All posts by Guest Writer

BGDMedS: Learning More Than Medicine

by Kayla Holston

“Kayla, you choose the music. You’re the most urban.” As a medical student at a PWI (Predominantly White Institution), I’ve become comfortable with being the only Black person in the room. From the engineering undergrad at the University of Virginia to the Master of Public Health at Emory University to now medical school at Thomas Jefferson University, PWIs have become quite familiar. But, whenever I forget just where I am and what assumptions I’m surrounded with, comments like this remind me.

My journey as a graduate student has been about finding out who I am when the security of undergrad has been torn away—who I am outside of school. Am I a yoga enthusiast, a family girl, or a travel fanatic? As it turns out, I am all of those. What I have discovered, though, is that I am also a pensive Black woman who can be disloyal to herself when it comes to confronting racism. And here’s how realized that:

At Thomas Jefferson University, our curriculum is divided into blocks, and each block focuses on a system (e.g., cardiology, pulmonology, neurology). During each block, we spend a few weeks dissecting Sally, our group’s human gift. One afternoon, two lab mates and I decided to go to the dissection lab while it was empty to re-dissect Sally as a form of studying. Since we were alone in the room, we decided it would be nice to play some music. That’s when it happened: “Kayla, you choose the music. You’re the most urban.”

All I could do was laugh. More of a crying laugh, but you know. I thought to myself, if Sally wasn’t here, I’d let you have it. Out of respect for her, I’ll shut up. That’s what I told myself but, honestly, I laughed because I wanted to make him feel more comfortable in a moment he had made uncomfortable. He laughed with me, and I became the “cool Black girl” who didn’t get upset over “silly jokes.’” Now he “jokes” whenever he sees me.

Being a Black medical student puts me in a weird place—I don’t want to be the difficult Black girl. Team learning is even more important here than in my past curricula, and I don’t want to ruin relationships with my assigned team members and then find myself struggling to group study with them. The comment my lab mate made illuminated a quality in myself that I am now grappling with. In academic situations, I tend to be conflict-averse at the expense of my mental health. I believe the reason is a combination of not wanting to hinder my learning (obviously) and not wanting to make situations awkward for myself and others.

I wish I could say, after this realization, I cut off every prejudiced person and clapped back to every racist remark. Still a work in progress. What I can say, though, is that I have become intentional about my mental health and the company I keep. I have embraced therapy for all facets of my life, began regularly engaging in mindfulness through yoga, and, most importantly, allowed God to be my center of peace. (Quick pause: Different approaches work for different people but, if you have not tried it yet, I highly recommend hot yoga as a healthy way to relieve stress and stay fit. But first, try God. Nothing will give you peace until that part is handled.)

Anyway, I have also become okay with the idea of a close, small circle. It is kind of crazy how we feel obligated to spend time with people just because we have in the past. I finally asked myself, why do you let this white girl (excuse me, white passing) keep talking to you like you’re stupid? Why do you voluntarily do Friday dinners with her? So, guess what? I. Just. Stopped. Not groundbreaking, but for me it was. I thought I needed to keep every friend I had because, if I didn’t, I wouldn’t have anymore friends and medical school is tough without camaraderie. Well, medical school is challenging either way, so may as well do it with woke people, even if there are only three.

So, what advice would I give to a future BGDMedS?

  1. Spend some time figuring out who you are because your identity will be illuminated and tested during this trying but exciting time of your life.
  2. Make a plan for caring for yourself before you get here. If you don’t, it probably won’t happen.
  3. Surround yourself with love and truth, nothing more and nothing less.

There are plenty of people who decide who I am before I open my mouth. But, even when I don’t know who I am, God is certain of my identity. So, I abide in him, embrace what He says of me, and care for myself. I hope you will too.


micahkaylagrad-23copuKayla Holston is pursuing an MD at the Sidney Kimmel Medical College of Thomas Jefferson University. Kayla earned a Master of Public Health in Health Care Management at Emory University and a Bachelor of Science in Biomedical Engineering & Cognitive Science at the University of Virginia. She is particularly interested in utilizing her educational background to improve patient flow and healthcare staff workflow in order to improve efficiency in understaffed health systems. Kayla’s current research focuses on improving quality and staff workflow in a Malawian health center in collaboration with Malawian medical providers and architecture professionals. Her second research focus is in orthopedic surgery, particularly with regard to how psychosocial factors affect hip pathology and postoperative outcomes. Professionally, Kayla hopes to blend the roles of a physician and healthcare administrator to continue projects like this, serving patients on both an individual and organizational policy level.

