Azucena Ramos – MD PhD 

August 7, 2024
Azucena (Suzy) Ramos Md PhD VC

Meet Azucena Ramos

When Dr. Azucena Ramos was just a child, her mother said something she never forgot. “You choose your future, mija. Don’t let life choose it for you.”

Speaking to Azucena is a unique experience. She sounds like no one else, the calm timbre of her voice suited for radio work or audio books as she effortlessly drops into and out of Spanish – one of the four languages she speaks. She spins complex words and concepts into poetry when talking about science.

I asked her, “What was your doctoral dissertation about?” She replied, “Understanding resistance to frontline immunotherapies for acute leukemias,” with the ease, excitement, and enthusiasm that one might say, “Peanut butter fudge drop ice cream.”

This woman is passionate about science and medicine. She doesn’t just seem to study these fields but to devour them. “I work like an animal,” Azucena says. That must be true, as she is currently in her internal medicine residency at Massachusetts General Hospital while working in venture capital at Nextech, publishing papers in respected scientific journals, and parenting her young son with her husband. She aims to do a fellowship in oncology when her residency is complete, the next step in the life of academia, medicine, and innovation that she continues to create despite warnings that doing so might be “hard.”

“I don’t do anything unless it’s hard,” she told me. “That’s my mantra.”

I met Azucena at Smith College. We all knew she was exceptional. One of the first things I recall her saying was, “I’m either going to be cum laude here or summa cum laude somewhere else, but I know I’m going to do amazing.” She said it without vanity, as the simple truth. Her self-confidence floored me.

Only when I spoke with her at length for this interview did I learn the truth behind such a bold statement made by that Smith College first year.

“Did I sound cocky? Because I was actually planning on leaving,” she admits to me. “I probably said that to convince myself more than anyone else that I could still succeed. I was so homesick and scared that I’d fail. I cried every night. I was going home to San Diego. Maybe to another college there.”

But fears ate at her, rooted in the deep pain of oppression, a concept with emotions she could not begin to deconstruct. For a few weeks, she feared that her skeptical family members, many doubting teachers, and anyone who had ever assigned her a remedial class because English was her second language might have been right all along: College isn’t for people like you.

Undocumented

Azucena’s mother was an undocumented immigrant. Years before Azucena’s birth, her aunt and mother crossed the border together. Her aunt stumbled on the border’s barbed wire and bled profusely from the injury. When she saw the extent of her sister’s injuries, Azucena’s mother hissed, “What are we going to do now?” Azucena’s aunt demanded, “Just keep running!” And so they ran. This is not the most harrowing of the stories Azucena’s family shared of their border crossings.

“That’s where I come from,” says Azucena. “Those are my roots. And my mother never wanted me to go through that.” Azucena was born in the United States and raised in the San Diego suburb of Escondido – a low-income area with a substantial Latino population and a crime rate far above the national average. Azucena grew up surrounded by the systemic racism that led to this poverty and crime rate, the oppression so pervasive that it took her many years to comprehend its vastness.

Her biological father unfortunately left her pregnant mother, and Azucena would have no contact with him again until age 12 – when they shared a brief phone call. Therefore, Azucena was primarily raised by her mother and grandmother. Her mother married when Azucena was only two. “It was hard. But he was there from the moment I can remember.”

Her mother spent her life in the United States working as a housekeeper despite her desire to be a nurse. Her mother’s unfulfilled dreams of a nursing career were a constant reminder of the fragility of goals. Azucena’s stepfather worked in construction, along with many of her uncles.

In 1994, Azucena’s grandmother caught the flu, which worsened until it became life-threatening pneumonia. Without legal immigration status, health insurance, or adequate financial means, the family watched its matriarch suffer, with no options but hoping for the best. Azucena recalls this as the moment she decided she would be a doctor. “Watching people die from preventable diseases, whether in the United States or in Mexico – and just because they had no access to healthcare – solidified this idea.”

While young, Azucena traveled frequently with her grandmother to Grandma’s rural hometown of El Organo in Mexico. Azucena’s great-grandfather still lived there. At that time, El Organo had no running water or working electricity. To get there, Azucena and her grandmother took an airplane to the closest airport in Aguascalientes, MX, boarded a bus, a taxi, and then a pickup truck to finally arrive. In El Organo, young Azucena rode a donkey.

