In one of Rachel Brickman’s blog posts she wrote, “As far as I’ve heard from upperclassmen, the fourth year of medical school is pretty wonderful. You’ve figured out which specialty you enjoy most, you do advanced sub-internships in that field, and you see all corners of the country during residency interviews. The residency match happens in March and then you start the next chapter of your life! It’s the perfect ending to this whirlwind of education.”
Fourth year, thus far, has definitely been the perfect ending, although it’s not without its chaos as well. This spring, as my third year ended, I chose to enter a career in obstetrics and gynecology. I then quickly discovered that I had spent most of third year thinking about this decision, and avoiding my parents’ incessant “what are you going to do for the rest of your life” questions, and I had thought very little about the next step: applying to residency. How do I apply? Where will I apply, and to how many programs? Just as these unnerving thoughts entered my conscience, my classmates and I received a detailed, step-by-step instructional email from Dr. Harper, a theme that would recur countless times over fourth year.
So in June, in between early mornings and late nights on my sub-internship, I took Dr. Harper’s advice and started adding my CV to ERAS, the Electronic Residency Application Service, which most specialties use for their residency application. At this time, I also asked four attendings for letters of recommendation, with the hope that I would have the letters by September 15th. In July, I started the first draft of my personal statement, which I then sent to family members, ob/gyn’s, and Dr. Harper to review. (I should note that I was quite thankful I chose not to procrastinate on my personal statement, as my editors were extremely liberal with the red ink, and I had a ton of revisions to make.) During the summer, I also researched programs using the APGO website and FREIDA, a residency database maintained by the AMA. I first narrowed my choices based on geography, and then after comparing many characteristics, I uploaded 27 programs into ERAS.
By the beginning of September, my application was complete. My file contained my personal statement, transcript, letters of recommendation, CV, and programs. I felt relieved. All I had to do was press submit (and pay a large sum of money). September 15th came, the day the ERAS post office opens and applications can be sent electronically to programs. I hurried out of an exam room at the clinic were I was rotating and rushed to my computer. I entered my login just as the clock hit 9 AM…but of course so did thousands of other type A medical students, so the system crashed for 24 hours, leading to much unwarranted anxiety. But eventually I was able to submit my application and move forward to the next step: residency interviews.
One year ago, my typical Sunday consisted of waking up early to study from notes and PowerPoint slides in a sterile, fluorescent lit library for several hours. Once 1:00 PM rolled around, I was back home on the couch, ready to soak in the mindless hours of football I felt I had earned. If anyone tried to talk about medicine during this hallowed time, I'd throw a yellow flag their direction and call a personal foul. When medicine exists only on paper, it's a chore and a conversation killer.
Now as a third year, I still wake up early to study, but the information comes from journals, research literature, and patient charts. I snuggle cozily in bed, sipping coffee as I review topics that came up at the hospital in the past week. Later, as I watch Eli Manning struggle to remain relevant, I'm happy to discuss particularly interesting or difficult medical cases with my friends. The words and diagrams from years past have now taken shape as children with meningitis and coaches with cancer. Even though I knew it all along, being on clinical rotations has reminded me that I am here not to expand my vocabulary, but to touch lives.
In comparison to first and second year, one learns relatively fewer "book smarts" as a third year. However, the "street smarts" acquired are not only innumerable, but invaluable as well. I am not the books that I read, nor the tests that I take. I am a student doctor discovering where I and my 2D knowledge belong in the 3D world that is medicine.
At this point in the academic calendar, it can be easy for for first-year students to think that the Admissions Office must have made a mistake by accepting them. But that's definitely not the case, writes Andrew Park ('18).
By now we have seen the passage of two "quiz" cycles, which are rather erroneously named as they carry the weight of biweekly midterms. Inevitably, there are some of us in the class who have already begun to question our ability to succeed in medical school. Some of us have never received a failing grade ever and had to meet its bitter taste while in the first month of Geisel. (But in reality, this is another misnomer, because 70% is hardly a “failure.” We’ve been groomed to believe that this is “average.”)
