Vulnerability and Where to Find It: A Doctor’s Tale

Medicine

Some patients we never forget.

She was a middle-aged white woman with brown hair and arms only a frequent gym-goer could possess. She walked through the clinic doors accompanied by her newfound love—newlyweds. My attending physician introduced himself and then it was my turn as the third-year medical student on the rotation.

She smiled in response, followed by a courteous, “Nice to meet you.” 

I had perched myself at the corner of the room against the sink at the base of what appeared to be an isosceles triangle. I was one of the bases, the neurology attending the other, and the patient and her husband represented the tip.

Here, I observed from my perch.

In her next few sentences she described how one morning, upon awakening, she noticed she was slurring her words of which she attributed to the notion of having suffered a mild stroke. In her mind, how could it be anything else? She was in her early 50s and unlike many of her friends she maintained a strict diet, a daily gym routine and a mentality to match. 

After multiple questions, some mild laughing with intermittent smiling even, the neurologist paused. He clasped his hands together as he let out a slow breath of air. 

“I firmly believe you have Amyotrophic Lateral Sclerosis (ALS), and the slurred speech is the beginning of this process. This is not a stroke, I’m sorry.” 

I do not know which came first—the hopeless shriek or the cascade of tears. She knew she had just been given a death sentence and despite her husband’s best efforts there was no consoling her. A tear fell from my left eye as I quickly tilted my head back looking up towards the ceiling hoping gravity would play an effect and somehow the tears would roll back into my head rather than onto my white coat. From the actions and demeanor of my attending physician it was evident he had given this news before—one too many times. Two thoughts filled my mind as sadness filled the room. 

First, I thought about the disease process itself, which I had read about the night prior characterized by “a progressive loss of motor neurons in the brain and spinal cord.” ALS is a progressive, disabling, and ultimately fatal disease of unknown cause starting with a gradual muscle weakness and wasting in the upper and lower extremities, muscle fasciculations and inevitably difficulty swallowing, phonating and breathing.1 This degenerative process continues until respiratory failure will most likely claim her life as it has so many before her.1

As my attending and I stood there watching her cry, the clock stood still. 

Why her? As time stood still, I kept asking myself. Why not her husband? Why not my attending? How would she spend her remaining months before the disease would cripple her into a wheelchair and the permanent requirement of mechanical ventilation would ensue? 

As physicians, too often, we are sculpted to believe we are invincible. We care for others at their most vulnerable time and it is always them—that is the vernacular. The patient’s tears made it clear she was not ready for such a diagnosis; she was not ready to die. I do not know if in the moment she was frightened by the certainty of death or death was far superior to the alternative life that awaited her. 

I, too, am scared of death. I am scared of being forgotten. After an obituary in a newspaper, a funeral, stories shared, beautiful words produced and dark clothing worn with covered eyes, life continues for everyone except the deceased. I wonder if any of these thoughts coursed through her mind at a rate similar to her tears.

Once her tear ducts seemingly dried up, she asked how she could obtain a second opinion. The attending told her he recommended she go to the Cleveland Clinic if she desired. She gathered her things with one tissue in hand and bloodshot eyes. As she stood up, my attending, gave her a hug she most deserved. A hug I will never forget. Once we were alone, he asked me if I was ok? “Yes, I’m ok. Thank you for asking,” I promptly replied. I thanked him for allowing me to join him in clinic then quickly left. 

I went to my car and I cried. 

I had lied. 

I was not ok. 

References:

  1. Zeller JL, Lynm C, Glass RM. Amyotrophic Lateral Sclerosis. JAMA. 2007;298(2):248. doi:10.1001/jama.298.2.248

Is the Road to Becoming A Physician Still Worth It?

adversity, medicine, Mentorship

In a simplistic answer, “Yes, it is. But it won’t be easy.” As my former track and field coach would tell me before an arduous workout, “If it were easy, everyone would do it.” Many are drawn to medicine with an affable desire to help others, but this task has a significant weight associated with it. Sadly, the mental anguish may lead some physicians to tell hopeful doctors that they should turn away and pursue a different occupation forgetting the excitement and enthusiasm they once felt. 

