiful wisdom there of the pendulum swings is sometimes you're a great doctor, sometimes you're a great parent. And I mean, it's, it's something from just meeting you, you have such a presence and you have such a, a humility and a, an energy that I just appreciate so much.

And it seems like. Often my friends who have a, a bit of a personal understanding of their own balance of life can radiate that. Whereas, like you said, sometimes my friends who are burned out, it's a very, like, what are we doing? Like, why are we talking? All right, make this quick. so I just, I just wanted to appreciate you for that.

And it radiates to others.

Chanel: I appreciate you saying that.

I will say, that is not always me. I certainly have my moments, especially at work. I just happen to be, you know, relaxed at my own house and not getting like 15 EKGs at once. So I certainly do not have it figured out. But, I aspire to more often in my life.

And I've definitely, made mistakes in my career and in personal life along the way, but you know, you got to learn and see what works with you and what doesn't. And I, and I will say,I'm so lucky to have the mentors that I have, but sometimes, and as you progress and you develop as a person, you add mentors and sometimes you outgrow mentors.

And so, I think The best way to go about it is to kind of like take pieces of everyone's life that you really love and respect, and admire for various reasons. Like maybe it's a person that you work with, but you just love the way they handle their personal life or you love the way that they do their clinical research.

Not everything is going to come from one person or one mentor. And so learning to be creative in like who you get advice from and what that advice is, is also really helpful.

John: Mm, beautiful.

So, thinking about one track that I'm very curious about here is your work with point of care ultrasound, you know, when I hear ultrasound, I do think of maybe pregnancies, but the way you're kind of speaking about it, I mean, can ultrasounds now be used for different type of disease detection?

I mean, can, can ultrasound be used now in so many different applications within medicine?

Chanel: Yeah, and I'll clarify. I mean, I did an ultrasound fellowship. I am not a radiologist, but the idea of point of care ultrasound training, for example, is that it is point of care. It is used in the moment, at the bedside.

It's, you know, you're not getting sent down to the radiology suite to get it done. Ultrasound from a point of care standpoint has certainly evolved within the last few decades. It's evolved especially within medical education and within colloquial clinical practice. the standard of care now, for example, to put a central line in is with ultrasound guidance.

Whereas, you know, I have colleagues that trained 20, 30 years ago and they were just doing central lines blind by palpation and by landmarks. so for that reason, obviously, there have been clinical adoptions of using ultrasound for various reasons. One, to cut costs in health care.

Two, because there's actually no radiation involved. three, it, you know, it's quick and easy. It's more comfortable. Four, but it can really help your clinical practice and, and confirm or refute What you do or don't think this patient has without, like, getting a really expensive CT or MRI read, but yeah, to answer your question, you can use it for, eyeballs to testicles, I mean, you can use it for, for eyes, for thyroid, for breast imaging, obviously, for skin and soft tissue, for musculoskeletal bones, ligaments, tendons, obviously anything in the abdomen, transvaginally too.

It's, it's funny cause I do put the probes on patients and the joke I'll often hear is, oh, do you see a baby in there? that's what we're traditionally used to. but I use it all the time for many, many different aspects, not just for obstetrics.

John: Thank you for that. Yeah, I was curious too. So the slogan, eyeballs to testicles, that, that might be the key phrasing for our podcast today.

Chanel: Yeah, I mean, time is testicle. Time is, vision. So,for example, you can use point of care ultrasound to decide whether or not, you have a retinal detachment with a macula on or off, which can mean the difference between you getting the macula laser back on and saving your vision or not.

Same thing with testicles. one of the most important aspects that are, uses of ultrasound for something like a torsion, a testicular torsion would be, Is there flow or is there not flow in this testicle? And you only have so many hours to try to decide that to salvage it. and so that's that person's fertility.

So, it can be really timely, especially when you're working in a really overcrowded ER or you're on a remote island and you got to tell this patient like, Oh, it's worth the two day journey to the hospital or it's not, And so that's the beauty of the point of care aspect of it is you can get an answer right there, right then.

John: Yeah. Yeah. It makes complete sense. I was just on an island and my partner and I were discussing, what would happen? You know, what would it take for us now to get to a proper medical, like, university hospital in the city? And it would be a multiple day journey.

Chanel: Yeah. I mean, I've worked in very rural sites or critical access sites, and that's within America. We are so lucky for what we're afforded even if you're working on a remote island in the States, at some point you can get to a reliable urban or suburban setting for good clinical care.

