Ryan Napolillo - Newest Faces of McGovern

Why did you choose to pursue a career in medicine?
I’m not the type of person who knew they wanted to become a physician their whole life, however I felt it has always been inevitable. It just took some time to figure out.

About seven years ago, I found what I believed to be my perfect career — cardiovascular perfusion. It seemed to have everything I could want: self-sufficient practice, a focus on complex physiology, critical problem-solving, and treating only the sickest of patients. So, I spent the next five years centering my entire life around becoming a perfusionist. I attended one of the only universities in the country that offered a BS in cardiovascular perfusion, and everything was going perfectly to plan.

That was until I was halfway through my degree, and my university abruptly shut down my program, permanently. Due to the unique nature of the program, I could not simply transfer my credits to another school and finish out my degree. I was left deserted.

However, despite the death of what had been my dream for half a decade, I strangely did not feel dejected. Instead, I oddly felt relieved. With enough personal reflection, I found that a career in perfusion did lack something I realized was deeply important to me — a personal aspect.

Perfusionists spend years studying anatomy, physiology, pathology, and pharmacology. While they know everything about the human, they lack knowledge of the person. The job of a perfusionist only starts once a patient is already intubated and sedated, and by the time the patient re-emerges, the perfusionist is long gone.

I concluded that all the hours I spent limited to the confines of the OR caused me to lack an understanding of my patients as a complete person, as opposed to a series of quantitative readouts on my monitors. I wanted to understand the person who was beyond the drape. My interest was evidently not in the human body but the person as a whole.

From there, the only path that would allow me to understand a person by both their physical and holistic components was clear. That is when I set off on my pursuit into medicine.

Why McGovern Medical School?
When applying to medical schools, I wanted to avoid the potential of forming a falsely-romanticized paradigm of any program, so I made the decision to not fixate on a “dream school.” Yet, after my McGovern interview day, I could not help but to do exactly that.

Objectively, the school offered everything I was looking for — top-tier clinical sites, a modernly constructed curriculum, abundant research opportunities, and a focus on creating strong clinicians capable of providing optimal care for patients.

However, what ultimately devoted me to McGovern were the interactions I had with the students and faculty. The professors spoke with me in such an entirely unpretentious and natural manner that our conversations felt more akin to a pair of colleagues chatting, rather than a master professional catechizing a candidate.

This also held true for the students, who similarly displayed vibrant personalities beyond just the academic and professional facets of their identities. Following my interview day, I knew that McGovern precisely fit my ideal niche, fulfilling everything I could ask for in a medical school.

What are your motivations?
Principally, I am motivated by my enthusiasm to eventually go out and apply my expertise to make a significant difference in the lives of my future patients. I have come to notice in the past, most of my boughs of indolence were associated with a stark contrast between the work I was completing and the work I am passionate about.

It is easy to get lost within the journey, especially while pursuing a career centered around personal interaction, which first requires you to spend years isolated in a study. That is why I try to make a conscious effort to recognize the connections that tie my studies to future application.

Who is your hero?
Due to the connotation of the word, I tend to refrain from referring to an individual as a “hero” as I feel it often paradoxically detracts from the magnitude of their character. Nonetheless, I have had the pleasure of crossing paths with many individuals in my life who I greatly respect and strive to emulate in some way.

One of the most recent additions that comes to mind is one of my closest friends, Olya. I first came to know Olya when she moved in near my home this past January. At the time, she was a new migrant from Ukraine, here by herself, with the rest of her family set to immigrate in just a couple weeks to join her.

Tragically, Russia launched its invasion of her home country just 36 hours prior to her family’s planned departure. For nearly two months, this young woman was stranded alone in a foreign land, of where she barely spoke the native language, unsure of when, or even if, she will ever see her family again.

I could go on describing the sprawling list of adversities I watched Olya overcome while I stood by her as she started this new life, but words alone cannot bring proper justice to how admirable of a person she is. If I were in her position, I am uncertain of how I would get through. This is why I hope to be able to gain a level of resilience and determination like hers, and I have done everything I can to support her during these difficult past months.

What is your ultimate goal for a career in medicine?
Being asked this question, it is very easy for my mind to first jump to undiscernably vague, grandiose proclamations, such as “promote health equity” or “achieve progress to close social inequalities.” However, one of the few important learns I gained while obtaining my sociology degree is that disseminated targets such as these rarely are effective in incurring change at any appreciable level.

Knowing it is best to initially focus change at a personal or interpersonal level, the most effective goal I could set at this point is simple: to provide the best care possible to each of my patients.

Further into my career, I can more closely refine and target my goals based on what needs and injustices I recognize as pertinent and obtainable. However, regardless of the specific goals I pursue, I hope to do so with the same level of passion and enthusiasm I express today.