Deferred Maintenance

By Enjoli Hall

How and why I made healthcare my top priority in my first semester

Twenty-nine. The number of visits I made to a doctor’s office during my first semester as a PhD student. In any given week, my Google calendar was a fall-themed collage of classes, advising meetings, on-campus events, and doctor’s visits. Scheduling my doctor’s appointments was akin to a research assistantship—I mapped the locations of Black female primary care physicians. I analyzed what combination of dental procedures I could afford with my insurance benefits. I reviewed literature on the antidepressants recommended by a counselor. I wrote reports detailing my medical history on intake forms. I presented my life story to the six therapists I was forced to meet with in order to evaluate my request for an emotional support animal in university housing. While I couldn’t add these lines to my CV, perhaps I could add a few years to my life.

Some of the appointments I scheduled might be considered “routine” check-ups: annual eye exam, seasonal flu shot, pap smear. But many of the appointments were for managing chronic pain and depression. Sometimes, these appointments were not planned, such as impromptu visits to the urgent care clinic on campus for frequent headaches or toothaches. What nearly all of these appointments have in common is that they were the result of deferred maintenance. In my field of urban planning, the term deferred maintenance is often used to describe the practice of postponing maintenance and repairs on essential infrastructure to save money, balance budgets, or reallocate resources to address more immediate needs. For example, a landlord might postpone fixing leaky pipes in an apartment to save money in the short term. Or a local government might delay replacement of lead pipes in its city’s water system due to budget shortfalls. The cumulative effects of deferred maintenance can be catastrophic—an apartment building that could have been rehabbed now needs to be demolished; a city’s population is poisoned by its water supply with lasting public health problems.

Prior to starting grad school, I deferred diagnostic tests, annual exams, small procedures, and mental health therapy for years. I was a first-generation, low-income college graduate barely making ends meet in an industry and city that people don’t choose to make money. While I am adept at understanding the functions of macro social systems such as racism and the economy, I often struggle to navigate individual institutions and bureaucracies to get my needs met. I could not afford the co-pays, the time off from work, or the transportation to get to doctor’s visits of all sorts. Sometimes I tried to schedule appointments, but would get discouraged when the closest doctor was located over an hour away, open during limited hours, not accepting new patients, or did not take my insurance. These challenges are common when you live in a poor, low-density region serviced by an inadequate public transit network. Or when you grow up in a community that discounts mental illness as laziness or a bad attitude: “You don’t need a doctor, you need discipline. Your problems will go away when you get a better job or a boyfriend.

I internalized my mental anguish as of my own making and normalized my physical discomfort as a fact of daily life. In effect, I deferred maintenance on the mental and physical systems that sustain my well-being. As a result, what were cavities became root canals. The situational depression I developed in college spiralled into clinical depression—a mighty vortex that seemed to grow more intense with each post-grad job, relationship, and life event. And what might have been managed with months of counseling sessions, probably requires several years of regular therapy. At times, it is very difficult to reconcile the access I’ve had to some of the most elite universities in the world with the barriers I’ve faced to accessing basic medical services. I don’t know how to describe the feeling of sitting in a class and knowing your lived experience is the outlying data point of educational success, the case example of why we need multifaceted definitions of “access” that consider affordability, availability, and awareness in addition to physical distance. When your GRE score is in the 99th percentile, and so is your cholesterol level.

I am sharing my story not because I think it is unique, but because I suspect it is quite common in some ways. Despite increasing awareness of the academic, financial, and sociocultural challenges experienced by minority, low-income and first-generation students, I have observed a persistent stigma and silence around health issues. I understand the disincentives and potential penalties that students—especially marginalized students—may encounter in sharing these stories. Or even just saying to someone “I have depression.” Our position in these programs is often marked by precarity and presumed incompetence. We’re constantly expected to prove our basic capabilities to handle the rigors of advanced research to our peers and professors. Our admission was not enough; at best it was a professional courtesy, at worst it was a statistical accounting. We should be so grateful. Talking about mental or physical illness—how it alters the way we process information, the way we move through space, the way we structure our schedule—carries tremendous risk in a profession that rewards intellectual acuity and constant productivity.

Grad school is hard. But for someone like me, it means improved access to care such as on-campus, free and subsidized providers, health screenings, and wellness services that I could not obtain for the last several years. The services are not comprehensive and my stipend is not enough, but it is more healthcare and more income than I’ve had for years. So, I am making my health my top priority. I cannot afford to defer maintenance of my mental and physical health any longer. Because the grim reality is, if I do not attend to these issues now, I might not survive to the end of my PhD program. I know this is only the very beginning of months and years of chronic pain, frequent appointments, and unforeseen consequences, but I am grateful for the opportunity to repair. My pain might not be my fault, but I am responsible for my healing.


Enjoli Hall is a PhD student in the Department of Urban Studies and Planning at the Massachusetts Institute of Technology (MIT). Enjoli’s research is focused on racism, social inequality, and urban policy, and the impact of these forces on local government planning, policy, and finance. Her work focuses on cities and counties facing chronic poverty related to deindustrialization. Enjoli’s research draws on over five years of experience working with non-profits, foundations, and research centers in her hometown of Buffalo, New York. She has worked in a variety of roles in community development, ranging from adult literacy tutor to youth advocate to program officer to regional planner.

