Empowered to Succeed

“I chose Meredith because they had this unique program and I knew I needed what they had to offer.” – Dr. Bea Zepeda, ’02

When most people take a vacation to Hawaii, they’re looking for some well-deserved down time to relax and recharge. But when Dr. Bea Zepeda, ’02, was on vacation in 1998, she took that opportunity to make a life-changing decision – to begin college at the age of 42, with the ultimate goal of becoming a pediatric physician.  With 14 years of school ahead of her, it would have been daunting to even the strongest woman.

Zepeda came to her decision having spent thirteen years working as a pediatric respiratory therapist.

“I was already in medicine and I always knew it would be pediatrics. That’s never changed, ever,” said Zepeda.

She has accomplished her original goal – and then some. She earned a bachelor’s degree in biology from Meredith College and completed medical school at East Carolina University’s Brody School of Medicine, an internship and residency at Helen DeVos Children’s Hospital, and a fellowship at Duke University Medical Center.

She has since returned to East Carolina University (ECU) where she is a pediatric critical care intensivist and is the medical director of the Pediatric Transitional Care Unit at Vidant Medical Center, Brody School of Medicine. She is also a faculty member at Brody.

She gives credit to Meredith for setting her on the path to fulfilling her life’s purpose.

“Meredith was the reason I was able to succeed, because it started there. The nurturing and the academic excellence that was really pushed there allowed me to succeed,” said Zepeda. “It’s a long process – starting in middle age and being able to have that opportunity that has shaped my life. I don’t know that I could have succeeded at another institution the way I did at Meredith. It gave me the confidence to go on to medical school.”

Getting Started

For many people, college is a foregone conclusion – a natural next step after finishing high school. Not so for Zepeda.

“I came from a poor family. My father was a laborer who never finished high school, my mother stayed at home. Nobody in my family had gone to college. My grandparents were illiterate, never went to school.” Zepeda continued, “If you have that background in another country, you don’t go to college at 42. You continue to labor on.”

When Zepeda made the decision to become a doctor, she had attended technical school and because of her work as a respiratory therapist she already knew that she loved medicine. Originally she thought she would become a physician assistant. But the doctors she worked with at WakeMed encouraged her to go to medical school instead.

As she considered where to start what she knew would be a long and challenging educational journey, she visited colleges and universities in the Raleigh area. It quickly became clear to Zepeda that Meredith’s adult education program offered something different, both for her learning style and her age.

“I chose Meredith because they had this unique program and I knew I needed what they had to offer. When I visited other, larger schools, I realized that there would be 300 students in Chemistry 101 and I thought, ‘I can’t do this. I need different things.’”

Zepeda said the faculty and staff helped her plan her schedule around her work, which was critical because as an adult student, she had to continue to work full-time to support herself. She graduated in three years by taking 20 hours a semester.

“In the hospital you can work weekends. I could work Friday, Saturday, Sunday night, and earn 40 hours. You can work around those things. You just learn to adapt.”

She was also nervous about going to school as an adult, thinking she would stick out like a “sore thumb.”

What she found surprised her.

“All the pre-health, pre-med people studied together and I was very accepted. I was never treated any differently – the professors didn’t, and the students didn’t. That was very reassuring about Meredith.”

Zepeda said Meredith prepared her well for medical school – as much as one can be prepared for such a rigorous experience.

“Meredith did a good job of getting us ready. One of the doctors I worked with said going to medical school is like trying to drink water from a fire hose. You get so much information so fast, but I knew that all my classmates felt the same way. I felt very prepared,” said Zepeda.

She credits Meredith faculty with that excellent preparation, adding that support came from across all disciplines. When she was getting ready to take the MCAT, the entrance exam for medical school, she was concerned that her writing wasn’t strong enough. An English professor who had taught her introductory classes gave her simple steps to improve her writing.

“When I took the MCATs my writing scores were higher than I thought they would be because she told me the basics to focus on. She really helped me – she didn’t have to, but she took the time to do that.”

A Lifelong Learner

Zepeda’s deep love of learning was evident throughout her medical school education. She described the training she had in technical school as very clinical and hands-on. It was appropriate for her work as a respiratory therapist, but she always had more questions.

“In my second year of microbiology at Meredith, it was fascinating. I had the pieces, but then was able to pull them together and to understand how we use this in medicine. It answered a lot of questions.”

She had similar experiences as she progressed through medical school, her internship, residency, and fellowship.

“As an intern it was a joy because I finally could put everything together after working in a hospital for 20 years. There were so many ‘aha moments’ when everything came together clinically, it was just wonderful.”

Zepeda describes herself as a lifelong learner, a characteristic she sees as essential for a medical professional.

“There are so many changes coming down the pike, it’s almost impossible to keep up with them,” said Zepeda.

To help stay abreast of such changes, Zepeda has formed a “journal club” with her colleagues at ECU. They meet regularly and present journal articles to one another. She also uses an app to maintain a digital library of every medical journal and then reviews monthly updates. Most important, she and her colleagues come together to discuss the challenges and successes they encounter.