The level of poverty was intense. “My mother and aunts hadn’t been born in a hospital. One of grandmother’s children died from a diarrheal illness, another from starvation, and a third from a terrible fever. This was a single generation before me, and they lived that way.”

But El Organo offered fun and stimulation for the girl, too; she enjoyed climbing the trees, exploring, and conducting experiments to answer the questions raised by her curiosity. She watched the women of her family do what they could to care for the sick in an environment where care was homeopathic out of necessity.

Susy from Escondido

While in San Diego, Azucena attended a hard-pressed school system that was low on money and resources but overcrowded with students. Azucena’s elementary school teachers frequently remarked that she was an intelligent student.

Azucena faced a new challenge upon entering fifth grade. Until then, she was only in Spanish-speaking classes. Stretched to its limits, her school eliminated its Spanish-speaking class block. Administration tasked her fifth-grade teacher, Mr. Lyon, with teaching Azucena how to read and write in English. She went from knowing little English to quickly assimilating the language. At the end of the school year, Mr. Lyon recommended her for several awards. Her family still talks about her fifth-grade graduation with pride. Mr. Lyon was the first of several teachers to impact Azucena’s life.

Despite her fifth-grade success, the school system put Azucena back in English as a Second Language, a remedial English class, when she went to sixth grade. She was immediately bored. Her teacher Mrs. Bonds soon realized Azucena was too intelligent to be in a remedial class; her English reading tested at the college level. Once the test results came in, she was moved into honor classes for sixth and seventh grades.

A family upheaval caused Azucena to change schools once again. When her mother reported abuse at the hands of her husband, Azucena, her three younger sisters and her mother were left homeless for a short amount of time. They slept in a car for a few nights until Azucena’s aunts allowed them to move in. They jumped from family to family, sleeping on couches until they finally settled in her uncle’s house.

“My uncle had a home with four bedrooms; four families lived there. My family lived in one bedroom, my grandparents in another, my Uncle Max’s family, and my Uncle Alfredo’s family. It was the only way to survive.”

In this new situation, Azucena attended Hidden Valley Middle School, where she was again placed in remedial classes for no apparent reason except perhaps that she was Latina and poor. Meanwhile, her mother, working to survive, did not have the bandwidth to intervene. The school only moved her into appropriate and challenging classes when they finally received the records from her previous school months later.

Her family, particularly her cousins, was involved with gang violence and drugs. “Home was horrible, with an abusive stepfather and sisters that I was responsible for.” Azucena took on the role of parent for her younger sisters, taking on the lion’s share of responsibility for them.

When Azucena recently asked her mother about this, her mother said, “I never had to tell you to do it; you just did it. It wasn’t fair to expect that of you.”

“Oh, there were definitely signals that I should take charge,” Azucena tells me during our interview. “But that’s how it is in our culture. The oldest daughter does everything.”

Stepping out of that paradigm was almost impossible.

Azucena told her mother she would like to attend college. Her mother responded sadly, “I don’t know how you’ll do it. We don’t have anything. You’re on your own.” That was the beginning and the end of the conversation.

When Azucena said something like, “I want to be a doctor,” in front of her family, the people she loved most, they usually responded, “You’re just a silly girl. You’ll get pregnant and have kids.” In her school system, it was not unusual for teachers to discourage Azucena and other Latino students from thinking of college. “It’s not for people like you,” they would say.

“Although at the time,” admits Azucena, “they might have been partially correct.” The stresses of her life and her family’s circumstances put her in dangerous circles. She hung out with her cousins and their friends, kids who were heavily into drinking, and the resulting trouble with the law. “I felt really small,” she says. Yet, the whole theme of her life – then and later – was trying not to feel small.

The idea of teachers actively discouraging students from wanting to learn better, learn more, and go beyond is profoundly disheartening. But Azucena also saw the other side of this coin: teachers who saved her life.

The power of mentors

An inspiring teacher, Mr. Keller, watched Azucena, knowing she was brighter than her peer-choices suggested. He instructed her to attend his seventh-period AVID (Advancement Via Individual Determination) class – dangling the tempting idea of a learning challenge in front of her and making it impossible for her to hang out with her cousins or the sketchy people she’d been meeting.