And while there are still percentages floating around on these “quizzes,” it’s easy to fall back into our undergraduate mentality that can only lead to a competitive mindset. There is a reason we got into medical school in the first place, and it was not by ignoring the competition around us. Typically, those that make it into any medical school, and especially one of as high a caliber as Geisel, are accustomed to being at the top of their class. It started in kindergarten, when we were proud to turn in our sheet of capital and lower-case letters written on brown recycled paper; continued in high school, when our friends were intimidated by how many AP or IB courses we were taking; and ultimately continued into college, where we still somehow managed to graduate with honors.
Each step along the way, there was an elimination process with stiff competition. We were part of the cut that was permitted to proceed to the next step. And if you didn’t make it through the first time, you found creative ways to bypass the traditional pathways. There is a wrinkle in society that has groomed us to feel that those sitting around us in Kellogg Hall are all competition.
But medical school is not college, it’s not high school, and it’s certainly not a group of five-year-old kindergarten gunners. Medical school is the apex of academic achievement. There are no further educational steps after medical school, and there are no further cuts that will diminish your chances of becoming a physician in which competition is necessary. (I should clarify that internship/residency is not school, it’s a job where you get paid money, which you can use to buy things that you can own. Money—I know you haven’t heard of it, you should look it up. It’s been around for a while.)
Ladies and gentlemen, welcome to the cream of the crop. We are the cream of the crop, and the cream of the crop is not divisible into lesser- or greater-valued parts. If we were a crate full of gold, the gold on the bottom is valued the same as the gold on the top. So while the weight of medical school and “quizzes” are starting to get heavier on our shoulders and causing depression of the scapula, realize that there are no failures here. Some of us may still feel that admissions made a mistake in accepting us, but I am certain that those who support us watching from the sidelines—our families, our mentors, our friends, and society as a whole—do not share in this belief.
“Oh, (s)he got into an Ivy League-medical school? Must be dumb,” said no one ever.
Andrew Park (’18) graduated from the University of California, Berkeley, in 2012 and recently moved from Los Angeles to New Hampshire. He has also written for The Atlantic and The Week.
In early September, members of Geisel's Urban Health Scholars program traveled to Massachusetts to attend several events that would give them a sample of some of the challenges and rewards of working with underserved populations in urban areas. A few of the scholars reflected on what they took away from the experience.
Thursday, September 4
Greater Lawrence Family Health Center
By Ali Corley (’17)
Our first stop on our 2014 Boston immersion trip was the Greater Lawrence Family Health Center (GLFHC) in Lawrence, Mass., just north of Boston. There we met with Dr. John Raser, a graduate of Dartmouth College and the Medical School, who showed us around and spoke about his work there. Dr. Raser is a family medicine doctor who lives and works in Lawrence and is an advocate for his patients both at the center and in the community. On our tour of the health center, Dr. Raser told us more about GLFHC and the type of medical care they provide. GLFHC has adopted a patient-centered medical home model, which emphasizes teamwork among health professionals and addresses health issues from many perspectives. They promote group health sessions, healthy lifestyles, and community-wide interventions to improve health in a lasting and effective way.
Dr. Raser discussed the importance of health professionals being involved in the communities that they work and live in. Doctors have great potential to be local leaders and can use their knowledge and respected positions to initiate healthy programs and initiatives. In fact, Dr. Raser recently started a project to open a bike shop in the community. We detoured along our tour of the health center to visit his shop, BiciCocina, which he started to fill the need of the city, which hasn’t had an operating bike shop open in several years. With BiciCocina, Dr. Raser hopes to promote active lifestyles and safe streets through youth programs and community events. We took the scenic route back to the health center and had the opportunity to walk through some of the Lawrence center streets and the common park. Lawrence is a unique combination of city and small town. We saw Italian, Greek, Irish, Dominican, and Haitian churches and buildings and were able to appreciate the diversity of the Lawrence population.
