Michelle Caunca, PhD on MD-PhD programs and Kitchen Aid mixers

Michelle Caunca, PhD is a MD/PhD student who studies neuro epi. She talks about struggles of being in her training program, being a second generation Filipino American, twirling rifles, Kitchen Aid mixers, Trader Joe's snacks, and more! 

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Michelle Caunca:

I still feel like I'm that kid in freshman year who just ate Taco Bell in her car, just because she was stressed out for a final and slept in the car after. I'm still her. I just now I have a PhD and then I'm going to get it. But I'm still that girl.

Lisa Bodnar:

Hi everyone. Welcome to Shiny Epi People. I'm Lisa Bodnar. My Michelle Caunca today is Michelle Caunca, an MD-PhD student at the University of Miami. Michelle defended her dissertation not long ago; yay. Michelle is interested in multilevel predictors of cerebrovascular disease and cognitive aging. She's in her final year of medical school and this fall, she'll be applying to neurology residency programs for her clinical specialty; a very exciting time for sure.

Lisa Bodnar:

Michelle is originally from Southern California and is a second generation Filipino-American. She grew up in a lower middle class family, and that has really shaped her perspective on research and medicine. Today, Michelle shares her experience being raised by parents who were immigrants and the barriers she faced as a young looking woman of color, and how she's used those experience in a way that she's learned to value and love them. Michelle is so smart and engaging, and she's also incredibly funny. I think you're going to enjoy this episode.

Lisa Bodnar:

Hi, Michelle.

Michelle Caunca:

Hey, Lisa. I am so honored that you asked me to be on the podcast.

Lisa Bodnar:

So happy you agreed to be on with me. I want to learn about how you got here, where you are. So your parents immigrated from the Philippines.

Michelle Caunca:

Yes.

Lisa Bodnar:

Immigrated to the US from the Philippines. Is that right?

Michelle Caunca:

Yes, oh my gosh.

Lisa Bodnar:

I had to look up immigrate and emigrate and I was like, "Oh my God, I'm so stupid." I don't know which is which.

Michelle Caunca:

I have to Google it now. I'm going to trust your Google on this.

Lisa Bodnar:

Okay. Would you share with me why they wanted to come to the US?

Michelle Caunca:

So they just wanted a better life for themselves, a better future. And then they built that for us and me and my two brothers. I know my parents, they worked really hard. When we were living in West LA, they scraped all of their money for me and my brother to go to private school, but all our money went to that. I mean, we were not well off. And I would see my parents experienced subtle racism.

Lisa Bodnar:

When did you start seeing that?

Michelle Caunca:

So my dad coached my little brother's baseball team and they made me go and do snack bar, which I was very good at, by the way. I'm like, "I did a great job." I was sitting near the parents and the things they would say about my dad's accent. I mean, I think I went off on a dude once being like, "Shut up. Don't talk about my dad that way." I think I was maybe, if my brother was eight, that means I was in my teens, because he was the random child.

Lisa Bodnar:

Do you call him that to his face?

Michelle Caunca:

Oh, totally, 100%. We call them the random child and he ... So he's eight years younger than me and then me and my other brother-

Lisa Bodnar:

I guess I've heard them call him the unwanted child, don't you?

Michelle Caunca:

Yeah. That has happened. I mean, we've called them that too, but I didn't know if I wanted to make that podcast ready. My mom likes calling him a surprise.

Lisa Bodnar:

Yeah. That's sweet.

Michelle Caunca:

I know you're a mom, so you love all your kids.

Lisa Bodnar:

I mean, let's not go overboard.

Michelle Caunca:

Sometimes I'll call her and be like, "Hey mom, let's talk." And she's like, "I'm busy. I need to go to my rowing class." "Okay. I guess I'll like sit on the couch and drink my wine. You don't want to talk to me. You want to go to your exercise class?"

Lisa Bodnar:

What was good about growing up a child of immigrants?

Michelle Caunca:

So many good things. I mean the Filipino culture is one of hospitality, of love. And I think you just appreciate things differently than other people do, who don't, I don't know, who didn't have to watch their parents go through a lot of sacrifice to make it. They taught us resilience by example. I don't take things for granted, I try not to, anyway. I found that it helps as clinical practice, because when my patients tell me they can't afford their meds and their meds cost $10, I 100% feel that. I'm like, "I understand what you're saying. Let me talk to someone. Let me find the resources. Let me try to see if there's a generic version."

