Lori Madden

It takes curiosity

On her way to being an advanced nurse practitioner, Lori reminisces about the first time she presented her research at the NIH.

portrait of Lori Madden, nurse at UC Davis Health


There's this mystery to some extent about what happens in what is often referred to as the box, your cranium, your skull and the brain. And it was probably a space that I felt like I had a lot of opportunity to learn more about. And so that was intriguing to me, but I was really fascinated with the physiology and the pathophysiology that occurs with brain injury, whether it's traumatic or illness or stroke or brain tumors, just it all fascinated me. I was also fascinated by the fact that we had clinical studies happening. And I remember there being a research study occurring when I first was hired into NSSU looking at treatment for spinal cord injured patients. An advanced practice nurse on the neurosurgery team, Karen Smith, was a leader and supportive and just a lovely mentor, I think for all of the nurses in the ICU, but who was really encouraging to me to ask questions and explain things and talked about her role in coordinating this study and in examining these patients.

It was great to see a nurse in an advanced practice role in this clinical area that I was really passionate about. Her exposure and her modeling of nurses working within that space of research made me feel like that was something I could do. So there happened to be a committee that I got involved with and eventually chaired in looking at research in NSSU. At the time our manager also managed the LifeFlight program, so we had a committee with NSSU and LifeFlight that looked at research. I chaired that, I think, but ultimately I put together this project to look whether or not proning patients, putting them face down, helped with patients with spinal cord injury. We dealt with that as an intervention. So I proposed that as a project, and I had a nurse scientist at the time that mentored me. Her name was Jean Davis, and she was a predecessor of mine in this role.

I got a little grant and did a project, and I even put together this poster for this conference that I was invited to go to at NIH. That was in 1995. I was so excited to present this poster. I was part of this loan repayment program. And so it wasn't even like, "Hey, Laurie, come in and present this poster. We think you're awesome." I was just this new little nurse and I got this invitation because I'm part of the loan repayment program. And I was so excited. I thought, "Oh my gosh, I can present my proning poster." I was also really interested in people learning about brain herniation.

Do you remember those encyclopedias that you could look at and they had like these clear graphics that you could turn the page and see different layers of something? I loved looking at encyclopedias when I was a kid. We had bookshelves full at my house and I would just page through them. So I made a poster in an effort to be like the peel away. Here you see a person's face and you lift it up and then you can see what's happening inside their head, like a cartoon image, so that you could see different herniation syndromes, because there's a progression and there's certain symptoms that are associated with different processes or steps in that process. So you could see, for example, someone's pupil changes and the anatomy that's happening behind the scenes or behind the curtain of the skull.

So I was excited. I presented a poster of my encyclopedia pictures of herniation and about this proning study. I got to go to NIH in Bethesda and it was a little bit like going to Mecca or like a fan going to their favorite band's concert. I was so excited to go to NIH. And I remember asking a total stranger to take a picture of me next to the sign that was by the road of NIH, National Institutes of Health. It was so fun to go to that. That was just a little taste, another step in the path of being excited and having the opportunity to share my excitement and to be curious and be part of that space.