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Today in the clinic, Hayley Jones ('17) had the opportunity to work with Dr. Delgado an Ob/Gyn at the Teche Action Clinic and Candice Miller, a family nurse practitioner.

imageBy Hayley Jones

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

Today in the clinic I had the great opportunity to work with Dr. Delgado an Ob/Gyn at the Teche Action Clinic and Candice Miller, a family nurse practitioner. With Dr. Delgado I able to learn about the guidelines for PAP smears and how they impact the patients he sees and the follow up that goes along with certain results. With Candice Miller I was abel to see a wide range of issues that come through the door of family practice as well as the importance of assessing patient understanding. She also emphasized and epitomized how as a care provider "You don't treat the labs, you treat the patient."

Today, four medical students headed out to the Bug O Nay Ge Shig School in Cass Lake. The "Bug School" is a K-12 school operated by the Leech Lake Band of Ojibwe, and serves students enrolled at any one of the nearby tribes (most students are from Cass Lake, Leech Lake, or Red Lake).

Over the course of their spring break in March 2014, 10 Geisel medical students took part in an annual trip to Minnesota to volunteer in Native American communities. Read all the entries from their trip here.

Today, the four of us headed out to the Bug O Nay Ge Shig School in Cass Lake. The "Bug School" is a K-12 school operated by the Leech Lake Band of Ojibwe, and serves students enrolled at any one of the nearby tribes (most students are from Cass Lake, Leech Lake, or Red Lake).

We had a great time with the kids! We gave two presentations—one for middle schoolers, and one for high schoolers—about the different kinds of jobs in medicine, and the various things that students can do to prepare themselves for medical careers. The kids were most engaged during the “skit” portion of our presentation: Liam pretended to be a patient, Chenge narrated, and Adam and I helped the students use stethoscopes, take blood pressures, and look at x-rays.

After answering the students’ questions, we took a tour of the school. Chenge and Adam even helped some of the high schoolers prepare fish for an upcoming event with the tribal elders! The teachers and staff were extremely generous, and gave us each some wild rice, maple sugar, and a birchbark container. We even got to take some of the smoked fish home with us!

Chenge helping to prepare fish
Chenge helping to prepare fish
Adam helping to put fish in the smoker
Adam helping to put fish in the smoker

Megan Laporte ('17) spends the day in a clinic in Cass Lake with a nurse practitioner.

By Megan Laporte

Over the course of their spring break in March 2014, 10 Geisel medical students took part in an annual trip to Minnesota to volunteer in Native American communities. Read all the entries from their trip here.

Chenge, Adam, Liam, and I had a fantastic day shadowing at the Cass Lake Hospital!

I spent the day in the clinic section of the hospital with a nurse practitioner named Joe. He grew up in the Cass Lake area, and came back to work in his hometown after training at Johns Hopkins. Joe and I saw patients with a wide variety of issues. I’m always amazed that primary care docs are able to care for so many medical and social conditions!

It seemed like a typical clinic—friendly and busy nurses, waiting patients, ringing phones—with a noticeably collaborative atmosphere. Many of the staff members have lifelong ties to the community. Some of the nurses were telling me that their children were delivered by the physicians at the Cass Lake Hospital!

Geisel students started their morning at the cozy house of Tommy and Thea Woon, located in a quiet residential alley in Minneapolis still covered with snow from the night before.

By Jihan Ryu (Photo credit: Michael O'Leary and Di Deng)

Over the course of their spring break in March 2014, 10 Geisel medical students took part in an annual trip to Minnesota to volunteer in Native American communities. Read all the entries from their trip here.

March 16th, 2014: Geisel students started their morning at the cozy house of Tommy and Thea Woon, located in a quiet residential alley in Minneapolis still covered with snow from the night before. Welcomed by hot green tea and hearty Korean-Japanese breakfast (jook), medical students gathered in circle and had somatic experiencing led by Tommy Woon. In a beautiful house that filled with words of wisdom, they were able to release tensions that were carried over from the brutal finals week and be mindful as they prepared to start an upcoming week in Minnesota.

In the afternoon, they crossed the Mississippi River and drove to St. Paul Central High School to help out with concessions and admissions at the Pow Wow event. Many neighbors in town came to see students pow-wow dancing and drumming in front of an excited audience. A collection of Indian jewelry and crafts were on display for sale as well. Decked out in blue volunteering t-shits, students had fun time interacting with the local community and eating some tasty Indian fried bread tacos.

Students wound down their day with the dinner at Dr. Angie Erdrich's house in Minneapolis. Native American musicians and writers in the city gathered; a delicious fusion of Indian street food and wild rice showed up. Time flew by as Geisel students mingled with anyone and everyone in the house, talking about medical school, traveling in Midwest, and a lot of others in between. They surely could not think of a better way to solidify the sense of community that was growing in them.

