The first time I rode in an ambulance was in May 2024. I was in the middle of my 10:30 a.m. Communication 200 class when I realized my vision and hearing were failing. I couldn't keep my legs or arms straight and I couldn’t speak.  The full memory is hazy, but I found myself sitting outside of Crash’s Market in the University Student Union with a handful of salt packets and on a Facetime call with my parents, who live in Tennessee.  This experience didn’t come out of nowhere. I have postural orthostatic tachycardia syndrome, or POTS, a chronic condition that I’ve lived with since my junior year of high school.   There’s not a lot known about POTS, but it's a disorder affecting the autonomic nervous system. When I switch positions (postural) – especially when I go from sitting to standing upright (orthostatic) – my heart rate rapidly increases. On average, it's over 100 beats per minute (tachycardia).  POTS leaves me with a slew of symptoms. Daily, I experience dizziness, nausea, fatigue and brain fog, among others. Some people who have POTS faint frequently, even daily. I'm lucky enough that this doesn't typically happen to me, but I do experience presyncope, which means I go through all the symptoms of passing out while still fully conscious. When it occurs, I'm not able to see, speak or hear anything. I’m so dizzy I can’t walk straight. I get heat flashes. I remember only bits and pieces of what happens during these moments.   The severity of my symptoms can vary, leading to an episode like the one I suffered in May 2024. If I have been walking or standing for too long, sitting for too long, am stressed out or if it’s hot outside, there’s a higher chance of an occurrence.   That day in May, while I was on the phone and sitting outside of Crash’s Market, my parents called the paramedics. Determining that I couldn’t walk anywhere on my own and wouldn’t be able to for several hours, they took me by ambulance to the emergency room at a nearby hospital.  Though it was my first time in an ambulance, I had made frequent visits to the ER over the previous four years. The process this time was the same as it had been for prior trips: They measured my vital signs, checked my heart with an electrocardiogram and did blood work to confirm POTS as the reason for the incident. Then I received an IV.   IVs have been incredibly helpful. People with POTS struggle with low blood volume and tend to get fewer nutrients from the food we eat. An IV provides quick hydration and extra electrolytes.  I also constantly consume extra salt, which helps improve blood volume. I add salt to my food, but in extreme cases, I will just eat plain salt packets.   At restaurants, I always take an extra handful of salt packets from the condiment stand. These live in my purse or backpack, and I keep them handy in case I feel an episode coming. Some of my friends even carry salt packets when they’re hanging out with me.   Despite the challenges, I try to focus on the positives. This journey has taught me to advocate for myself and surround myself with people who care about me, which is easy to do at Cal State San Marcos.  Self-advocacy became a necessity as I went through many months of doctors’ appointments during high school trying to figure out what was wrong. Several doctors said everything I was going through was normal. But I knew it wasn’t.   I wasn’t officially diagnosed with POTS until two years after my first symptoms. I had COVID twice during that time, and doctors believe that may have exposed an underlying condition.  POTS is a chronic illness, meaning there is no cure. I’m a regular at the doctor’s office, with multiple appointments every month. Attending events causes heightened anxiety – both for me and the friends I’m with – and I do my best to be prepared in case of an episode.  I had to take another ambulance ride in March. A friend and I were at a Kelsea Ballerini concert in San Diego. Though I had been fine the whole day, I started feeling nauseous and dizzy during the first opening act. I couldn’t stand. By the time Kelsea took the stage, the combination of the heat, crowd and strobe lights proved too much. My friend had to help hold me up as she guided me down the stairs to find the medics.   Situations like this are frustrating. I don’t want to be a burden to friends and family, and I don’t want friends constantly worrying or family having to pick up slack.   