 

Should I Stay or Should I Go?: How I Came to My Final Decision to Leave My Full-time Job to Pursue Full-time School

by Ebony Davis

Happy spring semester to all of you GOATs out there on a journey to pursuing higher education! Whether it is a master’s or a Ph.D. program you are in, welcome to the chat. Over my winter break, I spent a lot of time pondering, questioning, reassuring myself, affirming myself, challenging my thoughts and habits all while in the midst of getting some serious well-needed rest (I literally drooled on my pillows every night) and catering to my inner adventurous self by having a little fun. The last two weeks of winter break consisted of me overthinking one plan of action: whether I should stay at my current full-time job or leave.

I currently work full-time at a social service agency in Chicago. The agency is a non-profit and is contracted through the Department of Children and Families (DCFS) here. My undergraduate degree is in Social Work and my graduate degree will be in Social Work as well. I have been working in the field for a little over a year now and my master’s degree program entails two full-time internships at two social service agencies all while spending time in class unpacking more layers of the field and what it means to be a social worker and working. All in all, my life is social work piled on top of social work piled on top of more social work and it has been that way for a while. Last semester, when my last class of the night was over, I was going home to prep and gear myself up to go to work.

Oh, did I mention I work during the day and overnights? My work schedule is pretty jam packed. I spend most of my time at work with the children I serve.

Well, over winter break, I started thinking to myself how different I wanted my spring semester to be.

First of all, I knew I wanted to switch over to being a full-time student, and I knew full-time work would not mesh with the demands of being enrolled full-time. This commitment resulted in me having to make a decision. A hard one. If I did not want to be exhausted, I knew I had to give up working in order to pursue and focus on school but my decision boiled down to a few things:

  1. I knew I was never happy with where I was. The pay this place started me off at was terrible. I literally had money to pay ONE bill a month, which was rent. Aside from that, it was just me consistently living check to check for the first five months I lived in Chicago. That feeling was miserable. Having to divide up my check to see which bills were going to get paid in a month and which were not was probably one of THE most humiliating things I have ever experienced. Do not be like me and settle for something like this.
  2. The work environment was extremely toxic, distracting and unhealthy. You all don’t know, but my friends heard how much I wanted to leave every single day. It was so hard trying to ‘do the right thing’ and serve a vulnerable population in the midst of unwarranted chaos. Drama between staff unfolded every day and some of the employees were borderline verbally abusive to the youth at this agency. It started to become concerning, and no one seemed to see that there was anything wrong.
  3. The final reason why I decided to leave and knew that it was time to go is because I never felt supported at my job. Yes, there were good days, but I took it hard when I was not receiving adequate supervision and support from my team. It’s like everyone was just stuck on ‘DUH’ and did not care about growth and the effectiveness of how the agency is run.

Even with these reasons in mind, it STILL was hard to leave the job. I felt so much resistance and through myself for a loop every time I got ready to submit my formal notice. A lot swayed my decision. I thought about that flow of income I would be cutting myself away from, I thought about my bills, I thought about what would happen to the children I served and worked with and how my decision to leave would affect them, and I thought about what people would say about me.

When my mind started to become heavy, I prayed and asked God to send me a sign or vision that would reveal the best decision for me. I prayed over my sanity and mental wellness and asked God to remove resistance and remind my mind and body that I am okay currently, and I am going to be okay in the future. I prayed about the contemplation and unrest the decision to stay or go was causing me.

Ultimately, God gave me a sign. He gave me a sign a long time ago and He is giving me another sign now. I am writing this because this is your sign. If you are not well because of a job, leave. If you are pursuing school and work full-time and cannot seem to find time for yourself, your children, your family or your partner, leave. If you have been putting off taking care of yourself for a job, leave. If the work environment is toxic and you do not see growth, leave. Because 1) the work you are putting in now, while in school, is going to create and expand opportunity for you. 2) Work will always be there, for all of us. Our peace, sanity and joy are things you and I cannot afford to sacrifice anymore.

You are still a Queen if you choose to leave. It’s going to be okay.


download (2)Ebony Davis is a 23-year-old from Kansas City, KS. She recently relocated to Chicago, IL to embark on her graduate school journey, and pursue some dreams she has had in mind for herself. She attends Loyola University Chicago, and is in school for her master’s degree in Social Work. She has been working in the social service field for a total of four years now, and she feels like she right where she needs to be.

Working in this field is her calling. Ebony enjoys being a source of support to other people, and she loves challenging and uprooting individuals into the very best version of themselves. Aside from all the social work she does, Ebony also writes and has been writing since she can remember. She enjoys journaling in her free time, and is working toward being a freelancer all 2020.