After a visit with the Louisiana Public Health Institute and 504 Health Net, Cristina Alcorta ('17) races raced to a meeting with Dr. Elizabeth Sack, a 2010 graduate of Dartmouth's medical school who was a Schweitzer Fellow during her time at Dartmouth.

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By Cristina Alcorta

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

After a nice long visit with the Louisiana Public Health Institute and 504 Health Net, Dave, Tina, and I raced over to Luke Restaurant for some light appetizers with Dr. Elizabeth Sack. We were running late from a very impressive tour, and our pencils skirts were seriously holding us back. Dave could not relate to these fashion woes. Needless to say we made it right on time for what would be a pleasant dinner.

Dr. Sack is a 2010 graduate of Dartmouth Medical School. She currently serves as chief resident in outpatient general pediatrics at Tulane University School of Medicine. At dinner we learned that Dr. Sack was selected as a Schweitzer Fellow during her time at Dartmouth. Her project focused on increasing awareness of end-of-life care among medical students and the community. She continued a palliative care elective started by two Schweitzer Fellows at Dartmouth and eventually made it a permanent part of the curriculum.

Elizabeth took additional time off during medical school to travel to Uganda and provide medical service in primary care clinics. It was an incredible eye-opening experience for her to witness the absolute poverty and hunger faced by many of the patients she encountered. Although she was only a medical student, her patients looked to her as their physician—a responsibility she reflected upon as she completed her medical studies.

Right now Elizabeth is expecting her first child. She lives with her husband, a Louisiana native and local attorney, in the City of New Orleans.

Cristina Alcorta ('17) writes about meeting with Dr. Eboni Price-Haywood at the Ruth U. Fertel/Tulane Community Health Center.

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By Cristina Alcorta

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

Happy St. Paddy's Day! Today we had the honor of meeting with Dr. Eboni Price-Haywood at the Ruth U. Fertel/Tulane Community Health Center.

Patient access to care (or lack thereof) was the most striking concept to witness and discuss with health professionals of Louisiana. We listened intently to Dr. Price-Haywood of Tulane Community Health Center as she offered insight on the various issues health-care providers faced on a daily basis. Louisiana already had a “broken” health-care system before Hurricane Katrina hit in 2005. There were several problems at the state level, including misuse of emergency rooms, the low number of insured individuals, and the lack of funding allocated to community health centers. There were some Federally Qualified Health Centers, but not nearly enough to meet the needs of the communities in New Orleans, let alone the rural areas of the state. Overall, Louisiana was (and perhaps still is) one of the poorest states with the worst health outcomes.

In some ways, Hurricane Katrina offered a new beginning to restructure the Louisiana health system. Providers from several community clinics united to create the 504 Health Net, a safety net of providers that worked to meet four important goals:
1. Improve the quality of care
2. Create a standard electronic medical record (many paper records had been lost in the hurricane)
3. Increase community health-care centers, incorporating mental health into primary care
4. Create a medical model of team-based care

In 2007 the region received a $100 million grant from the Centers for Medicare and Medicaid Services (CMS) to promote the sustainability of these four goals along with other funding sources. Although initially the state received multiple grants and donations for the improvement of care and support for Katrina victims, that money began to dwindle after a few years. Clinics ran into the difficulty of maintaining stability and recovery. New Orleans powerfully supports the restructuring of its health-care system by creating organizations such as policy advocating groups and student-run free clinics. However, Dr. Price-Haywood stated that the struggle for stability continues and that the work towards acquiring funding runs on a day-to-day basis. She knows the money will come, but she is never sure from where.

It was wonderful to tour this clinic and learn about the different projects the Tulane Community Health Clinic conducts in order to promote community empowerment. Many of these projects promote both physical and mental health. The center has a community room in which classes are taught about shopping for and cooking healthy food, computer literacy, and texting. Many of these classes are taught by Tulane medical students, who are required to fulfill a service component before graduating. Mental health resources focused more on group discussions, smoking cessation conversations, and mind-body meditation.

We greatly appreciated the time Dr. Price-Haywood took to give us an overview of the issues in the pre- and post-Katrina eras, and how the community strongly continues to build itself anew.

