Madison LaCasse ’22

Boston Children’s Hospital, Biobehavioral Pediatric Pain Lab, Boston, MA

This summer I worked as an intern for Dr. Christine Sieberg in the Biobehavioral Pediatric Pain Lab at Boston Children’s Hospital. Her lab focuses on studying chronic pain disorders in children and adolescents, specifically working on identifying different neurological, psychological, social, and biological predictors to chronic pain. During this summer, the lab was working on a study of chronic pelvic pain due to endometriosis in adolescents and young woman, a reasonably under-researched area.

Endometriosis is a reproductive disease in women where the endometrium, or the lining of the uterus, grows outside of the uterus in other areas of the pelvis, like on the ovaries, fallopian tubes, and into the abdomen. This causes pelvic pain in patients that can range from mild to severe and in some cases gastrointestinal symptoms as well. Additionally, this disease can cause reproductive issues that can lead to infertility, which unfortunately is how a lot of women are finally diagnosed with endometriosis. The disease can only be diagnosed through surgical procedure and since its main symptom is pain related to the menstrual cycle, it is an underdiagnosed disease in general, but especially overlooked in adolescents and young women.

Our study focused on a specific subset of young women diagnosed with endometriosis, that have had surgical treatment for the disease, but who despite this treatment still experience chronic pain. Our hypothesis is that through experiencing the chronic pain that comes with endometriosis, their central nervous systems have become hypersensitive to pain and sensation, a process called central sensitization. Our study administered a series of surveys about pain perception and sensitivity combined with QST testing, which involved testing sensory and pain perception of the arm and abdomen with changes in temperature, pressure, and touch.

My job this summer was mainly to recruit, screen, and test control patients—patients who don’t have endometriosis or chronic pain. We compare their data with those of endometriosis patients in our analysis to test our hypothesis of central sensitization. Additionally, I worked on entering and cleaning the data from each participant and recruiting patients in an adolescent medicine clinic at the hospital. I learned not only about how QST (Quantitative Sensory Testing) worked, but I also learned how to interact with patients, give clear instructions, make our participants feel comfortable, and how to make clinical judgment calls during the testing procedure.

Another part of my job was to conduct literature reviews for Dr. Sieberg when she was getting ready to write papers for publication. Literature reviews involve a search of what current research and publications have to say about your topic of research. At the beginning of the summer I conducted a literature review on the long term cognitive and psychosocial effects on pediatric patients who have undergone cerebellar tumor resection. Near the end of the summer I did another literature review on the mechanisms of chronic pain in diseases where chronic pain is a primary symptom, like sickle cell anemia, irritable bowel syndrome, chronic post-surgical pain, and fibromyalgia. I learned a lot about chronic pain in general and some of the challenges that are involved with understanding and treating chronic pain as biological, immunological, genetic, psychological, neurological, and psychosocial factors all play a unique and largely still unknown role in chronic pain. I learned more about how clinical psychology can play a role in a wide range of diseases, some that traditionally are not thought of as a psychology disorder. I really learned more about how large a role psychology plays in medicine and it reaffirms my decision to major in psychology during my time at Williams. I hope to go to medical school post-grad and working in this lab this summer has shown me that having a background in psychology as a physician will really help me treat my patients most effectively and holistically.

Dr. Sieberg really incorporated me into her lab, which allowed me to fully understand how clinical research works. I attended weekly lab meetings where I would summarize what I was currently working on that week to the rest of the lab. She was eager to chat with me about her current research projects, her plans for the future, and her past experience working as a clinical psychologist seeing patients. Dr. Sieberg and her research assistant, Claire, fostered a positive work environment and were eager to share their personal experiences in the field and to offer me advice. Claire, a recent college graduate who is working on getting her Ph.D., brought me to events at Boston Children’s like grand rounds, where other research assistants presented their research. Claire, like myself, eventually wants to go to medical school and it was interesting to get a perspective on what a possible path to medical school post-grad can look like. I want to take at least two years off between graduating and applying to medical school and working in this lab and listening to Claire’s story made me strongly consider working as a clinical research assistant during this time.

Finally, I really enjoyed just being in the Longwood Medical Area where Boston Children’s, Dana Farber, Beth Israel, and Brigham and Women’s Hospitals are all located. Walking around to get coffee with my fellow intern or walking back and forth between the hospital and our lab and being surrounded by people who are passionate about healthcare was really inspiring. Being in an area where so much innovation and commitment to caring for others occurs was such a positive experience for me and affirmed that I want to commit my life to providing healthcare. I had a great summer internship experience thanks to the Kraft Family and the ’68 Center for Career Exploration for providing me with the ability to do so. Due to their support I was able to spend my summer helping with research for an underdiagnosed disease and also exploring what my future in medicine could look like, forming connections with those in the medical field, and being inspired by simply getting to work at Boston Children’s Hospital, one of the leaders in children’s healthcare.