Category Archives: MedEd

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PULSE- Spring 2016

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Learning about Radiology (A Discussion with Future Generations)

Luther B. Adair, II, M.D.

There they were, my dad and my new cocker spaniel, Jocko (seemed like a great name at the time). It was no different a night than several other nights in 1982 when my father came home and trained Jocko in the concrete floored basement of our split-level, ranch-style suburban home. At the time, the stairs that led to the basement were open to the view of the basement from an unenclosed stair rail. As a 5-year-old, however, this was not a stair rail at all; it was a gymnastics paradise to display my ninjutsu expertise—plus a bonus view of my personal dog trainer and my new puppy. It does not get much better for a 5-year-old except for the frequent chastising I would receive for using the rail for that very purpose. “You will fall and hurt yourself,” was the usual caveat.  On this particular night, that warning would go unheeded and my grip would betray me. Gravity was there to teach me a lesson. I fell head-first and landed on the concrete. Now much of what happened later is recalled from a post-traumatic memory and what my parents later told me, but to make a long story short, I remember waiting a very long time in an unfamiliar emergency room.

I guess now would be a good time to tell you that my father was a neuroradiologist, the chairman of the Department of Radiology at the more familiar hospital, and a student of the great Juan Taveras (MGH Neuroradiology) during the dawn of the CT scan.  Needless to say, my father would not allow me to be evaluated with radiography alone and insisted upon having the hospital perform a CT scan evaluation of my head (imagine a time when routine brain MRIs from the emergency department weren’t the norm).  My father’s hospital did not have a CT scan. I eventually received a CT scan and a diagnosis of a concussion. Subsequently, my father was able to convince his hospital board to allow him to use his personal finances to help purchase a CT scan for the hospital where he was employed.

This story seems inane now because most hospitals in the U.S. have CT scans that are readily available. However, in many cases such ubiquity has become another spectrum of the same problem—the overuse of such technology and the radiation associated with the overuse.   There has been extensive controversy regarding the overuse of CT scans ordered by the emergency departments over the last six years—just “google” CT scan, pediatrics and CNN. Some argue that the legal system is causing doctors to practice defensive medicine. Others argue that the training of emergency personnel promotes a flippant approach to the use of diagnostic imaging.

Recently, my 8-year-old nephew suffered a head injury while playing and I realized after talking with his parents that the responsibility should also lie with the parents to understand their available options in similar circumstances. Hence the reason my company, Viewbox Holdings, LLC, and I decided to create our second (and most unlikely) product, a children’s book.

The book, Learning about X-rays with Lula and Ethan, is loosely based on my nephew’s experience and it attempts to educate the pediatric population about possible concerns around radiation exposure, but also explains its necessity in certain situations.  Most importantly, and aligning with the ACR’s Heart of Radiology campaign to educate the public about our role as radiologists, this book introduces readers, both parents and children, to one of their key health care providers—the radiologist.  This book was written for ages 7+ and features two children eating lunch and discussing one child’s experience of getting an X-ray.  Obviously, it is our desire that parents would never need such a resource, but given the trend of increased diagnostic imaging in the emergency setting, as well as the large numbers of allied providers joining the health care force over the next few years, we believe this resource will help families and providers.

It is our hope that any provider that treats the pediatric population has access to this resource for their patients (even radiologists in the outpatient or emergency waiting rooms).  You can purchase either the paperback version for $9.59 or the e-book for $4.99 directly from the publisher by following this link http://www.blurb.com/b/6950764-learning-about-x-rays-with-lula-and-ethan.  The book will also be available through Amazon, Barnes and Noble, and in the Apple iTunes Store where you can also find our iPad application for radiology trainees, Viewbox.  Because the information and message in Learning about X-rays with Lula and Ethan also aligns with the Image Gently Campaign, this non-profit organization has also agreed to endorse the book by placing it on their website: http://www.imagegently.org.   During the editing process, we received guidance and amazing support from the chair of the Image Gently Campaign, Dr. Donald Frush, as well as my sister, Dr. Candace Adair, who is a child and adolescent board-certified psychiatrist.  If you have any questions or comments please feel free to email me directly at luther.adair@viewbox.net.

Speak Life, Speak Love

Thanks to all the fantastic performers at the Speak Life, Speak Love Spoken Word Event held on Meharry’s campus on Feb 12th!  A full house of those inspired and inspiring. *snap, snap*

**contact Estevana Isaac, MSII for more information about getting involved in creative writing or future spoken word events.

