Being a mentor

“A mentor is someone who allows you to see the hope inside yourself.” — Oprah Winfrey

Reflecting on my journey, I realized that every patient I cared for; every position I held; and every time I dared to change my location provided an opportunity for professional and personal growth. There were painful moments of uncertainty and regret, but they gave me strength and determination. It was the colleagues I worked with that in their small ways lifted me beyond those difficult moments and allowed me to develop my clinical and leadership skills.

When I started in academic Family Medicine in 1996, there were so few African American and Latino educators in Family Medicine. Unfortunately, that is still true but for those of us who are there, we are committed to mentoring the next generation. I still feel like I am early in my career. I feel I have so much more to share. Those pioneers that I met are still paving the way for me and others through their work. I have been fortunate to have those mentors request that I accept a leadership role they held because they knew I could handle the responsibility. I always said, “are you sure?” and they would answer “yes”. They showed support by just saying “please call me if you have any questions.” Believe me I have so many times. I value their experience and wisdom.

I am fortunate enough to be mentoring some wonderful URM women who are so intelligent and full of great ideas to impact our profession. They have a unique prospective because they are first generation medical professionals who come from hard working families. They see like I did the small numbers of underrepresented minorities (URM) in medicine. They are especially concerned about the low number of URM males.

I was fortunate enough to have one of my mentees ask me to do a mock interview with her cousin who was having a big interview at a very prestigious medical school. On the day of our call, we went through some questions. I asked him “why he wanted to go into medicine”. And he gave me the usual answer. I found myself telling him, that we have heard that before. “Tell me who you are and why you should be here?” He then told me about his family and his personal commitment to be in medicine and care for patients. I was almost in tears as he opened up and shared his family’s struggle. I told him “that is the story you tell.”   It is hard to believe that he is almost ready to graduate from medical school . He is a Black male who was provided the opportunity to study and thrive in a supportive environment. I know he will impact medicine by just being a role model for so many other Black males.

Each time I am contacted to talk with someone about how to navigate getting into medical school, I am so angered by the misinformation they have received. This goes back to 1996, when I met a young man who with some direction is now a successful medical professional. I still have the letter that the Dean of his medical school sent informing me they had accepted him. He thanked me for my encouragement and support.

Mentoring is what revives my spirit and renews my hope. Every time I meet with one of my mentees, it is an exchange of ideas and the energy that is palpable. I have had the opportunity to mentor a diverse group of medical students and residents.  I edit articles, give advice on career opportunities or just listen to what is happening in their personal life- the wedding plans, the choice to go into Obstetrics and not family medicine or choose a fellowship. I do have a copy of almost every letter I have written. I enjoy reading each one. They have gone on to successful careers. I have pictures of new babies and see journal articles and presentations they are doing. One student is now a successful Urologist. I remember his interview. If you just looked at the paper, you would have passed him over. He told me his story. At that interview, I saw such potential in him, and he proved me right. I have so many of these stories. They all are such bright stars.

It is so inspiring to see those who I have mentored pay it forward. There is a whole new generation of aspiring URM doctors that despite all the work we have tried to do, have to deal with poor academic advising, lack of mentors and role models, the high cost of just preparing for the MCAT and then applying to medical school. We must get to them early and make sure they know how to navigate through a system that favors those privileged few. The information out there is generic and does not address the challenges of those who are working their way through undergraduate and postbaccalaureate degrees while studying for the MCAT and supporting themselves and their families.

So, let’s all roll up our sleeves because we have work to do. Let’s use our talents to mentor the next generation.

  “A mentor is someone who sees more talent and ability within you, than you see in yourself, and helps bring it out of you.” Bob Proctor

 

 

I am a doctor and thank God I have Health Insurance!!

