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PULSE- Spring 2016

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Letter from the Editor

Estevana Isaac, MSIII

My voice often feels muffled. People say I mumble. I come off as shy, hesitant and quiet.

“Speak up.”

“I can’t hear you.”

That was a lot of my feedback growing up. And now I wish I could tell you that adding my opinion comes natural to me. As a training physician, I still think about the consequences of criticism, rejection and conflict in both my work and personal life. To be honest, as a black woman, my opinion has never been as rigorously sought as it has been now. But what muffles it? Is it the system, my superiors, my peers or is it me?

I remember when President Obama first won the election in 2008. I was anxiously sitting in the lounge of my undergraduate dormitory. At the University of Pennsylvania, my peers and I represented a minority and now we suddenly mattered – a black president. For the night, we had a voice. We forgot about the divisions between race and class. We forgot our opinions were not that of the majority.

Eight years later and two successful terms in office, we now have the opportunity to witness another historical stride. Secretary of State Hillary Clinton has been a forerunner in the Democratic Party and the first female candidate to gather this much support in presidential elections. In February 2016, she visited us here at our institution, Meharry Medical College.

I witnessed the diversity of supporters that flooded the ballroom of The Cal Turner Family Center for Student Education. While standing in the crowd with my classmates, I knew my voice mattered. I am a black female voter with the opportunity to witness leaders that generations before me would have never imagined. The American political system has seldom allowed individuals that look like myself to have roles of leadership. As a result, my voice has always felt muffled in such arenas.

Regardless of who wins the 2016 elections, seeing candidates that look like me brings my viewpoints to the forefront. So the next time, I doubt voicing my opinion as a doctor, because of fear of being critiqued by my superior and peers, I must remember that I, too, am a leader. Children that look like me see my role as a physician and picture themselves in my place. And it’s my understanding of those patients with similar experiences that gives me an advantage in the quality of care that I provide. Hence, not applying my diverse background to the health care arena will only exclude my voice and that of my patient from the conversation.

So how can I speak louder than the system, my superiors and my peers? As an American citizen, not voting for the candidate that represents my opinion allows the system to drown out my views. As a physician, not advocating for patients that I empathize with stifles the concerns of my patient. And not speaking up for myself muffles my voice amongst my superiors and peers. But I stop mumbling when I project my voice louder than my own hesitations and vote for a 2016 candidate that empathizes and advocates for me.

Letter From the Editor

Estevana Isaac, MSIII

“One afternoon walking on the right-hand side of the hallway with my head down, there was a person walking towards me. I looked up and the person was me. I actually passed myself in the hallway. The other me was ignoring the real me,” President Hildreth stated while recalling his medical school experience at Johns Hopkins School of Medicine in 1982.

He recalled staying up 3 nights without sleep so he could impress a world renowned prostate cancer surgeon the next morning. As he elaborated more on his personal story, I could not help but think of how the idea of losing sleep in order to impress, perform and excel is not a foreign concept to many students at Meharry. In fact, it is a notion that largely defines many of our graduate school experiences.

The academic rigor of Meharry’s curriculum alongside national board exams has challenged us all at one point in our graduate school experience. For me, that challenge came my first semester in medical school– for the first block of exams, I made the lowest grades in all of my classes. At the time, I would have told you that “my memory was bad” or “I didn’t have a strong enough background” or rather “I just wasn’t getting the material as fast.” So I lost countless hours of sleep wanting to prove myself to my professor, the dean and my peers. I spent hours at a time in tutoring, office hours, study groups – you name it, I did it. And it wasn’t long until, my entire day was spent in exhaustion, body aches, headaches, sleeplessness, difficulty concentrating and ultimately, sadness. You see, the defining issue was never an unmanageable workload, difficult material or forgetfulness. But rather the greater problem was that I was almost 1000 miles away from home, no friends and no family in a whole new culture unlike the one I had been familiar with my entire life. In a matter of months, I had to learn how to adjust and balance all of it on my own.

