There and (Someday) Back Again

It was a summer afternoon in 2021 and a clinic on Cape Cod’s outer shoreline was packed. It had just beaten its daily record for patients seen, and the atmosphere and pace were frenetic as short-staffed medical personnel churned through those still waiting.

Working in the hectic and stressful environment of a rural urgent care clinic located in the heart of the state’s most popular vacation destination can sometimes mean doctors see patients before triage is complete. That afternoon, a boy diagnosed with swimmer’s ear was the final patient. All that was left to do was dispense his medication before the clinic could close for the day. Lexis Grandel ’24, who was working triage as a medical assistant, hadn’t completed the patient review before the doctor prescribed Augmentin, a standard antibiotic to treat bacterial infections. Finishing up with the usual questions, she asked whether the boy had any allergies to medications. He did, said the father, to penicillin.

“I felt a pang of doom,” Grandel wrote in a self-reflection essay. The prescribing doctor had already left for the day, so she told the father to stay put. She found another physician, who confirmed it would be dangerous for the boy to take the medication as Augmentin fell within the penicillin family. The child’s father looked at Grandel and told her that she may have saved his son’s life.

“I learned through this experience how vital it is to pay attention to the small details,” she wrote. “Additionally, I learned the importance of raising a question when a patient’s well-being could be on the line.”

Grandel’s experience in the clinic, her love of medical science and her intense connection to her community shifted her future from one that initially involved remaining on the outer Cape to work in a year-round or seasonal business to one filled with white coats, research and patient care.

Today, she’s on the cusp of making the latter a professional career.

In July 2023, Grandel, a biology and neuroscience major and a member of the Alpha Sigma Nu honor society, submitted applications to medical schools throughout the country. Throughout fall 2023 and winter 2024, she started hearing decisions — some acceptances, a few rejections and multiple interviews. The dream of having her family help her put on her white coat as a first-year medical student is within reach. 

The Outer Cape 

Grandel grew up in Truro, a small town on the outer Cape peninsula with a year-round population of 2,000, which swells to nearly 20,000 in the summer. As a teen, she worked collecting beach parking passes, chatting with beach-goers, answering questions and reading.

Her dad, Josh, owns a construction business, while her mom, Laura, works as the Provincetown, Massachusetts, tax collector. Both graduated from Provincetown High School, which closed in 2010 due to drastic enrollment decline, and immediately entered the workforce.

"In our tight-knit community, my parents embody hard work, finding fulfillment in their everyday jobs. I learned to be content with the idea of this lifestyle, as well,” Grandel says. She expected to graduate from high school and seamlessly transition into life on the peninsula working in a local bank or waitressing at the town’s only year-round restaurant.

During her freshman year at Nauset Regional High School in Eastham, she took physics and loved it. As a sophomore, she doubled up on honors biology and honors chemistry. By her junior year, Grandel realized she wanted more science courses than the school offered. So, at 16 years old, began taking classes at Cape Cod Community College (CCCC) in Barnstable.

“Once she made her decision, she just never looked back,” Laura Grandel remembers. “She is one of those kids. I never had to ask her about her grades and whether her work was done. We were thrilled for her.”

Initially, Grandel thought she’d take a few classes to prepare herself for college: “But I loved it and stayed.”

Cape Cod Community College

Four days a week during the school year, Grandel rose early to drive nearly one hour to the college four days a week, commuting with friends on a similar academic mission. The more science courses she took, the more she was convinced that her lifelong passion was health care. At CCCC, Grandel took biology and chemistry, added anatomy, physiology and psychology to her list, and became recognized by faculty as a leader in the classroom.

“Some people have a quiet leadership quality about them. They’re not the alpha of the group, but they very much set the tone for how things work,” recalls Thomas Schaefer, associate professor of language and literature at CCCC. “Lexis is that type of person.”

A good part of Schaefer’s classes involved building community through the writing process. “A big part of living and growing up on the outer Cape is a strong sense of knowing the people around you, caring for them, existing together," he says. “You develop a deep connection to your neighbors. Lexis has that.”

In his class, students never wrote an essay on their own; it was a communal effort. Grandel wasn’t typically the first to raise her hand, but Schaefer remembers her supportive, encouraging and humble approach to quietly working with classmates on peer reviews. She offered different perspectives and connected with students 10 years older than her.

