“The Homeless Situation” – Reflections of a Neighbor and Doctor

by Suzanne Minor, MD, FAAP

The subject of the email read “MDC Commissioners Meeting to Address the Homeless,” the body asking me to attend the Commissioners Meeting to describe my challenges in dealing with the “homeless situation in our area” in order to force the Homeless Trust to allocate dollars to target the Miami homeless populations.  Common scenes in the nearby downtown Miami waterfront public park included all manner of dogs and owners frolicking in their respective packs, designer-clad joggers and boot campers, tourists snapping photos, parents hovering near toddlers, and men and women rolling out blankets or spreading out cardboard for the night.  This email started me to seriously reflect on the homeless living in the park.

I’ve lived in this area for 10 years now.  There are more homeless now than when we moved in, displaced to the local park by museum construction.  At first, it was awkward as the pristine park felt overrun with this new population.  For a time, I even avoided the park in the evenings, not wanting to be reminded of the poor after working to provide healthcare for them in the face of great obstacles in my professional life throughout the day.  Looking at the homeless in the park was painful, bringing up feelings of helplessness, hopelessness, failure – providing health care for the poor of Miami was so difficult.  For any patients in the county safety net system, subspecialty appointments might take 6-12 months patients and if homeless, those patients might not get the appointment notification at the shelter address they gave until after the appointment was actually scheduled.  Just to see me as a walk-in patient required them to spend hours in the waiting room to be fit in to the day’s census.  Work was like constantly climbing a steep hill without the necessary gear or support.  And seeing those patients at night reminded me of this defeat and wore at my reserves.Read More »

The Power is Yours: An Exhortation from an Undocumented Medical Student

By Sumbul Siddiqui

My parents immigrated to the United States when I was 4 years old, hoping to give their children a better life. I was raised in Georgia with my three younger siblings, two of whom were born here. Georgia has a policy called 287(g), in which some counties are proud to work together with ICE agents to detain immigrants.

My first encounter with ICE officers was probably when I was 14 years old, just about to enter the 9th grade. I remember this moment very well, because the night before I had watched this scary movie called Saw. So, I was terrified that someone was going to kidnap me. I checked my closet and slept with the lights on that night. No one came for me, but my mom was taken. Two ICE officers entered our home that morning. I only heard bits and pieces because my mom had closed my bedroom door and told me to go back to sleep. Eavesdropping, I heard them tell my mom to go with them, and she would return back to her family soon. That took 3 months. She was taken to the Atlanta Detention Center, and then transferred to an Alabama detention center.

I don’t remember much of what happened during that time, but I do remember visiting my mom in the Atlanta Detention Center. We were only allowed to see her for a brief moment. She was wearing an orange jumpsuit – crying. Her handcuffs were taken off so she could talk to us through the glass window. I told her that everything was going to be okay even though I had no idea what was going on – or really, a clue about our immigration system. When my mom returned, I started high school, and I didn’t think much about immigration again.

Fast forward to my sophomore year in college. They come for my dad. Within just a few months, they come for my brother. My dad was gone for 2 years, and my brother was gone for 7 months. They were both in two different detention centers. Sometimes, I had to figure out who to visit – whether I would drive an hour up from Atlanta to see my father or 3 hours down to see my brother.Read More »

No Smoking This Side of Room: Reflecting on things that aren’t there any more after 42 years as a student and a teacher in a medical school

By Michael Dauzvardis

In The Beginning

It was June of 1977 and I had just begun my graduate career in anatomy.  Little did I know that I would be taking all my major classes with the medical students.  A lifelong journey in accompanying medical students in various ways had begun.

The Lecture Hall

A typical day in anatomy class began with 130 or so medical students, shuffling sleepy eyed into their small seats with swing out mini desk tops. They came bearing newspapers, coffee mugs, 3 course breakfasts, adorned in hair too long and shorts too short.  Bell bottoms, blue jeans, and baseball caps ruled the day.  I quickly assimilated by wearing my new Levi overalls. On the right side of the room (while facing the podium) was a sign affixed to the wall which declared “No Smoking This Side of Room.”  Now I must say that on the opposite side of the room I did not observe a lot of smoking but on more than one occasion I observed a student chewing tobacco and spitting into a large plastic cup during lecture.  The class of 122 consisted of 90 men, and 32 women– with a racial and ethnic composition of 1 black person, 3 Latinos, 7 Asian-Americans, and 111 Caucasians.  Forty-six of the men had mustaches, with the majority of those also sporting beards.  It was the prime of the disco period and it showed.