“It’s helpful to talk things through with your colleagues. We’re always there for each other – it’s helpful to have that kind of collegiality. We’re very lucky to have that.”

Peaks and Valleys

Such support is critical, for Zepeda’s chosen branch of medicine, pediatric intensive care, is equal parts difficult and inspiring. Often the children who come to the pediatric intensive care unit (PICU) have been subjected to a trauma, such as an accident or a near drowning. Such experiences are devastating for the child as well as the child’s family.

Part of Zepeda’s role is to coordinate the multitude of resources that are required to support critically ill children and their families. As director of the transitional care unit, she cares for approximately 40 chronic, complex, medically-fragile children, including paying home visits.

According to Dr. Bill Novotny, co-director of the pediatric intensive care unit, Zepeda’s contributions to the unit cannot be overstated.

“I have known Dr. Zepeda for going on three years. What you see is what you get … she is an unapologetic straight shooter. She is energetic and tireless as a clinical care provider and takes every opportunity as she provides that care to teach the residents and ancillary staff the nuts and bolts of pediatric critical care medicine. Interactions with families are exemplary, and she is especially effective at caring for Hispanic families of children under her care because she is fluent in Spanish,” said Novotny.

He noted that she is rarely content with the status quo and continues to advance the work of the clinic.

“She has created, largely by herself, a simulation laboratory where she teaches residents basic skills needed in the mastery of procedures performed in critically ill children and is currently planning to implement a hospice/palliative care/bereavement program that will help critically ill children and their families deal with the all too often and too soon reality of death.”

For Zepeda, and her colleagues, that hard reality is the most difficult part of their job.

“In the PICU it can be daunting when you have to talk with a family and tell them that there’s no hope. You always want to give them hope, but sometimes there isn’t. It’s heartbreaking because it’s their child,” said Zepeda. “It’s hard on the staff because we care about what we do. We care about the children and families.”

While the losses are distressing, the successes sustain those working in the PICU. Zepeda told the story of a child who was on mechanical ventilation for a long time. Contrary to expectations, he ended up not needing any of the more invasive supports they thought he would require. Ultimately they were able to send him home.

“We see patients who have had traumatic brain injuries and by the time they go home, they’re talking. It is amazing how resilient children are. That’s the part of pediatrics that’s rewarding. You know you can make a difference, you can help this child to succeed, to live as fulfilling a life as possible.”

Giving Back to Meredith

Zepeda has stayed connected to Meredith, particularly to Liz Wolfinger, dean of the school of natural and mathematical sciences and one of Zepeda’s favorite faculty members.  When she returned to ECU after completing her fellowship at Duke, she reached out to Wolfinger, who put her in touch with Karthik Aghoram, professor of biological sciences and chair of the health professions advising office at Meredith.

Zepeda invited Aghoram to shadow her for half a day in the PICU.

“My goal in physician shadowing was to become a more knowledgeable pre-health advisor. It was a very eye-opening experience. It gave me a first-hand look at how medical professionals work together as a team to provide quality care,” said Aghoram.

He was inspired to see Zepeda at work.

“She is a great example of a Meredith alumna who combines professional knowledge and inner strength with empathy, compassion, and professionalism,” he said.

Since shadowing Zepeda in 2014, Aghoram has sent a number of Meredith students to do the same. Zepeda believes it’s a valuable experience for students to see the vast differences between pediatrics and pediatric intensive care.

Zepeda said that she feels loyal to Meredith because it made such a critical difference in her life, and looks for ways to give back to the College.

“I feel very blessed. There’s a community of giving and gratitude at Meredith that you don’t find at big universities. It was vital to my success to have a place like that.”

New Horizons

Zepeda continues to seek out opportunities to grow professionally. Currently, she is excited about telemedicine, an emerging form of medicine that she believes holds particular promise for Eastern North Carolina. She is working with the telemedicine department at ECU to develop its use in pediatric intensive care.

“You can do a physical exam from a distance. Here in Eastern N.C. we have patients who are hours away from us. For my chronic kids, that’s the next piece. Being able to do a home visit every four months and do this in the interim would allow me to use my time in a more efficient way,” said Zepeda.

Using telemedicine with children on mechanical ventilation at home, for instance, would allow her to move faster with the weaning process and get them off the vent. She also noted that families of children on ventilators often have to take several days off from work to get to the clinic because it’s so complicated to move them, so telemedicine would be especially beneficial for such families.

Seventeen years after her fateful Hawaiian vacation, Zepeda still relies on down time for inspiration and renewal, and to feed her creativity. She laughs that her division head always knows when she’s been away.

“I take my vacation time. For me, having time alone is when I recharge and can think about things and not be influenced by the people and stress around me. When I go on vacation, that’s when I come up with these ideas, these decisions.”

For Zepeda, prayer is also essential to her ability to meet the demands of her profession.

“By the grace of God is why I’m here doing what I’m doing. It’s not me. I say that with all humility. There’s no reason that I should be able to do this – it is through grace that I have this – through grace that I found Meredith. All those pieces came together.”