A Home Away from Home

January 29, 2012

Rachel Nash and Leah Nash smile at table with textbooks in front of them

Twins Rachel Nash (left) and Leah Nash (right) regularly study together as they pursue health-related careers at GW.

By Anna Miller

The Nash twins have a routine. It plays out in their Pentagon City apartment on the occasional nights when their schedules overlap. Rachel prepares dinner and Leah packs tomorrow’s lunches. Grapes, carrots and sandwiches made with wheat bread are all staples in the health-conscious sisters’ matching lunch boxes.

After dinner, the work begins. The dishes are cleared and the books laid out and the living room transformed into a library. Their studying is both side-by-side and solitary; Leah studies public health and Rachel medicine.

The quiet rustling of papers is sporadically interrupted with bouts of conversation that might sound something like this:

“What’s MHC Class II?” asks Leah, a first-year student in GW’s School of Public Health and Health Services, where she’s studying public health communications and marketing.

Yes, thinks Rachel, a second-year medical student at GW’s School of Medicine and Health Sciences , I know this one.

“It’s a molecule that helps with immune function and recognition of cell-cells versus a cell like a virus or bacteria,” she says.

Of course, that’s one of their more productive conversations. The sisters, who grew up near Philadelphia, might also launch into chatter about plans for the upcoming weekend, the perils of maintaining a relationship while in graduate school or the name of their hypothetical line of makeup.

After all, it’s hard to stay on track when you’ve spent five years apart from your other half.

“The last time we were together in an academic situation we were in high school,” said Leah, who went on to study political science and journalism at Lehigh University while Rachel attended Brown, where she majored in biology. “We were friends back then, but we had different learning styles and different strengths.”

They still have their differences — Leah’s the straight-haired sarcastic brunette with a knack for language, Rachel’s the freckle-faced math nut with a nurturing side — but now, these differences are an asset, not a competition.

“This is the first time we get to discuss content and common ground in a way that helps us both learn,” said Rachel. “We have complementary perspectives.”

Leah was the first Nash sibling to move to Washington, D.C. She took a job at the U.S. Department of Justice and thought little about public health. But her position, which entails reviewing medical records in order to determine which applicants qualify for the radiation exposure compensation program, gave her a unique window into the field’s essence.

“Trends started to emerge in the records that specifically plague Native Americans— chronic alcoholism, diabetes and hypertension,” she said. “Was that surprising? Not really. But it’s made me think about health disparities and access to care.”

Meanwhile, the youngest Nash, Jake, moved to Washington, D.C. to begin college at GW, where he studies political communication. He was the first Nash sibling to become a Colonial.

Rachel, who had toiled away her post-college year in Rhode Island applying to medical schools and conducting research on sleep and attention deficit hyperactivity disorder, became more and more set on the city of her siblings.

“I wanted a school that fit me, and I really liked the people I talked to when I visited GW,” she said. She also liked SMHS’s track program and its option of a dual M.D./M.P.H. degree.

And, of course, there were the familial pleas. “I was pushing for Rachel to live in D.C.,” said Leah. “Not living together in five years was a nice break in our shared life, but I was ready to have her back around more often.”

So Rachel committed to SMHS, where she is enrolled in the health policy track.

“Medical schools are different from other graduate schools in that they all have to teach the same things. They’re all licensed by the same organization. We all have to take the same exams,” she said. “So other factors start to matter more in your decision — and that’s location, things like the track program and friends and family.”

Then, as Rachel launched into her second year of medical school in fall 2011, Leah entered SPHHS. Three siblings, one university.

Their parents are both internal medicine physicians, though neither practices clinically anymore. David Nash is the founding dean of the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia, and Esther Nash is the vice president of Clinical Innovation & Strategy at OptumHealth Care Solutions, a health management company.

“They showed me the broad range of things you can do with a medical degree,” said Rachel, who originally resisted a future in medicine because she didn’t want to share a profession with her parents. “But at the end of the day, you can’t help what you’re interested in. This is what I want to do, and I know I’m in the right place.”

Though she anticipates a change of heart after going through rotations, Rachel is currently most interested in internal medicine and obstetrics/gynecology. She hopes she can carve out a career that pairs clinical practice with policy work.

Leah, on the other hand, imagines a future working in a communications department of a national association, like the American Heart Association. She wants to use her writing and communication skills to help promote awareness of a certain health conditions. In five, 10 and 20 years, she hopes she’ll still be consulting with her sister.

Turning to her Rachel, she said, “I think it will be really helpful to bring in ideas from you once we’re really trying to think about how to change people’s behavior. Like, ‘in your day-to-day, do you think this technique would be effective?’ ”

Rachel is eager to contribute. “How to actually change people’s behavior is not really covered in medical school,” she said. “We learn about diseases and treatment, but what happens when the patient leaves? I think Leah’s work is a fascinating and important area, and one that’s vitally important to people’s health.”

“I think this [partnership] will be very mutually beneficial,” said Leah. “In my ideal world, working together in some capacity would be wonderful.”

But for now, it’s back to the books. Leah has work tomorrow (she still holds her position at the DOJ part time) and evening class; Rachel is prepping for a full morning of class and an afternoon with the physician she shadows. Though they might bump into one another in the Ross Hall lobby, they hope it’s not too long before they reconvene on their couch.

“At the end of the day, I feel very lucky to be at GW and with my family close by,” said Rachel. “I have a good place to come home to.”