Mack Brickley and Alanna Boyajian: Mixing Medicine with Adventure

Before Alanna Boyajian and Robert "Mack" Brickley met in their first year at P&S, they both decided to take time off after college to be sure medical school was the right choice. Coincidentally, each found affirmation and direction by working with troubled teens, albeit in very different contexts.

For Mack, who studied biology as a pre-med at Williams College in Massachusetts, the decision was “either medical school or eight other different things.” He decided to go somewhere completely different: the deserts of Utah, where he spent a year and a half as a counselor in a wilderness therapy program. The program was designed as an intervention for teens whose life was going awry.

“Some kids came from the court system. Some were suicidal,” Mack says. “The trick is to take them out of any known environment, put them into an unfamiliar place—the Utah desert—and hit a grand reset button.” He eventually got certified as a wilderness EMT, which was his first exposure to acute care medicine. “We were eating meals over a campfire and under a tarp, 60 miles from the nearest paved road,” he says, “and meanwhile you have kids who are threatening to hurt themselves, or fight, or run off into the desert.”

Ultimately, it was the Columbia-Bassett program that convinced Mack to enroll in medical school. His premed adviser had heard about the program before it was off the ground and thought the program could be a great fit. When Mack applied, Columbia-Bassett was still so new that none of the inaugural class had begun the clinical curriculum yet.

“It’s a truly unique program not being offered anywhere in the country,” he says. “The appeal was the combination of being able to split time between New York and a rural setting, with the longitudinal curriculum that allows students to follow patients over time. But the third major reason was its focus on health care systems and leadership.”

Mack also found a way to balance his studies with his love of the outdoors: in 2012, along with two other students, Mack founded the P&S Outdoor Orientation Program (P-SOOP), which leads three-day backpacking trips for new students to upstate New York and the Catskills.

Around the same time that Mack was in the desert, Alanna was in Manhattan, about as far from Utah as possible, working as an intern with Planned Parenthood. After studying community health and teaching sexual education classes at Brown University, it seemed the best way to continue to develop her interests.

Alanna’s focus at that point was on communities and population-level health, but after her time at Planned Parenthood and later at an ob/gyn clinic, her thoughts began to change. “I realized that I love interacting with patients, and I could have a more meaningful impact in a one-to-one relationship rather than focusing on the health of a community.”

When she entered P&S, Alanna planned to go into obstetrics and gynecology. But during her first rotation in primary care, an adolescent medicine physician at Harlem Hospital made a big impression on her. Reasoning that the best way to help teenagers in the long run is to encourage them to take responsibility for their own health, the physician required teenage patients to sign a contract saying they would come to their own appointments and pick up their own prescriptions.

“This concept resonated with me,” Alanna says, “as I had spent years in college learning about the importance of prevention. Encouraging comfortable relationships with health care seemed like the epitome of preventive care. I found that much of adult care was directed at secondary prevention; working with young patients provides greater opportunity for primary prevention, because they are relatively healthy, and there’s often a clear intervention point to instill positive behaviors that will allow them to live healthy lives.”

Both Mack and Alanna will begin residencies at the University of Pittsburgh Medical Center, he in emergency medicine, she in pediatrics. They will be about 45 minutes from where Mack grew up and close to the outdoor spots where he finds pleasure and solace.

Outdoor adventures are new for Alanna: Mack took her camping for the first time in the beginning of their relationship, and just recently the couple went backcountry kite skiing in Montana. “My ‘introduction’ to anything outdoorsy is always at his very experienced level,” Alanna says. “Instead of learning to climb in gyms, I went straight to the Gunks and Yosemite—some of the premier climbing spots in the country. He never eases me into any of these activities, but it has always been worth trusting him.”