Ashley Lengel, PA-C, MMS, has been interested in science and medicine for as long as she can remember. As an undergraduate, she majored in biomedical engineering but later pivoted to being a physician assistant. Now she’s our latest APP Neurology Fellow, where she’s using her knowledge of engineering to better understand the functions of the nervous system. In this week’s Spotlight interview, Lengel talks to us about her path to the APP fellowship program, her future career plans, and being a “huge band nerd” outside of Duke.
What are your current responsibilities as an APP fellow? What does a typical day look like for you?
Like many other APP residencies, this program is one year in length, dedicated to learning more about neurological practice. Throughout the year, I’ll be rotating through outpatient neurological subspecialties (i.e. headache, epilepsy, etc) and also through some inpatient neurological services. To get started, though, I’ve been spending time in the General Neurology clinic so I can get exposed to a wide variety of conditions.
Typically the night before, I read about the next day’s patients so I can be familiar with their care and actively participate in each visit. After gathering information about the patient and their neurological concerns, we’ll collaborate about a plan to ensure the patient has appropriate medications/therapies, discuss our plan with the patient, and make sure we set up proper follow-up care. They’re usually a pretty busy service, so I feel like I’m constantly seeing new things and learning so much every day!
How did you decide to become a physician assistant? How did you decide to focus on neurology in particular?
I’ve been interested in science and medicine for as long as I can remember, but I could never seem to make up my mind on how exactly I wanted to be involved. When I went to college, I had decided that I wanted to do research and come up with creative solutions for lots of patients, so I pursued biomedical engineering. I learned after just one shadowing experience in Child Neurology that I absolutely wanted to spend my life in front of patients instead of behind the lab bench!
I didn’t know any PAs at that point, but once I met one and heard about all they do, I was sold! I love the flexibility that being a PA offers; PAs can work in so many settings and specialties, and the ability to spend my career doing many different things really excites me. I love the relationship between the PA and physician and the teamwork that treating patients entails. As far as neurology, I have a bit of a personal stake in the field. I’m a neurological and neurosurgical patient, myself, and that experience drives me to spend my lifetime serving others who may experience similar hardship. Plus, neurology is such an innovative and fascinating specialty, so it’s easy to be interested in!
What plans do you have for after you complete your residency? If you could have any job in the world what would it be?
I’d absolutely love to stay with Duke after my residency is over. I’ve already met so many kind people and my experience has been overwhelmingly positive, so I can’t imagine a better place to build my career. Right now, I’m mainly interested in working in the outpatient setting, but who knows what the year will bring!
I came into this program being really interested in movement disorders, but I’m excited to learn and experience it all. In addition to seeing patients, though, I’m really passionate about education and advocating for the PA profession. I’d absolutely love to serve as full-time faculty at a PA program so I can teach future PAs and pay forward the outstanding impact my professors had on me during my PA training at Baylor College of Medicine.
In addition to your clinical degrees you have an undergraduate degree in biomedical engineering. What do you enjoy about that field, and how does that knowledge inform your clinical perspective?
Biomedical engineering is such an incredible field! There is so much creativity happening behind the scenes of what we see being applied for our patients. It seems like a strange jump to come from engineering to patient-care, but it really did shape my passion for medicine in the best way possible! Being able to see the science first-hand behind the medications, tools, therapies, and devices we give to our patients lead me to not take any of those things for granted and gives me a huge sense of trust for what I’ll be recommending for my patients.
Also, neurology has been a good fit for me because it seems to make sense to my “engineering brain.” Neurological function comes from electrical signaling, feedback systems, and particular findings linked to exact anatomical locations/structures, and all of those things remind me of how we’d approach technology! There are also countless devices used in neurology, like deep brain stimulators and transcranial magnetic stimulation, that hold me to my engineering roots while working with these patients.
You’re also involved with the Chiari Project, an organization that connects patients suffering from Chiari Malformation. How did you come to be involved with this organization and what is your current role in it?
Patient advocacy and education are huge passions of mine, and I’m really fortunate to have the opportunity to work with The Chiari Project (TCP) to do those things. After a long diagnosis process and some really debilitating symptoms, I decided to undergo a posterior fossa decompression procedure for my Chiari Malformation I. Thankfully, I was blessed with a wonderful outcome that alleviated the majority of my symptoms and brought others to a tolerable level.
With my new-found health and energy now that I was feeling well, I got this crazy idea that I wanted to give a motivational speech about my experience. Some quick Googling led me to a page on TCP’s site that said “Do you want to become an advocate?” Obviously, my answer was yes! I connected with TCP’s founder and after a lengthy discussion about my experience and my goals, I ended up leading a motivational speaking series called “Brainspire.” Brainspire features three neurological patients or loved ones of those patients, who speak about the diagnosis, symptoms, treatment, and aftermath of their illness. Every person goes through some sort of hardship in life, and the goal of Brainspire is to give listeners an opportunity to hear the strategies our speakers employed in their battle against their illness and apply those lessons to their own lives. We’ve had three virtual events and can’t wait to keep raising awareness!
What other passions or hobbies do you have outside of Duke?
I’m a huge band nerd! I started band in fifth grade and participated all the way through college! College marching band with the University of Cincinnati Bearcat Bands was one of the most rewarding experiences of my life! I marched mellophone (basically a marching version of a French horn) for my first two years and then was a Drum Major (field conductor) for my last three years. I participated in the Houston Pride Band throughout PA school, and of course now that I moved here, the first thing I did was sign up for the Durham Community Band! I can’t wait to start outdoor, socially-distanced rehearsals in August!