Naturally, over the course of a time period there are certain parts of our lives that change. One day you fall asleep at 20 years old, and the next day you wake up 21, now considered legally responsible enough to drink, gamble or even adopt a child. In contrast, the road to becoming a doctor is a long series of intentional and mindful decisions. Few of these decisions are big, some are medium and unlike the television shows most are small and boring. If you’re reading this you may wish, as I think I did at times, that we could instantaneously wake up a physician. But, the beauty in becoming a physician is in transforming into the version of yourself that will best fulfill this life of service. This becoming requires sacrifices in the form of no; no to certain parties, trips, weddings, and relationships. Instead, one will say yes to long, unappreciated and unapologetic hours with concomitant late nights in windowless rooms surrounded by books instead of people and silence instead of noise. Sometimes, I said yes to the no decisions and years later had to work much harder to make up for those responses. Furthermore, there are also decisions one will need to make during moments where we are no longer in control. 

Writer Anne Lamott, once penned, “When God is going to do something wonderful, he always starts with a hardship; when God is going to do something amazing, he starts with an impossibility.”

From a post-baccalaureate, non-traditional, student studying in a Starbucks coffee shop in Manassas, Virginia to addressing the audience as student body president at the Ohio State University College of Medicine graduation I had to navigate my failures to arrive at my successes. However, each piece of adversity I faced sculpted me into a more compassionate and understanding person and ultimately a better physician.

The first African American patient I treated, sixty-years in age, told me he had never seen a physician who looked like me—like us he meant.

If this dream will make you happy and give you the life you desire, then this field is for you. No one can answer this question for you, and no one should. The time will go by regardless. One day I walked into the auditorium for my first medical school course. The next, I was performing a nasal intubation in a patient with severe Down’s Syndrome readying the patient for the dentistry team to extract his diseased teeth. There is nothing like what I see or do on a daily basis. It is simply amazing, frightful, enlightening and humbling all in the same breath. As I said before, “Yes, it is worth it.” But, it’s up to you to decide that for yourself.

Commentary: Father’s Day and the moments stolen from too many black families

Fatherhood, medicine, Mentorship, Race

Originally published in Chicago Tribune, June 18th (online) & June 19th (in print), 2020

I once attended a funeral where the pastor asked the audience, “How do you continue to believe in God when your father has been taken from you?” I did not have an answer as I tried to pat my eyes dry with the few crumpled tissues I had.

For me, this Father’s Day will be another annual occasion where I will pick up the phone and on the other end will be the voice of a kindhearted, compassionate and articulate man. I will wish him a happy Father’s Day, and when I ask him for details of his plans for the day he will note that a day of relaxation awaits him. Next, he will inquire how things are for me with an unparalleled yearning, and once he has been informed of any new happenings an exchange of “I love you” and “See you soon” will conclude our conversation.

Yet for some, Father’s Day has become unrecognizable from the celebratory day it once was.

Ask Michael Brown’s father, Mike Brown Sr.

In America, black men are rarely seen as innocent and are sometimes even invisible.

Wearing my cloak of visibility — a doctor’s white coat — I kneeled on the ground recently with my head bent over in prayer and protest for 8 minutes and 46 seconds. The hardened and unforgiving cement left me wanting to change the position of my knee to lessen the discomfort, but I refused. Out of my periphery I saw other protesters switch their dependent leg. Some stood up, while some began to kneel on both knees to soften the unilateral pressure on just one.

But some pain cannot be lessened. The image of George Floyd with the knee of another man pressing into his neck — the man’s hands casually in his own pockets as he balanced himself on Floyd’s neck — is one. “Please, I cannot breathe,” he cried out prior to calling for his mother. Floyd’s words reverberate those of another black male, Eric Garner, who in 2014 was killed under police custody while uttering the very same last message. This is another example of a transformed Father’s Day that will never be what it once was.

Ask Ben Garner — Eric’s father.

Growing up, my family went to church almost every Sunday, but especially on Easter, Mother’s Day and Father’s Day. I’d be the last one to get up but after a shower and dressing in my Sunday’s best I would rush into my parents’ room —tie in hand. I would pass the tie to my father, and he’d stand behind me slowly crossing one end over the other. Then he would come around in front of me prior to securing the tie and sending me to admire the wonderful job he had done.

When I played soccer, if I looked to the sidelines there he was sporting his vest and transitional lens eyeglasses — the one where the lens changes to dark when one steps outside into the sun. I am sure those eyeglasses earned him the nickname “Mr. Cool McCool” by my teammates.