In that class, Azucena met an AVID and English teacher, Rachel Bronwyn, who had studied at Princeton. “She’s probably one of the smartest people I know,” says Azucena. Emotional gratitude for this special teacher is evident in her voice. “And one of the fiercest, most loving, most selfless people in the world. She changed everything.”

Ms. Bronwyn quickly understood what Azucena needed, understanding that Azucena felt angry and small. “I told her that money was hard.” So Ms. Bronwyn made Azucena the lead tutor for languages, English, math, and science, a paid job. With a soft sigh of amazement, Azucena adds, “I didn’t realize it was out of her own pocket.”

She keeps in touch with this beloved teacher even now. When Azucena spoke with Ms. Bronwyn just a few weeks ago, she asked, “How did you know what to do with me?” Ms. Bronwyn responded, “What I do deliberately is make my students’ worlds bigger.”

Azucena explains it further. “She creates a narrative in your brain. You don’t know it’s happening because you’re a dumb 15-year-old kid.” While high-school-aged Azucena had difficulty believing that she had any career options, much less that she could go to a place like Harvard or be a physician-scientist at MIT, with her “little Escondido brain,” Ms. Bronwyn forced her to change that outlook.

In Azucena’s sophomore year, Ms. Bronwyn told her, “We need to send you to Phillips Exeter. There’s a summer program there.” Azucena could barely comprehend the idea of going to the east coast of New Hampshire. Her first reaction was to push back, but Ms. Bronwyn found donors among her college alumni to buy Azucena new clothes and a plane ticket. Soon, Azucena was standing on the campus of Phillips Exeter.

She recalled, “It was the most infuriating experience of my life. Escondido was overpacking my schools. We shared outdated books. They offered only a handful of AP classes. And we were the lucky ones, compared to some other schools. Now I was at Phillips Exeter, which was basically mini Harvard.” She felt like she stood on another planet.

For example, her marine biology course expected students to write a marine life paper. “Cool. Give me the book,” said an enthusiastic Azucena.

“No, no,” they corrected her. “Meet at the docks at 5 a.m. to suit up.”

“Wait – what – suit up? You guys have docks?”

Indeed, at 5:00 a.m. the following day, the students met at the dock, dressed in wading suits and rubber boots, and went out at dawn’s low tide with the necessary tools for collection. In their classroom was a massive tank where they kept their specimens for a week before releasing them back into the ocean. Azucena had never imagined school could be like this, and she returned to Escondido with solid aspirations for higher education.

Azucena graduated when she was 18, in the top ten of her class, with a GPA well above 4.0. Ms. Bronwyn insisted throughout her senior year that Azucena apply to colleges. “Well,” thought Azucena. “Ms. Bronwyn knows what she’s doing.” So she applied to every school Ms. Bronwyn suggested.

Make them eat their words

Smith College gave Azucena an incredible opportunity to study when other colleges balked at her student loan issuance, a process severely handicapped by her biological father’s refusal to provide requested and necessary information. So, student loans were impossible; Azucena had to attend on scholarships.

In the Fall, she was at Smith. Almost immediately, she was desperate to leave.

The adjustment was brutal. Trouble at home had driven her from her family’s house and into living with a boyfriend (“A sweet guy,” Azucena remembers, “but ultimately not who I needed to be with.”). Now, she had left both him and her family behind, and her homesickness was intense. She missed her grandmother terribly. “I started getting everything together to go back home. I looked into scholarships to go to the University of San Diego. I was bawling all the time.”

This was the Azucena I met – though I never suspected the depth of her discontent. I was in awe of her, so this reminds us that we never can know what another person is enduring. Fortunately, things changed for her.

As Azucena prepared to leave Smith, she called her mother to catch up. During their conversation, Azucena’s mother mentioned a conversation with one of Azucena’s aunts.

“I remember where I sat, what I was wearing, and what webpage my computer was on when she told me this. I got so angry.”

Mom said, “I was talking to your auntie today about how much I miss you. Your auntie reminded me that your cousin tried to attend college in Santa Barbara but dropped out right away.”

Of about 60 cousins, only Azucena and another one of her male cousins had “gone away” to college, and one other would later go on to achieve an online degree. Once more, the belief was that college wasn’t for people like her. Azucena’s aunt said, “He’s a man, and he couldn’t do it. What makes you think Azucena can?”

