Laura Carr, MD, is currently in the first year of a three-year pediatric critical care fellowship at Primary Children’s Hospital in Salt Lake City, Utah. A 2011 alumna of the University of Virginia School of Medicine, her career path has included working for Doctors Without Borders/Médecins Sans Frontières (MSF).

Laura Carr’s journey in the field of medicine has taken her from Charlottesville to South Sudan. In the process, she has strived to carve out a career not in medical tourism, but in culturally appropriate care.

Originally from the state of Washington, Carr moved with her family to Virginia at the age of 7. When she decided to go to medical school, she says UVA was the logical choice and one that would keep her close to her family.

Carr says she was fortunate to have mentors at UVA who inspired her and helped shape her career path. They included Mark Mendelsohn, MD, in the Pediatric Department and Susan Modesitt, MD in OB/GYN. “Both of them were very open to talking with me and encouraging me in choosing my path. I did one of the summer research experiences with Dr. Modesitt and was able to present at a national conference that year, which was really cool,” she recalls.

When it came to choosing a specialty, Carr found herself initially torn between surgery, OB/GYN and pediatrics. She applied for residencies in surgery and OB/GYN, and then didn’t match. “I was part of that small subset that doesn’t match, so I scrambled into a one-year prelim surgery program at Carolinas Medical Center in Charlotte, NC,” she says. “A couple months in, I started the match process again and decided I wanted to be one of those smiling people in the hospital and those seemed to be the pediatricians. I ended up at Wake Forest for pediatric residency.”

It was during her residency years that Carr’s childhood dreams of doing some type of humanitarian work started to re-emerge. “I had done some international work starting at UVA with a two-month Guatemala Service Culture Language Experience, which was my first real introduction to global health,” she says. “I knew from that experience that if I wanted to do that type of work, I wanted to do it thoughtfully and didn’t want to do something that felt like medical tourism.”

Trips to the Philippines and Guatemala during her residency years helped solidify Carr’s interest in global health and what she calls “culturally humble care.” She turned her attention to Doctors Without Borders/ Médecins Sans Frontières (MSF) after learning about its goals and talking with friends who had experience working with the organization.

After finishing her residency, Carr began the lengthy interview process with MSF, which she describes as humbling. “I think many people have a preconceived notion that being a qualified physician makes you wanted in the rest of the world,” she says. “But you really have to be the right person at the right time for the right job. It took five months after I was accepted for them to find what they felt was the right job for me.”

In May 2016, she took on a nine-month placement in South Sudan, an African country that has been marred by an ongoing conflict between the government and opposition forces. “I don’t think I knew enough to be nervous, but my father certainly was – a perfectly normal parent response,” she says. “I was able to reassure him that I was going to a town that wasn’t near the war area, but my parents also knew better than to try and stop me. In the end, they were very supportive of my decision to go.”

Her contract with MSF was for a “malaria peak doctor.” The hope was that adding an additional physician to the local pediatric hospital would be helpful when the peak season hit for the deadly disease. Malaria had struck in unprecedented levels the year before Carr arrived.

“I was pretty nervous about it, because I think had seen malaria once when I was in North Carolina and that was a pretty big deal at the time. But when I arrived, malaria really hadn’t gotten bad yet, so I ended up taking over a 40-bed inpatient therapeutic feeding center for the malnutrition program,” she says. “Our patients ranged from 6 month to 59 months. They had to have severe acute malnutrition with a medical complication to warrant admission. It’s quite an intense unit to work in – you’re seeing patients with malaria, HIV, or tuberculosis plus malnutrition. The outcomes are quite satisfying, though, when you see children start to recover.”

When malaria season hit, Carr’s responsibilities shifted. The peak was worse than anyone had anticipated, Carr says. “We had a 120-bed hospital. Normally we’d admit maybe 40 patients a day, but we started seeing as many as 150 patients per day, many with severe malaria. Expanding the hospital to cover that many patients was an interesting process,” she recalls. “At one point, we had 80 patients sleeping on the floor in a corridor and the nurse to patient ratio was about 1 to 80. We just didn’t have the staff or the beds. Luckily we had the medication.”

Fortunately, Carr says that MSF responded quickly to the needs of the community, sending additional doctors and nurses and expanding the hospital. Eventually, with the rainy season ending, activity at the hospital slowed down.

During her time in South Sudan, Carr gained experience in other areas, including working in the neonatal unit of the pediatric hospital and an adult hospital in another part of the country, where she treated diseases like cholera. She also took part in building an emergency room to replace what was essentially a triage area. “It was a pretty incredible experience,” she says.

After her assignment in South Sudan was over, Carr returned to the U.S. She would later take on a brief assignment in Liberia as the only pediatrician in a 90-bed hospital.

Her experiences with MSF helped Carr determine what she wanted to do next. “After going to South Sudan and working there, I decided that I really liked critical care medicine. I wanted to learn more about the physiology of critical illness so that if I was working with MSF in the future, I would be able to make better guesses, knowing that I still wouldn’t be able to intubate or do all of the fancy things we can do in the United States,” she says. “In July 2018, I started a three-year pediatric critical care fellowship at Primary Children’s Hospital in Utah.” Despite her busy schedule over these next few years, Carr says that she hopes to stay involved with MSF by helping with research or developing new protocols.

Carr says that being flexible has opened up a world of opportunities to her and set her on the path to be the physician she is today. She encourages others who are early in their medical careers to do the same. “Be flexible. Take a step back and look around to see what’s going on around you before deciding what should or shouldn’t be done or if you need to make any change at all,” she says. “You never know what you’re going to learn as you experience life and it takes you to new places.”