Monday, January 29, 2024

The MedEd Blog Takes a Break

The last post? Maybe or maybe not.


The MedEd Blog Takes a Break




The MedEd Blog is taking a break as the Transformational Times evolves ...  


For two years, I served as the founding editor-in-chief of the Transformational Times newsletter, a project that supported our community as it reeled from—and adjusted to—the COVID-19 pandemic while re-envisioning the future of medical education. 

Three months after the first TT issue in March 2020, I started this blog as a personal project. Although I was a faculty member at MCW, the blog has never been affiliated with either the Medical College of Wisconsin, the Kern Institute, or any of their funders. I held the password, set up the blog, and added every bit of the content. I did all of the work on my own time. 

Here's why I started the blog: As soon as one issue of the TT was released, the previous week's edition all but disappeared into a non-searchable corner of MCW's website. I conceived the blog as a way to give continuing life to some of the most interesting and inspirational essays that appeared in the Transformational Times newsletter. I was able to share links with the authors so they could do the same. 

This blog's format is searchable, although metrics tell me that there have never been many visitors and Blogger (the platform) no longer enables subscribers. Nevertheless, I persisted since the blog gave the essays some online presence and was invaluable when I curated the two Character and Caring books. 

For the few of you who have found this little corner of the Internet, I hope you will continue to use the tags and search function to browse the essays, poetry, images, and articles. They tell a fine story about a period of time when medicine went through a pandemic crisis and emerged. There are voices of strong and resilient people whose viewpoints are not regularly amplified. The blog explores visions of a future medical education that enhances, rather than suppresses, character and the entrepreneurial spirit. 

Reading and editing these pieces taught me much, made me stop and think, and exposed me to new perspectives. I didn't always agree with the essayists but know that I am a better person because I read what is contained here. 

The machinations of the institutions involved are completely opaque to me. Amplifying certain voices, though, might be counterproductive while the powers-that-be discuss the Transformational Times and the people who inspired and maintained it. Rather than inadvertently poking a bear, it seems best to suspend or even shut this down. Therefore, this 366th post might be MedEd Blog's last.

That said, I hope that my family and I will always be able to locate caring, character-driven physicians and healthcare workers. The remarkable accomplishments of the Kern Institutereflected, in part, by the essays contained heregive me hope that the next generation will be more than up to the challenge. For those of you who spend time with the pieces archived here, I hope you catch the same vision.

Be well, friends. 

In appreciation,

Bruce


Bruce H. Campbell, MD FACS 

Tuesday, January 23, 2024

MCW Professor Helps Fellow Native Americans Improve Wellness by Reclaiming Culture

MCW Professor Helps Fellow Native Americans Improve Wellness by Reclaiming Culture


This essay and video were produced by MCW about our Indigenous partners in Lac du Flambeau. The video is narrated by Brian Jackson, EdD, an MCW faculty member and enrolled member of the Ojibwe tribe. 


MCW's connection with the community has been featured in previous MedEd Blog posts:


Released by MCW Communications Office on November 21, 2023


There’s a major phenomenon growing with Indigenous people, according to Brian Jackson, MS, EdD, an assistant professor at the Medical College of Wisconsin (MCW) and member of the Lac Du Flambeau Band of Lake Superior Chippewa Indians, also known as the “Fish Clan.”

“We’re reclaiming our ways,” Dr. Jackson says. “It’s not about asking permission.”

The ways of his people, he says, include harvesting wild rice in autumn, tapping for maple syrup and spearfishing in the spring, and picking medicine throughout the year.

They include sharing foods like deer and fish.

“Elders first,” says Jackson, who added that the practice reinforces ancestral teachings related to taking only what you need and sharing the rest. “They’ll get a package of fish, then the community folks come after that.”

But before they even enter the water for rice, tap the trees or fish or hunt deer, a give and take must take place – an offering of medicine, usually tobacco.

“Those things are really what shaped us,” he says. “We still practice those ways because that’s who we are.”


Click on the photo of Dr. Jackson to watch the video:


Unfortunately, some of who they are is also shaped by the historical traumas Native Americans endured during attempts to strip those traditions from them. Among the tragedies, Dr. Jackson says, happened throughout the late 1800s and well into the 1900s, when youths were taken from their families and forced into boarding schools, where their hair was cut and they were forbidden to speak their languages.

