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Archive for the ‘public health’ Category

When the Boughs Break

In disparities, medicine, public health on September 15, 2010 at 4:04 pm
Judging by the date of my last blog, it’s evident that school is in full-swing. Actually, med school is a lot of fun! Consuming, but fun!

Background:
I just finished attending an extra credit lecture for my Foundations in Medicine course in which we had a discussion based on the viewing of Unnatural Causes…is Inequality Making us Sick? – Episode 2:When the Boughs Break.  The documentary explores the phenomenon of African-American women at every socioeconomic level having higher rates of pre-term birth and infant mortality than white women who haven’t even finished high school or Black immigrants. The basic findings were that it’s not genetic and not socioeconomic (in fact, being a higher educated Black woman increased your risk instead of lowering it).  The general idea discussed is that birth outcomes are affected by the negative impact of racism over a lifespan and that racism in America is an addedsource of stress for people of color, leading to poorer health outcomes.  That’s the basic synopsis.  I’d highly recommend watching the documentary if you can get your hands on it. It was an eye-opener for many of my classmates.
Reflection:
I learned about the study discussed during the video this summer in one of my public health courses (Social & Behavior Aspects of Global Health).  At the time, the study was briefly touched upon, highlighting the possibility that operating under a lifelong level of elevated stress hormones is detrimental to overall health.  However, the course did not nearly go into as much detail as this film.  I was literally holding back tears at certain points during the film, telling myself, “this can’t be life.”  Nothing stated here struck me as new – I’ve always been one of few (if not the only) Blacks in a given environment (exception being college). As such, I have been aware of my race every day of my life since I can remember, and have had many struggles and obstacles because of it.  However, something about this film really struck a nerve in me.
Perhaps it is that I am older and have more life experience and feel that I have fought to carve out a good future for myself.  Now I finally feel that I have full ownership of my life.  It is frustrating to think that no matter what I do to shift things in my favor, certain things that I think I should have a significant handle on are out of my control.  Furthermore, according to this film, by working to put myself in a high socioeconomic level will actually have adverse affects on my life.  Coupled together, frustration, anger, and sadness abound within me.
I fully believe the Life Course Perspective, that the accumulation of this chronic life stressor of race is a determinant of health.  Unless we were able to do away with racism and prejudices, I don’t really see that stressor going away.  Therefore, I suppose it would be in my best interest to implement some coping mechanisms to deal with it, rather than to just sit back and accept it.  Easier said than done.  How do I take time and energy to calm myself down or cheer myself up sometimes multiple times a day when time is becoming an increasingly more precious commodity?  As one of three Black students in my class, I am all too aware of my race every day.  I play well with my peers and like most of them.  But even the ones I am closest with from time to time slip up and say something offensive about other Black people, or interact with me based on assumptions about the few other Black people they’ve had close interactions with over their life spans, or just interact with me differently than they do others.  I won’t even talk about the bad classmates…  To be honest, at times being here has been lonely – and one I don’t see improving over the course of my career. How does one stop ignorant comments and prejudiced actions of others? I have no problem fighting off verbal attacks, but how am I supposed to fight back against the subconscious physiological effects of these offenses?
As I sit and reflect on all the issues brought up in this film, and other underlying concerns triggered by this viewing, I am left with a series of unanswerable questions.  So, what am I to do? Right now, I feel it best to stay on my course to become a physician who will work to help study and, hopefully eliminate, some ethnic health disparities.  But, once again, I am left with a question that can’t be answered: what good will my future research be if it all boils down to the influence of a lifelong battle with racism yielding subconscious physiological consequences?
Aside: I am very happy I am pursuing the MPH degree – the MD is incomplete to developing a forward-thinking physician capable of making lasting societal change.  These questions might not yet be answerable, but at least they’re being asked, right?

Overdue Update

In medical school, public health, research on July 9, 2010 at 8:37 pm

Wowsers, it’s been a minute since I’ve stopped by this page.  My apologies. Relocating, summer MPH courses, and meeting new classmates has taken over my life.  It’s interesting really.  Back home, I’d say electronic communication was fairly integrated into my daily activities.  Down here, I hardly go online save during class – such a bad habit, I know.  I rarely watch tv or get on my laptop unless it is something school-related.  And it’s not like I’m swamped with work or anything of the sort, I guess I am just slowly transforming into a local and picking up their lifestyle habits.  Bye-bye fast-paced, cold tri-state area, hello warmth and relaxtion!

I usually stray from personal updates on this blog, but I feel inclined to share a little of what I am learning and what has been occurring in my life.

As previously mentioned, I am enrolled in an MD/MPH program and am focusing on epidemiology.  As it currently stands, I hope to use this MPH coursework to better understand how to study disease among a population, as opposed to individual treatment, how to recognize patterns and trends, and how to implement new procedures and treatments to help allievate the burden of disease on a population.  Vague? Yes, but I am of the mind that at this point in our careers it is better to start broad and narrow in as we go along, rather than start with a limited scope and miss out on opportunities.  I figure that with this broad overarching theme guiding my studies it might also help me eliminate possible specialties.  Aside: already out of the running are Peds (unless a pediatric specialist) and OB-GYN.  While I am not a fan of these introductory courses all MPHers are required to take, I am hoping that the upperlevel courses will be more applicable and relatable to the role and responsibility of a physician.  I like epi because it translates well into any specialty I chose.  As a bonus, I’m thinking that it also has the potential to make me a more attractive residency applicant – I mean, what program wouldn’t want a doctor who wants to really focus on and research a pressing issue in that specialty and who has learned the techniques to do so?  I smell a potential for breakthroughs, which leads to a potential for positive attention (re: money) for that institution.  Perhaps I’m overreaching, but I’m trying to stay positive and hope for the best – after all, this other degree isn’t cheap…I’m going to make it work for me! Lol

In other news, it looks as if I’ll be transitioning from clinical research to more translation and/or bench research – and I’m amped for it!  At the moment, I am unsure what I want to specialize in, but am leaning heavily towards surgery, with neuro coming in a close second and maybe emergency med.  I will start working with a surgeon here on some research. Aaaaaand, not only is it in surgery, but it’s regarding organ transplants!!! All you have to do is scroll a few posts back to see how much this area of medicine personally interests me.  I think it’s great because even if I wind up not doing surgery, I will be grateful to have contributed in some capacity to the knowledge database in this arena.  In addition, she is working on many projects with  long-range potential involvement, meaning there will be many opportunities for me to learn numerous different aspects of research and to gain invaluable experience.  Only downside is it’s not paid, BUT we know experience really is invaluable, so I’m all smiles.

So, that more or less brings us up to speed.  With that being said, I’m out again.  Hope you’re staying cool where ever you are…this heat around the country is slightly ooc – Hello, Global Warming!