Michelle Caunca:

My parents had an abundance of love, but they didn't have a college fund for me. They would have loved to, but it just wasn't going to happen, given our circumstance. I had to work throughout college, at least part-time. I had to take out loans that are my loans. Even when I moved out, I moved out and I knew I was going to be living that college life, Ramen or Jack-in-the-Box or whatever.

Michelle Caunca:

I have to give a lot of credit to my husband as well. I mean, I think he was the first person outside my family to be like, "Yeah, you can do MD-PhD, duh. Of course you could do it." And I was like, "Oh, really?" And he legit supported that emotionally and financially did help me pay for ... And he had to pay his way through college too. He had to work throughout college too.

Michelle Caunca:

So when you have that experience of, I remember having to stay in a really shady hotel for one of my med school interviews and I don't think I slept. I think I stayed on the phone with him for five hours, because I was like, "I might be on TV murdered in West Sacramento right now." It was not wise. My mom's going to listen to this and she's going to be horrified that I did that. Sorry, mom.

Lisa Bodnar:

Will she listen? Will you tell her you're on a podcast?

Michelle Caunca:

Yeah. I told her when I was like, "By the way, I'm going to be on a ..." And I didn't even know she, no offense, mom. Love you. But I didn't know she listened to podcasts, because I only started recently. See again, she's too cool for me. But she was like, "Oh yeah, I'll definitely listen." So yeah, sorry, mom. I did stay in a shady hotel in Sacramento when I applied to UC Davis. But you know what? I'm here.

Lisa Bodnar:

You made it.

Michelle Caunca:

I made it.

Lisa Bodnar:

Why did you choose to do an MD-PhD program?

Michelle Caunca:

I think it was all about mentorship, honestly. I don't think I would have done it without Claudia Kawas and Maria Corrado at UC Irvine. I wanted to do MD-PhD. I really thought that it was a good way to use what skills I had to help people, but I thought they only did basic science and I spent six months in neuroscience and I was like, "I don't really want to be in the lab all day. I don't really like this. I'm sad. I guess I can't do this."

Michelle Caunca:

And then towards the end of college, the postdoc in my lab, like, "You should have an MD-PhD in epi." And then I talked to my PI, Claudia Kawas and she was like, "If I could have done it, I would've done it." She was hardcore trained at Hopkins, woman of color in medicine. I knew she would have been able to do it if she could. And I was like, "I should just do it. I know that I want to be a legit epidemiologist."

Michelle Caunca:

And then my future mentor, I met at interviews Clinton Wright throughout the first couple years of med school, really, really said, "You have a knack for this. Keep going. Do it." And then Tatjana Rundek did the same thing when I was in PhD world. So mentorship is key. I always tell the younger MD-PhDs, it doesn't not matter one bit what they study. I don't care if they had studied CVD epi or cancer epi, I would have done it because they were such a good mentors. It doesn't matter truly in PhD. For all of you PhD students out there, pick a mentor you like, because it literally changes.

Michelle Caunca:

I've seen people go through bad mentors who don't end up in science, who should be in science. They are bright. They ask interesting questions. These are often women. These are often women of color and then they just leave, because they've had bad mentorship. It's sucks. These are the people that we should be keeping, not the people we should be pushing out.

Michelle Caunca:

In my 20s, I feel like I really learned my priorities in life.

Lisa Bodnar:

That's early to learn priorities, so good for you.

Michelle Caunca:

I mean, some. I don't know everything obviously, but I don't know. I just feel like it used to be about the grind. And now, it's about trying to do things that really fulfill me. And that's still the same job that I want to do, it's just, I don't want to do it without considering family and all that stuff.

Lisa Bodnar:

Do you think that that change, was it a slow thing or quick thing?

Michelle Caunca:

I think it happened when I had a super burnout period in the middle of my program, to the point where I had to take a week off and really think, "Do I really want to be miserable every single day? I mean, there has to be a way to do this without sacrificing everything else. That just doesn't seem reasonable."

Michelle Caunca:

I was so tired. I was so miserable. I needed to stop working. And then I started seeing the therapist available to us, thank goodness at U Miami for the medical students. I mean, she's a godsend. She taught me so much about how to manage expectations, manage stress, how to take away those negative thought processes. So, that was a major part of it. But I realized that if I stopped working, it's not like my bosses were hounding me about this paper draft. I learned that it was kind of up to me to decide what my life was going to kind of look like.