In 2009, Academic Medicine published a study based on a survey of 2000 medical students and residents.[1] It found that medical students have the highest rates of depression, nearly twice as high as the rate found in residents. The article further noted that nearly 25% of cases occurred in the second year of medical school studies – in other words, depression peaks during Step 1 studying. I mention this because I have seen a lot of my classmates question their intelligence this past year, their knowledge base and capabilities as a student in regards to Step 1. It is a feeling that I am able to relate with from my own personal experience my first semester. You are redefined by a letter grade, a board score and a comparison to the next. However, in truth, it is an unhealthy pattern of thinking that can easily leave your true self lost and forgotten.

Like President Hildreth said, “The other me was ignoring the real me.”

A loss of self, a sense of hopelessness and isolation can lead to the most lethal mental illness amongst  students to date – suicidal ideation. According to the report, black medical students are particularly prone to suicidal thoughts, with 13% of black students reporting suicidal ideation. Nationwide, a little under 1200 black students out of a total of almost 20,000 medical students (~6%) enter into the academic arena each year in the US according to the AAMC.[2] Each graduating class at Meharry is roughly 100 students, a large percent being African, Afro-Caribbean or African American descent. As a result, Meharry trains almost 10% of the incoming black medical professionals in the U.S. Being apart of the small and valuable 6% of those medically trained professionals, it is important that we acknowledge that  losing ourselves, our peers and our careers to depression or suicidal ideation is a very real concern for all of us at Meharry.

A lot of fear has been driven into us as graduate students concerning grades, board scores and clinical performance. So much so that during difficult academic, personal or emotional times we are too afraid to ask for help. While some of you may not have experienced depression, anxiety or suicide ideation at Meharry, it is important to acknowledge that many of your classmates have and still are struggling with these or similar matters. Medicine, dentistry and higher education studies are competitive fields, however, we should recognize that we all have something of value to contribute to the larger healthcare community. I successfully completed my first semester of medical school and am currently training as a third year student because of my Meharry family. My contentment, energy levels, confidence and grades quickly improved because of my friends and support system away from home. President Hildreth reflected on his own time in medical school and gave this advice,

“People should understand that some of the relationships that you form in medical school will last you for the rest of your career and life. So take time to nurture those friendships.  It is true that what you put into the experience is what you get out of it.”

With President Hildreth’s words in mind, let’s hold each other accountable for making a safe space amongst the student body where no one is afraid to ask for help. Because, in the end, it is our job to ensure that not only ourselves, but our entire Meharry family has the opportunity to make contributions to our nation’s healthcare.

If you or anyone you know is suffering from depression, suicidal ideation or may need help contact:

Counseling Services at Meharry

Suite #325, Third Floor

Meharry Clinic Building

(Near Student Health Services)

 

Monday–Friday

8:00 a.m.–5:00 p.m.

 

Telephone: 615.327.6915

 

[1] Goebert D, etc. Depressive symptoms in medical students and residents: a multischool study. Acad Med. 2009 Feb;84(2):236-41. doi: 10.1097/ACM.0b013e31819391bb

[2] AAMC. Table 9: Matriculants to U.S. Medical Schools by Selected Combinations of Race/Ethnicity and Sex, 2013-2014 and 2014-2015. https://www.aamc.org/data/facts/applicantmatriculant/

Letter from the Editor

Estevana Isaac, MSIII

My voice often feels muffled. People say I mumble. I come off as shy, hesitant and quiet.

“Speak up.”

“I can’t hear you.”

That was a lot of my feedback growing up. And now I wish I could tell you that adding my opinion comes natural to me. As a training physician, I still think about the consequences of criticism, rejection and conflict in both my work and personal life. To be honest, as a black woman, my opinion has never been as rigorously sought as it has been now. But what muffles it? Is it the system, my superiors, my peers or is it me?

