The story was seared into Maria Sofia ’18’s brain as a middle-schooler. Sitting in the passenger seat of her mother’s car, Sofia listened intently as her mom, a physician assistant who works in the emergency room, told her about treating a single mother who had no health insurance and was too ill to work. The woman had brought her kids with her to the ER, which she was using for primary care. “The children were asking for snacks the entire time they were there,” Sofia says.

Being a child herself, Sofia empathized with the hungry kids. “The story just stuck with me throughout my life,” she says. “It really had an impact on me. I just remember being taken aback. I was very privileged in that I didn’t know what hunger, true hunger, was. That’s not a situation I had ever been in.”

Over time, she put the children’s plight into context. How did their disadvantages at such a young age affect them over time? What health problems would they have later in life as a result of their difficulties now? Most importantly, would the cycle continue?

These questions and others vexed young Sofia, and she began to be drawn toward medicine. She knew the dedication it took to treat people like the ones populating the ER. The hours were long and the work was brutal, but it was also alluring. It could be frenetic and exciting, and you had the satisfaction of making people better.

She also had a role model who seemed superhuman in her ability to help those in need.

“My mom, she’s the biggest B.A. I’ve ever seen in the emergency room,” Sofia says. “She can take on anything. She didn’t miss a day of work after having a massive knee-reconstruction surgery after a skiing accident. She went through breast cancer and didn’t miss work during her chemotherapy treatments or radiation treatment. She’s one tough cookie.

“Seeing her doing that, and the fast-paced nature of it, always seemed fascinating to me.”

But how would Sofia contribute? Would she become a P.A. like her mom? A nurse? A doctor? Would she, too, work in a hectic emergency room?

Sofia came to Wingate as a biology major intent on going on to medical school. Things haven’t quite worked out that way. Thanks to some prescient guidance from one of her professors, Sofia rethought her career goals and eventually wound up in a master of public health program in her hometown of Greensboro.

That move proved extremely beneficial in May of 2020, when Sofia finished her master’s program just as the world was really waking up to the importance of the public-health profession.

“I walked out with a master’s in public health into a public health crisis,” she says. “I couldn’t have timed it better.”

Crisis of confidence

Like many students at Wingate, Sofia used her professors as more than just a knowledge resource. She’d often stay after class or visit during office hours to get advice or just to chat and enjoy the company of others who loved science. “The bio department was kind of my home away from home,” she says.

Sofia prodded her advisor, Dr. Alison Brown, for nuggets of wisdom. Brown was both sounding board and mentor, doling out wisdom accumulated during her 18-year career in higher education.

Sofia needed the advice. During her junior year, she started having real doubts about her potential career trajectory. She confessed to battling bouts of “imposter syndrome.”

One day, she sat in Brown’s office, more dejected than usual.

“I had had an exam, and I worked my butt off,” she says. “I did OK, but I didn't do what I wanted to do. I think that’s what triggered it. I didn’t think I would be competitive enough for something like medical school. I didn’t think I was good enough to make a difference. I was having a little bit of a pity party.”

“I think her grades were not as good as they could have been,” Brown says. “She was just trying to think of some alternative pathways. Like, what would be a good master’s degree to pursue if I didn’t go to med school right away?

“I think she definitely could have gone to med school, but at that time maybe she needed to repeat a class or two. It was a little rocky.”

Brown did more than simply console her student. She was pragmatic. Reaching on the bookshelf behind her, Brown handed Sofia a book about public health, a field that Sofia confesses had not been on her radar at all.

Sofia dipped into the book off and on for several months (she admits that she kept the loaner much longer than she intended to). Slowly, she began to see the importance of public health and how she might fit into the picture.

“She actually read it,” Brown says, “and it made a big difference in her career trajectory.”

Sofia began to see that the forest needs tending to as much as the individual trees do. She learned that when governments introduce policies aimed at, say, reducing the number of people who smoke, health outcomes can improve. And how preventive measures – vaccines, screenings, etc. – are a powerful tool. And how something as seemingly bureaucratic as altering bus schedules can affect people’s health.

“Primary prevention is hands-down our best method of improving overall health outcomes,” Sofia says. “It’s the best tool we have for lowering healthcare costs. That’s done by improving access to healthcare, by improving promotion and improving access to transportation and developing a greater network of providers that work in lower-income communities and are able to build trust in marginalized communities.”

Transportation is one example of an issue that seems to relate to one aspect of public life but in reality is hugely important to health.