“In a class with dual-enrollment students and those who are the average age of 27, there is a pretty stark contrast in how they approach their work. Lexis could live between those two groups,” he recalls.

In March 2020, COVID-19 had upended the world and her community. She continued volunteering at Cape Cod Hospital in Hyannis in as a patient transport helper, which required her to be the go-between for patients, hospital staff and physicians, until volunteers were no longer allowed in the hospital. Unable to continue with her volunteer work, Grandel created a self-study, of sorts, calling it “interpersonal communication in medicine,” during her final semester at the community college, pulling from her experience at the hospital.

“At that point, I realized that medicine was for me. I was interested in clinical and research science, but what I really liked was communicating with patients and those connections,” she says. “It made me understand what medicine is on a different level.”

Being in that community hospital environment reminded her of the tremendous pride her CCCC classmates — all Cape Cod residents from different walks of life — took in their work and their own paths. It reminded her of her parents.

“An immense part of my identity is being a first-generation college student. I’m proud of my parents and their work ethic. I want to apply that to a medical career,” Grandel says.

Medicine

While simultaneously earning a high school diploma and an associate’s degree, Grandel took money from her savings account and put a down-payment on courses to become a certified Emergency Medical Technician. In 2020, as soon as she turned 18, she became state and nationally certified. The next summer and on school breaks, she began working as an urgent care technician in two Cape Cod clinics. There, she learned the importance of showing compassion, the reassuring power of human touch and staying longer even when it’s past your time to leave.

When a middle-aged woman visited the clinic for treatment of rib pain she said she sustained after slipping on stairs, Grandel listened to her gut. She went through the normal course of triage questions — Can you describe the pain? How long has it been going on? — and then listened with her ears and eyes. After taking the woman’s vitals, she had two final standard questions to ask: Have you had any suicidal thoughts in the past two weeks? Do you feel safe at home?

Although her patient’s verbal responses were expected — no for the first and yes for the second — her nonverbal convinced Grandel otherwise. She let her concern show in her eyes.

“I knew I could not walk out of the room without her knowing that she was in a safe place,” Grandel recalled in her reflection. “I grabbed her hand. I expected her to pull away, but she gripped onto me tighter. Her eyes began to water.” Grandel told her she wouldn’t leave her side. The woman was a victim of domestic violence and had multiple broken ribs.

“Some days, after repeating the same questions with each patient, I felt like I did not have a substantial impact, or really any impact at all, on the care they received. I realized through this encounter and others whether I’m taking an active role in treating a patient or simply there to hold their hand, my actions do make a difference,” Grandel wrote.

Her experiences working in the clinics, as a volunteer in Cape Cod Hospital and as an EMT, reinforced her desire to pursue medicine of some sort as a career. That decided, her next step was identifying where she’d continue her academic journey enroute to medical school.

Ultimately, she saw her greatest opportunities at Holy Cross.

College of the Holy Cross

“It was the science complex and the lab space,” Grandel says of her first visit to campus. Visiting those spaces, envisioning herself at a research bench, made the decision for her.

She was familiar with Holy Cross; members of her extended family — distant aunts, uncles and grandparents — are counted among the College’s alumni. All went into law. It wasn’t a school she initially considered, yet when she drove onto the campus, toured the grounds and walked through the science complex, she felt immediately at home: “My parents told me that they could see me here. That meant a lot.”

A class of 2020 high school graduate, Grandel started her collegiate career online due to the ongoing pandemic, yet she was not deterred. The summer before she enrolled at Holy Cross she met Alexis Hill, assistant professor of biology, and jumped at the chance to join her neurobiology lab, which she has remained a member of throughout her years at Holy Cross.
 
“Sophomore year, I mostly assisted people with their projects, but my junior year and this year I’ve done more independent research. It's an incredible experience,” Grandel said. Part of that research experience resulted in Grandel being included as an author on one of Hill’s papers, which was published in the journal Developmental Biology. Grandel’s contribution involved collecting fruit fly eggs and tracking how long it took for the flies to develop.

“Being included as an author on a published paper is something that is really hard to accomplish as an undergraduate,” Grandel says.

