A third-year med school student, Brianna Celix doesn’t get a lot of free time. Even with the one afternoon off she gets each week at the Medical College of Wisconsin in Milwaukee, Celix is being challenged to take care of herself.
Her cat, Frankie, dense as a log, offers plenty of cuddles. And a slice of rich chocolate cake from her favorite gluten-free bakery sits in the freezer. But managing two autoimmune conditions requires more than animal affection and treats. Celix, 25, has to keep up with the demands of medical school while keeping Hashimoto’s thyroiditis and celiac disease in check.
“‘I’m really tired. I might need a medication change,’” Celix remembers telling her doctor a year or two ago. “She says, ‘Well, you’re also a med student.’ So it’s like, OK, which one is it? And I don’t know.”
STAT called Celix to talk about how her chronic conditions led her to study medicine, how she works with the dietary restrictions required of her celiac disease, and more. This interview has been edited for clarity and brevity.
How have rotations been going?
It’s been going OK. I started off with surgery, so that has been a shock to the system. It’s early mornings, long days. Luckily, the site that I’m at specifically doesn’t require me to be there every weekend. I was just there for one full weekend and then I traded that off with a couple of other third years. I have call tonight, so I’ll go into the hospital and stay overnight.
Can you tell me about being diagnosed with Hashimoto’s?
I didn’t get diagnosed with that until I was in high school. I was tired all the time. I was cold all the time. My hair was really brittle and I didn’t know why. I had gained a lot of weight because of it and I had a goiter on my neck. I went to the nurse one winter for strep throat and the nurse said, “Your thyroid feels a little odd. Have you ever had that checked out?” The first pediatric endocrinologist I met with essentially told me — this might sound very crude, but it was our interpretation of it — “You’re an unhealthy, fat kid and you need to get it together.” So that was really hard to deal with.
And then you were diagnosed with celiac disease.
A couple of years later, I ended up getting really sick again with strep throat. I noticed that things weren’t getting better and I was still feeling really tired, really fatigued. I started having stomach pains and other GI symptoms and just not feeling good at all. And there was one morning where I could not wake up. It scared my mom. I remember her being like, “Hey, time to wake up. Time to go to school.” And I kept falling asleep and I kept falling back asleep.
It probably took about a month and a half for us to figure out what was really going on, until someone in the urgent care said, “Hey, it sounds like it sometimes happens after you eat. Have you ever been tested for a gluten allergy, anything like that?” And again, no, because it didn’t run in my family.
Did your illness impact your social life or how comfortable you were with others?
The doctor having that kind of weight bias was definitely a big, big factor for me. I remember in high school there was one year where I would just wear jeans, a T-shirt and a sweatshirt every day. During my junior year, when I got sick with celiac disease, I was missing so much school. For about six months, I would only go to school for half a day — I was missing so much school, was missing so much social time with my friends — and it was isolating. I remember going back in the fall of senior year and people being like, “I didn’t know what happened to you. What went on? I don’t know where you went.” So it was nice to come back and realize that people cared.
How do you decide when or whether to disclose to people your diagnoses?
With celiac disease, I have to disclose that a lot earlier because of the direct impact that it has on me and others. Definitely in my medical school journey, it comes up a lot because that’s my “why” for medicine. It’s like, “Why do you want to do medicine? Why do you want to come to our school?” And so I usually disclose it right away: I’ve got this and I’ve got this, and I want to help folks with it and figure it out with them.
How is it trying to eat within the bounds of your celiac?
That has been really, really, really difficult living in the Midwest. For folks with celiac disease, any little bit of cross-contamination…if you use a knife to cut bread and then that same knife to cut fruit, that’s cross-contamination, and I can’t eat that. It’s also a bit more expensive to live because we can’t get bread. Or if we do get bread, it’s the gluten-free version, or if we get pastas, it’s the gluten-free version. And so that’s also something I’ve been trying to navigate in med school is budgeting with celiac disease because as we also know fresh fruits and vegetables are more expensive.
When eating out, do you tend to avoid certain places altogether?
I will avoid certain places if I know there’s a history of not being gluten-free. I might ask a couple of questions, like, “Do you heat your flour and corn tortillas on the same surface?” Or, “Do you heat hamburger buns on the same surface as where you cook your hamburgers or the caramelized onions? Do you have a safe space in your kitchen where you can prepare gluten-free things? Do you have a dedicated fryer for fries and gluten-free items?” And if you have social anxiety, like I once did, and you are still working through it, that can be a lot more intimidating.
Is there anything else about celiac that you think is misunderstood?
We like being included. One of my love languages, or manifestations of my love languages, is sharing food. It’s hard when you have celiac disease to do that. I might invite folks over for dinner or for tea and provide my gluten-free items to share, and I hope that they don’t mind if it tastes a little bit different.
A couple of times some of my friends have invited us all over for dinner and they make it gluten-free. They’ll even ask, “Can I borrow your pots and pans and cooking utensils so I don’t have to worry about cross-contamination from my pots and pans and cooking utensils that normally would touch gluten or bread?” That always makes me feel very seen and heard and understood. And it makes me just feel like a normal person. It’s really nice to have those moments because when I was first diagnosed with celiac disease, I was so sick, I was isolated. And part of that was also a little bit of self-isolation because I didn’t know how to navigate telling friends.
How have your autoimmune conditions changed your relationship to your body?
I did yoga at one point in college, and the instructor would say, “Recognize your limits, go up to your limits, but don’t push past them if it isn’t safe.” I feel like that’s kind of how I’ve been learning and dealing with my own health.
Sleep is super important, diet is super important. Making sure that I take at least a little bit to breathe. That’s kind of a hard thing as a med student, especially on rotations when it’s so busy. But there have been a couple of times when I’ve managed to pull myself out of the busyness of the day. The other day, I was just driving to work as the sun was coming up and I was like, ‘Wow, that’s really pretty … OK, I’m human again. Let me remind myself that I am human.’
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.