And, as I walked across the stage to receive my medical degree, I distinctly remember hearing, “Go Dr. J” coming from his seat. The joy of watching his son become a physician, when his own father could neither read nor write, is a moment I am sure he will never forget.

These are key moments that fill picture books, but for some families, those books will be left empty: Rayshard Brooks will not be there when his daughter scrapes her knee while learning to ride a bike. Ahmaud Arbery’s father will not see his young man become a father himself one day; he will forever be frozen at the age of 25. George Floyd will not be there to screen his daughter’s potential boyfriends as a rite of passage that encompasses being a “girl dad.” Michael Brown — 18 years old — had an entire future lying ahead of him with countless Father’s Days, but his father will only have the memory to replay of that smile that used to walk in the door — Skittles in hand.

We cannot go on like this. It has taken a once-in-a-lifetime mix of events: a pandemic, economic fears, political polarization and an untimely murder to clear the opaque lens through which society views us to see that we are and deserve more. This is the time to see the exhaustion in the hearts of black families who have to watch as another Father’s Day is altered due to racism and police brutality. And, we are tired.

Ask George Floyd’s 6-year-old daughter, Gianna.

Jason L. Campbell, M.D., M.S., recently known as The Tik Tok Doc, is a physician resident in the Department of Anesthesiology at Oregon Health & Science University in Portland, Oregon.

Growing up a Black man in America: Why our souls are on fire

Race

June 1, 2020 at 2:19 pm, Special to The Seattle Times

I was 7 years old when my mother yelled at me, “Stop. Listen. Stop. If you don’t start listening to me, then you’re going to get yourself killed one day. Because the cops will only say stop once.”

Like many young boys of color, the only thought I had in that moment was for my mother to release me from her tight grip and allow me to continue on my way. Many years later, many shootings later and many deaths later related to police brutality, America is at a tipping point. The souls of men of color are on fire much like the buildings and streets of America. America’s truest colors are showing, and it is a frightening sight.

In 2016, I sat in one of the largest football stadiums in the country. As the national anthem began playing, Colin Kaepernick was mocked for kneeling peacefully against police brutality only moments before the same men applauded the Black athletes whom Kaepernick symbolized. Yet another example of how being a Black man in America can feel as though our actions are continually viewed as incorrect. Protest peacefully? Wrong. Protest with violence? Wrong. On the athletic field, we are viewed as equals, but in society this bar of equality has been fractured and, some might argue, destroyed.

When and how does inaction change to action and listening result in transformation? I sit with the rage of my Black community, and I march with the nonviolent protesters. I write with no distinct answer, but there exists a perpetual myth that halts the conversation of progress: Only certain Black men become the result of such police brutality. I assure you that what has occurred with George Floyd or Ahmaud Arbery can happen to me or any male with my skin complexion. Understand, we as Black men are not given the benefit of the doubt. When I leave my home, I do not walk around with a sign that reads, “Dr. Campbell, former student-athlete at Emory University, Graduate & Former President of The Ohio State University College of Medicine student body, M.D., M.S.”

I am just another Black man.

In 2011 — as a recent graduate of Emory University and AmeriCorps member — I had just dropped my girlfriend off at her home in northeast Washington, D.C. I was driving my mother’s Lexus sedan when I fell asleep at a red light — exhausted from a 60-hour week of service. Five seconds later, I awoke. I lightly pressed my foot on the gas pedal and began advancing through the red light a moment before it turned green. As I recognized my error so too did the police officer in his car. Understandably, he pulled me over. It is what happened next that puzzled me. An Asian-American officer approached me. I was wearing a Ralph Lauren jacket, button-downed collared shirt and slacks. I provided him my ID and registration. He ran the plates. I explained it was my mother’s car, and then he asked, “Do you have any weapons in the car?”

“No,” I responded, calmly. “Mind if I check?,” he asked.

“Not at all,” I said as I stepped out of the vehicle. He dropped to one knee and looked under the car seat while reaching his arm as far as he could. He then stood up, handed me my ID back and wished me a good night. In reading this there will most certainly be a level of anger toward either my willingness or my inaction of combating his prejudice at the moment. However, a compliant voice then now allows for a provocative pen. I was alone, on a dark street in the middle of the night. It was the police officer and me.

