Jessica Cerdeña is an MD/PhD student in medical anthropology at Yale University. She is a part of Health Policy Research Scholars Cohort 2017.
Before we begin, tell us a little bit about yourself and what your research interests are.
I want to live in a world with universal health care, paid parental leave, reparations for slavery, and vegan cheese that would pass a blind taste test alongside the real thing. Although my large and loving Italian-Chilean family always gave me a hard time for my nerdiness, they instilled in me the conviction to fight for what I believe in. I grew up in northern New Jersey, surrounded by immigrants—an experience that shaped my interests in anthropology and social justice.
I am currently completing my MD/PhD in medical anthropology at Yale, where I study intergenerational trauma in Latin American migrant women and their infants.
When I’m not doing bio-ethnography or seeing patients, you can find me with my husband, Ignacio; my son, Nahuel; and our dog, Toby; either exploring a new restaurant or hiking trail around New Haven or in our kitchen proving that vegetables really do taste delicious!
What’s the story behind why you’re doing what you’re doing?
When I was working in the local free clinic, I provided mental health support to migrants who had harrowing experiences. As we worked together to develop coping strategies, I learned that many of them—especially the women—were concerned about how their trauma was affecting their kids. This first got me to search the terms “intergenerational trauma,” which I found out is, in fact, a thing. Yet, most of the research I came across focused on “parenting behaviors,”which struck me as blaming the victim. Instead, I’m interested in seeing whether trauma may induce physiologic and molecular changes that can persist into the next generation.
Tell us about a project you are currently working on that you are excited about.
You know how when you see smoke you can’t just walk on by—you have to call 9-1-1? Well, when I’m on the medical side of campus, there isn’t just a lot of smoke, there are 10-foot flames! My other passion project involves researching and writing about how we can address systemic injustices in medicine.
Right now, I’m working with another HPRS scholar, Marie Plaisime, on two projects surrounding race-based medicine: the racist practice of patterning medical treatment based on a patient’s race. We are preparing a policy statement denouncing race-based medicine while also analyzing instances of race-based medicine in evidence-based guidelines used routinely by clinicians. We hope this kind of work can reduce race-based medicine and lead to more equitable care.
For people unfamiliar with your research area, what is one piece of information you think is important for them to know?
When I talk about my research, one thing that confuses people—my family included—is the concept of “epigenetics.” Epigenetics refers to chemical tags on DNA that change how that DNA is transcribed. In other words, if your DNA, or your genome, is a box of Legos, epigenetics determines which Legos each cell uses and how often. It doesn’t change what you start with—you can thank your parents for that—but it decides whether they’re combined to form a skin cell or a brain cell or a heart cell. Oftentimes, it’s much more subtle than that. Epigenetic tags are constantly responding to signals in your body, and this helps humans respond to changing environments. It’s part of what has made our species so successful!
Now how does this relate to trauma? Well, human bodies can experience various stressors that can alter their epigenome—things like starvation or extreme cold. Trauma is like that: We understand that trauma can induce epigenetic changes to genes involved in the stress response, causing them to be more or less activated. The questions in my research are (1) to what extent do we see this in Latin American migrant women, and (2) do we see any of these changes in their young babies?
Who is a researcher you admire and why?
I’d have to say my son, Nahuel. He’s five months old, and he’s the most curious and persistent little investigator I know! He observes everything, he’s always trying new things, and he never lets anything set him back—except maybe hunger and fatigue—but hey, we’re all human! I admire his innate inquisitiveness, and that motivates me on days when I feel weighed down by the pressures of academic life.
How has being an HPRS Scholar helped you during your time as a doctoral candidate?
HPRS folks are my hype people. They have pulled me through the toughest moments of my PhD and shared in my greatest highlights. HPRS provides an unparalleled community of peers and mentors who share my experiences and values. The program has opened my mind to new career possibilities and made me even more excited about my potential to achieve change by applying the cultural capital I am building through my training.
In the RWJF HPRS program, we have worked with you to help you think further about using your research to develop policy. If you could use your research to change any policy, what policy would it be?
Health care. When the Affordable Care Act was put into effect, as transformative as it was, it expressly excluded undocumented immigrants. In my work as an anthropologist and clinical trainee, I have seen how the lack of access to health care leads to paralyzing debt and delayed care-seeking that worsens illness and even kills. Health care access is a key component of what we call “structural vulnerability,” or how a person’s position within power hierarchies affects their life prospects. If I could use my clinical experience and ethnographic work to advocate for policy reform, it would be in favor of guaranteed health care for all residents of the United States, regardless of immigration status.
OK, here’s a fun question to wrap things up. If you had a talk show, who would your first three guests be?
Ooh, this is fun! OK, so along with my celebrity status, I am going to grant myself the superpower to interview those who have crossed to the other side of this world: I would interview my grandmother, great-grandfather, and great-great-grandmother. My research on intergenerational trauma has prompted me to reflect on my own family history. As I trace my family tree, I come across these shadows of cultural loss that I wish I could bring to light.
My great-great-grandmother was a Mapuche traditional healer, but apparently everyone called her a witch. I would love to learn more about her methods and how her knowledge was contested—especially since I am training to be a biomedical physician.
My great-grandfather left his ancestral lands and moved to the city, eventually leaving Chile for the United States. Everyone in my family speaks about him with such endearment, but I want to know how he came to make such a great sacrifice, which values and practices he held onto and which he was forced to let fade.
My grandmother is still living, but she is beginning to struggle with dementia so I want to capture the memories she holds onto. I want to know what she remembers of growing up as a first-generation Latin American immigrant living in Hell’s Kitchen, how she reflects on her marriage to a strong-willed, patriarchal Italian man, and how she makes sense of her longstanding mental illness.
Thank you so much for your time!