That was the moment Azucena rejected all thoughts of leaving school. After hanging up with her mother, she deleted every application to other schools. “I decided I would stay, no matter what, and make everyone eat their words.”

At this point, the fire that had burned strong enough for Azucena to survive and succeed despite challenging circumstances surged into an inferno, and she never looked back.

She double majored in neuroscience and chemistry, following her love of science and applied math, although some professors warned her against it. “Don’t double major,” they said. “There’s no overlap except for intro chem. 80 percent of your credits will be science.”

But Azucena said, “I don’t care; I like both.” So she did it and loved it. By her junior year, becoming an MD PhD entered her consideration. A developmental biology class taught by Michael Baresi – a class Azucena was unenthusiastic about at first – showed her the potential for cutting-edge research.

She thought, What if I paired scientific research with medicine? The idea was so exciting she felt “like a kid in a candy store. Biology was the place where I could be creative and solve problems by designing experiments. I could be the one writing the textbooks.”

But there was another side to Azucena’s aspirations: her desire to escape the pain of growing up in poverty. She wanted no one to ever make her feel small again. What better place, she thought, than a laboratory where the language is sterile, oppression doesn’t exist, and one works in an enclosed world that reputably operates like a meritocracy. She saw this as the ideal combination of her interest in science combined with a place of financial power and independence.

Four years after enrolling, Azucena graduated from Smith with a degree in Neuroscience and Chemistry. She needed a brief respite from education to earn income to help her mother – who had suffered a severe injury – as well as take the time to decide her next career steps. She applied to only one place – and was hired.

Blood production

For three years, Azucena worked for the Stem Cell Institute of Harvard in the lab of Whitehead Fellow Fernando Camargo. She was the lab manager and the lead of one of its three biggest projects, eventually publishing an article in Nature. Azucena remained at the lab for three years. The work was rigorous, as Harvard remains a high-pressure environment.

Three months after beginning this lab work in Boston, Azucena was invited to a friend’s birthday dinner. There, she sat next to her future husband. They were with a table full of English teachers speaking about their curriculums – not of much interest to either scientist at the table. So they began an intimate conversation…about science. “We really just clicked. The next day, he told his family that he’d met his soulmate. It’s a bit cheesey for my taste. I would usually get bored a few days into dating someone, so I wasn’t so sure. I just thought, ‘We’ll see how it goes.’ But it’s been 15 years, so maybe he was right.”

At the Stem Cell Institute, Azucena’s lab project studied blood production, a process known as hematopoiesis. I’d like to thank Azucena for explaining the process to me in terms I could follow and reproduce for this article!

In the past, scientists studied hematopoiesis in this manner: Mice were irradiated because an irradiated animal’s bone marrow dies. Bone marrow from another donor was extracted, labeled, and introduced into the irradiated mouse, and from this, hematopoiesis – blood production – could be observed. The problem was that this process was artificial. A stem cell relies heavily on its environment for its identity and the removal of bone marrow is disruptive. Thus, it was unclear whether the data collected over so many years was an artifact of the experiment or if it was real.

Azucena’s project’s aim was to find the answer to that question. They engineered a system using transposons, “little pieces of DNA that jump into other DNA.” They can be turned on under a controllable system; one can induce expression by introducing an antibiotic in the animals’ drinking water. Once the transposons jump, they insert randomly, so one can use the DNA sequence between the transposon and the native DNA as a barcode to track. “Thus, the experiment was to turn on the transposon, let it jump, turn it off so it stops, and track them through looking at the progeny’s B cells, T cells, and myeloid cells.”

Again, this sounds elegant coming from Azucena, who sees science as beautiful, valuable, and exciting. She brings me into that passion, so I feel it, too.

She summarizes, “We proved with that set of experiments that what had been discovered almost a century before was all artifact. Hematopoiesis at normal steady state is not driven by one or two hematopoietic stem cells but by many.” This was a very different take on how blood works, so the subsequent paper published in Nature (a leading multi-disciplinary science journal) was critical and influential. The paper has since been referenced by over 800 others.

Azucena’s dream of working in a bias-free laboratory environment – a meritocracy – where background didn’t matter and the language was clean and clinical – suffered a reality check. Unfortunately, any environment where people come together has the potential for bias. More than once, Azucena was stereotyped as a “spicy Latina.” That’s pretty shocking, considering that she was a fiercely motivated researcher. Azucena was so fascinated by science that she conducted experiments inside experiments, collecting her own data even as she followed lab protocols and duties. Her intense work ethic was not to ingratiate herself with others but to follow her curiosity and passion, which explains much about her consistent successes. “I worked like a beast in that lab,” she tells me. I am not surprised.