I was just another Black man.

The concept of anti-racism has newly emerged through the weeds of complacency. This concept is the only way to move forward as a non-Black ally. The moving walkway of discrimination, prejudice and bigotry favors the racist and standing still places one in this jurisdiction of hatred. To antagonize their message, one must walk by actively fighting, disrupting and dispelling their racist tones — both overt and subtle.

In the book “The Fire Next Time,” James Baldwin wrote, “You were born into a society which spelled out with brutal clarity, and in as many ways as possible, that you were a worthless human being …”

When one watches the video of George Floyd on the ground with another man’s knee pressed into his neck, it is nearly impossible for these words not to haunt one with a distinct level of truth and accuracy. Irrelevant of profession or walk of life, we deserve an America that gives us the benefit of the doubt or at least an America that allows us to breathe.

Dear Anxiety: But Still I Stand

medicine

I scurried across the campus to the bricks that housed the Department of Psychiatry. Sneaking in the back door, I hurried to the elevator. Fifth floor, the sign read. Sweat coursed down my back as nerves ran up my spine. A conversation with this doctor was going to determine if I would be allocated an additional four to six weeks to study for my step one board examination. This is the board examination one must pass to transition from a second year to third year medical student and begin clinical rotations in the hospital. That is what they tell you. They do not tell you this is the score that almost entirely dictates what type of physician you can become. A lower score on this exam and Ear, Nose and Throat (ENT), Orthopedic, Cardiothoracic, and Plastic surgery are subspecialties you can surely kiss goodbye because these residency programs will likely never see your application.

In the corner of the waiting room, I hid behind one of the partitions set up to enhance patient confidentiality. The psychiatrist greeted me prior to ushering me into his office. A dimly lit room, a couch and two chairs welcomed me. This felt more like an audition than an appointment. My heart was not beating, it was throbbing.

Globally, approximately 1/3 of medical students are being treated for anxiety or have been diagnosed with anxiety by a clinical practitioner. For me, I had never experienced anything like this before; sleepless nights, a lack of appetite resulting in substantial weight loss, an inability to focus, tears streaming down my cheek for no apparent reason and an unending catastrophic feeling surrounding my studies and upcoming exam. At the time I felt alone. Many years later I have come to know there are many who share this story.

At the conclusion of our visit I thanked him for his time and left down the elevator and out into the cold Midwestern evening. Staring into the distance the Ohio Stadium stood proud, a gladiator’s coliseum, while a shell of myself stood frozen in the night. He would either agree these symptoms were inhibiting my studying or he would not. The fate of my future was in his hands—this man I had only met only 60 minutes prior.

The next morning my cell phone rang.

“…We are granting you four additional weeks for your studies…”

In his report, the psychiatrist had noted the anxiety levels I was experiencing dramatically hampered my ability to adequately study.

A sigh of relief set in.

The throbbing within my chest had now decreased to a dull roar that would allow me to finally sleep for the first time in weeks. I made my way to the couch and as I began falling asleep, my mind started retracing my steps to medical school.

Abruptly, I woke up to my cell phone ringing. This time it was the pharmacy—my new prescription for anti-anxiety medications was now available for pick-up.

The journey to medicine is unique to each individual who embarks on it. One commonality is that it indirectly teaches success through repeated adverse conditions and failures—it teaches perseverance. Many of the leading educators and clinicians I have met in this sphere maintain an intrinsic motivation that far outweighs their innate level of knowledge. This intrinsic motivation increases their aspirations, knowledge and purpose; aspiring to serve as a physician, understanding that knowledge precedes healing, and a purpose dedicated to caring for others.

In essence, these men and women are the ordinary ones. They are you and me. They were once pre-medical students with a dream who became medical students embarking on a journey, then resident physicians gaining the skills and knowledge to become attending physicians. Ultimately, these attending physicians continuing to turn dreams into reality for anxious pre-medical students.

This is the journey.

Commentary: Off the court, LeBron James’ vital role as father

Athletics, Fatherhood, Mentorship, Race, Sports

Originally published in Chicago Tribune, Feb 17, 2020

“I am invisible, understand, simply because people refuse to see me.” The remarkable line from author Ralph Ellison’s book “Invisible Man” may seem hard to apply to LeBron James, a 6-foot-8 African American man known for his unparalleled athleticism on the basketball court. But, for a father with unmatched enthusiasm for the success of his sons, society has struggled to view James as the loving dad that he is.