Back at the center, Dr. Andy Smith joined us for dinner and discussion. Dr. Smith spoke to us about the overlap between urban and global health and gave us a presentation about the qualities required to deliver care in both settings while also managing to maintain optimism, idealism and compassion. We learned about the special challenges that come with working in a primarily Dominican community and how the ability to relate to patients is enhanced when you speak their language or have been to their home country. Dr. Smith told us about cultural differences concerning patient-doctor relationships and how the strict professionalism we are taught in school may need to be adjusted depending on the patient. For example, he greets some of his patients with a hug and kiss on the cheek, which is custom in many Latino cultures. For others, he finds that showing them pictures of his family helps strengthen his relationship with patients and break down barriers to trust.
The Greater Lawrence Family Health Center offers programs for residency training and rotations in family medicine, with opportunities for Spanish language learning and immersion. After our vist to Lawrence today, I think many of us will consider pursuing these opportunities in our third or fourth years and beyond.
Friday, September 5
Revitalizing the Hennigan Elementary School with Harvard Pilgrim, the Celtics, and City Year By Brendin Beaulieu-Jones (’18)
We kicked off the second day of our Boston immersion trip at Hennigan James Elementary School, where we joined Harvard Pilgrim, the Boston Celtics, and City Year for a morning of community service. Before jumping into the work, we heard from the principal of Hennigan James Elementary School, who stressed the importance of providing a warm, learning environment for children in order to contribute to a healthier, stronger community. The school is currently expanding to include sixth- through eighth-graders, and it serves as a pre-K learning center, Boys and Girls Club, and recreational center for the community.
After some additional opening remarks by the presidents of both the Celtics and Harvard Pilgrim, we enjoyed some brief entertainment by Lucky the Leprechaun (the mascot of the Boston Celtics) before heading out to start our work. A few of us painted the exterior of the school, including the courtyard, four-square courts, and main entrance, while others removed some weeds and debris from the neighboring fields. It was refreshing to have the opportunity to serve the Jamaica Plain community and help contribute to a more positive learning environment at Hennigan.
Meeting with Dr. Megan Sandel By Hayley Jones (’17)
After an exciting morning working with the Boston Celtics and Harvard Pilgrim at the Building Healthy Communities day of service in Jamaica Plain, we headed to Boston University’s medical school to meet with Dr. Megan Sandel, a graduate of Dartmouth's medical school, for a Q&A about Boston’s Medical-Legal Partnership. Dr. Sandel’s enthusiasm and understanding of the social determinants of health were engaging and exciting to hear about. Even better, work that she has done has helped to create laws that holds landlords in Boston responsible for basic upkeep so that apartments in Boston are less likely to make people sick. The law addresses mold, mice, and other infestations that can adversely affect the health of inhabitants. Dr. Sandel’s exuberance for understanding how housing status affects health outcomes from children to HIV positive individuals was outstripped only by her determination to search for a solution. UHS took away much more than information from the Q&A.
Boston Health Care for the Homeless
By Cristina Alcorta (’17)
On Friday afternoon, we had the opportunity to meet with Dr. Jim O'Connell, President and one of the founding physicians for the Boston Health Care for the Homeless Program (BHCHP). We were very much looking forward to meeting the man who established the nation's first medical respite program for homeless persons and implemented the first electronic medical record for a homeless program.
With open arms, he welcomed us to his brainchild. Starting our tour off with a little history, Dr. O'Connell brought us to the historic main entrance of the old Mallory Building, describing its historical roots as Boston's center for medical pathology research and city morgue from the 1930s to the 1990s. We then shuffled to a conference room for a discussion about homeless health care and street medicine. Here, we learned about the Family Van, which brings necessary items such as blankets and warm soup to individuals on the streets. Dr. O'Connell feels that it is important not to offer medical services right away, because homeless individuals are often wary of the medical system. "They feel like they are going to get locked up, or taken away," he explained. Instead, Dr. O'Connell simply lets them know he is a physician as he leaves and that they can approach him if they ever want or need to.
Under the Affordable Care Act, affordable insurance is no longer an issue for the homeless. However, that does not mean problems have subsided. Ten percent of the BHCHP participants are chronically homeless. That is, they have been living in the streets for over one year. Fifty percent of the first-come-first-served beds taken up each night are used by that ten percent. Individuals not only need services, but support to find housing and manage a stable household. Unfortunately, many do not find the support they need to be on their own. Many do not find comfort in shelters: some fear large crowds; couples refuse to be split up; others feel enclosed. A patient once said to Dr. O'Connell, "I do not like the shelter because I cannot tell which voices are mine. . . . When I'm on the street I know which are mine and which aren't."