After having emergency surgery in 11/10/2019, I was hospitalized for 4 days. When I got home, the next day a letter arrived from my insurance company denying my hospital stay. Through the pain, I laughed and thought this is not true. In 2 days, another letter arrived saying that my bill would be covered. That was a relief. I had to apply for short-term disability because I would be out of work for 4 weeks. Thankfully, I had applied for the insurance which would guarantee some income. I would be paid through Cigna and my health insurance is with Aetna. Despite having never taken any of my allowed sick leave, I found out that does not matter.

I now know why it is important to complete all those forms for my patients and advocate for them. The problem is this can be overwhelming because you must not only complete the forms but call your case manager. I was confused because I got so may forms in the mail. I called and found out that my doctor had completed them. The ones I received were only copies.

This time around, I did increase my coverage. The bills are rolling in but thank God I have insurance. The total cost will be low because my employer-based insurance has a low deductible and I stayed in-network with my surgeon and was admitted to the hospital where I work. As we look to the election, we must consider how important health care coverage is. If I had to pay the actual cost of my care, I would have to take out a loan. While we ignore the need for Medicaid expansion and cut taxes to the wealthy, Americans are filing bankruptcy because of inflated health care costs, even the cost of a Tylenol is more that one bottle.

I hope that the political debate can shift to real issues: access to culturally aware health care, healthcare costs, social justice, healthy communities and racism. Health disparities in the US are based not only on income but access to care for minority communities. Also, we will have a shortage of primary care providers who are African-American, Hispanic/Latino, and Native American who will practice in these underserved communities. We will have to address all of these issues.  Thankfully for me, my African-American female physician who also trained with me was there to get me the care I needed.

20000 steps to my Birthday

On Friday, October 11, I had emergency surgery even though right before the procedure, I had a phone meeting with one of the plenary speakers for the 2020 STFM annual meeting.  I reassured him I was fine but just had to move the meeting up by an hour.

My friend and colleague came over to give me a hug and helped me with my gown right before I went My husband was there until I was ready to go the operating room (OR).  After I woke up from anesthesia, I had no memory of the events after I kissed my husband and went to the OR. I do not even remember speaking to my surgeon.  Thankfully, he told my husband the findings and why I had to have an open surgical procedure. Details in the next post.

My first steps were to the bathroom to urinate.  That was a major step.  You see, I had a catheter in my bladder for the surgery.  I also had an endotracheal tube (to help me breathe) and a nasogastric tube (to keep my stomach free of air).  I can tell you that once you start walking, don’t stop.  There is no amount of narcotic pain medication to take away the pain from recovering from abdominal surgery.

The gas pains are horrific.  But for me, the worse was the back spasm.  The hospital got these expensive beds that are like sleeping on a moving rock.  Thankfully, I could walk with my IV pole in the hall.  You would think that we could come up with a more convenient pole but not yet.  It is still the same that you see on all the hospital shows. Also, the gown has not changed. It still needs to be tied the right way so your rear end is not displayed. Also, thanks to one of the nurses who found one of the old recliners for me to sleep in.  When she helped me get comfortably positioned in the recliner, I just remember thinking” Hallelujah, thank you, God.”

You need to pass flatus (pass gas) and have a bowel movement before discharge.  So, initially, I was NPO (nothing by mouth).  That was fine with me as I dealt with the pain.  However, two of my favorite things have always been the chicken broth and the lemon ice on the Liquid diet menu.  The best was the extra strong cup of coffee made by one of the nursing staff and the warm prune juice. The next step was one of the nurses gave me a Pedometer.  It took 20000 steps for me to do the two most important things you need to do after abdominal surgery.  So, I finally passed gas and had a bowel movement.  That pedometer was a symbol for me of success and recovery for me.  I did lose about 12 pounds, but I could not just sit.  You see, narcotics slow the bowel function and can make it more difficult to have that bowel movement which can increase your pain, so it is a double-edged sword.  You must balance the pain and the need to keep moving.  I used the pedometer instead of my phone app because I did not want to be distracted during my walking by phone calls from my family and friends.