Nevertheless, slowly he is silencing the belief present in society for many years that black men do not play a role in raising their children.

James’ enthusiasm at his son’s basketball games has been seen as juvenile, outrageous and childlike to some who refuse to see the love, compassion and fortitude in his movements. I remember as a young athlete looking into the stands and seeing my father — a validation of my dedication and being. In a similar manner, I suspect James is teaching his sons one of the most important lessons my father taught me: The world is full of opportunities for you to discover, and if you must, to create.

LeBron James, who then played for the Cleveland Cavaliers, celebrates with his sons LeBron Jr. and Bryce Maximus after defeating the Atlanta Hawks during the Eastern Conference Finals of the 2015 NBA Playoffs on May 26, 2015, in Cleveland, Ohio.
LeBron James, who then played for the Cleveland Cavaliers, celebrates with his sons LeBron Jr. and Bryce Maximus after defeating the Atlanta Hawks during the Eastern Conference Finals of the 2015 NBA Playoffs on May 26, 2015, in Cleveland, Ohio.(Gregory Shamus/Getty Images)

In 1972 a young black man, trunk packed and ticket in hand, boarded a bus headed to Philadelphia. For the first time in his 18 years of life, my father, Thomas Campbell, was leaving home in pursuit of a college degree — the only one of his siblings to do so. One of eight children, born into modest beginnings, my father persevered to college at a time when only 20% of black men had achieved more than a high school diploma. This was only the beginning, as he persevered to earn a law degree.

 

Forty-six years after my father embarked on his journey, I climbed six shallow steps to receive my medical degree. In that very moment, what I struggled to understand is what my father must have felt as I was declared “Dr. Campbell.” Growing up with a father who could neither read nor write, it must have been unimaginable for my father to believe he could cement a path for my sister and me to earn five degrees between the two of us.

 

But, in actuality all of my father’s actions have continuously encouraged my sister and me to pursue opportunities he never had. Thus, the magnificence of our achievement truly belongs to him. Similarly, James continues to inspire his sons to not only dream but to believe in the realism of their dreams.

LeBron James and my father serve as shining examples of the many black fathers who have created a future for their sons to change the world — a far cry from society’s vision for young black men. These fathers exemplify a view of the world where the finish line is not dictated by the starting line, but is full of boundless direction and achievement — and is not tied to skin color.

Once criticized for their invisibility, our black fathers are now visible, illuminating their brilliance for the world in a way they always have — for us.

Why I choose to spend Christmas in a children’s hospital | Op-Ed

Race

Special to The Seattle Times, Originally Published Online and In Print (December 23, 2019)

On Christmas morning, many children excitedly race downstairs chasing the smell of  fir and are presented with an adorned tree and piles of wrapped gifts.

For kids in a children’s hospital, there is no fir smell, no tree to call their own and no racing. However, it is still a special day within the walls where smiles, laughter and joy are remembered.

Nurses walk around with Santa hats while administering medications. Christmas cookie decorating occurs down the hall in the arts and craft room if a young patient can make it in between uncomfortable procedures. “A Christmas Carol” is scheduled to play that night in the movie room. Similar to the snow outside, it is one day in the year where fears and stressors melt away as families enjoy this special time.

Reality is never far, though, and it is not uncharacteristic during the holiday season to find a hospitalized child with a disease called cystic fibrosis. Cystic fibrosis, or CF, is an inherited disease affecting mainly the lungs and digestive system. It produces a thick mucus that often clogs the lungs and obstructs the pancreas, making it difficult to breathe, causing lung infections and preventing normal digestion. As a result, the children’s hospitals becomes a second home, especially during the winter season, when respiratory diseases are in full effect, and where these young boys and girls can receive antibiotic therapy and other treatments.

On a Christmas-past morning, a stethoscope around my neck and a matching red Santa hat covering my head, I walked into Sarah’s room — a young girl with cystic fibrosis. Boughs of holly were laid above the head of her hospital bed. Her outline under the covers was made visible by Christmas lights her parents had strung up just a few hours earlier — orange, red, green and blue beacons of hope shining bright. But now, all was silent, as her father’s prayer-filled body lay asleep on the bed adjacent to her. In hopes of not waking up Sarah or her father, I slowly closed the door. Right before the door shut, I caught a glimpse of her Christmas list, which only had one item on it.