In light of recent events, a post by Annam Abbasi, MSII

If you don’t know what happened in Pakistan recently, here’s some background reading:

______________________________
There are people who selflessly exist to improve the lives of the deserving and the deprived.
“I am heartbroken by this senseless and cold-blooded act of terror in Peshawar that is unfolding before us. I, along with millions of others around the world, mourn these children, my brothers and sisters – but we will never be defeated.” – Malala Yousefzai
Then there are beings like this.
These are not people. These “people,” who are so far removed from reality they’ve convinced themselves that taking the lives of helpless CHILDREN to punish the Pakistani Goverment for choosing not to enforce Sharia, will continue to ruthlessly murder the innocent out of belief that their cruelty is coming from a well-meaning place. These “people” have left countless parents to spiral into states of depression for as long as they may live because they believe that violence and unwarranted homicide will help whatever hallucination they believe to be Islam reach its full potential. These are the “people” that make the rest of the world forget that Islam is a religion of peace.
No one who claims to have “deliberately kill[ed] older pupils to spare small children” deserves to assert that they act for the preservation of Islam.
No one who shoots a 15 year old girl, whose very core is built on advocating for her right to an education, through the head in a failed attempt to forever silence her deserves to identify themselves as human. No one who “vow[s] to complete the [failed] job next time” deserves to breathe.
I’m taking a moment to honor the lives of the 141 children who woke up in Peshawer on December 16th with a thirst for knowledge in the morning and never made it back home. I’m taking a moment to pity these deranged minds who have lost touch with the fundamentals of their religion, the understanding of righteousness, and the sense of compassion – the very essence of humanity. I’m taking a moment to applaud Malala Yousefzai, a young woman who not only rose above an attack that nearly took her life, but who channeled all her subsequent negativity into earning the Nobel Piece Prize through enduring hardships of all sort to put an end to childhood suppression – to ensure children have the right to an education. Most importantly, I’m spending today in faith of the belief that the people of my country, my family, will one day be relieved of the constant terror of uncertainty that they endure so elegantly while carrying out their lives to reach the highest potential that they possess to break free of their constraining roots to make a difference in the world.

“Medicine and Technology,” Andranik Agazaryan, MSIII

In the present era of evolving innovation in technology, we as future physicians must have an awareness of the pioneering medical devices, procedures, and technology available for potential use in our respective fields. As Moore’s Law foreshadowed the rapid progression of technology [1], its application in medicine is reaching the point where it will establish the current standards of care.

Continue reading “Medicine and Technology,” Andranik Agazaryan, MSIII

“Improved Medicare for All: Why Adopting a Single Payer System Could Solve Many of the Financial and Structural Problems of the United States Health Care System;” Morolake Amole, MS IV

The problem with health care in the United States is not that it is inadequate. This is the furthest thing from the truth. Though there are constant mentions of unsavory health outcomes, namely infant mortality and its link to the unserved, the United States health care system has been at the forefront of medicine and innovation many times. In some ways, the extensive bureaucracy and heavy regulations that are instituted are present as a way to protect citizens from being victim to products and services that are cost consuming and inadequate.  The real issue with US health care is how it is paid for and who gets covered.

With that said, it is also obvious that our current health care system leaves quite a bit to be desired. Even with the passage of the Affordable Care Act, there will still be a substantial amount of Americans who are not covered and many more that remain underinsured. Approximately 7.1 million individuals signed up for health care through the Affordable Care Act. However, in a recent survey by The Henry J. Kaiser Family Foundation, 36% of Americans between the ages of 18-64 who remain uninsured stated that they opted out of buying insurance because the plans available were too expensive.

So, what can be done to improve the American health care system and keep costs low if the Affordable Care Act is not the final answer?

Many physicians believe that the answer lies in the adoption of a single payer system. Such a system has already proven to be successful in Great Britain and Canada. Citizens of these nations enjoy quality healthcare that is government funded. Such a system is successful for a variety of reasons.  By establishing a payment system in which citizens pay taxes that are then designated toward health care, there is an implied idea of transparency in health care spending and financing at the federal level. Citizens will have the ability to see where their money is being spent. Also, such a system would take the power away from insurance companies. Consumers will no longer have to look to insurance agents for decisions on health matters.

Another important idea is the fact that there will be a substantial decrease in health care costs in the United States. The US health care system is one of the most expensive. In 2010, The United States spent roughly 2.6 trillion dollars on health care. Greater than $8,000 per person. There is obviously a huge discrepancy between yearly health care costs and health care outcomes. By adopting a single payer system, costs will be reduced on many fronts, but mainly through greater promotion of preventative medicine strategies. If more patients are able to establish primary care and receive preventive screening and intervention, Emergency room visits, which are amongst some of the costliest care, will be reduced. Also, there will be a natural decrease in disease treatment because illnesses will be treated at an earlier stage, thus requiring less intervention in the form of costly surgeries and diagnostic and therapeutic technology.