Michelle Caunca:

I think a lot of women in academia feel this way because there are those every day microaggressions. When we do rounds in the hospital, no one thinks I'm a med student. Or when we do presentations at conferences, the first thing people will comment on is my appearance and how young I look and how cute I look.

Michelle Caunca:

And I mean, I've had linear mixed models [inaudible 00:11:00] by a doctor who did not know what he was ... I was like, "Dude, please, I know that I'm just a grad student quote unquote, and you're an MD quote unquote, but you have no idea what you're talking about. I just took a class on this."

Michelle Caunca:

I think a lot of us internalize it and try to overcompensate, but I think it's as a result of structural barriers to success. But now I know you can still work hard and try to prove yourself, but it's not about, you can't sacrifice your mental health or whatever you enjoy; family, friends, whatever. It's not worth that. You can work hard, I'm a hard worker, but it's not worth sacrificing all that other stuff.

Lisa Bodnar:

What do you actually do differently now, in terms of how you work compared with before, when you were kind of verging on burnout?

Michelle Caunca:

I mean, I definitely try to take at least a day off a week with clinical rotations, that's usually my goal. But when I can, I take the whole weekend off. When I don't have to study at night or work, I don't. And I'm better at setting boundaries now, I think. It's hard for, I think a lot of us can relate to not being able to say no, blah, blah, blah, the classic problem. But now I think I'm better at saying, "I'm happy to do this for you, but I need time. This has to wait until next week, because I already have a bunch of Zoom meetings today. I'm not going to drop everything and help you." So kind of realizing that I do have a say, instead of doing what everyone else says.

Lisa Bodnar:

Trainees who are in MD-PhD programs are obviously uniquely situated where you understand both the struggles of someone who's getting a PhD, writing a dissertation, and the struggles of someone who is a med student. Are there struggles though that are especially unique to people that are doing both?

Michelle Caunca:

A unique struggle, I think is just that you're always going to be straddling the two worlds. For me, I've always felt like an outsider in both. For me, it's made me a little bit used to being really independent and resourceful, because I feel like I don't mind being an outsider. It is a little bit different having a dual kind of identity, because I do feel strongly that I'm both, it's not one or the other, although I think people's personalities kind of lean one way or the other.

Lisa Bodnar:

So at this point in your training, what do you wish PhDs and epidemiology knew about clinical medicine?

Michelle Caunca:

The problems they see in medicine we see too and we see it up close. And often, the physician can't do anything about it. That's the saddest part of it. I'm thinking of all my patients who are lost to follow-up, who can't afford their meds, who can't get transportation to the clinic. The physician is so trained to focus on the pathology and not the social determinants of health. And there's no resources too, even physicians who want to address those. That's why social workers are so critical to medicine. I mean, they don't get enough credit. I mean, shout out social work, because they do, they try to make sure your patients are discharged safely.

Lisa Bodnar:

How of the challenges of being an MD-PhD student changed as you've progressed in your training?

Michelle Caunca:

I had a real self-confidence struggle throughout, which started in college. I feel like throughout grade school and high school, I don't know. I was pretty self confident. I didn't really compare myself to other kids, an honors kid. I was a nerd. I was in band and I loved it. I wasn't-

Lisa Bodnar:

What did you play? I was in band.

Michelle Caunca:

Okay. So I in color guard, I didn't play an instrument. My husband hates when I say this, but no one knows what color guard is, so I just say-

Lisa Bodnar:

Do I only know what it is because I was in band?

Michelle Caunca:

Yes, totally, 100%.

Lisa Bodnar:

Did you use rifles or just flags?

Michelle Caunca:

I was also spun rifle and saber. Shout out to Jenny and Jason. My high school, they were my first real mentors. Shout out, y'all.

Lisa Bodnar:

So wait, saber, is that a sword?

Michelle Caunca:

It's basically a sword.

Lisa Bodnar:

Wait, so you had a rifle that's a fake rifle, but it looks like a rifle and it's heavy-ish, right? And you kind of twirl it like it's a baton.

Michelle Caunca:

Yes. And I toss it in the air and dance and was a huge nerd and I loved it. [crosstalk 00:15:35].

Lisa Bodnar:

Wait, but what you do with the sword?

