When I Was 17: Ryan Kruis

Ryan Kruis manages the statewide partnerships for the South Carolina Telehealth Alliance in Charleston, South Carolina. I met Ryan at a moment of transition in his life as he was preparing to finish graduate school and move halfway across the country to start his life with his now husband. Things worked out even better for Ryan than I could have hoped for, and I loved getting to hear the ins and outs of his professional (and personal) adventure. Our conversation has been edited for length and clarity.
 
When you were 17, what did you want to be?
 
When I was 17, I was a bit all over the place; I had a lot of interests. I was pretty involved in the church growing up, and part of me was interested in working with the church. I come from a long line of folks involved with the church, and I’ve always been very social and relational, so I was exploring avenues to try to work with and help people. I was very fascinated by religion and spirituality, but I also questioned that a lot, being gay and struggling with coming out in that context. I think that it was also related to my interest in people's stories and the way that people make meaning in their lives. But I had lots of other interests as well.
 
I was also very into science at the time and I actually won a big chemistry award. So I thought that I might do medicine. Right around then, I fell in love with literature as well. I started talking to one of my English teachers and she encouraged me to think about teaching English. So I went into my senior year with lots of different interests and I knew that I would need to do some exploring.
 
How did you decide to attend Calvin College?
 
I grew up in Grand Rapids and I went to Calvin Christian High School. The summer before my senior year of high school, I did this immersive program at Calvin College where we went to Turkey and studied church history. That gave me a lot of exposure to Calvin, and some of the people involved in the program were going into their first year at Calvin. I also had a lot of friends there already, and I had taken a couple classes there so I already felt somewhat invested.
 
I had considered some of the state schools like Michigan State and University of Michigan, but not very seriously. The other thing was that I got a scholarship that paid for my first year of Calvin, so that had a big impact as well.
 
How did you choose your major?
 
I went in pre-med, but I also took some sociology classes and some pre-law classes and I fell in love with all my English classes. And then I got increasingly involved in the Service-Learning Center on campus, so I became very interested in community development and social justice.
 
The Service-Learning Center did lots of different things, but as a student worker, I worked closely with the faculty to help them develop service-learning opportunities. I worked with Spanish professors and with some of the English professors to develop opportunities and spring break trips that intersected with their curricula. All the residence halls have partnerships with community agencies as well, so I supported that program too. That's actually where [my husband], Devin, and I met.
 
I ended up an English and religion double major. Again, it was just this fascination with story and how people read or interpret different stories to make meaning in their lives. I also studied in Hungary for a semester which was so great; Budapest has such an interesting history.
 
How did you get from college to where you are now?
 
I did AmeriCorps and continued working in Calvin’s Service-Learning Center post-grad as an AmeriCorps. Then a year after that, one of their directors left so I filled in in the interim, leading the student workers and running different programs. And then around that time, I decided to go back to get my MSW.
 
I had become increasingly interested in social justice and community development. I was out by then, and I was very interested in the LGBT community. A lot of the folks that I interacted with who were leading these nonprofits had MSW degrees. I also became interested in marginalized communities because of my own story of coming out, and I wanted to help others navigate that. So the MSW mapped on nicely with some of my interests.
 
I went to Grand Valley State University in Grand Rapids because it was local and I wanted to stay invested in that community. I had built a lot of relationships with folks in the nonprofit sector there, so that made sense. And at the time, I was living in an intentional community with a number of friends from college. I was actually at the home birth of one of my housemates, and I cut the umbilical cord. So I was very much rooted in Grand Rapids and did not see myself leaving.
 
My program was two years long, and I interned at their university counseling center doing career counseling and psychotherapy with students for a year. I loved working in higher ed because it's a formative stage when young adults are leaving home and their identities aren't fully shaped and they aren’t stuck in their patterns. They’re willing to look at their behaviors and think about change. It's just a really ripe time for transformation and growth.
 
I also really loved the career counseling aspect too, helping students explore their interests and seeing how those might map onto different careers and thinking about different options that maybe they weren't aware of. It was there that I was first introduced to the term “career happenstance,” which, I think, has marked my own career trajectory.
 