In addition, the majority of homeless individuals suffer from major, incapacitating mental illness. Those suffering from substance abuse have a difficult time staying sober and continuously fall back into the cycle of hard-core, chronic addiction. Overall, mortality rates continue to be high.
Our tour continued. A personable, compassionate man, Dr. O'Connell stopped at various points during our tour to introduce us to a patient or a dermatology resident to get a glimpse of their experience with the BHCHP. He shared deep and personal stories of the homeless individuals he has met throughout his time with BHCHP which encompassed both sad and triumphant anecdotes of his dearest patients. We saw several facilities, including the dental offices, pharmacy, inpatient floors, and the outdoor patio meant for moments of relaxation.
At each stop, we learned about the several services offered to patients: dentures, medications, prenatal care, walking aids, and initiatives to accommodate transgender individuals. We saw the rooms where patients slept and the rooms where they played bingo, cards, and pool. Though the homeless world faces strenuous trials each day, BHCHP seems to provide at least an iota of stability and calm in a sea of chaos.
Some of the hallways proudly display photos of the smiling faces of former patients of the BHCHP. "Turns out they wanted to have their pictures taken. It made them happy," said Dr. O'Connell. Most, however, had already passed away at too young an age.
Mattapan Healthcare Revival By Fernando Vazquez (’18)
“When you connect with Mattapan Community Health Center, good things happen.” The organization’s motto is quite the understatement. For nearly 20 years, Mattapan Community Health Center has been organizing a revival; a festival centered on enabling community members to become more competent in taking charge of their health. From cholesterol screenings to dental checks, the event brings together an underserved community and not only educates them, but also urges attendees to spread the word to neighbors that help is available to all. Geisel’s Urban Health Scholars capped an immersion weekend with the valuable lesson in the importance of true integration into the communities we will go on to heal and serve.
"I want to be tall and have a tie like that!” The first words out of my very first pediatrics patient. Given that I had spent a considerable amount of time deciding on that particular tie (more time than I care to admit on such a public forum), I welcomed this rather enthusiastic introduction to the world of pediatrics.
The five-year-old patient and his three-year-old brother were in the clinic for their regular checkup. Full of energy, bouncing off the walls, and touching all the instruments they could lay their little hands on, they answered all our questions in very loud matter of fact tones. “I wear a helmet when I ride my bike so I don’t get hurt!” The little one watched his older brother closely and tried to emulate his actions and speech, much to his brother’s chagrin. Their interactions reminded me of my older brother and me when we were around the same age (we’re separated by just over a year). Through all the proceedings, my preceptor was somehow able to obtain a very thorough physical exam and history. I watched as he jumped right into the fanfare, skillfully engaging the boys while simultaneously soliciting the necessary information.
Several hours later, our last patient of the day had arrived. We were seeing this child to give the go-ahead for an operation that would be performed the following week. As I was about to ask why a two-year-old would be receiving such a procedure, I was told the patient’s diagnosis. Mustering all the self control it took not to let my jaw drop, I dug deep into my memory bank, rattling off the many features of this rare syndrome. This disease carried a grim prognosis—very few kids survive past their first birthday.
Still in shock from the news, I followed my preceptor into the room, gearing up for a solemn visit. But the mood in the room could not have been further from my expectations. Instead of gloom, it was filled the room with excitement and joie de vivre.
The parents happily recounted the history of their child’s disease, going into great detail and offering to show me more upon discovering that I was a medical student. The mother at one point even whipped out her phone to show me pictures. Toward the end of the visit, perhaps sensing my bewilderment, she turned to me and offered a few words: “Our child has been more than a blessing to our family, and we try to treat each day as a gift.”
As I drove home, and replayed the days events in my head, I pondered on the contrast between how my day had begun and how it ended. Two rooms inhabited by very different people in very different situations, yet somehow with similar doses of enthusiasm and positive energy.