I remember when President Obama first won the election in 2008. I was anxiously sitting in the lounge of my undergraduate dormitory. At the University of Pennsylvania, my peers and I represented a minority and now we suddenly mattered – a black president. For the night, we had a voice. We forgot about the divisions between race and class. We forgot our opinions were not that of the majority.

Eight years later and two successful terms in office, we now have the opportunity to witness another historical stride. Secretary of State Hillary Clinton has been a forerunner in the Democratic Party and the first female candidate to gather this much support in presidential elections. In February 2016, she visited us here at our institution, Meharry Medical College.

I witnessed the diversity of supporters that flooded the ballroom of The Cal Turner Family Center for Student Education. While standing in the crowd with my classmates, I knew my voice mattered. I am a black female voter with the opportunity to witness leaders that generations before me would have never imagined. The American political system has seldom allowed individuals that look like myself to have roles of leadership. As a result, my voice has always felt muffled in such arenas.

Regardless of who wins the 2016 elections, seeing candidates that look like me brings my viewpoints to the forefront. So the next time, I doubt voicing my opinion as a doctor, because of fear of being critiqued by my superior and peers, I must remember that I, too, am a leader. Children that look like me see my role as a physician and picture themselves in my place. And it’s my understanding of those patients with similar experiences that gives me an advantage in the quality of care that I provide. Hence, not applying my diverse background to the health care arena will only exclude my voice and that of my patient from the conversation.

So how can I speak louder than the system, my superiors and my peers? As an American citizen, not voting for the candidate that represents my opinion allows the system to drown out my views. As a physician, not advocating for patients that I empathize with stifles the concerns of my patient. And not speaking up for myself muffles my voice amongst my superiors and peers. But I stop mumbling when I project my voice louder than my own hesitations and vote for a 2016 candidate that empathizes and advocates for me.

Simple Medicine

Following up with some previous article posts, I’d like to expand on the idea of the doctor not just as someone who gives medicine, but someone who is medicine.

 

There is a two-fold promise implicit in the oath we take to become stewards of medicine. First, medical students swear to safeguard the profession on the vocational level, to preserve its tenets as it was originally decreed in the Hippocratic Oath. The second promise is the more interesting one. It requires that the physician become a vehicle of medicine, bestowing a medicinal effect onto her patients simply by being their doctor. This promise cannot come to fruition without appreciating that the true subject of medicine is not the disease but the patient. Each patient is invariably more than his present illness. He is a dynamic individual with a complex psyche, spectrum of emotions, and irrevocable personal history. Ignoring this as the core principle in effective medical practice undermines the essence of healthcare altogether.

 

Continue reading Simple Medicine

Are We Losing Touch?

The first frost of winter has settled on the ground and our country takes a short break for the holidays. Thanksgiving Day is a time of reflection, gratitude, and the appreciation for our health, family, and relationships. Unfortunately, this brief idyllic moment is soon trampled by the frantic rush of consumers eager to purchase new [insert products here] during holiday sales events. There are newspaper headlines of people injuring each other at supermarkets for a good deal on a toaster oven. I’m sure I’m not the only one who finds this display of behavior unnerving. This insidious growth of a culture of greed and desperation may be the symptom of a larger social sickness, but it also raises the concern for our dissatisfaction at large. The consumeristic aspect of our culture often blinds us to the bigger picture. Continue reading Are We Losing Touch?

New Beginnings

 

From my 9th floor apartment window I have a wide view of the Meharry campus, the surrounding neighborhood, and the tops of skyscrapers etching Nashville’s downtown skyline. A view such as this certainly puts things into context. I’ve been thinking lately on the nature of new beginnings, as it seems much is transforming around here at Meharry. With a new generation of students, multiple new buildings being built, a new curriculum in effect, and many new rhythms driving our lives, a kind of rebirth seems to be taking place.

 

Continue reading New Beginnings