Sarah’s Christmas list: “1. A new lung for breathing.”

In actuality, Sarah needed two new lungs. Even with a lung transplant, her life expectancy is still much shorter compared to the general population. A few hours later, as I returned to Sarah’s room, a huge smile sprawled across her face as she was shaking in her chair undergoing vest therapy — the treatment needed to break up the mucus in her lungs — as the Christmas classic “Sleigh Ride” filled the room. One can imagine life is hard for these children living with chronic illnesses, but these are some of the most resilient boys and girls you may or may not ever meet.

Dec. 25 is the one day of the year families get to focus on their child’s happiness instead of the financial burden or the fear of their child’s disease. It is a day of gratitude to spend one more Christmas together as a family — a recognition that next year is not guaranteed. The exploration of gratitude and appreciation should not be seasonal, and Sarah reminds us that every week, day, hour and breath we take, matters.

This is why I choose to spend Christmas in a children’s hospital.

Pay Collegiate Athletes If It Is Tied To Their Education: Former Black Student-Athlete Turned Physician Weighs In

Athletics, Race, Sports

There is a script I continue to watch unfold: A young African-American male heralded in college as an elite athlete raises large amounts of money for his university. He then leaves this Mt. Olympus-esque world prior to obtaining a degree for the dream of playing in the National Football League. A few years, seasons and many injuries later this same young man is 30 years old, financially unstable with little to count for his past triumphs but some old newspaper clippings, ESPN highlights found on YouTube and unending aches and pains in his joints. I propose that if the NCAA provides financial compensation under a strict framework of academic compliance and encouragement, multiple issues can be resolved. I am a 30-year-old African-American medical school graduate, a current resident physician, and a former division III track and field All-American.

In 2011, I graduated college and returned to my hometown of Washington D.C., while a savior was moving in from Waco, Texas. Robert Griffin III the former Baylor University QB—nicknamed RGIII—had just been drafted #2 overall by the Washington football team. Each Sunday he had the crowd roaring, game after game, night after night, under the lights and loudspeakers. He was the second most popular person in town next to then President Barack Obama. Years later, as RGIII and I—nearly identical in age—look into the future, divergent futures stare back at us as his career lights are dimming while mine are beginning to illuminate.

Recently, California Governor Gavin Newsome signed the Fair Pay to Play Act allowing collegiate players to be financially compensated for name recognition and to hire agents beginning in 2023. If one steps back, this bill can serve as an opportunity to embolden student-athletes to increase their academic focus for a more enriched future. The financial burden for some players and their families is evident and demands consideration. For many of these families, they send their sons to elite football powerhouses with the hope of winning a national title and the goal of one day playing in the National Football League changing their familial financial landscape. The Fair Pay to Play Act or any bill of this magnitude can be utilized to promote academic compliance through financial compensation. Enforcement of class attendance in conjunction with assignment completion would hold these players more accountable. I propose there be an allocated amount of money a player be eligible to receive on a weekly basis. Yet, missed classes or assignments would result in a weekly reduction or removal of the financial stipend. Daily, the notion of a student-athlete loses its values with certain sports as institutions refuse to hold their student-athletes accountable in the classroom as much as the coaches are holding them responsible on the athletic field.

In 2015, according to Tuscaloosa News, Alabama’s football program earned nearly $46.5 million for the school during their 2015 championship season. Shockingly, this number was nearly $7 million less than the year prior. In the same breath, the organization pushing vehemently to deny these young men the chance to profit from their dedication—the National Collegiate Athletic Association, or NCAA—averages nearly 1 billion dollars in revenue annually. These earnings come from exposure and marketing derived from competition and winning, from the coaches who recruit the talent, and from the talent who sacrifice their beings and future. Financial compensation based on academic compliance would allow the players to send money home to their families, to save money and most importantly to better invest in their futures through educational attainment.

I can no longer bear to see former student-athletes holding onto memories everyone else has forgotten not daring to dream of more for their futures. Most NFL players have finished their career by age 30 with no college degree, dismantling financial instability and lasting damage to their bodies. This has to change. There needs to be more retired NFL players becoming businessmen, news personalities, and even coaches. A bill of this nature can create this narrative for these current and future young men. The compass needs to be realigned moving from viewing athletics as the highest point of ones life to utilizing sports and academics to more lifelong achievements.