What is your story?

Harvard welcomed Azucena as a medical student. She had not really expected to be accepted. Says Azucena, “I didn’t know if they’d be interested in someone who looked like me. I wasn’t someone I thought would ever walk those halls.”

But she got an excellent reference letter from her mentor, Fidencio Saldana, a Mexican American cardiologist. He took her under his wing, wrote her a letter of recommendation, and helped her refine her personal statement.

Azucena had shadowed Fidencio at Brigham as he cared for Latino patients. His work reminded her of many things in her past that had pushed her toward her career decisions. “His patients looked like my family. That brought me back to remembering when my family and I didn’t have access to health care. We were impossibly poor at times. I had no idea how to deconstruct that experience.”

“I remember the day I got my letter of acceptance from Harvard. That radically changed how I thought about myself: a hoodrat from Escondido, at Harvard.”

Following her mantra of doing nothing that isn’t hard, Azucena made the decision she’d started considering years ago: to become an MD PhD. The process means working on the MD for two years, tackling the PhD in the middle, and returning to MD study for two more years.

Starting her work at Harvard was a gratifying experience. Yet Azucena found herself in a place where people actually talked about systems of oppression. At this point, she was obliged to look at oppression head-on for the first time. “In that way, it was a grueling two years,” Azucena said. “I had to come to terms with my identity.”

This obligation landed on her when Azucena applied for the Soros Fellowship during her first Harvard year. The Fellowship is a highly competitive award that pays its yearly recipients 90K for graduate school.

The Soros committee liked her very much, and she was a finalist, but they ultimately gave the award to someone else. They told Azucena, “You’re a great candidate, but you don’t understand your story.”

She realized then that the Fellowship expected its applicants to understand their personal context: who they are, where they have been, and how that experience moves them forward. Azucena precisely didn’t like thinking about these things because they seemed inevitably to lead to shame and anxiety.

How could she reconcile being Azucena from Escondido, scrappy and hanging out with Westsiders, to being Azucena at Harvard? What did it mean that she grew up this way? She didn’t want to investigate what that meant regarding her identity.

“I remember we read this study on how Latino patients in Southern California with long bone fractures (such as femur fractures, known to be excruciatingly painful) experience significant time delays before being offered adequate pain medication. And I had seen this first-hand. Many of my uncles working in construction would sustain painful injuries, but they weren’t offered pain regimens or often, even medical attention.”

Azucena’s inability to talk about her experience led to bouts of anger and confusing emotions. Miserably, she sat through courses that referred to her people, her family, like statistical victims. While science was ordinarily her way of looking at the world, with the ability to deconstruct processes into their fundamental pieces, the pain of racism could not be so easily broken down. “It gave me horrible anxiety to go to the class. I felt so impotent.”

Meanwhile, the East-coast institutions were filled with moneyed people, and very few of whom had grown up poor, fewer still who had experienced absolute poverty. Azucena is still angry at her biological father for refusing to do even the slightest thing to help her apply to school; he refused to provide the documentation proving himself a United States citizen. For some reason, he was convinced that it was a scam, that later he would be forced to pay the 90K back to The Paul and Daisy Soros Foundation. “He was antagonistic; men had been that way my whole life. All my father figures.” This lack of support was another layer of shame and disconnect.

She recalled that Ms. Bronwyn once said this disconnect was very likely due to the fact that she was using the wrong referential metrics. “My guess is that a lot of the people around you have “emerged” from very different backgrounds and life experiences….the very parts of your personal history that make it possible for you to see past extant paradigms or boldly pursue possibilities (because you are not afraid), also signal insidiously to you that you are somehow “not correct”–stand in your truth: wear the pearls and know that you can take off your earrings at any time if needed and throw down–you have that strength in your very fibers–in your DNA. You have the blood of fearless, indomitable women coursing through you. (I almost feel sorry for anyone who thinks they can best you.)” ”

Azucena grappled with her identity for the whole first year. Then, during her second Harvard year, she reapplied for the Soros. “In my first application, I hadn’t submitted exhibits. They wanted a list of all the things I’d ever done that I was proud of. I thought, well, I should sit down and figure that out.”