“That’s what really halted our language during that time,” he says. “We struggle today to revitalize our language.”


A Feeling of Personal and Native Pride

Dr. Jackson says that reclaiming their languages, traditions and ceremonies are key to improving wellness in Native American communities and overcoming the many challenges it faces, including disparities in cancer and diabetes, and drug and other substance use.

“A lot of folks are struggling with wellness and being sober,” he says. “So we get a person to feel proud again about who they are, and that begins their healing journey pretty well.”

Supporting people on their journeys has been a life mission for Dr. Jackson, who grew up in Milwaukee before moving to the Lac Du Flambeau Reservation in northern Wisconsin as a troubled high schooler.

He credits his grandfather, Joseph Jackson, Sr., who retired after working in the automobile manufacturing industry for 35 years, and father, Dr. Alton Sonny Smart, a professor and Vietnam veteran who speaks fluent Ojibwe, for helping him turn his life around and motivating him to follow the path of education and culture — his two journeys.


Engaging Native Youth

He’s filled many different roles along that journey, including working with youth and families at the Boys and Girls Clubs, with 15-and 16-year-old juveniles at the Woodland Hills Correctional Facility, and with participants of the Family Circle Program in Lac Du Flambeau, and by helping develop the American Indian Science Scholar Program at UW-Milwaukee, which serves students interested in health and science.

“I open their eyes to on-campus experiences, to careers they never even thought of,” says Dr. Jackson, who plans to help develop a similar pathway program for high school students at MCW.

He’s also recently led immersion work that brings non-Native Americans into the reservation for a tour of the community, to meet tribal elders, and experience a powwow at the Indian Bowl.

“It’s about providing opportunities to know our neighbors so we can function and get along,” he shares.


Community-Based Participatory Research

Another major component of Dr. Jackson’s journey has been conducting community-based participatory research as part of the Great Lakes Native American Research Center for Health (GLNARCH) Community Scientific Advisory Committee. Conducting research with Native American communities can be a challenge in a community that is understandably skeptical about being studied.

“How’s it going to benefit our communities?” Dr. Jackson asks. “We’re not just numbers; we want people to be helped.”

Dr. Jackson says a key to research with Native Americans is earning trust and sharing stories.

“You have to sit down with them, take the time, maybe have a meal with them, share some tobacco,” he says. “Not just a one time shot, there’s some follow up to it; that goes a long way with Indian people.”

Dr. Jackson also finds it crucial to collect stories from elders to share with young people as a way of supporting cultural connections.

“We connect them with who they are, their ancestors,” he says. “It’s really the core for anybody for that matter.”

Dr. Jackson views his new role at MCW, which began at the beginning of 2023, as an opportunity to elevate the work he’s done in Indian Country for more than 25 years. It’s also a chance to help more Indigenous communities understand how vital it is to return to traditional values as Native Americans as a way to improve wellness.

“Our values are glossed over at times. It’s about the American Dream,” he says. “The more you get, the more important you are. It’s the opposite with Indian people. If you are sharing and elders see you sharing, that’s what it’s all about.”


Brian Jackson, MS EdD, is an assistant professor in the Department of Epidemiology and Social Sciences at MCW. He serves on the Great Lakes Native American Research Center for Health (GLNARCH) Community Scientific Advisory Committee. He is a Family Circles AODA Prevention Program facilitator, providing instruction in language, traditional cultural practices, history, and culture of Native people will be preserved, thereby restoring pride in the identity of Anishnabe.

Monday, January 15, 2024

We Belong to One Another: A Lesson from Dr. Martin Luther King, Jr.

From the January 21, 2022 issue of the Transformational Times (Urban and Community Helath)



We Belong to One Another: A Lesson from Dr. Martin Luther King, Jr.



Cassie Ferguson, MD



In his letter he wrote from a Birmingham jail—the letter that began in the margins of a smuggled newspaper and on found scraps of paper—Dr. Martin Luther King, Jr. shared this:


“Whatever affects one directly affects all indirectly. For some strange reason I can never be what I ought to be until you are what you ought to be. And you can never be what you ought to be until I am what I ought to be—this is the interrelatedness of life.”