Inyang Udo-Inyang (’16) is a medical student at Geisel and a member of the Urban Health Scholars. He is originally from Lagos, Nigeria, and graduated from Oberlin College in 2012, where he majored in biochemistry. Read all posts by him here.
Don't know which ventricle is right and which is left? Not a problem. Haven't heard the word "organelle" in a couple of years? Awesome. Never smelled formaldehyde? Well, then do yourself a favor and remain in ignorance until after you've committed to a medical school. More comfortable around Shakespeare than a cadaver? Good—for the sake of your social life, you should probably keep it that way. Nervous about entering medical school as a non-science major? So was I.
Though I've been known to sarcastically claim to have become a French major because of the language's direct application to medicine, I really became a French major because I loved it—everything from culture to conjugations. Like many of my colleagues here at Geisel, the liberal arts inspired my curiosity and provided me with intellectual balance, with sanity, in other words. The prospect of entering medical school, however, is daunting by itself, but entering without prior experience in anatomy, physiology, histology and metabolism (just to name a few) borders on terrifying.
In thinking about what my first term at Geisel would be like, the adjective "overwhelming" immediately came to mind. Although this turned out to be true, what I didn't realize at the time was how awesome it would be to feel that way—I failed to recognize the beauty of the word. At Geisel I feel overwhelmed by the generous support of the school and local community; by how invested the faculty members are; by how helpful, brilliant, happy, and impressive my classmates are; and by how glad I am that I came to Geisel, even as a French major.
For those of you that are nervous, as I was, about being overwhelmed in medical school, here is the evidence-based (see, even French majors can be taught to write like scientists) advice that I have for you: it's okay. Throughout the first two years of your medical school career, you will be learning everything for the first time, which is actually an incredible thing. Like the first time that you rode on a roller coaster, or tasted ice cream, or read a book, the things that you learn will fill you with awe, curiosity, and wonder. Your science-major classmates will feel this, too, but you will be able to remind them that all of it is pretty darned cool and they will have the opportunity to learn to be teachers, providing you with support and help—mutualism at its finest.
And where is the evidence as promised, you ask? Well, after our first quiz a fellow student lamented his status as a "Fysio Failure" on the class Facebook page and another student responded with the comment, "Welcome. Thanks for your share. You're safe here." Twenty-two likes—numerical evidence proving that truer words were never written. The conclusion: prepare to be overwhelmed with knowledge and support.
So, here is my last piece advice as a French major to a potential medical student: being nervous is okay, and when you find yourself beginning to be overwhelmed, remember that ooh la la, it's the best kind of overwhelmed.
Lauren Fall graduated from Centre College in Kentucky in 2014 as a French major and she is thrilled to return to her hometown as a member of the Class of 2018 at Geisel. At Geisel, Lauren hopes to get involved in global health programs as well as health education in the community. She is excited for the next four years!
At some point before we submitted our applications to AMCAS, we dreamed of saving somebody’s life, or at least of making the lives of others better, and, by gosh, that’s what we’re here at medical school to do. I don’t mean to sound pompous, but we are in the process of becoming superheroes. Like all superheroes, we soon find out that we have to shed all traces of what has shaped us to this point in life. It is simply a matter of necessity: the material tested on a midterm as an undergrad is equivalent to about one day’s worth of material in medical school.
And so our minds undergo a form of autophagy, removing the unnecessary bits of information to make room for the new. It matters very little now if you can still remember how many times Ross and Rachel were “on a break,” or what that song was that you learned in second grade to help you recall all 50 states. (The only states that matter now are New Hampshire, Vermont, Massachusetts, and, of course, California in third year. Maybe New York, too—the city, not the state.)
I wish that the premise of the movie Lucy were true—that we only use 10% of our brain. I know it’s not, but it would certainly be useful, as the after just the first couple of days in class our minds have been bombarded with material to the point that we don’t even know how to feel overwhelmed.
That feeling of half of your brain imploding? That’s simply your brain making room for what you’re about to learn. It’s autophagy alright. Our mind is eating itself to get rid of a big chunk of our self-centered desires to make room for the reason we came to Geisel. We are here to bring healing to the world, to bring a smile to a sick child, and to put others before ourselves. So while that feeling of a numbing headache is still fresh in our minds, let’s take time to reflect on our old selves. It’s now time for us to put on our undergarments over our trousers and face this new chapter in life.
