I first heard the phrase “When you hear hoofbeats, think horses, not zebras” during my genetic counseling internship two years ago. Oftentimes, physicians tend to select the most likely disorder—“the horse”—that matches most of the symptoms, overlooking rare disorders—“the zebras”. But behind all diagnostic processes are real people. While I was shadowing a clinic patient visit, a patient mentioned some dissatisfaction with her diagnosis, because she felt physicians overlooked the symptoms she was experiencing. However, she seemed truly relieved when she was given a diagnosis of Fabry disease, a lysosomal storage disorder characterized by an inability to digest fats due to a dysfunctional α-galactosidase A enzyme, which perfectly summed up her experience. This is why genetic counseling, as a field, appeals to me: knowledge and practical assessments are so integral and connected in delivering a diagnosis. Throughout my experiences with genetic counselors and adults with intellectual disabilities during my time in college, I have been able to support others, helping them feel like they belong and are understood. During my job as residential counselor this summer, I was walking to the dorm with my campers when one of the girls came to me and mentioned she was feeling sore and a little dizzy. I asked her if she wanted to pause our walk, but she said no, because these feelings are normal for her. She asked “Have you heard of Ehlers-Danlos syndrome and POTS?” I confirmed that I had, and she was excited to learn that I knew some ways to help her when we arrived back at the dorm. From one case study on EDS and POTS in a class I took, I was able to allow my camper to be understood and encourage a sense of belonging among her and the other campers. Once educated as a genetic counselor, I can continue to learn more about heritable disorders, blending both patient care and the field of genetics, and finally connecting patients with future options to find them a supportive community. In both of these instances, I was able to use my knowledge of genetics to offer some relief to young women handling challenging diagnoses. Both of these conditions experienced by these women affect females differently than males, something I found particularly interesting when further exploring these conditions after meeting these individuals. Fabry disease is X-linked, meaning it is carried on the X chromosome. Traditionally, this was believed to mean that females, who have two X chromosomes, would not be affected if one of their chromosomes had this mutation as the other chromosome would compensate, whereas males would have the most severe symptoms. However, recent advents of research into mosaicism have revealed a possible cause as to why many women with Fabry disease often have symptoms as severe as men with the condition (https://www.fabrydisease.org/images/support-orgs/docs/A%20Guide%20for%20Women%20Living%20with%20Fabry%20Disease%20Patient%20Brochure%20Update%203.pdf). Ehlers-Danlos syndrome also affects mainly women, though the mutation triggering EDS is unknown. Some studies have hypothesized that this higher ratio of women to men with EDS is due to differences in hormone levels, such as estrogen (https://www.ehlers-danlos.com/iwd2025/). The issue with both of these conditions is that they have hardly been studied in women. My realization of this information continues to inspire me to pursue genetic counseling. By contributing to the genetics involved in these newfound research efforts, I can hope to help women find answers to these conditions and more, as just these two examples are not the only instances of diseases in women being overlooked. With more information being made available regarding these conditions, I also hope to offer a shoulder for my future patients and community resources so they are not alone.

