Paul Rufo, AB 1985
I grew up here in Boston, and was lucky enough to get selected for the class of ‘85 at Harvard. I’m surprised to say that I am coming up on my 40th reunion. I came to Harvard thinking I was going to major in Economics and head toward law school. I came to realize that Economics was really a study of human behavior. It challenges us to better understand how people respond (individually and in aggregate), in the context of real or perceived limited resources. It’s a wonderful and unique combination of science, statistics, and applied psychology with principles that are generically applicable in one’s daily personal and professional life. The one concept that resonated with me most has been opportunity cost.
When you choose to do something, you are (at the very same time) actively choosing not doing other things. It’s a great framework for thinking about individual or group behavior, and that’s why economics resonated with me.” All too often, it’s the information and resources that we have access to that drive these choices.
Shortly after I arrived I decided that the Law was probably not going to be the path that I wanted to take. At that time, I found myself in a dorm full of Freshmen interested in going to medical school. I had never thought about that before, and there were no physicians in my family. That being said, I spoke with my freshman advisor, and she then wisely suggested just testing the waters by taking a year of inorganic chemistry. The “experiment” went well, and I really warmed up to the idea of going to medical school. Flexibility in scheduling afforded me the opportunity to remain an Economics major and use my elective time to complete my pre-med requirements.
I took a gap year after graduation and worked as a childcare worker with the New England Home for Little Wanderers. I worked with many kids with very tough backgrounds and very little opportunity, but was nonetheless consistently impressed by their resiliency. My gap year also gave me the opportunity to meet my co-worker and wonderful wife of (now) 30 years. I went on to graduate from the University of Massachusetts Medical School in 1990, and it was there that my interest in pediatrics was further cultivated. I left the greater Boston area for a brief three years to complete my residency in Pediatrics at Johns Hopkins University. I came back to Boston in ‘93, to complete a fellowship in Pediatric Gastroenterology, and I have remained here ever since.
In what seems in retrospect to be a never-ending series of 45 degree career pivots, my experiences during fellowship prompted me to give up the plan of a life as a full-time clinician, and I chose to work in the lab for the next 10 years as a funded independent basic scientist.
My studies primarily related to the role played by potassium and chloride channels in regulating fluid secretion in the GI tract. When my studies point away from the bench and more toward the bedside, I pursued a Master's degree in Clinical Investigation at Harvard Medical School and MIT. I have continued to do patient-oriented translational research for the past two decades. About 15 years ago, I was given the opportunity to help lead our GI fellowship program. We have five fellows per year, and my goal each year is to foster competence, confidence, and openness to impact through innovation and change. I try to help smooth their career track and pass what few pearls of wisdom that I’ve accrued through the years.
I had a network of supportive people at Harvard. My pre-med advisors touched base with me and made sure I was checking off all the boxes as I went along. I found a lot of support with the people in the financial aid office as well. My father passed away in my sophomore year of college. I went to the financial aid office, and within an hour my aid package was reassessed to meet my increased needs and they provided me with a great summer job.
I found support wherever I needed it. Deciding to go to medical school was a fairly abrupt sea change for me. In situations like this, you rely on external support and input to help push you along.
Pediatrics is a field characterized by optimism, because most kids who come to see their doctor get better and return to 100% function. In adult medicine, it’s much more focussed on damage control. Internists engage their patients in an effort to help them to “age well”. In contrast, the practice of Pediatrics can be much more of a cognitive challenge. You might see a 7 year old, a 17 year old, and a 27 year old all on the same day with the same disorder. The 7 year old has a parent who provides all of their care, the 17 year old is struggling for independence, and the 27 year old is all out on their own. I have to explain to each of these patients the same information about their diagnosis and treatment in language that they can understand. I can’t change the fact that they have IBD, but I can make them understand what they have and how we’re going to treat it. When you explain things correctly, you can take away a lot of that uncertainty and anxiety. There is a huge developmental component to Pediatrics as well. How you impact on your patients will affect the way they think about doctors and their disease for years to come.
We initially conceived this mentorship program because of what we saw as an unmet need. Diana found that one of her son’s college roommates needed accessible real-time support to think about career opportunities and the paths they take. My own experience certainly underscored the importance of having the right exposure and access to the right resources at the right time, to make the best decisions. This program can be just that opportunity for those students that don’t have lots of external support to push them to pursue their interest in medical care.
You need folks to validate and support your interests early on. Eventually you’ll build a level of resiliency that you can rely on your own to help sustain you through more difficult patches.
Paul A. Rufo
AB 1985 | Economics
MMS 2002
Pediatric Gastroenterologist
Interviewed and Compiled by Felicia Ho