I’ve made some lifestyle changes in an attempt to lessen my symptoms. I take daily medication to ensure that my body keeps the right balance of salt and water. I drink tons of water with extra electrolytes and salt added. I try to walk every day to get my body more adjusted to moving. On hot days, I carry a mobile fan. And I also make sure to eat well.  When I decided to attend CSUSM, the Disability Support Services office proved invaluable – they set me up with first-floor housing so I could avoid stairs (and anyone who has spent time on campus knows it’s no easy task to avoid stairs at CSUSM!).   I also have learned to be more open about my condition. Through my on-campus job as a writing intern in the University Communications office, I’ve made great friends and found people who understand and support me. The experience has been an important part of pursuing my goal of becoming a writer.  While CSUSM has helped me grow, my family and I made the difficult decision for me to move back to Tennessee at the end of the spring semester to focus on my health. I’ve had my share of challenges, but I also know how difficult it has been for my family to get calls in the middle of the night to learn I’ve been taken by ambulance to the ER when they’re 2,000 miles away.  Though I’m heading east to finish college, I’ll always be thankful for my time at CSUSM – for the friends I’ve made, the support I’ve received and the confidence I’ve gained in sharing my story.  Media Contact Eric Breier, Interim Assistant Director of Editorial and External Affairs ebreier@csusm.edu | Office: 760-750-7314

Cal State San Marcos Theatre brings the complexities of teenage girlhood to the stage with “The Wolves.” The play, written by Pulitzer Prize finalist Sarah DeLappe, is a coming-of-age tale that follows a high school girls soccer team as players navigate degrees of adolescence, identity and growing up. Performances of “The Wolves” will take place in Arts 111 at 7 p.m. from Nov. 12-15. Tickets for students are $10, while general admission tickets are $15.  Through their interactions, rivalries and moments of vulnerability, the girls grapple with the nuances of teenage girlhood and the unspoken bonds that form within the team. Set entirely during pregame warmups, the performance captures the chaotic, overlapping conversations between players as they discuss everything from global politics to personal anxieties. To perfect the soccer moves in these moments, the actresses are being coached by Emily Mahmoud, a senior midfielder on the CSUSM women's soccer team. Media Contact Eric Breier, Interim assistant director of editorial and external affairs ebreier@csusm.edu | Office: 760-750-7314

Student teachers across California now have access to a new financial support program aimed at easing the burden of unpaid teaching hours required for credentialing. Signed into law on June 27, Assembly Bill 121 (AB 121) established the Student Teacher Stipend Program, which provides $10,000 stipends to eligible student teachers who complete at least 500 hours of student teaching. The program, which will go into effect for student teachers in the 2026-27 academic year, is designed to support future educators and strengthen the state’s teacher pipeline. The initiative is funded through the California General Fund, with $300 million allocated for the 2025-26 fiscal year. Beginning in 2026-27, up to $100 million annually may be made available, depending on future state budget appropriations. The stipends will be available to local educational agencies (LEAs) – including school districts, charter schools and county offices of education – that host student teachers, teacher residents or apprentices. Intern credential holders are not eligible. The program is non-competitive, meaning all eligible LEAs that apply will receive funding, subject to availability. LEAs apply through a streamlined online process managed by the Commission on Teacher Credentialing (CTC). In addition to supporting student teachers, LEAs may use stipend awards to offset wages for apprentices or support residents not funded through other residency programs. LEAs can apply through the CTC’s online portal. Each eligible student teacher receives a stipend of $10,000, paid during the year they complete 500 hours of student teaching. For more information, the commission has established a specific email box for questions: STSP@ctc.ca.gov. You also can contact Moses Ochanji, director of Cal State San Marcos' School of Education, at mochanji@csusm.edu. This stipend program represents a significant investment in California’s future educators and aligns with CSUSM's commitment to supporting students pursuing careers in education.