A portion of a newspaper containing the daily crossword puzzle would be passed around for each student to contribute. The instructors drew on a thing called a chalk board while some students tried to keep up on their yellow pads of legal paper. Audiovisuals consisted of carousels of 35 mm slides projected onto a pull down screen in the front of the room. On more than one occasion I observed a professor drop his entire tray of slides before lecture.  The slides would fly in all directions. Students and staff, eager to be helpful, would assist in reloading the carousel, but since slides needed to be placed upside down and reversed in order to be projected correctly, this usually resulted in much confusion and sore necks during the lecture.  These slide carousals also provided for the mischievous opportunity of inserting bogus slides into the lecture.  If a lecturer wanted to show a “film strip” he had to notify the AV department in advance so they could bring in a reel-to-reel projector, whose sound never worked and which often melted the film.

There were no computers or cell phones (two payphones were mounted outside the lecture halls).  Pocket calculators were the rage–and I even saw an occasional slide rule.  Virtually all students participated for 15 dollars in a co-op note club.  Each student would be assigned a lecture at which he or she would take detailed notes.  These were typed out, mimeographed and distributed to the entire class.

The lecture hall had a center aisle, but no side aisle.  As a result, students had to climb over each other to get to and from the end seats.  Furthermore, the floor slanted at almost 45 degrees toward the front such that a dropped pencil or spilled cup of coffee made it all the way down to the lecturer.  The lecture hall spanned two floors with the upper half flanked by the outer windows in a manner leaving a precarious eight-foot drop hidden by curtains– which on more than one occasion gobbled up a medical student like a bug in a Venus flytrap.

The Pub

There was a long, often leaky, run-down hallway that connected the medical school and hospital with the dental school, a dark tiny basketball court, an old theater, and the beloved pub. The pub served pizza and sandwiches and soft drinks for lunch during the week.  But, at 2:55 pm on Fridays, students, staff, and faculty could be seen with their tongues attached to the outside of the pub Read More »

The Past Today: A Southern Physician Visits the Mississippi Civil Rights Museum

By Suzanne Minor

At this year’s Southern Group on Educational Affairs conference, the University of Mississippi hosted an outing at the Two Mississippi Museums, consisting of the Museum of Mississippi History and the Mississippi Civil Rights Museum.

I focused my visit on the Mississippi Civil Rights Museum.  It was exhausting, difficult, heart-wrenching, and, in the end, hopeful.  Growing up in rural Georgia and Jacksonville, Florida, I witnessed legalized segregation through small private schools and experienced rampant racism as the norm. Thankfully, college and medical school broadened my perspective, particularly gross anatomy.  Once without skin, all of those black and white cadavers looked so similar.  Not better than or less than, but equal in skinless death.  I dove into former slave narratives, reading Frederick Douglas and trying to reconcile the message from my upbringing – that I was better than because I was white – with my new learning in gross anatomy and in my direct experience with people who looked different than me.  I was learning that we were all just human, no better and no worse than each other.  My professional career has been dedicated to attending to the medical and holistic needs of the underserved communities of Miami, Florida, a diverse area in which I’m in the minority.

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Closing the Door on the “Closing Doors” Metaphor: Reframing our Step 1 Advice

By Emily Green

Anyone who advises medical students about USMLE Step 1 will be familiar with the metaphor of “closing doors”.  Upon receiving their Step 1 score, worried students wonder if the sound they are hearing is the slamming shut of gateways to particular specialties.  The problem with the pervasive “closing doors” metaphor is that it presents career options as being either available or unavailable, with little in-between.  In a student’s mind, a score of 240 might mean that the door to a particular career is open, but a 239 means that it is closed.  Convincing students the wrongness of this thinking is a challenge.Read More »

Extension

By Tim Lahey

Every March I run the last required course at our medical school. It’s a three-week-long, 47-hour sprint – a sort of boot camp for professional formation. We polish clinical skills, revisit foundational sciences, let students pick from a menu of interesting tutorials, and discuss professional formation.

Students grapple with hypothetical gastrointestinal crises on scatalogically-named student teams. They resuscitate rubbery patients with various flavors of hypotension. I don a sparkly red bowtie to MC a game show called Antibiotic Jeopardy.

Throughout, we discuss the evolution of their professional identities. I ask how their idealism has changed during medical school, and every year over 60% say it has waned. We share the stories that shape us, and how they can stay true to the values that brought them to medical school in the first place. Then they hand in a tall stack of confidential essays that I reply to on nights and weekends right up until the day they speak the Hippocratic Oath. Read More »

Going the Extra Mile: A Med Student’s Marathon

By Shoshana B. Weiner

“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles.”  AKA how did you manage training for a marathon while in medical school?  The simple truth: I decided to run a marathon so I did.  Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.

Training for and running a marathon is a time-intensive commitment of physical and mental endurance.  Age-old lessons of “you can accomplish anything you set your mind to; hard work pays off” hold true and gained new meaning for me. Read More »