She expanded her lab experience when she worked as a teaching assistant in a genetics lab course taught by Geoffrey Findlay, associate professor of biology, where she helped with lab prep work and assisted students with the lab portion of their genetics class. During summer 2023, through the partnership between Holy Cross and UMass Chan Medical School, Grandel conducted summer research with clinical geneticist Helen Lyon, M.D., associate professor of pediatrics at UMass Chan Medical School. In March 2024, Grandel joined Hill at The Allied Genetics Conference in Washington, D. C., where she presented a poster on her research related to how glial cells in fruit flies affect seizure susceptibility.

Her time at Holy Cross hasn’t been spent completely in a lab, however. At some point in time throughout her four years, Grandel has mentored first-year STEM students as part of the Seelos STEM Scholar program and served as a volunteer peer tutor and co-chair of Bio Buddies. She’s co-chair of the Holy Cross chapter of the American Medical Student Association and the Biology Department’s Student Advisory Committee which, among other duties, helps review faculty being considered for promotion.

“There are many ways to navigate college and she figured out these really successful ways to pay it forward and continue driving toward her ultimate goal,” Findlay says.

In recognition of her work, Grandel was named a Dana Scholar, received the Teresa A. Churilla Second-Year Book Award in Biology and the Rev. John W. Flavin, S.J., Award in Biology for her excellence in scientific achievement and significant humanitarian service.

Medical School

An outsider’s impression of Cape Cod is an area of affluent beach communities and a summer vacation mecca of fun. In reality, it is a region with a high rate of substance use and one that qualifies as a rural health care region by national definition. Grandel knows this firsthand. This is why one of her goals is to return to the Cape to work in medicine.

“Although the residents of Cape Cod may appear rich, there are many people who lack access to medical care or proper resources,” she says. “I have witnessed how patients appreciate having tight, genuine connections with their physicians. I want to be able to make my own long-term connections with patients in a setting like this one day.”

Currently, the majority of physicians in the Truro area focus on primary care, with specialists more than an hour's drive away. Grandel imagines herself opening a cardiac or neurology clinic — depending on her specialty — to help members of the Outer Cape have greater access to specialized care.

“We have a lot of talented students in the pre-med track. As they gain experiences during summer internships or in clinical research jobs after graduation, some of them understandably gravitate toward niche specialties or research-oriented positions at academic medical centers,” Findlay says. “Lexis, despite all she’s done, has not changed her mind. She wants to get back to the Cape. She wants to work with and help her community. I appreciate and admire that.”

A more traditional route to medical school involves students taking a year or two between finishing their undergraduate degree and applying to medical schools. They use the time to work in research labs or a clinical setting to gain more experience. Grandel has remained dedicated to going straight through. 

With applications submitted, Grandel now waits for decisions. For several months, she has either traveled to medical schools throughout the eastern and central part of the country for in-person interviews or held them via Zoom. She is providing additional information and continues her research. As of late April, she has been accepted to four medical schools and waited listed at three more. 

“We keep telling her that ultimately she will end up where she’s meant to be,” Laura Grandel says. 

All paths lead home

Grandel has become more sentimental about the Cape. To her, Cape Cod, specifically Truro, is a tight-knit community, a place of natural beauty year-round. The “year-rounders” bond over how quiet it gets in the cooler months, when the tourists are scarce and there is not much to do unless you want to drive over an hour to get to the closest shopping center.

“I have so many memories attached to Truro and the Cape — that is what continuously draws me back. I remember finding it funny when someone was surprised that people live on the Cape year-round, and it's not only meant for vacationers or second homeowners,” she says. Before coming to Holy Cross, Truro was all she knew: “It felt like living in a bubble, but not in a bad way.”

She occasionally tries to see Truro through a tourists’ lens, knowing how excited people are to vacation there: “I’m more appreciative that I get to experience the beauty year-round.” And the little things mean a lot: the peace that arises from being able to walk on an empty beach or visit local businesses; the cookouts, family beach days, seeing her grandfather’s garden and visiting her grandmother at her whale watch job. Grandel wants to start her own family in the same setting, while simultaneously pursuing her dream career.

“Truro,” she says, “is home.”