Meet Ema. Disaster volunteer. Mushroom forager. Family nurse practitioner.
The earthquake started with a ferocious crack. Next came the shaking. Gentle at first, then in ground-buckling waves. Six minutes long.
Ema Ando was studying in the University of Tsukuba library in Ibaraki, Japan, when trembling began. She was an international studies major, and this natural disaster was poised to make her rethink her entire future and point her toward a career in medicine.
In the moment, however, Ema was simply searching for clues on how to react. She turned to the girl next to her. The terrified look she saw told Ema everything she needed to know.
Living in earthquake countries
Earthquakes are common in Japan. Citizens are accustomed to small seismic events and their cities are designed to cope: Many buildings are earthquake-resistant. Bullet trains slow and freeze when movement sensors are tripped.
Ema herself was aware of the dangers earthquakes pose. Born in Japan, she moved with her family to the Pacific Northwest when she was just two. However, while the specter of “the big one” looms over Washington and Oregon, significant earthquakes are few and far between.
Cut off for a week
That day in the library, Ema was living through the March 11, 2011, Tohoku earthquake. It remains the most powerful quake ever recorded in Japan—a magnitude 9.1.
Ema’s university was in the prefecture below the epicenter. Electricity, water, and cell service were cut off for a week. The floor of her apartment split in half and she and her roommates had to move to a new place. Her university closed for the next month. However the area was spared from the worst of the devastation.
“Without infrastructure, we didn’t know the extent of the damage until a week later,” she said. “It was a delayed understanding of the gravity of what happened.”
Anxious to volunteer
When Ema learned about the ensuing tsunamis that claimed more than 15,000 lives and decimated several cities, she immediately felt compelled to help. She volunteered to pick through debris on the shoreline, cleaning up trash and trying to salvage any remaining belongings so they could be reunited with their owners. The experience was a turning point.
“I quickly realized that I had nothing to offer but my hands,” she said. “I was seeing people who worked in counseling, medicine, and nursing. They could do so much more than I could. It made me re-evaluate what I wanted to do in life. I wanted a hard skill.”
A home in family medicine
Ema decided to finish up her degree in international studies then return to the U.S. to follow a different path. She enrolled at a community college where she completed her nursing prerequisites. From there she attended an accelerated program at Seattle University, earning a master of science in nursing. She joined the Cowlitz Family Health Center and, finally, Vancouver Clinic’s Family Medicine Department in 2020.
“Family medicine is the first place patients come to,” Ema said. “I feel like you get to know the patient the most—their family, what they do in life, what their hobbies are. I enjoy that aspect of it.”
As a provider, one of Ema’s primary goals is to build a strong relationships with her patients. Talking about medical issues can make people feel vulnerable, so she believes it’s essential people feel comfortable and confident that they won’t be judged.
Ema also values patient involvement. She helps individuals understand their health conditions and why she recommends a medication or lifestyle change so that they feel included in their own care.
“I want people to come to me not as an authority, but as their guide to make healthier choices,” she said.
Finding her medical passion
One of Ema’s passions within medicine is diabetes screening. Finding and managing diabetes early is critical to preventing future health problems. Yet most people don’t show symptoms until the disease is advanced. Complicating matters, some populations tend to be underdiagnosed because of medicine’s reliance on body mass index (BMI) to trigger screenings.
“It’s just a number and it doesn’t tell us your health status or your overall wellness,” she explained. “It doesn’t take into account how much muscle weight you must have, that you worked out five times a week, or you eat a healthy, plant-based diet. Someone with the same BMI can look a million different ways. It’s an easy first screening tool, but it has a lot of limiting factors.”
Lifestyle, genetics, and ethnicity also contribute to diabetes risk. Ema, who wrote her master’s thesis on diabetes, keeps all of a patient’s risk factors in mind and is proactive about recommending screenings.
She also prioritizes contraceptive counseling. With so many types available, she finds it valuable to walk individuals through their choices and explain how different options can alleviate other health concerns. At her previous clinic it was difficult for patients to see a specialist. Ema became adept at inserting IUDs and implants so patients didn’t have to wait.
Coming full circle
Because caregiving requires a lot of time inside, Ema spends her time outside of the clinic with her partner in the great outdoors. In the spring she starts seedlings. In the summer she tends her vegetable garden and hikes. Come fall she forages for chanterelles. And in the winter she does some cross-country skiing. Then she starts the cycle again.
In the future, she plans to spend time volunteering at local free clinics—places where she can offer not just her hands, but the skills she dreamed of having 10 years ago in Japan.
“I just want to be able to give back and share what I’ve learned,” Ema concluded.