Michelle Gonzalez was a Cal State San Marcos student only about a month away from graduating in 2003 when she started working for an organization then called North County Health Services.  Her degree (communication) was unrelated to health care, and Gonzalez had no intention of staying in the field. The main appeal of the job was that it was close to her home and the university.   Beginning her journey as a program assistant in an entry-level role, Gonzalez quickly developed a fondness for the local nonprofit and its high-minded mission: providing quality health care and wellness services to underserved communities, regardless of income or insurance status. Her early connection to community health mirrored CSUSM’s commitment to accelerating social mobility through leaders who serve with purpose.  What Gonzalez imagined to be a brief pit stop instead turned into a rewarding career, and over two decades, she climbed the rungs all the way to the top – she was appointed president and CEO in 2020, the same year that North County Health Services was reborn as TrueCare.   With Gonzalez at the helm, TrueCare has expanded into a regional force with 21 health centers and five women, infants and children (WIC) locations, covering a footprint of more than 42 miles, from Encinitas to Ramona. Her leadership has driven key advancements, including the opening of new health centers, expansion of the mobile fleet and specialty services, implementation of an advanced electronic health record system, rebrand of the organization, and launch of a successful doula program supported by a $2 million federal grant.     Question: This year marks the five-year anniversary of you becoming the leader of TrueCare. What does that milestone mean to you?  Michelle Gonzalez: I think it's a reminder of how quickly time flies and how quickly things can change and evolve. It's hard to remember that we were in this worldwide pandemic. It feels like it's been a couple lifetimes. We've had a lot of growth for the organization, and I think at this five-year mark, it just underscores how resilient we are, how much people matter at the core of everything we do – whether it's providers, whether it's patients, whether it's the community, our staff. It's a culmination of the strength of the organization and everything that we've accomplished, which is a lot in the last five years.    Q: How would you sum up the growth and changes that have occurred since 2020?  MG: We've expanded our footprint. We've opened new sites, we've added new service lines, we've added acupuncture, we've added podiatry. We've really stabilized our workforce during a time of a lot of shortages and uncertainty. I’m proud of the fact that our provider retention rate is over 90%. We continue to hire at an accelerated pace, and I start there because everything we do, all the growth and all the accomplishments, it always starts with people. Without a solid workforce, we wouldn't be able to achieve anything.   Our patient population has grown significantly as well. We had a slight decrease post-COVID, but we're back up to almost 70,000 patients. We've rendered more than 350,000 visits in this last year. Our workforce continues to grow. We're over 800 employees now and close to 160 providers. And then our budget has grown significantly, by almost $55 million in the last five years. We've tripled our mobile fleet. In all the areas of the business that you would expect to continue to progress, we're not only progressing, but we're thriving.  Q: How did your appointment as CEO come about?  MG: My predecessor went on a leave of absence in January 2020. The board asked me if I would be willing to step in on an interim basis. They were initially planning to do a national search, which I was fully supportive of. I didn't have any aspirations to be a CEO. I sometimes say I'm an accidental CEO. I was working in that interim capacity for several months, and then COVID made its presence known and we had the stay-at-home order. By April, the board had unanimously appointed me to maintain the position full term. After a lot of conversation and some prayer and reflection, I decided to pursue the position, and it's been a fantastic journey, in large part because I have such a great team around me.     Q: What was the biggest challenge in taking over just as the pandemic was heating up?  MG: There was so much uncertainty and fear. At one point, we had to close more than half of our clinics, probably 75-80% of our sites, we had to furlough staff. You think you can sort of ease in to becoming a CEO. There was no ease-in period. I remember talking with colleagues in the industry and saying, “How are you handling this? What are you doing?” And I realized very quickly that there's no playbook and everybody was truly figuring it out as they went along. Very early on, I made a conscious decision that I would be the type of leader who was always grounded and surrounded by strong advisers. We offer health care, but I'm not a clinician, so I made certain that we had strong clinical leadership on our team. It was about trying to understand what was unfolding in the world around us and how TrueCare plays an important part and ensuring that we were keeping our workforce intact. We’re back on track now, but it was an incredibly stressful time.     Q: How did TrueCare pivot during that time and how does the organization look different now than it did in 2020?   MG: Before the pandemic started, we had pieces of a telehealth or virtual health program. We realized very quickly that it would be crucial to continue to offer services to patients. For many patients, we are their lifeline, and cutting off their health care was not an option. So we were able to stand up a virtual health program in three days. It started off with telehealth visits and as soon as we were able to, we migrated to a video visit platform. We essentially worked around the clock to make sure that we didn't cut off access for patients, but it also gave employees a sense of purpose. And we've continued to build on that virtual health program while staying true to the traditional methods that you would expect to render medicine.   