Figure it out? I can hardly believe this; it seemed her life overflowed with achievements. Like many high-achievers, Azucena found it difficult to see anything remarkable about her actions and seldom took the time to celebrate success. High achievers see success as a necessary step to the next big thing.

But Azucena made her list of achievements for which she took pride. It included her working at the Umana, a low-income school in East Boston with primarily Latino students. There, she taught a STEM course on the weekends and led her team to the Massachusetts state semi-finals. She also taught sex ed to at-risk youth throughout Boston with the student organization she led at Harvard (Prevention, Health Awareness, and Choice through Education, also known as PHACE). She mentored students of all colors who had come from places similar to her past, helping them see they could get where she was.

She notes, “Seeing visible leaders of your own identity doing the big, difficult, important, and powerful jobs makes it easier for you to see yourself doing it. My mentees can be pretty honest with me about what their identities mean to them and what it’s like to live in their shoes.”

She realized she wanted to be a highly visible Latina academic and serve disenfranchised communities directly in clinics.

The Soros Committee once again chose her as one of sixty finalists out of thousands of applicants. They knew it was her second year applying and asked, “What’s different this time?”

Azucena replied, “I finally understand my own story. This experience has taught me my narrative and how that’s shifted as I’ve found success. It doesn’t matter if you don’t pick me for the fellowship because I’ve already gotten what I needed. So thank you. I’ve already won.”

They did give it to her, though. She was their 2014 recipient.

PhD work at Massachusetts Institute of Technology

Azucena was delighted by the atmosphere when she went to MIT for her PhD work. “It was just the nerdiest place you could imagine. I loved it. All I did was think about science, read science, and digest science all day long.”

Azucena worked on two main projects and many side projects. In one, she looked at tumor mutations that lead to resistance against CAR-T therapy: “You take a patient’s T-cells and engineer them so they attack the tumor. That was the basis of my Nature Communications paper.”

She also interfaced with industry-driven Principal Investigators like Harvey Lodish when she applied to co-teach a course with him and Jianzhu Chen. The course she taught centered around the biotech business. This was the first time Azucena saw how a primary science finding turns into a drug. Azucena was quite curious about the lifecycle of a drug – but she didn’t feel she had time to explore the question right then. She had to finish her Ph.D, so tabled the question for later.

Harvey Lodish informed her that his elite MD PhDs – of which he believed she was one – rarely returned to medical school, instead focusing on lab work. Azucena had to decide, “Did I want to return to medicine or just do science? I realized very quickly that I wanted to do medicine. I really love taking care of people.”

Azucena finished her PH.D. in 2020 and then returned to finish her MD work.

Massachusetts General Hospital

During her fourth year of graduate school, Azucena was diagnosed with multiple sclerosis. She went into medical school rotations thinking she wanted to do something procedural, like surgery. Yet, surgery did not seem feasible with MS, and there was uncertainty about how her condition might manifest and evolve.

“In the end, I really did fall in love with medicine. I’m a data-driven person and ultimately, that’s what medicine is, interpreting lots of incoming data to help prioritize a list of possible diagnoses.” So, Azucena applied for a physician-scientist position at various places.

She got offers from all of the programs she applied to, including Harvard and MGH. Though she was warned that MGH was a “toxic environment,” she found quite the opposite to be true. “People at MGH are really down to earth. They’re some of the smartest people I’ve ever worked with, but really humble about it. They’re really open to hearing other perspectives. It’s very much a teaching hospital. The administration recruits people dedicated to teaching and raising up other people around them.”

Venture Capital Work

Since teaching a course on the subject at MIT, the question of how even tiny ideas become science and then become treatments, including medications, had continued to fascinate Azucena. In her residency at MGH, she worked on the inpatient cancer floors, treating some of the sickest cancer patients. She suddenly realized that her research work, while a valuable contribution to science, was “so far from anything that would ever see a patient. There was something really frustrating about that.”

“Suddenly, I wondered about all these targeted therapies we were prescribing on the wards. How were these drugs developed? What was a drug’s lifecycle? Why do some discoveries become drugs while others flop or languish in the development pathway?

“Do I go to the FDA to figure out how this happens? No, because their work is at the end of the drug’s lifecycle after the basic science discovery and clinical trials.

