Assessing maternal health in Ethiopia

StudentSpeak is pleased to share this guest post from Elena Phoutrides, MS2, a student in the joint M.D./M.P.H. program. Elena is working abroad this summer in Tigray, Ethiopia thanks in part to the R. Bradley Sack International Scholarship and the OHSU Global Health Center.

It’s mid-morning: somewhat watery sunlight lighting up the bougainvillea, the appealing smell of fresh-roasted coffee in the air. Just about time for a coffee break here in Mekelle town in Tigray, Ethiopia.

I am fortunate to be working this summer with Healing Hands of Joy (HHOJ), a non-profit, nongovernmental organization based in Mekelle. HHOJ works with women who have experienced obstetric fistula; this condition occurs during prolonged obstructed labor, which creates a hole between the uterus and the bladder, the rectum, or both. The direct result of this injury is urinary or fecal incontinence. Indirectly, many women who experience fistula are traumatized and socially isolated as a result of the smell that accompanies obstetric fistula.

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Reflections from year one

StudentSpeak is pleased to share this post, reprinted with permission from Roheet’s blog, The Biopsy.

“What is your hand on?” the surgeon asked, her question punctuated by the whirr of the ventilator wheezing away in the chilly operating room.

I stood there for a moment, quietly, just trying to get a sense of my orientation. In reality, I knew just where my hand was placed. It wasn’t a trick question and it wasn’t particularly hard to answer. Part of me, though, just didn’t allow the realization to sink in. So, I stood there, searching for something more, something other than what my fingers obviously felt.

My mind stretched back to anatomy and embryology at the very beginning of the year for answers. Last August, everything, everyone, was new. My white coat was freshly white, uncreased, neatly kept, gleaming with my newly minted nametag – “Roheet Kakaday, Medical Student”. I had achieved the dream, but the promise had yet to be fulfilled.

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A year older, a year wiser

Almost a year ago to date I attended new student orientation as a very anxious and excited new student. I peppered the students going into their final term with lots of questions and eagerly awaited the first day of this program. Today, I was one of the “seasoned” students who was answering new student questions. I have less than 100 days until graduation. Approximately 300 clinical hours, 1 skills lab, 1 simulation, a few other random things and a test (that shall not be named) stand between me and those magical letters R.N. after my name. I think my greatest learning is yet to come this summer but today’s reminder of where I started got me thinking.

A student asked me today if it feels like last year’s orientation felt like forever ago or a blink and my answer was both. This program has absolutely flown by but I don’t feel like the same person I was when I started it so it also feels long that way. I’ve stretched and mushed my brain with new knowledge until it was coming out of my ears. My heart has constantly been full…hearing a refugee’s story, caring for a patient in a vulnerable moment, or just feeling so much passion for this work. I’ve picked up this new language that is nursing. I’ve incorporated so much into my definition of nursing. Teaching. Being present. Holding space. Translating. Safe guarding. Nursing is so much more than I initially envisioned and it really is forever evolving, especially right now.

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You know you’re a grad student when….PART DEUX!

I was going through some old posts – my little, growing collection of posts – and realized that some of them are just, well, kind of depressing.  That’s not to say grad school itself is depressing, or that I am even depressed. And then I found one of my all-time favorites ‘You Know You’re a Grad Student When…” I wrote that post in March of my second year. Those were good times – sigh. But now, on the flip side of third year, it occurs to me there are a few things that really, really should be added. So, without further ado…you know you’re finishing your third year of graduate school when…

1. Your PI has to confirm how many years you’ve been in lab because, well, it feels like you’ve been there forever (true story).

2. The post-doc who hates pink and Hello Kitty left to Taiwain for three weeks and you papered his bench with Hello Kitty as a welcome back treat (also a true story).

3. You haven’t seen some of your classmates since first year.

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Research by the day

In this place, every week is Research Week.

May is always an exciting month for graduate students because it is in May that OHSU Research Week annually falls. The modern manifestation of what was once called the Student Research Forum, Research Week is a time to see what other people on campus are doing, learn new things, lend support to fellow students participating in the 3 Minute Thesis, and hear from interesting keynote speakers. Despite my excitement for it my first and second year, I am a little embarrassed to admit that I approached this year with apathy. I made  a poster, I had a list of workshops I wanted to attend, speakers I wanted to see, but I felt settled – my project is running and experiments are competing for my attention. Was it really worth hiking all the way up from School of Dentistry just to see some poster topics with which my own has nothing in common?

