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Shannon
Martin [not her real name] sees more than a dozen patients a week,
demystifying scientific jargon and assuaging fears. A genetic counselor
at a multispeciality group medical practice on the East Coast, Martin
spends at least an hour with each patient, taking family medical
histories and creating profiles for families and individuals with
potential genetic predispositions, as well as for high-risk couples
trying to conceive a child. Her organization has 300,000 patients,
and her three-person department caters to all of its members with
genetic disorders or those who have been deemed at risk by family
history or genetic testing.
The
science behind the emotions
In February 2001, scientists announced the isolation of the gene that
causes breast cancer to progress into malignancy. Part of a larger
project to map the human genome, this discovery - and others like
it - could lead to early detection and deterrence of a number of genetic
disorders.
However,
just because a relative developed cancer at doesn't mean you're
destined to follow along the same path.
"Most
people come in much more scared than what their reality actually
is," Martin said. "Their risks are usually much lower
than they think."
Martin
and her colleagues don't do the testing or research themselves.
They strictly deal with the emotional repercussions of potential
genetic risks, providing support and information to individuals
and families of those who suffer from birth defects or proven genetic
disorders. Through intensive documentation, a family history is
pieced together and genetic risk assessed.
A visit
with a genetic counselor is usually a good opportunity for people
to discover more about their extended relatives. Taking
a detailed history involves a lot of time and research. "I'll
ask questions about people's family members that I probably don't
know about my own family," said Martin.
Some
people come to Martin with their genetic code already mapped out.
People who have received genetic testing and show a predisposition
for a disorder see Martin to help cope with their health risks.
Others, who are simply at risk due to family history, Martin helps
decide whether genetic testing is necessary. She points out that
testing can help or harm, because the emotional and physical ramifications
of the test can be tremendous. Martin tracks patients before, during,
and after testing, acting as a medical interpreter and support staff
if the information proves upsetting. Most of her patients are short-term,
but a few use her services over long periods.
"The
emotional side is very rewarding. You can get very close to the
families," Martin said. "It's a hard time for most people,
and if you can be there to help and listen to their questions, it
means a lot to them."
A burgeoning
field
According to the National Society of Genetic Counseling, a nonprofit
trade organization, genetic counselors must hold specialized graduate
degrees in genetic counseling. Coursework includes clinical, population,
and molecular genetics; as well as psychosocial theory, ethics, and
counseling techniques. Internships are necessary and field experience
is essential.
Martin
holds a master's degree in genetic counseling, and remembers spending
"countless hours" in internships during her graduate career.
But she found the study of genetics captivating.
"I
wasn't sure if I wanted to go into medical school or not, and I
had a really great genetics professor in college. I found it fascinating,"
Martin said. "I like the science of it – the whole field is
exploding."
The
diversity of the field also attracted Martin. "If you get burned
out in one area, you can find something new to do." When she
first became a genetic counselor, the field was all prenatal or
pediatrics-based, but it now includes all portions of the population.
Plus, genetics as a whole is constantly advancing. "You have
to read a lot, you have to keep up on things," Martin said.
Even
though genetic counseling is still a relatively unknown field, Martin
has seen unprecedented growth in the number of colleagues in her
profession. "At the first professional meeting I attended,
there were about 200 people. Now there are about 1,200 to 1,500
involved," she said.
And
the only way is up, according to Martin. "The field will get
to be more well-known, especially with the completion of the Human
Genome Project," she said. "People want to know what they
are at risk for, what they can do about it."
Cracking
the code of this dream job
Practitioners in this field must combine the scientific acumen
and the emotional fortitude to help people cope with genetic predispositions.
Like most counselors and therapists, Martin points to internships
and field experience as the best litmus test for aspiring genetic
counselors. She was lucky enough to work with a genetic counselor
during her graduate program. But it's possible to start smaller, too.
"Spend some time in a counseling setting to make sure that's
what you like," she said. "Volunteer at a suicide hotline,
or Planned Parenthood."
She
also advises students, "Taking time off [between college and
graduate school] is a wise thing. I didn't, and I was burned out
when I started," Martin said. Also, Martin was quite young
when she entered the profession almost 15 years ago. "There
I was, 25 years old with patients who were 40," she continued.
"So it's a little strange. You have to learn how to deal with
it."
Like
most health care professionals, Martin also has paperwork to keep
in precise order. "The worst part of the job is billing,"
she said. "Dealing with insurance companies is hard."
So,
if you think you can handle the complexities of both human emotions
and human wiring, crack the books, crack the code...and dream on!
-
Regina M. Robo, News Editor
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