There is also the huge implication that such a system would have on physicians. Not only would physicians be able to be paid for providing healthcare, but also they would be rewarded for implementing preventive medicine techniques. If physicians are better compensated, at the primary care level, this would allow for a greater incentive for medical students to pursue primary care fields as opposed to higher paid specialties.

The most important reason why single payer or “Medicare for all” is such a novel and legitimate idea is that coverage would be expanded to most, if not all, citizens. This idea does what Obamacare could not by allowing all people to have adequate access to health care, something that is truly their right. Also, there is the idea of expanded autonomy, in which citizens are more in charge of their own health.  By implementing a system where medical services are paid for from a central source, health care would be re-routed toward its original goal, which is giving people optimum care and an improved quality of life.

Morolake Amole, MS IV

mamole11@email.mmc.edu

Support your fellow Meharrians on a medical mission trip to Guyana!

GIVE (Guyana International Volunteer Experience)!

http://www.gofundme.com/givelife

According to the World Health Organization, the adult mortality rate in Guyana is 379 per 1000 for males and 258 per 1000 for females. In addition the prevalence of HIV is 814 per 100,000 and the incidence of malaria is 6049 per 100,000. These statistics are far above the global averages for these ailments. In collaboration with the Davis Memorial Hospital of Georgetown, Guyana it is our goal to raise funds to bring medical, dental, and graduate students for an opportunity to serve from June 21 – June 28. Our group has aptly been named GIVE (Guyana International Volunteer Experience). It is our plan to bring needed health supplies for the medical and dental clinics as well as provide assistance to the health providers of Davis Memorial Hospital in working with the physicians, dentists, and hospital administrators in addressing the health needs of the locale. We hope to establish a long lasting relationship with Davis Memorial Hospital and the country of Guyana as we give our students practical experiences in our service to mankind.

Last year, with your support, we were able to organize a successful medical mission trip to Haiti. We were able to bring much needed supplies to one of the largest Tuberculosis Clinics in the country. Our actvities can be seen in the video that is on this page. With your assistance we would like to have similar success in meeting our goals for this trip. We humbly ask for your monetary support and thank you in advance for your generosity. Upon our return, pictures, videos, and documentation will be provided so that you can see where your support went.

THANK YOU!

First Lady Hildreth Interview

 

Rechelle Jackson, D2

Last semester, The PULSE, formally introduced the college’s 12th president, Dr. James E.K Hildreth in our fall edition. Dr. Hildreth was named president in July 2015 and since then has been working tirelessly to make his presence known and goals realized.

However, as the old adage states, behind every great man is a great woman and Mrs. Phyllis Hildreth is no exception. The PULSE was able to have a few moments with the new first lady of the institution and learn more about her past, present and future.

Mrs. Hildreth was born in Berkley, California to an Oklahoma father and Missouri mother. During the interview, she frequently spoke of her love of history and how she felt everything happened for a reason and during a certain time. “I believe that our individual stories and community stories are so heavily marked by larger national and historical stories that seem not to be related, but when we pull back and pay attention we see why something happened,” she recollected.

During the Civil Rights movement, her father graduated from Lincoln University, an HBCU in Jefferson City, Missouri.  Concurrently, the Korean War was taking place and opportunities for blacks were very limited. Therefore, young black scientists and doctors ended up on the West Coast where they could thrive.

“I was trained in California schools during a time when Sputnik happened and the Russians got to space first, so everyone felt the need to train more scientists,” she said. She also stated that she was brought up during a time where there were linear roles and individuals had to identify as one particular job. “There wasn’t any deciding my career path, it was fairly organic, the question wasn’t was I going to be a scientist, but more so what kind.”

Although Mrs. Hildreth did major in biology in undergrad and soar through ecology and learning about the macro systems, a part of her did not feel complete because of the lack of interaction with people. “There was no social component, so it did not interest me,” she said.  She admitted to enjoying the bonding and identifying with others during her self-proclaimed “15 minute” stint as a pre-med student.

After graduation, working as a laboratory technician for five years did not stop Mrs. Hildreth from her true passion. She instinctively felt the need to help the family and believed that healthy families were the core of healthy communities. “I loved the centrality of maternal child health,” she said.  “Maternal and child health systems are the heart of my universe.”