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Dr. Darrell Solet greeted Ali Corley ('17) and other Urban Health Scholars us at his home in southern Louisiana. Dr. Solet is a graduate of the medical school at Dartmouth and a practicing cardiologist in Morgan City.
Urban Health Scholars in New Orleans
Dr. Darrell Solet (center) with members of the Geisel Urban Health Scholars

By Ali Corley

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

Dr. Darrell Solet greeted us at his barn-turned-luxury-guest-house this evening and welcomed us to his home in southern Louisiana. Dr. Solet is a DMS alum and practicing cardiologist in Morgan City. He and his wife, Loyce, are generously letting us stay at their guest house for the week while we are meeting with health professionals at clinics and organizations around the New Orleans area. As Dr. Solet gave us a the tour of the guest house, we can't help but feel incredibly lucky that he is opening up his home to us and letting us stay in this renovated barn which has the rustic feel of the country, but is completely modern in the inside and comes equipped with multiple rooms, a kitchen, a gym and a comfortable living room. After the tour, we had the chance to meet Dr. Solet's family, including his parents and two sons, who were all very friendly and welcoming.

Dr. Solet and Loyce invited us to a home-cooked southern dinner prepared by none other than Dr. Solet's father, Pierre. Dinner was not only beyond delicious, but also gave us the chance to get to know our hosts a bit better. To start off the meal we had chicken gumbo over rice with fried shrimp boulettes, then we had shrimp jambalaya with bean and ham sauce on the side and homebaked sweet bread to top it off. At dinner Dr. Solet and Loyce spoke to us a little about their time in Hanover while Dr. Solet was attending DMS. His experience at Dartmouth seems very similar to ours and while he was there, he also participated in several away rotations, however in different locations than where they are offered now. We were able to commiserate about the cold winters up north and also learn about Dr. Solet's career path to cardiology. Dr. Solet also told us a little about his current practice and we were interested to learn about a couple really amazing nonsurgical procedures for mitral regurgitation and aortic valve replacements. We each discussed some of our potential interests for residencies and thoughts for the future. Dr. Solet is working with Geisel to set up an away elective rotation in cardiology at his practice and we are looking forward to hearing more about that as it develops.

The Solets also have a chicken coup with five hens and a rooster. One of the hens is brooding and will hatch 6 or 7 new chickens soon. The hens lay eggs every day and we are looking forward to omelets for breakfast tomorrow.

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After a good night's rest, the Urban Health Scholars started their trip to Louisiana with some community service at the SJ Green Charter School.

By Tina Jaramillo

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

After a good night's rest, we started our trip off the right way- with some community service! We all boarded the minivan and took a drive into New Orleans for the first time. our first stop was the SJ Green Charter School.

This school was unlike anything we have ever seen. In a special partnership with Edible Schoolyard, the organization we were volunteering with, the students helped to manage and run a real, functioning produce garden right in their backyard! In addition to learning and working with the process of actually growing food and gardening, the school also had a gorgeous kitchen that the students worked in daily to help learn to prepare healthy and delicious meals for themselves and their peers. The mission of Edible Schoolyard is to promote healthy eating habits and awareness in students early on, something we, as future physicians, strongly believe in. They have multiple locations all over New Orleans.

The volunteering day was phenomenal! Over 100 people from around the city gathered to help truly transform the garden. Jobs that we were able to work on ranged from shoveling compost and weeding, to painting brightly colored signs and preparing the venue for Edible Schoolyard's biggest fundraiser, a night where local restaurants come together to serve a meal in the garden, that was happening in a few weeks. By the time we were finished in the afternoon, the garden looked even more amazing than before and we were able to partake in a healthy lunch prepared in the school's kitchen. The menu consisted of a salad with a side of potato salad and pasta salad. Even some students gave their Saturday to come down and volunteer at their school.

What was even more great about our Saturday was that pre-medical students from Xavier University were able to join and work with us. While volunteering, we were able to chat with and answer questions about our paths to medical school and how we are enjoying it thus far. The students were a really bright and inquisitive group and we loved getting to know them better! We hope to see each and every one of them at Dartmouth in a few years, obviously.

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After much deliberation, the Urban Health Scholars decided to spend their spring break immersion trip in New Orleans, writes Tiffany Hoang ('17).

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By Tiffany Hoang

In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.

Every year, the first year Urban Health Scholars organize a spring break immersion trip to an urban city. After much deliberation, we decided to spend our spring break in New Orleans to cultivate the relationship between Geisel and Xavier University and to explore the culture of the region and the impact of Hurricane Katrina on New Orleans and surrounding areas.

Right after our last final on Friday, we quickly packed and headed to Boston to catch our plane to New Orleans. We finally arrived late Friday night. With our first community project early the next morning, we knew we had to get plenty of rest!

We are all extremely excited for this trip. We invested hours of meetings, email exchanges, and phone conversations to plan activities throughout the coming week. We hope you would join us as we explore the culture of New Orleans and gather new insights into its healthcare system. Stay tuned as we update you on our experiences!