Michelle Caunca:

Same thing; dance around with it, toss it in the air, try to catch it, try not to hit people.

Lisa Bodnar:

Did you swallow it?

Michelle Caunca:

No.

Lisa Bodnar:

I like to post a photo of people at least-

Michelle Caunca:

I definitely have color [crosstalk 00:00:15:51].

Lisa Bodnar:

Okay, thank you.

Michelle Caunca:

110%. I have them.

Lisa Bodnar:

I need that.

Michelle Caunca:

I'm going to call my mom. She has everything.

Lisa Bodnar:

Okay. What is your mom's name?

Michelle Caunca:

Mylene.

Lisa Bodnar:

Mylene, find us the photos.

Michelle Caunca:

She's going to love this.

Lisa Bodnar:

You can go to your rowing class, but your priority is finding the photos of your daughter holding a fake rifle.

Michelle Caunca:

And a lot of glitter, a lot of bright eyeshadow and blush, just a lot of blush and hair gel.

Lisa Bodnar:

You're a woman of color. You also are very youthful looking.

Michelle Caunca:

It's good genes.

Lisa Bodnar:

I'm sure. Mylene.

Michelle Caunca:

I think people just don't take you seriously, immediately, but they immediately take others seriously. I just feel like I have to work harder to get people to believe that I'm competent. And I used to fight it a lot. I remember when I was applying to med school, I did mock interviews. And I was told to change the way I sounded, change the way I looked, I needed to lower the pitch of my voice. I mean, I'm from SoCal, so my real SoCal voice is, I mean, I'll say like more times than you can count.

Lisa Bodnar:

I do to and I'm not even from Southern California. It is a serious problem.

Michelle Caunca:

It's a problem, or is it? I don't know. I think that those are just constructs that some white dude decided that was professional and I'm small, so the space I take up is not that big either, right? Whereas, some of my colleagues are 5'10" dudes who, they take up space in a room, they command space in the room.

Michelle Caunca:

Yeah, unfortunately, sometimes patients would be like, "Oh, you're too young to be a doctor." That's from patients who I helped to care for, and they eventually listened to me. But I don't know, I'm trying to work on just being a little bit more compassionate to people about that. I really try to think about how scary it is to be a patient in the hospital. I mean, we get so acclimated to the hospital. The hospital is not a normal environment for anybody. It's scary. It's cold.

Michelle Caunca:

And now during COVID, I was doing my surgery rotation. Patients were in there, their families couldn't be there with them. I was just like, "Are we really doing good care by not letting this dude's wife sit with him as he's waiting to go to surgery?" As routine as the surgery might be for the surgeon, it's not routine for the family. It's scary. Their pain is real. And I don't know. I think it goes a long way when you can just be like, "Yeah, it sucks being here."

Lisa Bodnar:

At a party, where can someone find you?

Michelle Caunca:

Food table, food table 100%.

Lisa Bodnar:

And what are you looking for?

Michelle Caunca:

Chips and dip and wine. Lisa, I have an idea. Have you seen drunk history? What if we did drunk epidemiology? I want to get Ellie on board.

Lisa Bodnar:

Yes.

Michelle Caunca:

I just think it'd be hilarious if we explained epidemiologic concepts drunk.

Lisa Bodnar:

I think that we should brainstorm who would be really good on this show, but probably off the air.

Michelle Caunca:

Yes.

Lisa Bodnar:

Yeah. DM Lisa. Oh yeah, yeah. Yeah. I don't need to give you the list of names, though I've got a lot of good ones. You know who you are out there.

Lisa Bodnar:

What can you talk about for hours?

Michelle Caunca:

Sports. So you'll probably like this, but I am a Steelers fan.

Lisa Bodnar:

Really?

Michelle Caunca:

Yes. So, my husband was a Steelers fan. I didn't know a lot about football before I met him. And then I'm a hardcore Lakers fan, basketball.

Lisa Bodnar:

Mm-hmm (affirmative).

Michelle Caunca:

Born and raised, out of the womb Lakers fan. That's just my thing.

Lisa Bodnar:

Is it comforting for you to see sports on TV again?

Michelle Caunca:

It is so nice to have something to cheer for, something to hope for. And sports is really important in my family. That's the way I connected with my dad. Back home, we were watching the Lakers games together. And what epidemiologist is going to study the bubble, the NBA bubble? Who's on that right now? Someone's doing it.