The importance of sports and athletic prowess is not in question but without a push for education, we are the hurt ones—the men of color.

Writing A Personal Statement: Who Are You and Who Do You Want To Be? Tell Me!

Mentorship

Every time I hear someone mention they are lacking a mentor or guidance I cringe. One of the true disadvantages in this world is having no one to call a mentor. Many applications require personal statements and without guidance this part of the process can be very daunting. I hope my personal statement from 2018, below,  for a residency position in a department of anesthesiology might help. Here’s my essay:

My first experience under general anesthesia was terrifying. A whirlwind of emotions taunted me as I laid in the pre-operative suite. On one hand, I was excited to finally get my torn labrum repaired; however, I was anxious about the anesthetic aspect of the operation. The anesthesiologist also recommended a nerve block to help with postoperative pain control. Even as a first-year medical student, attempting to understand lower extremity anatomy and the mechanism underlying local anesthetics was unnerving. Despite feeling unsettled due to my limited knowledge of the procedure, the anesthesiologist gained my trust only after five minutes of interaction. His demeanor, empathetic manner and smile—a very caring one—gave me the desire to pursue a career in anesthesiology. I admired his ability to swiftly ease my fear of receiving general anesthesia. This reminded me of my experience with AmeriCorps (City Year DC) in which I worked countless hours with students on various English and mathematic assignments. During my year-long experience, I helped the students grow more comfortable with their studies, their public speaking and increased their desire to learn. This service year required many hours of multi-tasking, working as a team player, and working well under pressure. These attributes will translate into the field of anesthesiology, allowing me to excel.

I have known for a very long time that I wanted to be a physician, yet I was unsure of which specialty.

Following my surgical clerkship, I began a rotation at Nationwide Children’s Hospital in pediatric anesthesiology. I love children thus I entered this rotation excited for the opportunity to serve this patient population. Small in stature but powerful in their own right, the pediatric patients undergoing surgery left a lasting impression. I realized that caring for the pediatric population is more than an “interaction.” The young boys and girls were scared as they minimally understood their situation except that they were being separated from their parents. The ability for the anesthesiologist to simultaneously calm these patients while placing the parents at ease was nothing short of an art. In a way, the pediatric anesthesiologist is forced to bridge the gap of the health care provider and friend. This evidenced the notion that trust is not earned by who we are but rather by what we do. I watched as Dr. Whitaker sat on a patient’s bed and inquired about the name of the stuffed animal she was cuddling tightly. She did not care too much about Dr. Whitaker’s occupation, but rather her newfound excitement was directed at his most recent question. At that moment–eager to experience that same level of patient interaction one day–I began contemplating a career in pediatric anesthesiology.

The pediatric patients from Nationwide Children’s Hospital shaped my desire to not only serve, but illuminated how a life in service to children is a life worth living. It is incredible to fathom that the face of the anesthesiologist is the last and first person a patient sees before and after a surgical procedure, respectively. Although–quantitatively limited in patient interaction compared to other specialties, from a qualitative standpoint an anesthesiologist’s interaction highlights the importance of compassion and enthusiasm. These are qualities that I possess and will afford me the ability, if given the opportunity, to fully care for my future patients. This specialty will allow me the flexibility to pursue being a highly competent clinical-educator, to conduct minority health disparities research analyzing anesthesia-related outcomes on various ethnic populations and to augment the relationship between anesthesiologists and surgeons to improve the overall patient outcome. Observing Dr. Whitaker and the pediatric patients has shaped my desire to pursue a career in the field of anesthesiology.

 

 

The Importance of Five Minutes

anesthesiology, medicine

Originally published in July 2019 edition, ASA Monitor (citation below)

‘Unexpected death of a colleague,’ I read in the subject line.

As I combed through the remainder of the email, I came to learn that a second-year resident had died in a car accident near his hometown. It was his name that gave me pause.

Just a few weeks prior, I entered one of the campus cafeterias for a meal. There, I noticed a young man sitting alone wearing a navy-blue jacket. A University of Pennsylvania Perelman School of Medicine crest was stitched on his chest.

