Mattapan Health Care Revival

On Saturday, the UHS scholars and a member of the Urban Health interest group attended the Mattapan Health Care Revival. This was the 17th year this festival has taken place with the purpose of engaging the Mattapan community in conversations about their health, and the 8th year that a group of Geisel Students has been in attendance. Four students ran a table about the salt and sugar content in a number of common food items. The scholars used a hands on demonstration with sugar and Cricso to help patients visualize the amount of sugar or fat in the foods they often enjoy. People were surprised to find that fruit yogurt in fact contains as much as 37g of sugar - almost 10 teaspoons! Students were able to engage visitors in conversations about alternative options, such as using plain yogurt and sweetening it themselves with honey or fruit. Another group of students worked in the children's tent, talking about healthy food options and heart health. Kids were encouraged to listen to their hearts using our stethoscopes and think about what kinds of things might give their hearts extra exercise. Other students engaged visitors in a variety of activities, including blood pressure screenings, health surveys and even voter registration! This was a great way to end our Boston Immersion Trip - a fantastic combination of community service, hands-on learning and a lot of fun! We look forward to visiting Mattapan again next year for the Health Care Revival!

 

Hard at work

After a long day of touring the city and meeting some amazing clinicians the scholars came back to the hotel to get to work!  We camped out in the hotel lobby and got busy blogging, studied a little physiology, and 1st years hunkered down to get ready for their upcoming Monday quiz.

Alumni Dinner

The scholars ended the day Saturday with an alumni dinner at Fire and Ice with Dr. Katie O'Donnell and recent graduate Dr. Chris Worsham.

Dr. Katie O'Donnell continues to be an incredible mentor to the Urban Health Scholars. Over dinner she talked about her work at Children's Hospital Boston as a pediatrician and toxicologist. As a DSM graduate, Dr. O'Donnell was able to provide advice about moving from a rural to urban location when she started practicing. She also provided advice about residency and finding balance into the future. We are so happy to continue to have her support and encouragement.

Dr. Chris Worsham graduated from Giesel this past spring, and jumped right into pursuing his interests in urban medicine as an intern at Boston Medical Center, Boston's safety net hospital.  We enjoyed hearing about the fast paced life of an intern, the diverse patient population he works with, and how much he has already learned in a few months!

Dr. Joyce Sackey and Tufts Med

Dr Sackey is one of those people that is truly hard to describe with words; certainly none of the words I know will do her justice. One needs to experience her genuine smile and brilliant gaze to truly understand how sincere and passionate she is about connecting with students. The funny thing is she seemed just as impressed with us and marveled at the varying experiences and passions that had attracted each member of our group to Urban medicine.

As she talked about her time training Ghanian physicians to care for HIV positive patients,  I couldn't help but feel a great wave of inspiration. She is a living example of how I hope to incorporate service into my medical career. She managed to channel her zeal for service into a successful career as a physician-educator. She talked about how even as a high school student she never dreamed of having the kind of impact she has had on Ghanian health care system. 

What truly stood out to me was that even as she talked about the amazing work she was doing back home, her devotion to her students always seemed to shine through.

Probably the most fun part of our entire discussion was talking to her about her time as a DMS student. As we presented our gift to her(a Smith society water bottle), we launched into an explanation of who the 3 societies were named after, but quickly realized that she was more than familiar with who they were as she launched into heartfelt stories of Dr Mosenthal and Tenney and the amazing service they did for Dartmouth "these are true giants," she said.

I have a feeling that ten years from now I will look back on this moment as a pivotal inspirational moment in my career. Meeting with Dr Sackey has served as a strong reminder of why I made the decision to join the ranks of this wonderful profession.  A "true giant" herself. 

Boston Health Care for the Homeless

After touring Shattuck Hospital we traveled to The Barbara McInnis House of the Boston Healthcare for the Homeless Program.  The Barbara McInnis House, located on the Boston Medical Center campus, provides “medical respite” care to people experiencing homelessness that are too sick for a shelter.  Many of the patients are in the process of recovering from a hospitalization or illness.  Beyond the Barbara McInnis House, BHCHP provides primary care and behavior health services to the homeless in outpatient and shelter sites throughout Boston.