Upon enrolling in undergrad as a psychology major, I had the idea that I would actually be learning how to counsel effectively as part of my coursework. I had become interested in counseling after my sister’s battle for mental health, and I saw how effectively therapy and open communication helped her with anxiety and stress. Unfortunately, the psychology coursework is mostly focused on theory and history behind psychology, rather than practical application of these ideas. So, looking for more experiences in psychology, I stumbled upon Crisis Text Line, an organization that allows individuals to text in to connect with trained Crisis Counselors for support and resources when they are experiencing a crisis. I enrolled in training to become a volunteer crisis counselor almost immediately after I finished my first year of undergrad. I spent that entire summer aiding those experiencing times of crisis, from thoughts of suicide, fear of coming out to family, to just being stressed about responsibilities. I loved how I could speak to anyone, anywhere in the United States, and take time to form a connection, with the majority of my conversations with texters lasting around an hour. Over the years since I began this endeavor, I have reached out to nearly 500 people that messaged in, amounting to around 300 hours of service. My experience with Crisis Text Line has taught me a lot about empathy and other psychosocial skills, as well as the importance of connecting with both large and local communities. These attributes are ones I will continue to cultivate and use in my future. My career goal is to be a genetic counselor, which is someone who aids individuals in finding a diagnosis and understanding it, as well as helping these individuals to find care and community support after a diagnosis. This career stuck out to me as unique because it gives me the opportunity to be an advocate for a patient who may not have anyone in their corner, which is something I have experience with from my time as a crisis counselor. I am ecstatic to continue to grow my psychosocial skills and my skills as an advocate for others. My first experience with genetic counseling was shadowing genetic counselors at a local clinic that focused on patients with a specific rare disease type called lysosomal storage disorders. During my time shadowing, I was able to learn about the diagnostic odyssey that many of the patients I saw journeyed on. The diagnostic odyssey is a term used to describe the exhausting path to finally receiving a diagnosis for individuals with rare diseases, where they often have to see numerous medical providers and spend years going to appointments before finally receiving a diagnosis. Genetic counselors play a vital role in helping patients get through this arduous odyssey to find a diagnosis by advocating for patients to see specific doctors, ordering genetic tests, and providing a shoulder to cry on when everything is overwhelming. I was able to envision myself as a genetic counselor embodying this role as a support system and advocate for the community of those with rare diseases, which pushed me to continue to pursue this career and apply to genetic counseling graduate programs. By receiving this scholarship, I can finance part of my education so I can spend less time working while in school and more time building fundamental counseling skills by continuing to do volunteer work with Crisis Text Line, before entering the workforce and becoming a genetic counselor.

"It is most definitively not a soup! It is a stew!" Morgan breathed out. Seeing how irate he was at this simple fact, I balked at responding for a moment. "Seeing as how it is written under 'soups' on the South Grill menu, I think that's where we should put it on ours too." "They're wrong and so are you. Chili is more solid than liquid; it is a stew." "I see your point, but given we are serving primarily soups, I think it obsolete to have one section of the menu titled 'Stews' and to just have chili written under it." I held Morgan's gaze, letting him sense my determination at this monumental choice. From the first notion we had to launch our startup into the skies, everything had gone remarkably smoothly. It is not easy to get a spacecraft up, especially since the Infinite Concordat was put into action 20 years ago, so I was shocked at how quickly everything was happening...until today. In creating our space-hotel, we had decided on a widespread menu for the guests to choose from at the hotel's single restaurant, with cuisine ranging from quinoa bowls to, you guessed it, chili. With everything going on, you'd think that something as small as what belongs where on a menu would be something easily resolved. Yet, here we were. Morgan was adamant on requiring a stew section, I was firm in my belief it could just be included in the soups section, and Samara... was nowhere to be found. I sighed and shook off what I was feeling. "Okay," I began. "If we added the stew section, do you think we should serve more stews? And what kind?" Morgan shook his head. "Nah, just chili." My eye twitched. “Why?” “Y’know, lots of other stews are just kinda complicated to prep. Chili’s simple. Just beans and tomatoes in a pot then simmer for a few hours.” To my relief, Samara chose that moment to stumble upon us. “Hey crew! What’s happening that’s making you both look so chuffed?” Morgan took the chance to share his point of view on the soup-stew debacle. “The menu needs chili, yeah? And we’ve been arguing about whether it, correctly, needs to be under a new ‘stew’ section or it can, incorrectly, need to be under ‘soups’. Tell me: am I right or is Theo wrong?” I shot a glare his way. Samara looked pensively, eyes darting between Morgan and me. “Why don’t we just combine the two? We can have something like a ‘soups and stews’ section. I promise the guests are not going to care about what classes as what, they’ll just want to eat!” Morgan and I locked eyes, and slowly began to nod. “That could work,” I stated, cautiously. Morgan nodded with me. “Really guys? I sometimes appreciate how detail-oriented you both are, but it can really be a boon at other moments!” Samara pulled a paper out of her bag. “Now, we need to name our soup-er beautiful and stunning enterprise. I’ll let you two stew over some suggestions, and I’ll go fix the menu!” Morgan and I groaned. “We cannot go to her to resolve any arguments in the future.” I nodded emphatically in response, and Morgan and I sat down to plan the rest of the future of our hotel.