We also had to pivot when it came to figuring out what our workforce was going to look like. We had to put people on furlough, but we made sure they still got a salary. We really believed that we needed to take care of our people, and a lot of funding from the federal government helped to shore us up. We laid off less than 15 individuals, and we were able to provide them with a severance so that they landed on their feet. I’m proud of that.   Q: How would you characterize the change in you that turned TrueCare from a short-term job to more of a calling?  MG: What I found was that people who worked here were very connected to the mission. They weren't here for the money. They were here because they cared about the people and patients that we were serving. The more I learned about the organization, the more in love I became with it and the more I realized, “My gosh, we have to make sure more individuals in the community and more community-based organizations know about what we do because there are so many people in need.”   There was a misconception about people who were accessing care at community health centers, that they deserved less or they were just poor. I discovered that these are individuals who work very hard and who don't understand the importance of preventative care, and a lot of times don't feel like they're worthy of having access to care. What became a cornerstone of the work I did early on, and has carried on throughout my time here, is making sure everybody understands that access to health care is a right, not a privilege, and we don't care about your walk of life, where you come from or your circumstance. We want to make sure we help everyone who walks through our doors to the very best of our ability.     Q: Tell me about your background.  MG: I was born in Virginia, which is where my father is from. My mother is from Guam, and my parents met there while my dad was in the military. I'm half-Chamorro and half-white, and my husband is Mexican. We were childhood sweethearts who met when I was 12 and he was 14. I've had a lot of exposure to his family and culture over the years, and I think that's something that has benefited me very well. Though I'm not Mexican, I'm not Latina, I have such an appreciation for the culture and the people who we serve, which is the predominant background of our patients.  My family traveled a lot while my dad was in the service. We moved to Vista when I was in third grade, and I've lived in North County pretty much my whole life. I'm also the youngest of seven children and the first in my family to go to college. So I'm a first-generation college graduate.     Q: Did your parents not encourage college among your siblings?  MG: We came from very humble beginnings, and I don't think we always understood that college was something within reach. My parents did the best they could to work and provide for us, but it was really the mindset of, you go to school and you get a good job. But my mom would say to me, “You're too smart, Michelle. You need to think about college.” I told her we couldn’t afford college, but she said we'll figure it out, we'll find a way. For most of the time that I was a student, I worked two jobs to put myself through school. I was also an AmeriCorps member, so I was able to receive a grant. But none of it came easy and none of it was without sacrifice or hard work – not just for me, but those around me who supported me.  Q: What I'm hearing is a story of social mobility.   MG: Oh, one thousand percent. I think that's why Cal State San Marcos and TrueCare are such great partners. We see health care as a right, not a privilege, and we think it's fundamental and foundational to everything. I think it ties in beautifully with social mobility. And there's so much good that is happening at Cal State San Marcos. There's a lot that we do together, and social mobility is a big part of that.     Q: One of the main areas in which TrueCare and CSUSM have partnered in recent years is mobile health clinics. How did that come about?  MG: Once I became CEO and started serving on the University Council, I learned about CSUSM’s interest in having a mobile health unit. I connected with (nursing lecturer) Matt Mincey early on and said, “You don't have to go on this journey alone. We have mobile clinics. We're right here, let's partner, let's figure out how to do this together.” What started out small has expanded into working not just with the mobile team, but also with the School of Nursing, public health, the entire College of Education, Health and Human Services. It’s a great opportunity to give exposure to students and help them understand that health care doesn't just come in a traditional hospital setting, that there's this whole other life of community health. There's a ton of overlap where our interests align nicely with what CSUSM is doing. We go to the same community events, and CSUSM students are able to do outreach, blood pressure screenings, things of that nature. Then, as they move farther along in their studies, when appropriate, they're also able to do internships at TrueCare.    Q: How would you summarize TrueCare’s model in terms of providing health care?   MG: One of the things I want to emphasize is that TrueCare will not refuse services to anyone regardless of their ability to pay. What we're focused on is the individual and the family who presents and what services you need, and how we can either provide those directly or connect you with somebody who offers them. At TrueCare, we provide high-quality, compassionate care. Like we always say, “Health inside, welcome in!”    Q: That seems like such a valuable service in the community – health care you don't have to pay for.  