Like a large majority of the world is not afforded that. This is, could be a surrogate to, to really at least improving the bare minimum of what they're afforded.

John: Yeah. And it makes me then kind of think about how you are now integrating AI into everything you do. It's so cool that you got to work at an early stage startup and, and do medical imaging.

And that just seems like it really gave you a good balance maybe as well of like research and academics with, you know, industry and application.

And it makes me think, what are the future applications of AI? I mean, is this now just for detection or is there other opportunities and things you see evolving from AI in medicine?

Chanel: Oh, I don't want to misspeak in other realms of medicine, but certainly there are, you know, thousands, probably. Many more applications of AI integration into medicine for a variety of different reasons. I mean AI can be such a broad term and just thrown around and everyone's like, what does that even really mean?

To me what it means in healthcare is, is really to hopefully offset the burden of a lot more of the more tedious tasks. I know there's like a fear of robots are taking over my job or my work or my clinical site, Realistically, I don't think that's going to happen at least in my lifetime.

But I certainly hope it'll improve the workload burden for me and a lot of other in a lot of other ways. a great example is text dictation. So, you know, dictating patient notes. A lot of burnout today for doctors is just being behind the computer and charting and dictating notes.

The implications of having something in the room documenting the whole experience that you're having with the patient. So you have one less note to do at work, you know, and you can really focus on the patient and be behind the computer less. I mean, it can be a huge patient care and Provider Care Improvement. Same thing with like medical imaging, there's just a lot of CT, MRI imaging, and there are only so many radiologists. To be able to have AI applications that either bump up or down in terms of urgency, Acuity of like what is seen on the image, for example, head bleed, no head bleed, perhaps the AI can kind of filter out a routine exam that otherwise may not get read out for 24 48 hours and then slot it to the top because The algorithm had recognized the pattern of blood versus, letting it sit and wait.

So, I mean, there are many applications, you know, ICU, and detecting patients that may code earlier just based on subtle changes that, we may not even notice or see in patient labs or vitals, could really potentially mean life or death just with like earlier intervention and earlier notice nuances within their healthcare.

John: Yeah, it's, it's well said thinking about the burnout that must happen from the annotation of the notes and maybe the documentation and all the formal reporting that must go on within a clinical setting. I mean, that's a great application. I haven't even really thought about that.

Thinking a little bit too about something I care deeply about and it's this serendipity and the impact of the mentors in your life.

And now I believe as you have become a mentor to so many, can we start with some of the mentors in your life? I mean, thinking about our audience who maybe is in this profession or they're just, you know, in any profession looking for, what to do next, how to do it right. What's been the role of mentors maybe to this point for you?

Chanel: Yeah, I mean, I, I have been so lucky, for the people that have, like, been in my life, and that really helped build my career, and, the first person that comes to mind is Dr. Chris Fox. I mean, he's family to me, basically. that man has given me so many opportunities for my career, One of my other mentors in med school is, Dr. Kaia Connolly, her and her husband have become lifelong friends of mine, and, and Greg, her husband, when I was a poor med student or a poor resident trying to negotiate my contract, I couldn't afford a lawyer, and he helped pay for a lawyer to look over my contract when I was trying to sign my chief medical officer, contract.

I mean, the people that have poured out into me and just to help me, succeed to the next step. I deeply believe in paying it forward. So for that reason, I will go out of my way to read an essay from a med student who I've built rapport with, or, um, take an hour of my day for someone that maybe it was a friend of a friend who was recommended to me.

I don't have all the answers, but if something and I've said helps them. I'm so happy to do it because so many people have poured into me. It takes a tribe to, you know, build anyone in healthcare, whether you're a nurse, or a paramedic, or a doctor, but especially on the doctor route, I mean, it's like a decade plus sometimes of training, you're poor for most of it, and you're trying to just, like, study as hard as you can for as long as you can and survive, and, so it really takes a village to get to the end, to be able to care for patients, and so, paying it forward I think is a really important part of that,

And so the best advice I can give in terms of like, how do I find a mentor? How do I find the right person? Would, kind of again, just be along the lines of well, who are you? What is it that you want from life and from your career? So, you know, for me, Chris Fox and I met like when I was an early med student because we just got along and he did something cool.

He takes this technology, all these cool places and sites, part of what initially allured me to medicine was that it was something that could help anyone in the world with, and ultrasound kind of fit into that category. And so I didn't go into med school being like, I want to get into point of care ultrasound, but watching what he had done with his career, I was like, I want to, I want to mimic some of that in mine.