“When the bus route doesn’t go to the doctor’s office, that’s a problem,” Sofia says. “Getting transportation to healthy-food areas, not just to the fast-food restaurant on the corner, can be a problem. The ability to pick up groceries from somewhere with fresh foods, with whole fruits and vegetables, and being able to take them with you, is important. It’s very cumbersome to be able to take a full load of groceries on the bus or walk back with groceries if you have to, or even bike.”

Sofia hopes one day to be in a position to help in one or more of these areas, or one of the myriad others that affect public health. But there’s another aspect of public health that Sofia’s master-of-triage mother can appreciate, and it reared its ugly head in the spring of 2020.

Making a difference

Sofia works best under pressure. “I like stress,” she says. “In my graduate program, and during undergrad, I used to make myself fake deadlines so I wouldn’t technically leave something off to the last minute but would still get that pressure.”

Last year, the universe said, “You want stress? I’ll give you stress.” Soon after she graduated from UNC Greensboro with her master of public health degree, Sofia stepped into the overwhelming and disorienting world of Covid-19. Contracted by a company to be a contact tracer, Sofia hadn’t finished even one day of training for that job when she was named a case investigator.

Contact tracers call people who have been in contact with a Covid-positive person to tell them they need to be in quarantine. Case investigators have a different, more-involved job. They interview Covid patients to find out who they’ve been in contact with, provide them with guidance on next steps, connect them with resources so they can remain isolated for several days, and collect all the relevant data, such as symptom and demographic information. They then help identify trends, outbreaks and clusters so they can report that information to the state.

It can be harrowing work.

“There were always people who didn’t want to talk to me,” Sofia says. “I got cussed at, yelled at. There were also people we were really able to make a difference with. What ended up being really hard was when we had really bad surges and I was doing paperwork on people who had passed away who were younger than I am. That was hard.”

By December 2020, Sofia had worked her way up to a much bigger role: team lead. Essentially, she developed contact-tracing and case-investigation protocols for, and then oversaw their administration in, four counties in North Carolina (Wilkes, Surrey, Stokes and Davidson). She later added Davie and Yadkin counties to her plate. She trained employees to make calls, use motivational interviewing skills, collect data, provide guidance and connect people with resources. She coordinated schedules, gave lessons on rudimentary epidemiology, and even worked with local school systems to better handle cases in classes or on sports teams.

All at the ripe old age of 24.

Sofia felt overwhelmed at times, since none of the counties was prepared for the onslaught of cases. “They were using communicable-disease nurses, anyone around who could help them, just to handle the astronomical holiday surge that we saw, as well as to keep up with data,” she says.

Sofia was pressed into service quickly and given little prep time. “Usually when you develop a workflow or a process flow, you’ve got time to do it,” she says. “You have people you can consult with. You have lots of people to talk to. That was not a luxury we had in this situation. It was: ‘There are thousands of new cases in North Carolina today. We need to do something ASAP. We don’t have time to sit around and make things pretty.’”

As spring 2021 rolled around, the caseload started to ease up a little. Sofia found herself able to breathe a little easier, and she eventually took a job with a life-sciences consulting firm doing “a little bit of everything: public-health-program evaluation, evidence-generation pipelines, clinical-trial design.”

“The vaccine has changed things,” she says. “It’s been the light at the end of the tunnel.”

But with public health, especially in the age of Covid-19, things can change quickly. As of early September, she’d been contacted by her old company looking for help as the healthcare community struggled to contain the Delta variant of the virus.

Sofia, who once saw herself wearing a white coat with a stethoscope draped around her neck, never thought she’d be affecting people’s health so much from behind a computer screen, but she has loved it.

“My heart is in helping communities and making the biggest difference for the most people,” she says.

“She was very clinically oriented, and I thought that would be a great fit for her,” Brown says. “You’re just there to listen and offer a lot of support, and at that point in time she needed a little. She turned it around. She retook those courses and did really well. She was like, ‘I didn’t go to med school, because I liked this that much.’”

Sofia was so grateful that, in the spring, she wrote Brown a note updating her on her Covid-related job and giving her much of the credit for redirecting her career path.

“I don’t know how she knew to point me down this way,” Sofia says. “She had that public health book and she said, ‘This is you. This is how I see you.’ And she was right. I don’t know how she knew that.

“That’s one of the great things about advisors: Sometimes they can see you from a completely different perspective than you can hope to. Dr. Brown is really wonderful.”