“Do I go to pharma and figure out how pharma makes the decisions? No, because those decisions are made on a very different timeline. And I only have limited time right now.

“Even biotech focuses deeply on only one part of the lifecycle.”

Azucena searched the industry, asking questions of her mentors, to discover the point where one can see a drug’s lifecycle from the 30,000-foot view: every success, failure, and decision that goes into deciding what becomes a drug and what doesn’t.

“Venture capital is the way to do it. From this viewpoint, I could be a vital contributor. Their math is for gains and bottom lines, and there’s nothing wrong with that. My math is for science and patient care. Together, we’re solving for impact.”

Azucena has a skill, or perhaps one would call it simply an essential honed habit, for success: she stays in touch with her mentors. Her gratitude for her teachers and mentors is boundless; she calls these people “massive lifelines.”

(Ms. Bronwyn and Mr. Keller from OGHS saved my life. My Smith professors helped me realize I was capable of achieving the dreams Ms. Bronwyn had allowed me to envision. This includes Dr. Michael Barresi, Dr. David Bickar, Dr. Doreen Weinberg, Dr. Esteban Monserrate, and Dr. Mary Harrington. My current mentors have helped me navigate this new part of my career and have been invaluable lifelines as I work to build on the groundwork I’ve laid down. These include my Harvard and MIT families, Dr. Fidencio Saldana, Dr. Hojun Li, Dr. David Altshuler (now at Vertex), Dr. Fernando Camargo, Dr. Michael Hemann, Dr. Matthew Vander Heiden, and Dr. Harvey Lodish. This also includes the amazing mentors I have met in the VC world, including Dr. Robert Tepper of TRV, Dr. Melissa McCraken and Kanishka Pothula at Nextech, David Lynch at Google Ventures, and Dr. Jason Ruth at MRL ventures. My MGH mentors continue to guide me as I journey through the rigorous path of medical training, Dr. Josh Ziperstein, Dr. Rashmi Jasrasaria, Dr. Sarah Street, Dr. Jose Florez, Dr. Timothy Graubert, Dr. Gaby Hobbs, Dr. Josh Metlay, and last but not least, Dr. Sherri-Ann Burnett-Bowie. )
Though many of her mentors were not Latino, Azucena enjoys finding commonality with people with vastly different experiences. “I stay curious about people, and I don’t make assumptions. I just try to find the bridge that will connect us. Inevitably, I always find one.”

Most of her mentors have also become sponsors and close friends, and this support network opens pathways. Through her connections, she met Melissa McCracken of Nextech. “I clicked with her and her team. They focus on oncology investments, and I have field-relevant knowledge in oncology. Pretty quickly, I became a big part of the investment team. And it’s just been really fun.”

“Pretty quickly” is correct. Azucena started working with Nextech just four months ago, dividing her bandwidth between her residency, her Nextech investment advisory position, and her home life.

Azucena will complete her residency in June 2025 and aims to do a Fellowship in Oncology. Nextech is clear about their desire to keep her on the team.

Azucena tells me, “I’m still trying to figure out what my life will be!”

So, what is her life going to be?

Anything and everything she wants, I have no doubt.

“I like the venture capital world; it’s been fun and informative, and it will change how I do science. Ultimately, I do see myself as an academic. I want a hybrid career. I want to be a physician-scientist who works on projects that are immediately relevant and translatable to patient care, and I want to take care of patients.”

Yet Azucena told me something surprising. “I don’t think I’m all that smart. I’m just really, really hard working. I’m smart enough to cross a critical threshold, but really, I’m indefatigable. You tell me to chew through a wall in order to be successful at X thing, and I’ll chew through it, no questions asked. That’s the differentiator between me and other people.”

“But Azucena,” I replied. “Both things are true. You work extremely hard, and you’re brilliant.”

“I try really hard to be certain that everything I do is in keeping with this vision I have for who I want to be,” Azucena tells me. “We all have to do that. Otherwise, you can get lost in the complacency and terribleness of this world.”

Thus far in her story, Azucena Ramos accomplished whatever she set her mind to do, with determination, humility, gratitude, and the willingness to accept help when it was offered: an indomitable combination when added to her own vast potential. She will likely achieve all her aims on a path no one could have anticipated and find new ways to accomplish even more.