My other aid in recovery was meditation.  I used the Insight Timer App.  I typed in surgery and found several healing meditations.  I listened to them when I had pain and they helped relax me and use mantras to keep me positive.  It also drowned out the hospital sounds that are present even with the door closed.

Today is my birthday. Thank you to the wonderful nursing staff at my hospital.  They took such good care of me.  Thank you to my amazing surgical team.  Just to let you know, if I wanted to, I could wear a bikini.  The scar is barely visible.  Also thank you to my family, friends, and colleagues for their good wishes.  I can truly say that I am blessed to be alive to celebrate today.

 

Why I love my Mother

I will be celebrating a birthday soon. Who could have predicted that a congenital problem would flare and lead to major surgery? Details another time. The day after surgery I called my mother to give her the details.

I started with “Mom, I am fine, but I had to have surgery yesterday.” Mom. “Oh no, are you alright. Do I need to come?” I reassured her I was fine. To lighten the moment, I reminded her of my problem as a child. You see I was always known to just start vomiting after meals. Sometimes it happened in the car so I was labeled and on each car ride I had to have a large can so I could throw up in it. Thank God for leather seats. I also had to have a large towel in the car.

I vomited at Kindergarten, so I had to carry an extra outfit every day. I was labeled the picky eater, so it was always exciting for everyone when I ate new foods. It is amazing how children can adjust to physical conditions. I think I avoided foods that could have exacerbated the problem. You see, I now know I had a congenital band that was the cause of all those episodes of vomiting.

I told my Mother. I am not sure if she had a slight twinge of guilt, but I reassured her that it would not have been found. Especially back  then. I grew up in Birmingham and let’s face it there was not access to good healthcare for African Americans at that time. Also, the cost structure was different.  Surgery would have been too costly and even dangerous.

“Don’t post it on the Family Reunion page.”

“Of course not.”

“I am going to the reunion meeting and I will tell your cousins and aunts”

“I am going to call your sisters now and then I am going to just fall out on the floor”

“Mom I am fine, don’t do that”

“Yes, I will call your sisters and then fall out on the floor”

I talked to her the next day and she was fine. She updated me on the meeting and the family gossip. She made me laugh so hard, I finally started to feel better. I had had a rough night. We are so resilient. It is based on love and faith. I know I am loved and that just makes me stronger and keeps me going. I love my Mother. She is the rock of our family. My sisters also called that morning and we continued the laughs and love.

“My mother is so full of joy and life. I am her child. And that is better than being the child of anyone else in the world.”

Maya Angelou

Going “Glocal” in Yuma Arizona: How to Introduce Global Health Into Family Medicine Curriculum

This is a great way to learn to help our patients

STFM Blog

By Natalia V. Galarza, MD and Kristina Diaz, MD

Global health has been identified as an increasing field of interest in medicine. As Koplan et al, mention, it can be thought as a notion, depending on current events. A definition for global health has never really been reached by consensus, and so it seems that global health can be adapted to the necessities of the location and time.

Many definitions touch on the fact that global health should improve health and achieve equity for all people and protect against global threats that disregard national borders.(1,2) It has deep connections with public health, blurring the boundaries between public health and global health. Within these connections, we have “border health” as a unique part of public health, with many characteristics being shared with the broader “global health.” For family medicine residency programs that are geographically located near the United States-Mexico border, the…

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We really do have a problem

“Wisdom comes only when you stop looking for it and start living the life the Creator intended for you. “

Hopi

“I refuse to accept the view that mankind is so tragically bound to the starless midnight of racism and war that the bright daybreak of peace and brotherhood can never become a reality… I believe that unarmed truth and unconditional love will have the final word.”

