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Sunday December 21, 2014

Identical Twins in Med School Study to be Doctors – and Learn About Themselves

Identical Twins in Med School Study to be Doctors – and Learn About Themselves

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Fascinated by how genes make them so similar, they have a mutual passion for medicine

Jessica and Jordana in white coats
Photo: Nick Romanenko
At first it is hard to tell first-year New Jersey Medical School students Jordana (at left) and Jessica Goldman apart, but their classmates and instructors are learning.

'Growing up as an identical twin you want to know why you and your twin look the same when other people don’t. Medical school is a natural place for us to learn more about the genetic profile we share.' – Jessica Goldman

Jessica and Jordana Goldman, first-year students at Rutgers New Jersey Medical School, are convinced that being identical twins is a big reason both want to be physicians.

“Growing up as an identical twin you want to know why you and your twin look the same when other people don’t,” said Jessica recently as the two sisters sat together in the medical school’s leafy courtyard in Newark. “Medical school is a natural place for us to learn more about the genetic profile we share.”

It is estimated that one birth in 250 produces identical twins. And Jessica and Jordana know well that the more science progresses, the more valuable knowledge about these special siblings becomes to researchers studying genes and their interactions with the environment. How can one identical twin develop a disease that the other, with essentially the same DNA, escapes? Why may one twin become outgoing while the other remains shy?    

The sisters look forward to learning all they can about molecular genetics while in medical school, and their message to researchers who study identical twins is “count us in.”

“I’m interested in participating in twin studies,” says Jordana, “for the sake of science, but also to help me figure out why certain things about us are similar and why some are different."

Just two years ago they discovered one intriguing difference purely by chance. Jordana learned in a psychology class about a neurological quirk called grapheme-color synesthesia, which causes people to think of a color when they a see a number or letter. Before then, Jordana never had reason to consider herself unusual, but that day she realized she fits the description. For instance, a numeral 5 suggests redness to her, while she associates 6 with blue.  The condition is presumed to have a genetic origin, but Jessica does not share it, while one of their cousins does. And they all wonder why. 

Jessica’s interest in DNA extends even further, with roots in her family’s Jewish faith. “My strong interest in Judaism has led me to want to know as much as possible about Jewish genetic diseases,” she explains.

Young doctors - age 3
Courtesy: Jessica and Jordana Goldman
Stethoscopes were already part of the Goldman sisters' ensemble when they were 3 years old.
Jessica and Jordana’s shared passion for medicine has been years in the making, going all the way back to early childhood. 

Jessica remembers drawing a picture of her future self in preschool, wearing a doctor’s white coat with stethoscope in hand. “Whenever anyone asked me what I wanted to be,” recalls Jordana, “I said, ‘doctor.’ I never said ‘ballerina’ or ‘I don’t know.’” 

They acted on their common calling precociously early. When one sister had a childhood illness, the other would grab a medical book off their parents’ shelf, look up the symptoms and declare a diagnosis. One day when Jordana went to the pediatrician with a case of strep throat and mom took Jessica along, Jessica told the doctor she planned to be a physician, and was thrilled to get a demonstration of how a positive strep culture differs from a negative one. 

All the way from pre-K in Paramus, New Jersey, through medical school they have gone to school together, and their shared interest has persisted. Jessica worked for a time in a genetics lab at Mount Sinai in New York City, and when she mentioned she was an identical twin, she and Jordana instantly entered a study where their heads were photographed from multiple angles so that any differences could be explored. 

There are indeed differences, yet another reason why they find genetics so fascinating. Matching DNA determines so much, but not everything, which they often emphasize to people they meet. 

Weeks into medical school, many people still could not tell them apart. But here is how. Look at Jordana’s left cheek. You will see a pair of beauty marks that Jessica does not have. Jordana says when people combine that with the fact that she has the less common name, it becomes clear who is Jordana and who is Jessica. 

The sisters are determined to be distinct individuals and for the world to see them that way. While they went together to Johns Hopkins for its pre-med program, they pursued different interests. Jordana majored in psychology and minored in studies of women, gender and sexuality. Jessica focused on Near Eastern and Jewish studies. They embraced the chance to make separate friends, and liked the fact that, as Jessica puts it, “there were people I got to know better than Jordana and vice versa, so when they saw us together they knew who was who.” 

They insist on preserving their separate identities to the point where they pledge that neither of them will ever pretend to be the other – even if doing so at the perfect moment could produce a lot of laughs. Among their reasons is their future as doctors. Jessica explains that especially in medical school, an environment that values ethics, it is not smart to “mess with people’s heads.” 

Jessica and Jordana Goldman say they root for each other “100 percent,” and if one does well on an exam while the other does not, the joy is diminished for the sister who scored higher. They often study together, which works especially well when one understands a concept and the other does not –  because the one who grasps the material knows better than anyone else in the world how to explain it in terms the other will understand.

It has crossed their minds that years from now there could be a medical practice with a sign in front that says “J. Goldman, MD, and J. Goldman, MD,” but they also know that the medical residency system or their own individual choices may finally send them in separate directions. 

If so, they look forward to what the future brings. “If it turns out that we want the same thing, great,” says Jordana. “But we are not tied to that.”

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