What emotions are you feeling beginning medical school?
I would say restless is the best term to describe my feelings preparing for medical school. As with everyone in my class, I have gone through such a long journey that has been ultimately surmounting to this point, so it would be challenging to not be excited about entering this new chapter of life.

With the colloquial visualization of medical school commonly portrayed as a monolithic challenge, on par with the labors of Hercules, I do feel somewhat daunted by what I am stepping into. However, with all the difficulties I have pushed through to reach this position, I feel confident that there is nothing ahead of me I cannot overcome.

What are you looking forward to most about medical school?
What I am most excited for is being in an environment surrounded by fantastic, like-minded individuals and beginning to watch my skills and expertise grow through the coming years. I am aware of how greatly this period of my life will shape the person I go on to become, both in and beyond my professional practice, so I am eager to make the most of it while I can.

What specialty would you choose if you had to pick now?
I would absolutely choose emergency medicine and possibly critical care. For the past 6+ years, I have worked extensively in the field of EM, so I am intimately familiar with the nuances of the profession, and I feel there are few other specialties that could potentially provide me the same level of gratification for another 60 years to come.

For the past four years, I was living in Miami, and I spent that entire duration working as an emergency department and resuscitation technician at Miami’s central tertiary care center. Despite how deeply exhausting and draining the work became at times, I could not imagine any other job I would rather have had. This is because I have yet to find anything as gratifying as having a stranger rapidly nearing death thrown in front of me, then racing to solve the challenge of not only finding what is harming them, but how to stop it.

Watching my patients improve right before my eyes — a neuro deficit subsiding after tPA, V-Tach converting to sinus, the MAP finally reaching 65 mmHg, the sense of impending doom relaxing off a patient’s face — it lifts my entire psyche in an indescribable manner. It truly feels like an addiction, as I have taken part in resuscitating hundreds of patients, but even now I still crave that sensation.

Even in the far less dramatic cases, EM is beautiful in that it allows you to be there for anyone who needs help; right here, right now. For instance, kidney stones are one of my favorite presentations, since we (usually) can help these patients. I can take a person in absolute agony and quickly throw in a line with some ketorolac. Then a few minutes later, I can already begin to see the immense relief washing over them. Even though it’s a basic, routine case, knowing the impact it makes for a patient always brings a smile to my face.

What was your role with the show Fight or Flight?
Fight or Flight was produced for Discovery Channel (you can now stream the full first season anytime on Discovery+). It’s formatted as a docuseries hosted by my best friend, Somy Ali, and co-hosted by myself. The show follows the experience of her and I running our non-profit organization, No More Tears, which is devoted to rescuing victims of domestic violence and human violence, then helping them rebuild their lives from the ground up.

Around a year and a half ago, Somy and I were contacted by executives from the Discovery Channel who had heard of our unique charity model, and asked to discuss the potential of creating a documentary focused on our work. The process of creating a TV show was an interesting journey for me to be a part of, especially since I had never considered working in the entertainment or TV/film production industry.

Overall, it was an experience that I am thankful to have undergone but certainly would not be thrilled to go through again, at least not in similar circumstances. Documentary makers usually frame themselves to be just passive observers of the subject matter, quietly documenting the world in its natural state, like a fly on the wall. However, I don’t think “fly on the wall” is an apt way to describe a documentary crew. I think “giraffe on the wall” better captures the essence of the process.

If you go to someone’s home to have a serious discussion with them, but when you walk in you have a giraffe following you, that person is going to behave differently than if you came alone. Even if the giraffe says “just act like I’m not here,” it’s still a bizarre creature breathing down your neck and occupying half the space in the room, which is hard to ignore. It’s not difficult to imagine how a miniature circus display could also make people uncomfortable, especially when they are amid the most traumatizing and challenging period of their life.

Beyond that, there are also the logistics of being contractually obligated to a giraffe 12 hours a day, six days a week. It takes a lot of planning and work to move, feed, and maintain a giraffe. Something as simple as driving a woman home from a doctor’s appointment, which normally would take me 30 minutes, suddenly becomes a 4.5-hour endeavor when you do it with a giraffe. And of course, every time you are in public, people will flock to the giraffe to gawk and find out what the giraffe is there to watch.

Now that I’ve let that metaphor overstay its welcome, in summation, it was simply a challenging experience, as it created inherent conflicts with the principal goals of our charity’s work. Far too often, Somy and I felt how the associated constraints of this project inhibited us from providing the proper support and services to the survivors we had in our care at the time of filming. Now, only time will tell if these strains and scarifies end up being a worthwhile cause.

Read the rest of the stories from the Newest Faces of McGovern Medical School.