Dr. Martin Luther King

 

My grandparents were often described decent people. The definition: “conforming to generally accepted standards of respectable or moral behavior” is a fitting description of them. They were not perfect but to me they were.  Many times, we would often wish a spanking from my grandmother rather than what my uncles called one of her “sermonettes. Her father, my great-grandfather was a Baptist Minister. She could quote the Bible from memory. When we even mentioned being bored, she handed us the Bible, the dictionary or the Encyclopedia and expected us to read it.. My grandmother was our childcare provider while our parents worked. These sermonettes required us to listen as she called upon us to be decent and caring people.  She wanted us to be better than those around us. She required us to be in church on Sunday mornings and with one look put a stop to any misbehaving. The “Golden Rule” was an essential theme in many of those sermonettes.  To paraphrase, “Do to and say about others what you would have done to and said about you.” My grandfather was just a gentle giant.  Kind, loving and respected by everyone.

I took those lessons to college and to Medical School and it influenced how I cared for my patients. From the first day of my internship, it became apparent that not everyone learned how to be decent.  I had to work hard to do all my notes. One attending critiqued each one to make sure they were grammatically correct and accurate. I went in to admit a patient and she kindly asked me to leave.  I was black and she was obviously a very wealthy white female.  Interns did the admitting history and physical on all admissions on the teaching service. I was happy to be sent away.  It meant I could leave early right after our  sign-out.  Well much to my dismay, I was summoned back to the nurse’s station and told to go back in and do the admission. It seems that my attending had told the patient that if she wanted to stay in the hospital she must be admitted by me, Dr. Washington, the Black female intern. The patient looked at me and said” It looks like you and I  are going to have to work together.” I ended up leaving late but I left with a sense of accomplishment.  I was fortunate enough to hear a story marked with pain, suffering and disappointment.  I paid her the respect I was taught to give to all patients and she responded.

It is obvious that more people should have had the benefit of listening to my grandmother and being in the presence of my grandfather. She has been gone from my life for over 10 years but I still carry the imprint of her love and guidance.

Racism, sexism, and fear  are impacting every aspect of our lives. In medicine, it is impacting the diversity of our workforce and increasing health disparities.  As we recognize the life of Dr. Martin Luther King, we see the erosion of the very values he stressed in his sermons and in his life. I often reread some of those sermons to gather inspiration. The January issue of the Society for Teachers of Family Medicine Journal is dedicated to looking at the issue of racism and highlighting departments that are addressing this complex problem.  From the Editor:

“We must create spaces that are more inclusive and recognize our unconscious biases. We need to commit to fighting injustice in health care and ensuring families can live well to the best of their ability. The real work to make this a reality will have to occur in every single medical practice and training program in the nation.”

Bich-May Nguyen, MD, MPH

https://journals.stfm.org/familymedicine/2019/january/

 “There comes a time when one must take a position that is neither safe, nor politic, nor popular, but he must take it because conscience tells him it is right.” 

Dr. Martin Luther King

Good-bye 2018! Hello 2019!!

Hope smiles from the threshold of the year to come, whispering, ‘It will be happier.’Alfred Lord Tennyson

2018 was both exhilarating and unsettling; with happy and sad moments. For me, it started with stress induced hair loss. I noticed it as we were preparing for a major electronic health record implementation. I volunteered to take a lead role in the implementation for our program. I panicked when I finally noticed the patch of thinning. I called my stylist looking for help and she calmly explained to me my options. She explained why crocheting was a better option than braiding, weaving or just having a very low cut natural style. I decided to go with crocheting. It has given me a new carefree look. Thankfully, my hair has grown back but I love this look and plan to keep it for a while.

I have spent 35 years taking care of patients bit you are never prepared  to confront medical problems in you families. After finding the best solution to my problem, I was hit with my mother’s sadness over not only the loss of her sister (the oldest) but also her diagnosis of breast cancer. Her sister had a stroke that would have left her debilitated but my cousins chose hospice care. She went peacefully after her sisters’ visit. My mother sailed through the bilateral mastectomy  We talk almost every day and but she still misses her sister. I could not make it to the funeral and my sisters were there to help her because I was studying for my Family Medicine Recertification Exam. The test was on Friday, April 13.  Not to brag but I passed with a higher score than I did 10 years ago.

