New Chapter

Rachel Chevalier, M.D. (PD ’14), bounced around the country for her training — on both coasts before landing in the Midwest. She received her undergraduate degree from Massachusetts Institute of Technology (MIT) and medical degree from West Virginia University School of Medicine, completed residency in pediatrics at Mayo Clinic and fellowship in pediatric gastroenterology, hepatology and nutrition at the University of California, San Francisco. For the last two years she’s been at Children’s Mercy Hospital in Kansas City, Missouri. Dr. Chevalier describes her medical training as nomadic. “I like seeing how people at different institutions do things. I carry the best of what I experienced with me.”

“I carry a small tote bag from the Mayo Clinic Alumni Association as my purse. They gave them to us when we finished residency. It’s the perfect size, but I also like that on the back, it says, ‘The best interest of the patient is the only interest to be considered.’ I always liked that, and it’s a good reminder, especially in pediatrics, when you do not always have patients who can advocate for themselves.”

Tell us what you do now?

I’m a physician-scientist at Children’s Mercy Hospital in Kansas City. I see patients in the clinic and hospital and for procedures. I do basic science lab research on drug delivery. I’m working to develop drug formulations to treat eosinophilic esophagitis.

The medication used most commonly is budesonide, which must be mixed with a thickener so the child can swallow it and increase the amount of time it stays stuck to the esophagus. The taste and texture are very unpleasant, which makes it difficult for children and their parents. And the medication can be washed away quickly from the tissue where it’s needed.

I’m working to develop a way to make sure the medication remains in the esophagus longer. My approach is based on a polymer that’s known to be sticky to these cells and a shape that will help the medication resist the flow of saliva and peristalsis. I’m using microfabrication techniques to fabricate coin-shaped discs that wouldn’t be easily dislodged from the walls of the esophagus. The discs are designed to slowly release the medication as they dissolve. I’m testing this delivery method in a pig esophagus model.

It’s exciting to work on something that can make a difference to these patients. I want to be in research for as long as I can be — there are a million questions I want to answer.

Why did you want a career in medicine?

I always wanted to do medical research. When I was in college, I worked in EMS and really enjoyed interacting with patients. My undergraduate research project involved working with physicians, and I saw that you could do both. That led me to pursue becoming a physician.

What led you to Mayo Clinic?

I’m from West Virginia, but my husband is from Nebraska. We met on the East Coast but wanted to return to the Midwest for a while. Mayo seemed really supportive of residents pursuing research projects during training, so I flew out to interview. During my interview day, the residents at Mayo Clinic seemed to be genuinely happy and to enjoy each other, which was ultimately the deciding factor.

What were your first impressions of Mayo Clinic?

I thought the tunnels from my hotel to the clinic were crazy and fun. That, and everyone seems happy and proud to work at Mayo.

Who were your mentors at Mayo Clinic?

Jeanne Tung, M.D. (PDGI ’06), now a pediatric gastroenterologist at Oklahoma University Medicine in Oklahoma City, has been an invaluable career mentor. She also introduced me to Bill Faubion, M.D. (PDGI ’98, GI ’02, Division of Gastroenterology and Hepatology, Department of Medicine at Mayo Clinic in Rochester), who let me rotate through his lab as a resident, where I learned a lot in a short time.

How is Mayo Clinic part of you?

I carry a small tote bag from the Mayo Clinic Alumni Association as my purse. They gave them to us when we finished residency. It’s the perfect size, but I also like that on the back, it says, “The best interest of the patient is the only interest to be considered.” I always liked that, and it’s a good reminder, especially in pediatrics, when you do not always have patients who can advocate for themselves.

I trained at a number of institutions and have met people from many more. The pride in your institution and job and the level of professionalism expected at Mayo Clinic isn’t universal.

I keep in close contact with my residency class. Hardly a day goes by that I don’t text one of my former co-residents. We send each other pictures of our kids, stories about work and contact each other when we need a second opinion from another specialty.

How did you choose your specialty?

As a medical student I was really interested in pediatric GI. I kept an open mind during residency but never loved anything else as much. My favorite patients were always GI. I was skeptical about pediatrics. I was never the kind of person who enjoyed babysitting, but I ended up really liking working with kids. Their diseases are more interesting, and they’re really funny. I like taking histories from kids. I asked a 5-year-old how she broke her arm, and she told me an extremely long and detailed story about falling off the monkey bars. The whole time I was thinking, “I can picture exactly what happened.” I was thoroughly entertained.

How’s life after training?

Life is so much better now! I went from having zero control over my life to having much more control over my life and schedule. It reminds you how little control you had for a decade. You get a part of your life back. You can say, “I’m going to take a vacation day,” and no one says no.

It is nerve-wracking to be an attending physician; you’re the decision-maker. When you’ve had someone looking over your shoulder for the past 10 years, this is a huge responsibility. At first you feel alone, but you’re not. It’s always a group of people making a decision, including the nurses, residents, fellows and nurse practitioners. If I’m still not sure, I can call any of my colleagues, and they’re glad to help. We’re very much encouraged to consult others, which makes the transition after training easier.

What do you wish you’d known sooner?

Be willing to take a chance or go for what you want versus what you “should” do. Don’t be afraid to go for it.

A lot of people supported my decisions to get where I am. I do basic science lab research but don’t have a Ph.D., which isn’t particularly common. Most in this position have a combined degree, or physicians do clinical or translational research — not bench science. I worried about not having a graduate degree in science for a long time, but for every person who said it was going to be too hard, about five more people told me I could do it.

What are you most proud of on your CV?

As a fellow, I received an award for excellence in teaching residents. Fellows are overworked, tired and sometimes angry, so it takes focus to remember to teach residents when they call you with questions in the idle of the night. I like teaching what I know and seeing others get excited about it. The award was nice recognition from the residents — they noticed and cared that I took time to teach them.

What do you do in your spare time?

I have sons ages 5 and 2. They take up a lot of my time. We’re still new to Kansas City, so we explore the area a lot.

I also sew — clothing and quilting. I find it relaxing. I made flower girl dresses for one of my nurses who got married. I made quilts for my sons and a coat for myself.

How do you integrate work and home life?

My division is really good at recognizing that everyone has a family and life, and that those are important aspects of the whole physician. Everyone is supportive of everyone else and willing to help out. The work gets spread around.

I try not to bring work home so I can focus on my family when I’m there. My hobbies, such as sewing, help to center me.

See past New Chapter stories here.