“Hey, man – I happened to notice your jacket. Did you attend UPenn?”

“Yeah, I did. I’m Joe! Nice to meet you.”

“It’s nice to meet you, too. A few of my closest friends also graduated from there!” I replied.

A conversation started, just pleasant banter that danced around the east coast versus west coast biases, shared colleagues and friends, Portland’s city designation with its small-town charm, and our respective medical specialties. The dialogue was short but delightful and lasted approximately five minutes in total. Before I left his table, I suggested we take a photo together to send to our mutual friends.

Our smiles are in my phone now.

In the five minutes when we spoke, a connection was formed, a foundation of trust laid. Unlikely as it seemed at the time, this simple exchange was similar to the swiftly created bond that forms when an anesthesiologist talks to their patient prior to surgery.

When I was a fourth-year medical student, I told my family and friends that I had applied to an anesthesiology residency program. Their responses varied. Most were happy but they had questions too, specifically concerns that my communication skills would be “wasted.” Knowing how much joy interacting with people brings me, they were disappointed that I would spend most of my medical practice with unconscious patients. My answer: there is a unique responsibility born in that five-minute interaction prior to surgery. In those five minutes, I may have the ability to connect to a patient, gain trust and portray a sense of safety to a complete stranger in a way someone else may not. My communication skills could be the difference between someone entering the operating room with wild fear or measured ease.

When I was a fourth-year medical student, I told my family and friends that I had applied to an anesthesiology residency program. Their responses varied. Most were happy but they had questions too, specifically concerns that my communication skills would be ‘wasted.’

I am not alone in feeling this way. “I have five minutes to convince someone I can take care of their life,” Dr. Marshall Lee – Oregon Health & Science University (OHSU) attending physician – stressed during residency orientation. This time restraint is a challenge that should be decorated for anesthesiology rather than seen as a reason to choose another specialty. A patient waiting in the preoperative area is possibly in one of the most vulnerable states of their lives. Patients may find themselves anxiety-stricken for the surgery itself, fearful regarding the aftermath, pained by the financial burden of the surgery and concerned for the risk of death. Most encounters we have with our patients are brief and delicate. A patient in this highly vulnerable state – concomitant with a short window of time – clings to every word from our lips. After a postoperative call to verify the patient is recovering appropriately, it is probable you will never see nor hear from them again. This does not detract from the memory of how you made them feel – one they may carry with them for a lifetime.1 

When recalling my conversation with Joe, I can no longer remember the nuances nor the minute details, yet I felt more connection and delight upon walking away from the table that day than after many hour-long discussions with others. As anesthesiologists, we only have a few minutes to gain the trust of the patient and family member, positively frame one’s outlook prior to their surgery, and provide the sense of comfort and reassurance they are seeking. During this brief encounter, we must gather information, set expectations and address concerns a patient may have – several factors underlying high-quality patient-physician encounters.2 One underestimated key is non-verbal communication – a grounding component of a therapeutic patient-physician relationship.1 And one example of this is evidenced in a study which demonstrates that sitting over standing is highly favored by patients as it creates a less dominant environment and more empathetic space.3 

As I embark on my anesthesiology journey, I will recall my feelings after I left Joe and the impact of a high-quality conversation – regardless of its brevity. It is a remarkable challenge that is requested of an anesthesiologist. At OHSU, attending physician Dr. Miko Enomoto is known for her saying, “the safest anxiolytic one can administer to a patient is their time, their attention and their care.” Let us never forget that in five minutes we have limitless influence on a patient and their family during one of the most vulnerable phases of their life. They may not remember the details of the conversation, but they will most certainly remember how we made them feel.

References:

  • Ha JF, Longnecker N . Doctor-patient communication: a review. Oshcner J. 2010;10(1):38-43.
  • Simpson M, Buckman R, Stewart M, et al. Doctor-patient communication: the Toronto consensus statement. BMJ. 2010; 303(6814), 1385–1387.[Article]
  • Strasser F, Palmer JL, Willy J, et al. Impact of physician sitting versus standing during inpatient oncology consultations: patients’ preference and perception of compassion and duration. A randomized controlled trial. J Pain Symptom Manage. 2005; 29(5):489-497.[Article][PubMed]

Jason L. Campbell; The Importance of Five Minutes. ASA Monitor2019;83(7):44-45.