In July, we went to the Arrington-Giddens Family Reunion in Chicago. It was so inspiring to see how the Chicago side of our family prospered after my grand aunt fled the racism of Birmingham and along with her brothers who followed built a rich life on the Southside of Chicago. The tour of the area was educational an included the homes Mohammad Ali, Louis Farrakhan, and the Obamas. Shout out to Michelle Obama for the top-selling book of 2019. The book beautifully showed life on the Southside of Chicago and the southern roots of families as they started new lives during the Northern Migration.

In August, we traveled to Birmingham to see my mother. I didn’t have time to visit all my old friends. We did go to church on that Sunday.  I was fortunate enough to wish my second grade teacher farewell because she is over 90 and transitioning from her long life of independence to live with her son in Texas.  I was overcome with both joy and sadness to see someone who once towered over me weakened by age. She was one of the architects of my success along with my mother.

In September, I realized that the love of my life had a terrible shoulder problem. Fortunately with physical therapy, we were able to celebrate his 75th birthday December 1st. I am now on the other side of 60. It seems like yesterday we celebrated his 40th birthday. Now it really is thirty-five years together. So, now it has been thirty-five Christmases and New Year’s spent together.

Politically, this year has been both disappointing and inspiring. The November election led the way for the most diverse group of legislators in our history  and the Mueller investigation were two positives.  The appointment of the most recent SCJ was a disappointment but many rulings by our circuit court judges have protected the rule of law. The fight over the Border Wall, immigration, and the separation of families was not our best moments.

2018 was also my year to embrace my meditation and yoga practice which formed the foundation for my positivity. I am going to rededicate myself to my yoga and meditation practice in 2019.

Here’s to 2019. I am ready to face it head on.  Happy New Year!!!

Your success and happiness lies in you. Resolve to keep happy, and your joy and you shall form an invincible host against difficulties. Helen Keller

 

Mi Gente

Quote

To inspire the next generation of underrepresented in medicine (URM) educators, the STFM Foundation is launching a year-long blog series. In the new series, The Path We Took, URM members will share the path they took to become faculty and leaders in family medicine. This post was written by Edgar Figueroa, MD, MPH

via Mi Gente

One African American Woman’s Leadership Journey

STFM Blog

Judy Washington, MD Judy Washington, MD

To inspire the next generation of underrepresented in medicine (URM) educators, the STFM Foundation is launching a year-long blog series. In the new series, The Path We Took, URM members will share the path they took to become faculty and leaders in family medicine. I’m delighted to kick off the series by sharing my own leadership journey.

One African American Woman’s Leadership Journey

When you have the privilege to serve in leadership, you have the responsibility to reach back and identify other colleagues who would not otherwise have the opportunity to be recognized. You can do this through mentoring, building systems to support the underrepresented, or financially supporting the individuals or the systems that assist them.

When the opportunity was presented to be a cochair of the Minority and Multicultural Health Collaborative, I said “Yes!”  I was fortunate to work with two wonderful African American women…

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One of Those Kids in That Class Is Me and They Deserve a Chance

STFM Blog

Crichlow_R_2015 Renee Crichlow, MD

In the last couple of years, I have been a co-teacher in an undergrad program part of whose mission is to increase underrepresented in medicine (URM) students in our medical school. There are many reasons I have chosen to do this and to fully understand, I thought it would be important to share a little bit of my student career history.

To begin, nothing in here is about bragging. It’s really about sharing a story that may be similar to what others have seen.

My high school was a very high performing public school: we had 13 National Merit Scholars in the year I graduated, and I was one of them. (Except at that time in 1985 my award was called National Merit Outstanding Negro Scholar. I’m not joking. That’s exactly what it was called in 1985.) I mention this because it’s an indication of the fact…

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