Andrew Park ('18) graduated from the University of California, Berkeley, in 2012 and recently moved from Los Angeles to New Hampshire. He has also written for The Atlantic and The Week.
In my last couple of weeks in Haiti, I’ve been concluding my projects at l’Hôpital Immaculée Conception (HIC), and have also had the chance to see a bit more of the country. (Read more about my work at HIC in my previous post.)
Some of the departments at HIC do not have consistent access to soap and water or hand sanitizer, which are important infection-prevention measures. Last week, my supervisor, Cleonas Destine, an infectious disease doctor here at HIC, and I mixed up a batch of hand sanitizer, as per the World Health Organization’s Formulation. We still need to find a pharmacy in Cayes that would be able to mix larger batches to continuously supply HIC with hand sanitizer.
The projects on tuberculosis diagnosis have also progressed further along. We have gotten comments from all the TB staff and infectious disease doctors on a shorter and translated-to-Creole version of USAID’s survey, “Reducing Delays in TB Diagnosis." This week, we’re meeting with the staff who could administer this survey to patients on a regular basis.
With the help of Cleonas and the TB staff, I have also learned a lot about the use of GeneXpert at HIC. Our research has been a bit challenging, as information on HIC’s TB patients is spread between three paper record books, an electronic lab register, and individual patient files (both electronic and paper), as well as the files at satellite clinics. I was able to visit one of these satellite clinics, the TB Sanatorium. The Sanatorium in Cayes is one of only a handful of sanatoriums that still exist in Haiti. The patients who stay here are being retreated for TB, so an additional antibiotic must be added to their treatment regimen. Because this antibiotic can only be administered by daily injections, these patients must stay at the sanatorium for the 60 days of their treatment. Worldwide, sanatoriums are being shut down or repurposed. The Cayes Sanatorium might become a general infectious diseases clinic.
Outside of work, I’ve gotten to see a bit of the regions around Cayes. This past weekend I went on an epic excursion organized by the students of the university where my host mother works. There were maybe 50 of us in a school bus, and we drove two hours west from Cayes to Port-à-Piment, the town where the Marie-Jeanne Cave is located. It’s over four kilometers long, and it is the largest cave in Haiti. All of us went with one guide into five rooms of the cave, two of which had natural light, and three of which were too far underground and so were pitch black, requiring flashlights (or, in our case, the flashlight app on our phones) to navigate. Most phones in Haiti are pretty basic (very few smartphones or flip phones), but they have a great extra feature, a penlight at the top, that is indispensable for things like power outages and, this weekend, navigating caves. Unfortunately none of my photos in the caves came out, but they were amazing and worth an online search of “La Grotte Marie-Jeanne” if you’d like to learn more.
After visiting the caves, we got back on the bus to visit Les 500 Marches de la Medaille Miraculeuse in the town of Côteaux, which are 500 stairs up the side of a mountain, at the top of which is a statue of the Virgin Mary. As the story goes, she was seen at this place once upon a time. After climbing the stairs, we drove to Port Salut, a beautiful beach, for lunch and swimming.
In all, I can’t believe my time in Haiti is coming to a close. It feels as though I’ve just arrived—one month is not such a long time, after all. There have been challenging things about my experience here—the frequent and unannounced power outages (including for five days last week, making it difficult for me and especially the doctors to work), and the questions I am asking myself about the roles I can most usefully play in global health work in the future. There have also been amazing things about my experience here—the opportunity to assist in research that can improve TB care for patients, the ability to practice my French, and the close community of Haitians living in Cayes. I feel like I’ve just started to get a good taste of that community during my last week or two here, and for that I am profoundly grateful to everyone who has welcomed me. Merci à tous qui m’ont accueilli ici aux Cayes! Vous allez me manquez beaucoup.
Tara Kedia (’17) earned a BA in Anthropology and Biology from Dartmouth College. She previously interned at the World Health Organization and at the DarDar Pediatric HIV Clinic in Dar es Salaam, Tanzania.