She recalls her last job being at Johns Hopkins University in the pharmacology department. She remembers one of her husband’s mentors pulling her to the side and asking what it was she truly wanted to do because she could not continue to hide in the lab.

“He did me a great service.  I would have signed up for a career that did not have much black life or culture,” she said.

With the hopes of pursuing a degree at the School of Hygiene and Public Health at Johns Hopkins and the ultimate goal of studying maternal and child health, Mrs. Hildreth applied to the University of Maryland’s law school. In 1984, she became part of the first law school class at the university to matriculate a large number of African-American students.  Incorporating her love of history she said, “With Brown vs. Board of Education they continued to segregate high school and higher education, so this class was a part of completing the desegregation process.”

In the course of her first year of law school, Mrs. Hildreth discovered that she actually liked it. Upon searching for a job during school she was forced to carry around her one-page resume stating that she had majored in biology, worked in a lab for five years and now wanted to be a lawyer. “The only person who said ‘yes’ was the public defender of Baltimore city,” she said. “They put me over the CINA (Child In Need of Assistance) division and I clerked there for the remainder of law school.”

Mrs. Hildreth went on to graduate in 1988—and because of her great work ethic and willingness to work in a narrow, but nevertheless, important area of law, she was offered a position at the public defender’s office.  Immediately after swearing in, she had piles of cases waiting for her.  “We must focus on that which we have passion and do it with exhausting excellence,” she advised when reminiscing.

Our first lady is currently a professor at Lipscomb University teaching conflict management where she was previously a student in the same program. When asked how she felt about having to move back to Nashville after her husband accepted the president’s position, she said that she had never left after he departed Meharry for California. “We were forced to have a long distance marriage for four years,” she stated. “But during that time I was able to empathize with mothers in a way that I had not previously. I was able to see what it was like for other families to have to do this and make it work,” she continued.

When asked how she deals with the pressure of being a professor, first lady and public figure, she said that she may work long and non-traditional hours, but the minute she gets home she has released everything and work is not the focus. Her hobby, knitting, is also a stress reliever that helps to ease the day’s worries.

In addition to assisting in fulfilling her husband’s goals for Meharry, she also hopes that, by her presence and practice, women of her generation begin to institutionalize a way to be easily accessible. “I want to figure out a way to have couch hours and it will be known that at a certain time on a certain day I will be findable,” she said.

Lastly, Mrs. Hildreth wants all Meharry students, whom she affectionately calls her babies, to know and understand that we are not just training to become doctors, dentists and researchers. We must realize that our purpose is bigger than ourselves, she said, and in some cases the things we want to do may not have been invented yet.

“If your goal is a value, then you have great freedom and flexibility to adapt to the different ways in which that value is manifested and addressed,” she continued. “However, if your goal is to a particular process, when that process is no longer needed, neither are you.”

AMSA Annual Conference 2014: A Reflection; Elizabeth Kightlinger, MSIII

On March 6th, a dozen medical students traveled to the vibrant city of New Orleans to represent Meharry Medical College (MMC) at the American Medical Students Association (AMSA) Annual Convention.  This conference was not only an optimal networking opportunity with dozens of lectures, it also allowed MMC students to show off their hard work through research, competition, and award recognition.   New Orleans was the perfect location for the keynote address given by Sheri Fink, M.D., PhD, the author of Life and Death in a Storm Ravaged Hospital, a tale of the difficult decisions physicians were faced with in one New Orleans hospital during Hurricane Katrina.  At this event, the Meharry AMSA chapter was honored with the Paul R. Wright Award, indicating that the Meharry AMSA chapter “promoted AMSA’s mission of inspiring future physicians though local events, innovative programing, leadership development or calls to action.  Additionally, the emphasis of this award is chapter commitment to improving member solidarity by increasing awareness, recruitment, and involvement in their chapters.”   Meharry students continued to represent MMC through numerous examples of hard work. Morolake Amole, MSIII, displayed her research: “Post-Islet Cell Transplantation Effects of a Long Acting GLP-1 Agonist” among eight other Meharry student research posters. Three MMC students participated in the Simlympics: a simulated patient encounter where medical students working in teams must work-up a patient in front of a panel of judges.  One MMC student, Jenny Ousley, MSIII, served on the Reference Committee to assist in AMSA policy. While being involved in all these activities, MMC students still made time to participate in lectures such as the “Do’s and Don’t of Applying to Residency.”   The AMSA 2014 conference, March 6-9th allowed MMC students to exhibit their school pride, all while learning and meeting future physicians in the beautiful backdrop of New Orleans!

 

Elizabeth Kightlinger, MSIII, AMSA’s National Primary Care Week Coordinator