There are two different career trajectories: one where folks have it pretty mapped out. It's a set plan. There are certain skills you need to acquire and certain positions. And then career happenstance is where you sort of fall into one opportunity after another and you have no idea where you'll end up. My husband, Devin, and I are sort of on opposite sides of that path, and establishing a partnership with him has impelled me to take on a more happenstance style.

During my MSW program, Devin was at Boston University doing his PhD program and we were long distance. When I graduated, I decided to move out to Boston, so my first job post-grad was in Boston.
 
I got hired by Fenway Health which is a federally qualified health center that focuses on the LGBT community (they serve a broader community as well), and I worked in their research department on a clinical trial looking at substance abuse counseling for HIV-positive folks.
 
I did that for three years, but in the process I took on more leadership roles, managing more of the grant aspects and reporting aspects of the study, and then taking on a few other research studies oriented towards different counseling interventions for the same community.
 
I went into my MSW hoping to have the opportunity to do something that addressed the queer community, so finding myself at this health center in Boston was such an exciting opportunity and also kind of the fulfillment of a lot of things that I had hoped for.
 
After working on that research study for three years, I transitioned into managing a grant that helped support different AIDS service organizations around the country adjust to the Affordable Care Act and think about how to transform their healthcare practices in more sustainable ways. I also started working on our LGBT health education center, where we would go around the country training other community health centers on LGBTQ health in ways that could make their practices and health centers more LGBT-competent and inclusive. So I was there for five years altogether.
 
Then I started working at MIT on a campus-wide suicide prevention program. We tried to look at different aspects of MIT from the culture to the policy to pinpoint some ways we could address suicide systematically. I worked there for a little over a year and then my husband got a job in South Carolina so we moved down here.
 
By that time, I had started to think of myself as a social worker with experience in public health and project management. So I was interested in finding a job in healthcare that mapped on to that. The Medical University of South Carolina was one of the main places doing health science research and public health interventions. And I was really fortuitous that a job opened up in their telehealth department.
 
Telehealth is using technology, video, internet, etc. to extend healthcare access in new and innovative ways. Like in South Carolina, along the I-95 corridor, some of the health outcomes among kids rival those in developing countries just because of poverty and systemic racism. In light of that, there are a lot of opportunities that telehealth presents. For example, we've got some counties here where there's maybe one pediatrician in the whole county. But there are schools in all of these counties and a lot of these school have nurses. So we can connect those school nurses to a pediatrician in Charleston, and kids can go to their school nurse and get their care that way.
 
Another big program of ours is for strokes. If you have a stroke, being close to a stroke care center is critical. The longer it takes to get it addressed and get the medication, the more your brain dies. In 2008, only 37% of folks in South Carolina lived within an hour of comprehensive stroke care. But what we've done now is we've equipped all of these emergency rooms with stroke carts, and you can go to your local small community hospital and the ER doctor can telehealth with one of our stroke doctors here and get a consult. Now 96% of folks in South Carolina live within an hour of stroke care because we've enabled all these rural hospitals to be able to access our doctors here.
 
At first, telehealth was an example of how to extend access if that's a problem. But increasingly, it's becoming a standard of care across the board. One of the reasons we're on the forefront is that our state legislature didn't expand Medicaid, but they invested a lot of funding in this. So we can evaluate our programs and share some of our successes and barriers with other folks nationally. I think it'll be more and more common in the future.
 
One of the things I appreciate about my degree and my experience is that it's pretty versatile. I've worked in suicide, I’ve worked in substance abuse, I’ve worked in training and education, I’ve worked in grant management. And now I'm in this telehealth space. So it's hard for me to actually imagine myself five years from now, what exactly I'll be doing.
 
Looking back, what seems clear to you now?
 
I am a product of the humanities. I think people should study what they love and get experiences along the way that complement that. I work with a bunch of physicians and public health scientists, many of whom don't have humanities backgrounds, so I'm really grateful for the way my education allows me to see the world differently in this role. And so, I would encourage students not to shy away from those degrees in college that seem impractical; the job will follow.
 
I'm kind of prone to anxiety generally, so not having a set plan can be hard
at times. But I think just sort of trusting that something will come along that will be a good fit would have made things easier. And this comes with a high level of privilege and I acknowledge that. But I've had to take some leaps to try something new and that has always paid off for me, even if it comes with some anxiety in the process.

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