 Upon arriving, the scholars hosted a Bingo game for the patients. While the numbers were announced, we met and engaged with the patients as we eagerly awaited winning numbers.  The scholars heard firsthand from the patients some of the avenues (personal tragedy, illness, financial crisis) through which people come to experience homelessness.  Many of these events that led to homelessness were out of the patient’s control.  With this lens, the scholars saw how incredibly essential the services the BHCHP provides are. We had a wonderful time playing bingo, getting to know the patients, and handing out prizes.

Lemuel Shattuck Hospital

The scholars had the incredible opportunity to speak with a group of interprofessional providers and tour the Lemuel Shattuck Hospital, a public health hospital operated by the State of Massachusetts. This 255-bed facility provides acute and ambulatory care to patients referred by public agencies as well as private sector providers, enabling economically and socially disadvantaged patients to receive top notch care. When we arrived at Shattuck we were greeted by Dr. Daniella Floru who gave us a description of the diversity of challenges and illness that patients at Shattuck face as well as insight in to her experience working with a patients who have high rates of mental and addictive illness. Dr. Robert McMakin, a clinical psychologist provided us with further insight by explaining that mental illness is not often what lands an individual in the hospital, but is nevertheless addressed and treated as equally important to providing quality care to their patients. Dr. McMakin's role is complimented by the Addiction Services Supervisor, Jennifer Malizia, who further elaborated on the challenges patients with addiction face. Ginger Bailey, a licensed social worker who coordinates the discharge plans for  patients, demonstrated  the hospital's commitment to making sure patients have access to resources that will allow them to stay healthier and hopefully out of the hospital long term. The team at Shattuck highlighted the stigma patients with addiction face each day, and emphasized the importance of treating addition as we would any other chronic condition.

Our visit ended with a tour of The Shattuck Hospital Correctional Unit, which serves as the primary acute medical care facility for the state prison system and provides medical services to all Department of Corrections inmates. In addition to speaking with the medical team we got the opportunity to speak with the officers on the lock down ward about the challenges they face working with inmates each day, a truly eye opening conversation about the heavy toll these demanding jobs take on the lives of correction officers.

We left Shattuck thoroughly impressed with the commitment of its interdisciplinary teams to providing quality care to patients who often have co-morbidities and psychosocial issues that are challenging for other providers.  Their compassion and understanding towards their patients was a prospective we are excited to take back to Hanover with us.

Dr. Megan Sandel and Boston Medical Center

We started the morning with a trip to Boston Medical Center to meet with Dr. Megan Sandel and learn more about her work there as a pediatrician and physician advocate for the underserved patients in Boston.  Dr. Sandel talked about several social determinants of health such as income, housing, insurance, etc, and also discussed how these issues affect the health of individuals as well as the hospitals and clinics that serve them. In our conversation with her we were able to learn a little about the financial infrastructure of "essential" hospitals like BMC that serve disproportionately poor patients.  We talked about the challenges they face to provide quality care to their patients while keeping costs low, and how they plan to adapt and innovate with the implementation of the Affordable Care Act.

 

We were also interested to hear more about the National Center for Medical-Legal Partnership and Dr. Sandel's role as the the Medical Director.  Many of the underserved patients coming to BMC are confronted with a variety of social barriers that prevent them from leading healthy lifestyles.  Dr. Sandel is particularly interested in housing issues and related several cases in which inadequate housing influenced the health of her patients. In one example, a child suffered from chronic asthma in large part due to mold growing in the child's house. This child has legal rights that could help address the asthma problem at its cause.  Other low income patients with chronic conditions are protected by the law to not be evicted in the winter months. With the Medical-Legal Partnership, Dr. Sandel hopes to provide these types of patients, and others, with access to legal help. The Medical-Legal Partnership seeks to promote teamwork between the health care providers and lawyers to address the health needs of patients not only in the hospital, but in the community and home as well.  We were very excited to talk and learn from Dr. Sandel about social interventions and policy changes at local and national levels that have the potential to positively affect urban populations.  Dr. Sandel encouraged us as future physicians to be advocates for our patients, especially those who are underserved, and she emphasized that physicians should be leaders in the community to promote change.