Blog of Bloodworks Northwest

"Why Everything is Everything" Dr. Ashley Ellis (S3 E18)

Dr. Ashley Ellis, the Assistant Medical Director at Bloodworks Northwest could never figure out why Black History Month was only confined to February. Here at Bloodworks, she’s deeply involved in the “All of Us,” a research program that aims to level the playing field when it comes to health care. She’s also been at the forefront of our response to the recent national blood emergency and its impact on Transfusion Services. That’s why her pager is always going off. What drives a committed professional like this? As Bloodworks 101 producer John Yeager tells us, it all started with Ashley’s big sister, Sonya. Episode transcript below:

John: How are you doing with everything?

Dr. Ellis: As far as really everything or…? Yeah, I’m hanging in there. Yeah, it’s been tough, but I’m doing okay.

John: Tell me about your job at Bloodworks Northwest.

Dr. Ellis: My position title is assistant medical director. And at the labs, I cover the transfusion service lab for regional hospitals, including Swedish. I cover the reference lab, red cell genomics, and apheresis. And so those are the services that I currently cover. And I also teach University of Washington residents and fellows.

John: I’m sorry. I pulled it away as you said that. And I also…

Dr. Ellis: And I also teach University of Washington residents and fellows.

John: Transfusions, boy, I mean, talk about a time to be in charge of transfusions when we’re code red all the time.

Dr. Ellis: Yeah. You get used to it. It’s honestly like chronic crisis mode, and we’ve sort of gotten used to it. Unfortunately, it’s not a good thing. Oh, see, that’s proof of it right there. I think it’s dialysis. Taken.

John: Something you have to take now?

Dr. Ellis: No. It can wait 10 minutes.

John: Okay. But a constant code red.

Dr. Ellis: Yes. Yes, it is.

John: Your beeper’s going off all the time.

Dr. Ellis: Oh, yeah. Yes, it is non-stop. I knew it would go off while I was in here.

John: So tell me about the legacy of your sister. You guys grew up together and she had a profound effect on what you ended up doing. Can you unpack that a little bit?

Dr. Ellis: Yeah. My sister, Sonja, was 11 years older than me, so she was the first girl in the family. I was the second. And so she was pretty thrilled to have a little sister and she took care of me. I spent a lot of time with her when I was young. And when I was 8, she got sick. I really didn’t know what was going on, but I knew it was her kidney. And so she had end-stage renal disease and she had to go on dialysis. And I remember saying, you know, I want to become a doctor so that I could help my sister. And I already loved math and science. So this pushed me in that direction. And also my mother is a retired nurse, RN. So I had exposure to the medical field early on. It helped propel me towards medicine.

She was just great. We were very close. She had a wonderful sense of humor. She was a great cook. She was very loving. And she kept a good attitude throughout her struggle with kidney disease. And along with that comes other things, usually, when you have a patient with kidney disease, there are other abnormalities or medical problems that come along with that. So she endured a lot with her kidney disease over 30 years. So, you know, even though I didn’t go into nephrology or transplant surgery, I still was able to use my expertise as a physician to help my sister to try to save her life. And I’m very thankful that I got the training that allowed me to be an advocate for her.

John: She’s always over your shoulder in a way.

Dr. Ellis: Yes, always. This ring I have on is her high school class ring. So she’s always with me.

John: Did she pick on you? She is a big sister.

Dr. Ellis: Of course, yes. But, you know, it was fine. She also really influenced me. She was an all-star athlete, but I would go to watch her at volleyball practice. And then when I got into middle school, I picked up volleyball and I actually became really good at it. And it all started because of her and that’s my favorite sport. So she really had an influence on me.

John: So tell me a little bit about this All of Us Research Program and how we’re involved and what your work is like in the program.

Dr. Ellis: All of Us is a national program that is looking to get genetic samples from people from all walks of life, all sorts of backgrounds, different cultures, different regional influences. We’re just looking to see what sort of things are common in certain groups, and America has become increasingly diverse. And so medical practices need to adjust to that because a lot of parameters that we follow as physicians are based on test subject population, which for a long time was predominantly non-minorities. So like, for instance, the example I gave during my talk with Victoria Baptiste [SP] was creatinine. So creatinine levels are a surrogate marker for renal function. And people of African descent, they tend to have higher creatinine because they tend to have higher muscle mass. So there’s been this disparity with creatinine levels with the cutoffs and looking at the creatinine levels and determining what level of renal dysfunction a patient has.

But I want to explain how lab testing works. If you have a parameter that you are measuring, when you test, you need a reference range. You need to know what’s normal and what’s abnormal. So what happens in laboratory testing is we test whatever parameter we’re looking for and we take the numbers and we order them from an order of lowest to highest. We take the middle 95%, so there’s 2.5% that fall below this range or 2.5% above. And we say 95%, this is what we consider within the reference range, or what some people would call normal. But it varies for different people. So for a reference range, if you’re doing it on one population, it might not be applicable to another population.

