Dr. Laura Zabalgoitia’s background in social work inspired her interest in public health, specifically health disparities and other socio-economic factors that impact care. She has crafted her residency curriculum to focus on these interests, and will further pursue them in fellowship and beyond, particularly as they relate to stroke medicine. Her weekends involve cooking for friends, exploring new music venues, and heaping affection on her cat.
Tell us a bit about your background prior to your arrival at Vanderbilt.
I was born and raised in San Antonio, Texas. I went to college in Austin at the University of Texas. I was there for 3 years. I graduated early but stuck around afterwards to work in social work. I worked a lot in the mental health field, providing resources for people in the community who were in crisis or needed certain resources such as getting medications, transportation, etc. Basically we would assist them with all the essentials of daily living. That had a big impact on me, showing me a whole segment of the population I wouldn't have had exposure to, as well as the needs present in communities that don’t benefit from the same resources as I had previously been exposed to. It was a good opportunity to understand how socio-economic factors can affect our health and create disparities in general. It made a big impact on me and made me want to address these health disparities throughout my career.
I took that experience and felt I could do something positive, which propelled me to pursue a Master’s in Public Health along with my M.D. in a dual degree program back in San Antonio. In that role, I was able to learn what it means to treat your patient and the community at large. I gained skill sets and perspectives on how physicians can be advocates for patients and their communities. That led to an interest in preventative care. If we can prevent these sort of lifestyle-related health conditions that are disproportionately affecting certain communities, what are ways we can address that? That led to my interest in stroke. I think neurology and preventative medicine come together in stroke medicine, which is what makes it so appealing to me.
What attracted you to Vanderbilt?
I felt like if I didn’t leave Texas at that time then I might never! The transition to residency seemed like an opportunity to broaden my horizon and meet new people. Nashville and Austin are sort of sister cities, so it didn’t feel like a huge change. That said, Nashville has been very welcoming, and it’s very easy to live here. I love the people I work with. [In Nashville], I really get everything I had in Texas, plus it’s gorgeous here with so many trees and trails nearby. I didn’t expect it to be such a wonderful place to live, but I really enjoy it.
What have been some high points of your residency?
A couple of electives and distinctions I’m involved with stand out. The first thing is that I’m pursuing a distinction in biomedical ethics that’s offered to residents and fellows at Vanderbilt that is a longitudinal, threefold program. We have monthly lectures, rotate on an elective such as the ethics consultation service, and a capstone project in which I’ll present a case discussion based on ethical dilemmas. These things are all very relevant to what I’d like to do. I found myself as a second year resident on nights having to deal with these very difficult, complex decisions, such as a devastating neurologic injury, and having to be on the front lines talking with family. I found myself looking for the tools to navigate that. This distinction offers a bit of structure in looking at these kinds of situations. I felt like that was a germane feature to supplement my training.
The other thing I think was really cool was a course I took that focused on health equities. It was two weeks of pretty intense lecture presented by the Emergency Department, but it incorporated every discipline. It included lectures from scholars, looking at health inequities, looking at data from the health department, and exercises to check one’s own biases and judgments you might be bringing into clinical scenarios. It was absolutely eye-opening and changed the way I approach patients—how I interview patients, even small changes in the way I speak, using the language line more often—small changes that have made a big difference in my approach.
With these additional electives, I feel like I’ve really rounded out a meaningful humanitarian aspect of my training. These things are a personal interest for me, but they are also really relevant in my day to day work as a neurologist.
How do you look forward to bringing all these varied interests together as your career unfolds?
I will be pursuing stroke fellowship training here at Vanderbilt. The public health perspective puts me in a good position to look at these interests on a larger scale, so I hope to work on these things in some sort of administrative role.
One of my co-residents and I have a project together looking specifically at stroke patients. Here at Vanderbilt we see patients from all over the state, but there are sometimes issues with continuity of care post-hospitalization. Sometimes folks coming in from far away have a hard time getting to appointments, so we’ve looked at offering follow-up appointments via telehealth, dropping burdens such as transportation or childcare that might prevent someone from being seen by a doctor.
The post-stroke period is very important to me because there is a high risk of stroke recurrence. So I would like to focus on keeping in close contact with those patients and make sure risk factors are controlled to reduce the risk of another stroke. I’d like to be in a space where I can think creatively about those issues and focus on those things and implement policies that cater to those priorities.
How do you spend a free weekend in Nashville?
I love cooking for people. I like to go to the farmer’s market, look and see what looks good, maybe find a vegetable I’ve never tried, and take it home and cook it. I’ve been learning a lot about music and jazz, going to shows at the Ryman and the Opry. I enjoy new restaurants, bars, and music venues. My goal this year is to get out to the waterfalls and just enjoy being outside more. Mostly I just enjoy being with friends and fostering relationships outside of work to keep up those interests not related to medicine. And I have a big cat who is very fat, so most of the time we just sit and play together!
What are you reading/watching/listening to?
I always listen to the newest episodes of This American Life, Freakonomics, and The Daily. I just started reading The Man Who Mistook His Wife For a Hat by Oliver Sacks—that’s been on my to-do list for awhile. I just saw Everything Everywhere All at Once and I cried twice, so I’d recommend that for anyone needing a good cry!