MG: In today's day and age, it sounds like something very novel. Does that really exist? And the reality is that it does. When you believe in your core that health care is a right and not a privilege, you fight to make that a reality. And that's what we're doing. We're growing in all possible ways and we're maximizing wherever we can, in terms of the revenue we're able to generate. We take that and we pour it right back into the organization so that we can continue to expand our footprint. We put a lot of emphasis on making sure we can get people enrolled in coverage because we know that if you have coverage, that's a reduced barrier and you're more likely to access health care. But that's not the only barrier you will have to face and figure out. We also spend a lot of time and resources and energy in cultivating a fantastic culture internally. We believe that people who are joyful at work are more likely to do a better job and will pour that energy back into our patients and community. We make it a priority to care for our workforce, to really give them opportunities to advance, to grow and level up. What we find more and more often is that our patients are a direct reflection of our staff, and our staff is a direct reflection of our patients. Pouring into one is pouring into the other, and we're proud of that because health care is daunting – not just for the patient in terms of navigating, but it's also really hard work. One of our VPs many years ago said, “Michelle, we do noble work.” And I was like, “Yeah, this is noble work.” That's exactly what we do.   Media Contact Brian Hiro, Communications Specialist bhiro@csusm.edu | Office: 760-750-7306

Cal State San Marcos’ Student Health and Counseling Services (SHCS) hosted its annual Real Monsters Art Exhibit at The Makery on Oct. 8. Displaying artwork from artist Toby Allen, the exhibit represented different mental illnesses depicted as monsters. The event included interactive art activities to showcase how creative expression can help make sense of mental health issues. Located on the second floor of Kellogg Library, The Makery is a place for students to exercise creative freedom and explore new skills using a variety of tools and materials. In partnership with the HOPE & Wellness Center at SHCS, The Makery will be hosting art and mental health workshops to enhance students’ mental well-being and connect them to mental health resources. During the most recent workshop students were able to create their own “monster” symbolizing their individual mental health experiences and struggles. Once crafted, the students were allowed to share what they felt comfortable with about their monsters. The workshop was led by Anahi Martinez Mendez, a Master of Social Work graduate assistant, and Madison Di Palermo, a peer lead health educator. These workshops give students the opportunity to process and express emotions and experiences that are often hard to put into words by using art. It also helps students to find community with one another and receive help whenever they need it. Media Contact Eric Breier, Interim assistant director of editorial and external affairs ebreier@csusm.edu | Office: 760-750-7314

Madison Perry didn’t have any type of physics background when he wandered through Science Hall 2 looking for research opportunities after his first year at Cal State San Marcos.   Perry wasn’t worried about pay or even the tasks he would be doing. He simply wanted an opportunity to gain some hands-on experience.  It wasn’t an easy sell, even if CSUSM is known for high-impact, experiential learning. Perry wasn’t a physics major (he was studying mathematics at the time), and he didn’t have any lab experience.  Perry wasn’t having much luck when he knocked on the door of physics professor Stephen Tsui.  “He just said, ‘Sure, why not?’ ” Perry said.  The simple gesture was the catalyst for Perry’s switch to physics and the beginning of his journey to co-founding TP Engineering Services, a Poway-based company that builds laser and electro-optic systems for defense and fusion applications.   The company has flourished since its founding in 2017, but a fusion contract that it secured three years ago has accelerated its growth.  “It’s pretty insane to think about us getting to this point already,” Perry said. “Did I ever think we'd get here? Yeah, but I had no idea what it was going to look like, and I had no idea how it was going to happen.”  The experience is similar to the one Perry had at CSUSM, where he practically lived in Science Hall 2 as a student. In fact, he was there so early and so late that the physics department eventually entrusted him with keys and after-hours access to conduct his work.  “That was my thing – just being in a lab setting, being around hardware, being around something that was tangible, something that wasn't just theoretical,” he said. “It was where I could put my hands on hardware and get some experience.”  After graduating in 2016, Perry headed north to UC Santa Cruz, where he earned a master’s in phototonics. His master’s thesis – on the design and development of a deep ultraviolet fiber laser system – caught the eye of a defense contractor who funded the project, leading to the formation of TP Engineering with his mother and father.  TP Engineering quickly grew from an optics table in Perry’s bedroom where they navigated every project to the Poway lab it calls home today. The company has expanded from the initial trio of co-founders to over 20 employees, including two from CSUSM.  The university still holds a special place in Perry’s heart. It’s where he met his wife, Amanda, who earned a bachelor’s in kinesiology. More than a decade after they met while both lived on campus in the University Village Apartments, they welcomed daughter Elli, who will be 3 years old in December. And he still returns to campus every year for Super STEM Saturday, an annual one-day science festival that brings thousands of community members to campus.  A longtime supporter of CSUSM Giving Day, Perry increased his contribution last year with a matching gift for the physics department.  “He's an alum who really believes in giving back,” Tsui said. “It's nice that so many of our graduates remember us so fondly and want to see younger alums and students do well.”  That’s certainly the case for Perry. He doesn’t take for granted the impact that people like Tsui had on him and his career.  “CSUSM took a chance on me a long time ago, and I want to support them being able to give other students a chance as well,” Perry said. “My professors gave me a unique perspective on life. If Dr. Tsui hadn't given me that opportunity to work in his lab, I don't know if any of this would have happened. They gave me a chance, and that changed me forever.”  Media Contact Eric Breier, Interim Assistant Director of Editorial and External Affairs ebreier@csusm.edu | Office: 760-750-7314