Incoming Hospice & Palliative Care Fellows 2024-25
Anna Astashchanka, MD
Anna Astashchanka attended the University of Colorado School of Medicine and completed her Internal Medicine residency at UC San Diego. She is currently a Pulmonary Disease and Critical Care Medicine fellow at UC San Diego. Outside of work, she enjoys writing fiction. “When had medicine became more about doing things to people rather than for people? It reminded me of a poem I read as a college student that I ended up finding again during fellowship - End of Days by Marge Piercy. One verse reads, 'I want someone who loves me there, not a doctor with forty patients and his morality to keep me sort of, kind of alive or sort of undead. Why are we more rational and kinder to our pets than with ourselves or our parents? Death is not the worst thing; denying it can be.'”
Julia Bu, MD
Julia Bu earned an MD from Case Western Reserve University and completed a Neurology residency at UC San Diego, where she was a chief resident. She is currently a fellow in Vascular Neurology at UC San Diego. Her hobbies include marathon running and kickboxing. “I aim to modify the adage ‘Time is brain’, and propose the addendum ‘Time is brain, but outside that window a whole person and community still remain’. Though we have made significant advancements in the acute treatment of stroke, I want to dedicate my career to equitable and meaningful care for patients both inside and outside the acute therapy window as a palliative care trained vascular neurologist.”
Lakshmi Kirkire, MD
Lakshmi Kirkire completed her medical training at the University of Chicago and is currently an Emergency Medicine resident at Johns Hopkins. “As a medical student, I had always thought that palliative care was hospice care, reserved only for patients at the end of their disease course. As I am now nearing the end of my training, I've learned that palliative care physicians play a key role in every step of patient care, from patient advocacy and helping patients understand their diagnoses, to symptom management and advanced care planning, all the way up to goals of care and hospice. I've found that this spectrum of practice has a large role to play in Emergency Medicine.”
Megan Lau, MD
Megan Lau is a graduate of the UC San Diego School of Medicine and is currently an Internal Medicine resident at UC San Diego. Outside of work, she is a member of a Spanish podcast club. “During residency, I have had the privilege of caring for patients in all stages of life with diverse backgrounds and a variety of medical conditions. Amidst that variety, my interactions with patients facing end-of-life decisions have been the most impactful. This has reinforced my desire to be a part of a field that provides personalized, patient-centered care to individuals and their families.”
Vivian Okonta, DO, MPH
Vivian Okonta earned her DO from Western University of Health Sciences College of Osteopathic Medicine of the Pacific and an MPH from USC. She is now a Family Medicine resident at UC Irvine and has an interest in narrative medicine. “Hospice and Palliative Medicine encompasses social, psychological, and spiritual well-being for each patient, all of which influence overall physical health and quality of life. According to a report published by the World Health Organization in 2020, less than 15% of those in need of Hospice and Palliative Care actually receive it. I look forward to a career in which I can be part of the solution to this area of need.”
Matthew Schoen, MD
Matthew Schoen attended Stanford’s School of Medicine and is currently an Emergency Medicine resident at Stanford. Outside of work, he has run multiple marathons. “My personal and professional journeys have encouraged me to engage with suffering and define my role as someone who helps others face uncertainty. I have found a home within the field of hospice and palliative care. I am inspired to keep this work at the heart of my career, as I continue to follow my passions for medical education and providing comfort in crisis.”
Nicholas Tom, MD
Nicholas Tom graduated from UC Davis’s School of Medicine and is completing his residency in Internal Medicine at Kaiser Permanente Oakland. He practices multiple types of martial arts, including karate and Wing Chun. “I have found my calling in Palliative Medicine, caring for patients whose medical complexity is matched by their social, emotional, and spiritual needs. The relationships I have formed with these patients and their care teams, and learning about their stories and values, have shaped the way I practice medicine and communicate with others. In my career, I hope to further explore disparities in access to end-of-life care and develop care models which help to narrow this gap.”
Julia Wilkins, MD
Julia Wilkins completed her medical education at New York Medical College and is currently a Family Medicine resident at UC San Diego. “My greatest joy as a physician comes from sharing life's most important moments with patients and their families. These opportunities tend to come at life transitions, such as the birth of a baby or the death of a loved one. To walk with other people in these moments is a precious gift, and not something I ever take for granted. It is common to hear physicians—especially residents—say, ‘I've forgotten why I went into medicine in the first place.’ Too often the job is tied to checklists and documentation rather than true human connection. Being present with patients as they experience life's transitions is deeply gratifying for me, never more so than when they are confronting terminal illness.”