I would be remiss to not mention a lot of the women that have played a role in that, like Dr. Vicki Noble, a colleague of, of Dr. Fox's that I met along the way, I mean, watching, like, what she's done in her career, also as a female clinician in a time when, the majority of the people that she trained with were men at the time. I still love seeing her and learning anything I can from her, like something as easy as how do you sit in a room of all men when you're trying to contract negotiate or whatever it is? so, there are bits and pieces of everyone's life that I've taken and I've really tried to like, craft and to, to what I would like mine and my career to look like, but, it has been really helpful to have mentors in all stages of life too.

And then people also outside, like you can have non medical mentors too. That's true of like any career, sometimes the most impactful people don't have to necessarily be in your, your own field even. and so again, I, I think, the best advice is finding the right people, finding the people that are going to be in your core.

And I would say the best mentors are really those that you can tell, want you to succeed. There is no greater privilege than watching your mentee outshine you, outperform, whatever. That's a true mentor is somebody that wants the best for you at all times. And it's going to push you in uncomfortable positions.

It doesn't have to be a day to day thing. Sometimes it's something as simple as, Oh, I was reading this article and I thought of you, like, have you considered applying to this job? You can mentor in even small ways. I think in a lot of ways it's, it's a lot like just being a good friend to somebody, knowing their strengths and weaknesses and what'll make them tick or what'll make them excel.

John: Thank you for that.

And it makes me think as well about your role now in healthcare education it feels you've, you've kind of joined this. next stage of life where you're like, everything I've learned and all the ways I've applied, I want to now teach and empower others, kind of fitting into that mentoree mentorship role.

But how do you think education now plays into all of this? Medical education, you know, in terms of someone's journey with medical school, and I believe you're the way you're actually taking on teaching responsibilities. How do you think about now healthcare education like this?

Chanel: I mean, it, it's obviously naturally more built in when you're connected to an academic university.

And of course it's expected of you and, and you're just engaged with the residents, with the med students more, with the fellows more. And so there's a, a natural environment that's just easier to connect with people and probably find receptivity from potential SED mentors. So it's, it's definitely easier.

But that being said, if you work in the community, like you also can have just like, you could watch someone practice medicine and be like, gosh, I love the way that they get out on time from shift and like, you know, connect with that person and say, Hey, how do you do it that you finish your notes on time before you leave every day, you know, and you, you're getting mentored in that way, but, of course, if, if anybody is drawn into medical education, like naturally mentorship and expecting to be a mentor would, would go hand in hand.

It's been really enriching too. I mean, I learned from, from my own med students and residents, like sometimes I'm definitely leaving shift, like, wow, I don't know if I have anything to teach them, they're just. Such great people are so accomplished already.

I think the humility in medicine is really important too. Knowing that, you're only as good as your weakest link, it really, really does function like a team. I think learning to be okay with not being right and not always knowing the answers is a really important part of that, even in mentorship. Sometimes, you'll mentor someone for five years and be like, you know what?

I actually think I've taught you everything I know, like you actually should connect with this person. Like that's the next best step for you. I think that's an important part, too.

John: I love it. And it makes me always so excited for humanity, too, when close friends of mine are working with the youth, the adults of tomorrow, even though I know, I'm sure med school students are. in their mid 20s at this point, but it does seem like you're getting a glimpse of the next generation. And so it always makes me so happy when you're like, they're incredible.

I'm not sure if I've taught them anything. Like when we hear so much in media news, like, Oh my goodness, the TikTok generation, you know, blah, blah, blah. So, yeah. Thank you for that. That's always refreshing to me.

Chanel: Yeah, no, I know. I mean, that's a proud moment where you're like, wow, if I could have even contributed a fraction to that person's education and watching them practice, I mean, like I would 100 percent let that person take care of my family.

Like, that's a really great moment.

John: Beautifully said. Well, Chanel, thinking a little bit too about all the incredible work you're doing. All over the world.

Are you able to share a little bit more about what you've done and different countries you've traveled to with Point of Care?

Chanel: So in terms of travel, I mean, it has been busy. I, I leave on a Fulbright soon in January. I'm, I am afforded the privilege of going to Lesotho, Partners in Health has a site there, and so I'll be going there and doing some ultrasound teaching, point of care at the bedside, For two weeks, and, yeah, so I'm excited about that.

