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Making time for the perfect match: Alan Makhoul (MD ’22), Lex Erath (MD/MBA ’22) find partnership at VUSM

Posted by on Friday, February 11, 2022 in Curriculum, Fourth Year, Match Day, Student Life .

Vanderbilt University School of Medicine students prepare to match into residency as a couple ahead of their wedding this spring

By: Lexie Little

He watched her gather her things.

Alan Makhoul, then a first-year medical student, walked with classmate Lex Erath at the end of a casual study session. The pair had met two months prior when they sat next to each other at a Vanderbilt University School of Medicine orientation session on July 25, 2017.

They approached the door. Alan, holding a bottle of Perrier, blurted out, “Hey, would you like to go out on a date?”

Lex turned and smiled.

“I thought you’d never ask.”

The next thing they knew, the Perrier crashed to the ground, and carbonated water splashed across the room.

Too much emotion bubbled up, one could say.

“I had been thinking about whether I was going to ask her for several weeks, and I was still a little apprehensive. I didn’t know if it was a good idea…It was still the second month of medical school,” Alan said. “But I said to myself, ‘I’ve got to do it. It’s time to ask.’ I was holding a bottle of Perrier when I asked her…She said yes, and it slipped out of my hand because I was so anxious. It splashed everywhere and made a giant mess right in the middle of everything. It was a moment we remember fondly.”

“It was cute,” Lex said. “You were so nervous.”

Five years later, the couple will serve Perrier at their wedding reception slated for this May. But maybe, just maybe, they’ll break out the bottles early when they learn their Couples Match destination on March 18, 2022. Alan intends to match into plastic surgery while Lex will pursue a career in anesthesiology. They look forward to the future, imagining what life might look like for two MDs — a life built on care and compromises.

A man and a woman pose with a dog wearing a red cape. The three subjects are dressed as superheroes for Halloween.
Alan Makhoul and Lex Erath met at Vanderbilt University School of Medicine. Now, they look forward to sharing life moments together like this Halloween memory.  

Lex entered Vanderbilt University School of Medicine intending to pursue the five-year MD/MBA dual degree program, which includes a full year of study at the Owen Graduate School of Management. However, for Alan to Match with her in the same residency application cycle, he would also need to extend his education by one year.

“One of the biggest challenges during medical school was what to do about the year out,” he said. “I knew I had strong mentorship through the Department of Plastic Surgery, and I knew a research year would be beneficial, but there was still some hesitancy. There was a lot of discussion about whether or not we were going to do the year out – if Lex was going to do the MBA now versus doing it after residency.”

Lex agreed that the decision was difficult.

“It was very easy on my end to say, ‘I’m going to do this extra year and get this MBA,’” Lex said. “For Alan, there was a lot more uncertainty about what would happen during a research year. There was a lot more variance. What if he didn’t have luck with his projects? Luckily, it ended up working out well for him, too. His research was very productive, and he speaks very highly of the year.”

As they discussed options, Alan realized that VUSM offered flexibility and more deeply appreciated Lex’s passion for exploring a health care MBA. Lex had worked in consulting before medical school, putting her undergraduate economics degree to use. As a result, her interests extended beyond medical practice to a broader view of health care, including administration and systems of care delivery.

“My favorite part [of the MBA] was using that part of my brain again,” she said. “In the clinical world, it’s easy to get pigeon-holed into how you think about things. So, it was really valuable to think about health care from another perspective. Folks may feel different ways about it, but the fact is there are a lot of administrators who are needed to deliver health care. Learning alongside those future administrators, I think, was really beneficial.”

Alan, too, found great benefit in the year out — the same year during which the pair got engaged.

“In hindsight, I’m really glad I took the year,” he said. “It was one of my favorite medical school years. It was a great time for professional and personal growth…I’m glad that we did it.

“I had several different projects that I worked on. My flagship project was a qualitative interview study that we conducted with the gender-affirming surgery patients here at Vanderbilt. We interviewed around 40 patients to learn more about improving the delivery of gender-affirming surgery. In addition, I had several other projects related to my interests in medical education, surgical equity, and bioethics. Important disciplines for me.”

Alan and Lex even co-authored a paper together. As Alan examined the responses to a residency program director survey he had conducted, he noted the possibility for a subgroup analysis of the anesthesiology sample. He immediately knew who to ask.

Again, Lex said yes.

“Now we have a publication with both of our names on it, which is pretty cool,” Alan said.