Lisa Bodnar:

Epi Twitter.

Michelle Caunca:

Yeah.

Lisa Bodnar:

Tell us, what's your favorite snack food?

Michelle Caunca:

Probably potato chips. I love Trader Joe's obviously. You should get an ad for Trader Joe's, because I mean, you should get paid. But they have these salt and pepper chips that are really good.

Lisa Bodnar:

If you had to be a kitchen appliance, which one would you be, and why?

Michelle Caunca:

The KitchenAid.

Lisa Bodnar:

The mixer?

Michelle Caunca:

Yeah. I love that thing. I think it's the best thing ever. My mother-in-law bought it for us. I'm a big baker and I like to cook and stuff. It's just reliable. It's in families forever and then you have cake at the end or bread or all the good foods.

Lisa Bodnar:

Yeah.

Michelle Caunca:

Only good things come from the mixer. Shout out to KitchenAid. Please sponsor this podcast.

Lisa Bodnar:

Mine is blue. What color is yours?

Michelle Caunca:

Mine is blue too.

Lisa Bodnar:

What kind of blue? Mine's a cobalt blue.

Michelle Caunca:

No, I was going to say cobalt.

Lisa Bodnar:

Whoa.

Michelle Caunca:

We have matching mixers.

Lisa Bodnar:

What makes you laugh the most?

Michelle Caunca:

I think my little brother, my youngest brother, Matt.

Lisa Bodnar:

The mistake?

Michelle Caunca:

Yeah. Yeah. The random one.

Lisa Bodnar:

Oh right. I called him a mistake. You called him the random one, and your mom called him a surprise.

Michelle Caunca:

Yeah, exactly.

Lisa Bodnar:

Who was your worst teacher and why?

Michelle Caunca:

I had an algebra teacher who was really mean, and he sat you in order of your grade in the class. Yeah. So he said that the students who were doing bad needed to be in the front because they would learn more. So I was in the front and I was like, "I am going to defeat you. You are not nice." And I made it all the way to the back A corner by the end, but Oh my God.

Lisa Bodnar:

Wow. Maybe that was the whole point, was to humiliate you into working harder.

Michelle Caunca:

It worked, but it doesn't have to be that way. This is the point, it doesn't have to be this way. It was horrible.

Lisa Bodnar:

Oh, that's sad. What person in your life could you team up with and have a good chance of winning the Amazing Race?

Michelle Caunca:

Oh, my husband, Cameron. He's athletic, we're a good team, and I'm really good at delegating so he can do stuff. And he's clever, he's very smart.

Lisa Bodnar:

So I guess the better question is, would he choose you to be his Amazing Race partner if I asked him the same thing?

Michelle Caunca:

Probably not. You can't win them all. No you can't. I wouldn't be terrible with that.

Lisa Bodnar:

I would be terrible too. I have the worst sense of direction. No one would ever choose me. No one would ever in their right mind would choose me.

Michelle Caunca:

Cameron definitely wouldn't then, my husband, no. I'm terrible at directions. You have to have a sense of direction? Oh my God, no way. No, no, no.

Lisa Bodnar:

It was just so lovely to meet you, get to know you.

Michelle Caunca:

This was so fun. Thank you so much.

Lisa Bodnar:

Thank you.

Michelle Caunca:

Oh my gosh, I hope it was coherent. I feel like I talked a lot. I don't know if it was all made sense, but-

Lisa Bodnar:

So it's my job to turn it into magic.

Michelle Caunca:

You work your magic. You get rid of my vocal fry. I don't know what you do in there. Whatever you need to do, Lisa, we got to get the ratings, we got to get Trader Joe's to sponsor. We got to make this happen.

Lisa Bodnar:

I realized that something we didn't do at the beginning, was say hello. So could we say hello and pretend like we said it at the beginning?

Michelle Caunca:

Yes. That was my fault.

Lisa Bodnar:

No, no, it was because we got on and I forgot to record. And then we said hello, but I didn't record it. So this was my fault purely, but I think we need to go back and I'll dub it in at the beginning.

Michelle Caunca:

Yeah.

Lisa Bodnar:

Okay. You ready to pretend like we're just meeting each other for the first time?

Michelle Caunca:

Yes, I am ready.

Lisa Bodnar:

Hi, Michelle.

Michelle Caunca:

Hey, Lisa.