So what All of Us is doing is looking at all sorts of genetic markers for people of every background that we can possibly find to find out what is normal for this group, what is expected function of whatever parameter you’re measuring for this certain group and so that we can personalize medical care. That’s the ultimate goal. We want to be able to be diverse and help everyone and be sensitive to their specific needs. So that’s why it’s so important for people to donate tissue samples, blood samples, cheek swabs to All of Us so that we can get an accurate picture of what America is like inside your body.

John: Because America is changing, because the complexion is changing, and the database has to keep up with America.

Dr. Ellis: Right. You have to keep but with the times, you have to evolve to be able to fulfill your purpose. Nothing stays the same. So you have to always adjust according to what’s going on around you.

John: So what are you asking people to do? If I got involved with this, what do I do?

Dr. Ellis: So go to Google, type in “All of Us,” click the first link that comes up, and it will give you information about All of Us. And it’ll tell you the background of the program, and then you can choose to sign up for All of Us, which is something that I did. And I think it’s important because I am African American, that whatever’s going on in my body is represented in this research. Just like for any other group, it’s important that they be represented in the research so that we can provide good healthcare to them. So you go and you sign up and then you will donate a tissue sample. It could be a cheek swab, it could be blood, maybe, you know, possibly urine, all sorts of samples for genetic testing. And that’s it. It’s very easy. You don’t have to do anything. You just give a sample and, you know, that’s it.

John: February is Black History Month. What does that mean to you?

Dr. Ellis: It’s a little bit complicated because I know like the first month that I ever heard about being dedicated to something was Black History Month, then you have Autism Awareness Month, Breast Cancer Awareness Month, Mental Health Awareness Week, things like that. So I grew up with Black History Month, you know, being in February, but I always thought shouldn’t every month be Black History Month? You know, seems to be just like anything pushed to the side when you only think about it at a certain time. I think all of these sort of issues need to be thought about all the time.

So Black History Month is a little…yes, I’m glad it’s there, I’m glad that black Americans have gained recognition for their contributions, but I feel like it’s something that should be around and in our thought process all the time. And, you know, okay, where do you stop? Okay. There’s Black History Month. There’s Asian and Pacific Islander Month. So it’s just like, you know, everybody needs representation. And so I think that we need to think about this all year round. Like, everyone is a little different and we need to be sensitive to the needs of other people.

John: Do you think we’ll be talking about this pandemic next Black History Month in 2023?

Dr. Ellis: Yes, I do, unfortunately. Well, we’ve seen how COVID-19 has disproportionately affected people of color, especially African Americans who often work in service industry jobs, frontline workers. They have to come to work. If you don’t go to work, you don’t get paid. You don’t eat. You don’t have a place to stay. So we’ve seen that disproportionately of people who are of color. So I think this is something that’s gonna be talked about for a very long time. It’s gonna take some time, let’s say the virus, you know, magically disappears, we’ll still be talking about it because it’s not just changed, rocked our lives so much in the last two years. We’ll still be talking about this 100 years from now.

John: Is there anything else I haven’t asked you that you feel that you’d like to include at this point?

Dr. Ellis: One thing I would like to talk about is organ and tissue donation, which is, you know, part of All of Us. But one thing that I’ve seen is in certain patient populations who might have a specific type, there isn’t enough of the resources, organs or blood, to give this patient a transplant so the patient ends up dying. So it’s very important to get representation and donations across the board for people because I’ve seen patients who have died because we couldn’t get blood that matched them because you can’t give them blood that’s incompatible, that could kill them. Same thing with organs, like people of different genetic backgrounds have certain markers and when you transplant or transfuse, they have to line up. And so you have to have a source of this. So it’s so important for everybody to donate whatever you can. You don’t take your organs to the afterlife, they have enough, people need them here.

So I’m an organ donor, and I encourage everyone who can be an organ donor to give the gift of life. And then it’s sort of a way you can sort of become immortal, like you are a part of this person’s life who you don’t even know or may know, and then your gift of life helps them influence other people. So I think it’s a wonderful thing. Organ donation gave my sister 17 years of being off of dialysis. So it really is so important. It changed her life so much not to have to go to dialysis three times a week.

John: She’s still with you.

Dr. Ellis: She’s still with me.

John: Thank you so much.

Dr. Ellis: You’re welcome.

John: I hope it doesn’t go off again.

Dr. Ellis: Yeah. I’m gonna call him. See. They must really…

John: Thank you so much.

Dr. Ellis: You’re welcome.

February 3, 2022 6:22PM

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