But tomorrow is, of course, another day, and Tuesday proved a big one indeed. Student Day has been a favorite of mine every year because it is the day by students, for students. On a campus where the graduate student population is a dispersed force, Student Day has had a unifying effect in the past. This year, I was honored to eat with and introduce the Student Day Keynote Jeff Lichtman, PhD MD.  Lichtman is a pioneer of the emerging field called Connectomics, the study of comprehensive maps of connections within an organism’s nervous system. He is an innovator and one of the most approachable scientists I have ever met. I first saw him speak at Cold Spring Harbor, where he politely told the students in the Drosophila Neurobiology class that our research was pointless, that the invertebrate systems are done. A blazing example of scientific snobbery? One could argue so. An oversight of the fact that approximately 70% of proteins associated with disease have functional homologs in Drosophila? Glaringly so. An opinion akin to the cavemen saying “This wheel thing? Like that will ever be useful!” Truly so.

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The balm of presence

Some days are rush, rush, rush and then some days are like this one. I had set aside school for this one day so that stress never raised its head. I took time to visit with family I had not personally seen in a while. I took time with several people, being present and feeling their aura.

Reflecting on the type of day, it is hard to put a label on it that is adequate. I spent a little time with hubby before I had to set out on a day that had certain mile points but no real definitive pattern. That time with my significant piece of my heart was filled with humor, warmth and even after all these years, a continuing increase in the bounds of our boundless love for one another. This always amazes me but is a common, expected and joyful part of my days that always, always makes me smile. If you see a smile on my face for seemingly no reason, if you were to ask, don’t be surprised if I tell you of a moment of something whispered in my ear, a touch, a look, a shared aspiration or just another smile and the statement, “just a piece of my heart.”

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What do you think she meant?

On Monday morning, I was sick. I also had an immunology exam at 8am. Bristling from the cruel irony, I stopped at a Starbucks near the highway in yoga pants, a T-shirt, and my OHSU badge at about 7:30am. Red-faced from sneezing all night and baggy-eyed from attempting to study in that condition, I ordered a black coffee and waited miserably while my cup was filled. As I stood there, pathetic, a well-dressed, middle-aged woman approached me.

“What do you do at OHSU?” she asked, standing so close to me that I was acutely worried about spreading my germs. I told her that I was a medical student, and that I had an exam in just twenty minutes. She wished me luck. The barista handed me my coffee and I smiled politely and turned to leave, but the woman stopped me.

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Temoignage

This year I took “Conversations in Global Health” as one of my electives for the Graduate Programs in Human Nutrition. If you have not heard of this class, I highly recommend you take the 1 credit and attend. It is held once a week and there are incredible speakers who engage and excite you about their work in the global community. Dr. Kravitz also has pizza for the first 20 or so people, just in case you needed another bonus beyond the presentations. You can visit the OHSU webpage to find the latest calendar and recorded lectures.

As we wind down this year, we were asked to write a reflection about our experience and what we are inspired to do to help those in need. I thought I would share with you my experience in listening to Dr. Martin Smilkstein’s talk on his experience in war-torn Sierra Leone. I hope you too will find inspiration and think about your place and the tremendous impact you can have on the world.

Temoignage 

To  bear  witness

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Bearers of bad news

When your time consists mainly of recycling facts, it becomes surprisingly easy to transition into a binary state – either you’re learning, or you’re sleeping. While that operative mode allows us medical students increased efficiency, it also behooves us to reconnect with our more human sides.

Thankfully, once a week, we participate in a course called Principles of Clinical Medicine (PCM), or, as I like to call it, “How To Be a Good Doctor 101.” From week one, PCM guides us through the bigger picture of medicine, patient care, and how we, as future health care providers, can optimally function in it.

Recently, PCM tackled one of the more challenging topics for physicians – death.

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The safety net

As students we get to experience opportunities inside a safety net. This safety net allows us the comfort to expand our horizons and experience to better utilize the knowledge and skills we are building to go to work in the “real” world. Being recognized as students gives us room to make mistakes that are part of the learning process.

“It’s okay. They’re a student. They’re still practicing; they’re still learning.”

As we validate our competencies, consolidate our skills and knowledge, the safety net begins to peel back, exposing us more to the real world.

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StudentSpeak

StudentSpeak

Ever wondered what life is like as a student at OHSU? What does it take to become a researcher? Just how gross is gross anatomy? Welcome to the blog that answers these – and many other – questions. It’s students writing first-hand about their commitment to careers in science and health care. It’s honest about the challenges as well as the joys. It’s not always pretty. But it is our story. Thank you for sharing it with us. And please, let us know what you think.

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