Megan Wren, MD is a Washington University undergraduate, medical school and residency alumna. She was a chief resident, and currently is a professor of medicine and serves as the associate program director of the Internal Medicine Residency Program. She has been involved in resident and medical student education throughout her career.
Kelly McDermott: Tell us how you ended up here!
Megan Wren: I’m a lifer here at Washington University. I grew up in the suburbs of Philadelphia, came out here for school, discovered it was a wonderful place, and have stayed on forever. Clinically, I am a primary care doc, so I see residents mostly in the clinic, but sometimes inpatient services as well.
McDermott: Do you have any favorite hobbies or passions that you like to do around St. Louis?
Wren: My hobbies all include making things. If you’ve been in the Center for Outpatient Health clinic, you’d know that I bring in baked goods periodically. I’ve been trying to back off on that a little, with too much indulging through these COVID times. But I enjoy baking, gardening, and sewing. Also, during my residency, my husband and I gut-rehabbed an old house in the Shaw neighborhood in St. Louis. So if you want to talk about how to hang drywall or lay tile, we would be happy to fill you in on that.
McDermott: How did you choose your specialty?
Wren: In some ways, don’t you think specialties choose us? It just feels right. When I came to medical school, I was pretty sure that I wanted to do something primary care related. I was initially thinking family medicine or maybe med-peds. But once I started doing my clerkships, I didn’t feel like I could master either of those areas, much less both of them. So I decided to focus on internal medicine and I really liked internal medicine a lot more. It just felt right. I really enjoyed the patients and the teams I worked with, the kind of things we were doing. I like that in primary care you get to really take care of the patient head-to-toe, deal with everything that comes up, and take care of them as a whole person.
McDermott: What aspects of your work bring you joy?
Wren: Teaching and patient care. As you know, both sometimes can be challenging and frustrating, but so incredibly rewarding when it goes well. You feel like you’ve made a difference in someone’s life. So whether it’s a patient or a student, the interaction will hopefully have lasting effects.
McDermott: What is the biggest challenge that you faced as a female faculty member in your specialty?
Wren: When my kids were young, it was obviously challenging having two young kids and working full time in medicine. There never seemed to be enough hours in the day; I felt very stretched and stressed at that point. It’s not as bad now that they’re grown. And I have to say that I haven’t felt gender discrimination through my career. Maybe because internal medicine has had a lot of women in it, especially in primary care. Maybe it’s more prevalent in some other fields, but, fortunately, I haven’t had to deal with that.
McDermott: Interesting point. Here’s a more fun, but also very important, question. Do you have a favorite on-call snack or food?
Wren: As a resident, it was very standard. The Jewish Hospital cafeteria closed at 1:30 AM, so right around 1 AM, we would make a cafeteria run for the last snack of the night. If it was going to be an “up all night” night, which was unfortunately the norm in those days when we usually worked 36 hours or more, every 3rd night, then it was cheese fries and a coke … so unhealthy. But if I thought that maybe I would get some sleep for a few hours, I would get milk and Suzy Q’s. As an attending I bring pseudo-healthy snacks for my on-call team: oatmeal cookies or banana bread.
McDermott: Amazing and relatable. My go to on-call drink tends to be an orange soda. Have you had any pivotal moments that have changed your career?
Wren: I can’t think of any big “aha” moments; no epiphanies, but more sort of serendipity. When you talk to attendings, you may find more serendipity that you thought. You think that so and so was destined to be a nephrologist, that they were born to be a nephrologist … but a lot of people’s paths were not as direct as you would think. When I was finishing my chief residency year, I was applying for primary care jobs in the St. Louis area and I almost signed at the Grace Hill clinic, now Affinia. I almost signed to work there, but the director of the resident’s clinic at Jewish Hospital stepped down right around that time and I ended up taking that job. I thought, ‘Oh I’ll stay in the academic environment for 3-5 years and see where to go next.’ But I fell into things and, the more time I spent doing residency administration and teaching, the more I liked it and here I am, 30 years later.
McDermott: What would you identify as one of the most challenging times in your career?
Wren: Internship – back in the bad old days, when there were not guaranteed days off … No guaranteed time to leave. I don’t cope well with sleep deprivation, so it felt like all I did was work and sleep. It was pretty miserable. (I got through it)mostly because I felt that I didn’t have any other choice… like the saying from Finding Nemo, “just keep swimming, just keep swimming.” It was sort of like that. Just make it through another day. I am so glad those days are gone. That was not healthy.
McDermott: What makes you most proud of yourself?
Wren: This may be stereotypically like a woman, but it’s hard to say that I’m proud of myself. I’m proud of my family and how wonderful they are. I’m proud of having, hopefully, good interactions with a lot of students and a lot of patients over many years. This is the 18th year that I’ve been teaching the Practice of Medicine course. Hopefully, over the years, I have influenced some second-year students, and laid some good groundwork for their future clinical careers. I am sure you still remember some of the things that you were taught 1st and 2nd year of medical school. I still remember a few little tidbits. And it’s not always the things that the professor is intending for you to remember … but who knows what little off-hand remark you make will stick with someone forever. It forms your first habits and the habits that you learn as a student will stick with you forever. So hopefully we are all working to mold people in the right direction … right from the start.
McDermott: If you could have one piece of advice for a younger female physician, what would it be?
Wren: Cut yourself some slack. We all feel like we ought to do everything. If you grew up with your mom making you iron the sheets and fold your clothes, you feel like you must do those things. But at some point, you let it go and realize that, no, you actually don’t have to. I remember a high-ranking female faculty member talking about how she used to drive herself crazy making seven different kinds of Christmas cooking every year because that’s what her mom did, then she realized that it was not accomplishing anything, so she cut it back. She only does two kinds of Christmas cookies and does them after Christmas, with the kids, and everyone is happier. And don’t we all have those little things that no one else cares about, but we have trouble letting go? So sometimes, just let them go. Cut yourself some slack. No one cares if you have ironed your jeans or not, or whatever it is.
But if something gives you joy, do it. When my kids were little, I enjoyed making their Halloween costumes. I like sewing and it was a fun project; we would all go together to the fabric store and pick out the fabric and patterns. It was a fun project for my girls and I to do together every year. But there were plenty other things that I didn’t do because I didn’t like doing them.
McDermott: What’s your favorite costume that you all made together?
Wren: One year, one of my daughters decided that she wanted to be an American Colonial girl. So she picked out a historical costume, a legitimate historical dress with a fitted bodice with boning in it and lace around the skirt and sleeves. A few years later, her little sister wore the costume when visiting Colonial Williamsburg and people kept stopping and asking her questions because they thought that she was part of the exhibit. So I think that was a successful costume.
Dr. Kelly McDermott is a first-year internal medicine resident with an interest in primary care and health equity.