A couple poses in front of the iconic sphere at Epcot, Walt Disney World
Lex Erath and Alan Makhoul have traveled all over the world together, literally, in addition to the World Pavilion at Epcot, Walt Disney World.

Partners in school and in life, they reflect on that time as good practice for the compromises needed to create their paired rank list in which they would state their preferred residency programs. With the Match just one month away, they have advice to offer to future couples who will one day enter this process.

“You have to be willing to compromise,” Alan said. “The whole idea of the Couples Match is that you’re going together, so all of the combinations on your list should be choices that you’ve agreed on. You should both feel comfortable with them.”

Lex agreed: “This is a huge professional decision and if you met your partner in medical school, it’s the first time you’re not just going after what you want. You’re having to factor in someone else’s very important, high achieving career [in addition to your own].”

Though the present offers an exciting opportunity to fantasize about the future, they can’t help but think about how it all started at VUSM.

Enter: the social calendar.

“I have all the dates,” Alan said. “I wrote them down in one of the many notes on my phone. We met on July 25, 2017. Our first text was July 31, so six days later. Our first run was Aug. 1, the day after we texted, and then our first date was Sept. 17.”

“You wrote all this down?!” Lex said, laughing, both in disbelief and totally unsurprised at the same time.

“I write everything down,” Alan said. “I have meticulous records of my entire life…it’s nice to care about the details. Everyone likes a detail-oriented person, especially in the surgical world.”

He smiled as Lex rolled her eyes.

“We met on the first day of medical school,” Lex said. “We sat next to each other during one of the orientation activities and started chatting. I was training for a marathon, so Alan offered to run with me despite not really being a runner back then.”

Two runners clasp hands as they cross the finish line
Lex Erath and Alan Makhoul complete the Nashville Half in 2017.

“That’s not true,” Alan said. “I was a runner. I used to run. I wasn’t a very good runner, but I could do it. I made it all the way through.”

“He could do one lap at Centennial Park before needing a break, while I was in great shape from marathon training,” Lex said. “But he put the effort in. Now he’s a great runner, and we’re both training for the Paris marathon. He’s come a long way.”

Lex tried to play it cool at the beginning of their relationship and waited a few days before making contact. Alan beat her to it, sending a message through Facebook Messenger to find a time to run. Those dates remain forever captured in Alan’s notes.

Then, as Lex said, the calendar life chose her.

“We have a shared calendar,” Alan said, pulling up a screen. “This is great; everyone should have this. It’s shared across all our devices so we can both edit it and see changes in real time. I call it the social calendar. We have all of our shared activities in here, from hikes and dinners to trips together. I mostly put things on there so I can look forward to them. It’s important for our wellness to see our time together on the calendar.”

The two can look back at moments like their road trip around Iceland or when they went to Patagonia, Chile, while wearing their ever-popular VUSM-embroidered Patagonia fleeces. They can also look ahead to celebrating major milestones in their careers and lives, always with a sense of playful levity to balance professional gravity.

Two people in gray fleeces stand in front of a snowy mountain
Alan Makhoul and Lex Erath sport their VUSM Patagonia fleeces in Patagonia, Chile.

Runs, climbs, double-dates – even breakfasts dot the calendar that Alan says will outlive him.

The pair laughs as they think about the specificity of the calendar, which breaks down time together in terms of hours and activities. A Saturday together: 9 a.m. to 10 a.m. Breakfast at Thistle Farms. 10 a.m. to 12 p.m. Hike at Percy Warner Park. 12 p.m. to 3 p.m. Computer time.

Though the calendar serves as a repository for date data, it also provides the opportunity for a good-natured gibe, at least for Alan.

“He retroactively corrects it,” Lex said. “If I’m going to pick him up for a hike, and I’m 15 minutes late, I’ll get a little passive-aggressive calendar notification that the hike time has been moved 15 minutes.”

Regardless of the calendar situation, the two remain grateful for the time they’ve had together and the opportunity to continue their careers with mutual support from partners who understand where they’ve been and where they’re going.

And, as the Match looms, they prepare to add more intentional time with each other to the calendar.

“That’s another piece of advice: the opportunities for spending time together as a couple are greater in medical school than they’ll be in residency, so take all the opportunities you can to enjoy time together,” Alan said. “Lex and I have spent holidays together, we’ve traveled around the world, we’ve gone on cool hikes and trips. Make the most of the opportunities you have now.”

Even if that opportunity means spilling a bottle of French carbonated mineral water.