Most recently I was in the Navajo Reservation working and, yeah, I mean, it's such a privilege to be let into that community, especially with the history that the Native Americans have with, you know, American culture and to be able to, you know, get to be with the Navajo people and take care of them and witness their customs and, just cultural values and then be able to hopefully, you know, educate or enhance whatever clinical care that they are getting. I mean, that's always a privilege.

I've been really, really fortunate, first, to have a career that affords me that, but also to, especially currently, be at a, at an institution that supports that, both from like a clinical and educational and research standpoint.

John: Wow. You are just doing so much and so well articulated about the work you're doing with the Navajo tribes and, and all the work you're doing all around the world. Thank you for sharing that. something that has really struck me when we spoke last is, is this personal philosophy of remember why you started?

Are there any ways, any wisdom or advice, you've given already so much, and so I hate to keep asking for more here, but any advice through that to those interested in emergency medicine, looking for ways to integrate technology and data into what they're doing today?

Chanel: Yeah, I mean, I would say, I, I mean, it's a marathon of training in medicine and, you know, you start out by writing the personal statement for medical school and you say, you know, I want to be a doctor because, pick me because, and the reality is, is like, there's just so many qualified, amazing candidates out there. I think it's really important to not lose your sense of self in that, it's really hard to do, especially when you're working long clinical hours, like in med school and residency and fellowship. But it's really important to keep that sense of self, like what makes you tick, what makes you survive, what brings you joy and like, keeps you grounded.

And so what I mean by that is like, if you're a really avid runner, keep running, keep something of your identity, aligned with you, because I think it'll help keep you grounded in the process. You can really lose sight of the end goal because the days are just really hard.

You're exhausted. Sometimes to remember why you started, it can be really important, especially when you feel completely overwhelmed with patient care, patient expectations, volumes of notes, You know, sometimes it's just connecting with the right patient on a really bad day. you may feel like you've helped nobody that day, but if you help just one person, it's more than zero.

I think keeping perspective of both who you. Were, and still are, and like hope to still be, is really important. the things that are going to keep you glued together in the hard training years is really important too. If giving back to certain communities is important to you, try to maintain what you can to keep at it when you're in med school or when you're in residency. Anything to keep you grounded will keep you sane throughout the process.

John: I love that you are just a wealth of knowledge and wisdom and I will send you a bill for all this incredible consultation you've given me.

Chanel: I don't know about that. I will say, one of the more humbling things I heard recently, was actually from one of our very, very high up chairman.

Af ew of us were asked to be on the resident panel for just like career and life advice and I just found it so humanizing to hear some of the advice that he gave and one of the most important pieces was, what do you wish that you would have done differently earlier in your career or whatever and, and I was just shocked that he said, I wish I would have started therapy earlier and, and I will say it has been really transformative, I think, in like a self awareness process, and I think usually there is some sort of self awareness process as you go through a career of medicine, you know, it'll push you to limits you didn't even know existed both spiritually, physically, emotionally, And so I think having the tools and the self awareness to like process through those harder times is, is a really important thing to have, and can really reground you in who you are when you're in times of crisis.

John: I couldn't second that opinion more, as I'm doing a lot of work right now in mental health. And so thank you for. Adding that in there. Well, Chanel, thank you so much for your time. Where can people maybe reach out to you or learn more about the work and all the initiatives you're involved with?

Chanel: So I work at, I work at the Brigham in Boston part of the Harvard Affiliated Emergency Medicine Residency. But also I have a Twitter handle you can tweet me at Chanel Fischetti. I tend to be quite responsive, so yeah, feel free to tweet me is probably the easiest way.

John: And that is beautiful as well, the fact that you're still reachable with all the incredible work you're doing. It does feel like, kind of what you were saying about, taking time to read somebody's paper. I feel like, we just came into that category with Labfront and you doing this podcast.

Chanel: Oh, no, I mean, I'm happy to help. I mean, I certainly do not have anything figured out. And so like if I said anything that somebody takes away and is helpful, I am more than happy to help. What you don't see is the thousands of mistakes that have been made along the way.

And so, you know, I just hope people keep perspective that failure is part of the process, and part of the refinement. anything worth having is, is not usually easy to acquire. Failure is just part of that recipe.

John: Hmm. Yeah, failure is part of the process. Awesome, Chanel. Well, thank you so much for joining us on Human Science, and we'll talk to you next time.

Chanel: Yeah, I appreciate your time. Thanks for having me.

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