Over the summer of 2014, Auriel August (’17) conducted research at the DarDar Pediatric Program in Dar es Salaam, Tanzania. Read all of her posts here.
Squeezing in one last patient on my last day at DPP, I was able to reach my target of 50 to include in the trial! Now I will begin a preliminary analysis of the data collected, looking at various parameters (e.g. age, years of antiretroviral therapy, history of TB) and their effect on forced expiratory volume and forced vital capacity. Hopefully, we will be able to replicate the results from the previous studies done in other East African countries.
Unfortunately, the time has come for me to leave Dar Es Salaam. As I pack up my room, I reflect on my six weeks in Tanzania. I attended a traditional Tanzanian send-off party for the daughter of a nurse with the DarDar Pediatric Project, swam with dolphins off the southern coast of Zanzibar, and explored the natural wildlife of the Serengeti. But most importantly, I got to spend every day working with incredible children living with a very serious and extremely stigmatized illness. I have learned far more than I could ever contribute, but it is my hope that the project can at least draw some attention to the well-being of HIV-infected youth in Tanzania. I feel privileged to have had the opportunity to live and learn in this community, and I will forever carry my experiences with me.
I want to give a special thank you to Dr. Paul Palumbo and Dr. Margaret Guill for incorporating me into their project and advising me over the past year, as well as Dr. Anna Kiravu and Dr. Yahya Binde for their mentorship while I was in Dar and their incredible patience as I struggled to communicate in Swahili. I would also like to thank Dr. Helga Naburi and Dr. Isabella Sylvester for allowing me to round with them at Muhimbili National Hospital. Finally, I want to thank the Dickey Center and Helen’s Fund at the Children’s Hospital at Dartmouth for supporting my project.
Even though I have not yet left Tanzania, I am already looking forward to my next trip back.
Auriel August is a member of the Class of 2017 at the Geisel School of Medicine.
"How many of you have experienced moving to a new culture?” I sheepishly delayed raising my hand until I saw most of the hands in the room were up.
I was joined by 13 other classmates seated in one of the conference rooms at DHMC. The air in the room was filled with excitement and nervous energy. Today was our first day on surgery, our orientation. Fresh off our board exams, we would finally be on the front lines. Taking care of patients. The very thing we had come to medical school to do.
Dr. Andrew Crockett, co-director of the surgery clerkship was explaining what the next eight weeks were going to look like. “You are now joining a new culture, one where we speak a completely different language. One you are going to have to learn to speak.” Anyone who has had the unfortunate pleasure of learning a foreign language is all too familiar with the beginning painful phases of hand-waving and facial contortion that occur before becoming comfortable with said language. True to his analogy, my initial foray into surgery would be much like assimilating into a foreign culture.
I had been assigned to my first choice, the orthopaedic surgery department. On my first day, I walked into the operating room (OR) with an almost unhealthy amount of enthusiasm, primed to take on whatever task I was assigned, only to find that everyone and everything in the OR already had a very specific role. The OR was a well-oiled machine with seamlessly moving parts, and I stuck out like a sore thumb (no thanks to my 6’ 7” frame).
As most people eventually discover in the process of integrating into a new environment, the acceptance and guidance of the “locals" is essential to feeling comfortable in the new surroundings. That has certainly held true in my four-week journey in orthopaedics. The residents whom I got a chance to work and interact with have been unbelievable. They fashioned an inviting environment of support, teaching, and mentorship replete with extensive suturing sessions, World Cup games, evening barbecues, lessons on spondylolisthesis, and much more.
It would be very remiss of me not to mention the incredible amount of help and support I have received from the nurses, from guiding my wandering attempts touse a Foley catheter to helping untangle me from my OR gown (yes, it happened), they have been very gracious and kind.
In the meantime, I have become enthralled with the world of orthopaedics and eagerly await the next time I can submerse myself in this new culture. With these kinds of people in my new environment and a whole career ahead of me, I have no doubt I will settle into this environment just fine.
Inyang Udo-Inyang ('16) is a medical student at Geisel and a member of the Urban Health Scholars. He is originally from Lagos, Nigeria, and graduated from Oberlin College in 2012, where he majored in biochemistry. Read all posts by him here.