The very same stardust

Dr. King suggests that if we would see how inextricably connected we are to one another—if we would see that we belong to one another not only by virtue of being born on the same planet, but also by virtue of the scientific and spiritual reality that we were made from the very same stardust—that then all of us could see how the systems that uphold and protect racism, health and wealth disparities, educational inequalities, and residential segregation dehumanize us all.

That if we understood our interdependence, we would move beyond empathy for those who are suffering the most under the weight of these systems and know in our hearts that when one teenager is murdered, we are all killed. That when a pregnant woman delivers a stillborn baby because her health concerns are dismissed, that we all lose a child. That when one of our students must repeat their first year of medical school because of inequities in medical education and in our learning environment that disproportionately impact students underrepresented in medicine (URiM), that we all fail.


Dangerous unselfishness

This kind of radical compassion is not for the faint of heart. Dr. King understood this. In his very last speech delivered in support of the striking sanitation workers in Memphis, Tennessee, Dr. King rallied the crowd declaring, “either we go up together, or we go down together. Let us develop a kind of dangerous unselfishness.”

At the Kern Institute, our mission has been to inspire and support this kind of unselfishness and this kind of compassion in our learners and educators, such that we might transform the system of medical education to ensure that every one of our patients feels seen and deeply cared for; such that every one of our patients is given the opportunity to flourish. This kind of systemic transformation requires tremendous courage, sacrifice, and love. It demands that we understand compassion not “as a relationship between the healer and the wounded…but as a relationship between equals.” (Pema Chödrön).

Despite these challenges, there are examples of how the MCW community is “showing up.” Here is one example. In the spring of 2020, student doctors British Fields, Jamal Jarrett, Morgan Lockhart, Enrique Avila, and Adriana Perez learned that the Apprenticeship in Medicine (AIM) enrichment program they had been chosen to lead that summer would not be funded because of the pandemic. Led by the incomparable Jean Mallet and supported by the Kern Institute, these students advocated for their program, pivoted, and in three weeks designed and stood up the Virtual Health Sciences (VHS) program. Over Zoom, they provided forty Milwaukee-area high school students from backgrounds historically underrepresented in medicine a meaningful and engaging look at careers in health care and showed them that there is a place in the profession of medicine for them. Our student doctors saw themselves in these high school students and this motivated and empowered them to take direct action.


“The Path of Joy is Connection”

What I have come to realize as a physician and, as someone who teaches medical students about well-being, is that when we become aware of our interrelatedness, we not only wake up to how we might design and redesign systems that assume the humanity of all peoples, but we also feel less alone, less fragile, less anxious; and, like these student doctors, we are empowered to become our best and truest selves. As the late South African anti-apartheid leader and Nobel Peace Prize Laureate Archbishop Desmond Tutu reminded us frequently, the path of sorrow is separation, and the path of joy is connection.

This week, as we celebrate the Reverend Dr. Martin Luther King, Jr., may we cultivate the awareness of our interrelatedness in our hearts, and find the courage to unselfishly redesign our world such that all of us may flourish. 


Catherine (Cassie) Ferguson, MD, is an Associate Professor in the  Department of Pediatrics (Emergency Medicine) at MCW. She is the innovator of the REACH Curriculum, and the Associate Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Thursday, January 11, 2024

The Mission of the SCU: The Saturday Clinic for the Uninsured

From the January 21, 2022 issue of the Transformational Times (Urban and Community Health)





The Mission of the SCU: The Saturday Clinic for the Uninsured




Thomas Ritter, MD


Dr. Ritter wrote this essay when he was a fourth-year medical student at MCW.


The highlight of my medical school experience has undoubtedly been working at the Saturday Clinic for the Uninsured (SCU). SCU is a student-run free clinic for patients without health insurance that operates at the intersection of North and Humboldt on, you guessed it, Saturdays. In addition to a name that is quite “on the nose," SCU has been a staple of the Milwaukee community for over twenty years. Our mission is to provide comprehensive, patient-centered, and equitable care to Milwaukee’s uninsured population.


Goal One: Provide high quality care

Uninsured patients in Milwaukee face an array of challenges to access healthcare and we have shaped SCU to meet the needs of our community. We have grown to become a long-term home for our patients to receive healthcare by marshalling resources at MCW and Milwaukee hospitals to provide access to lab work, mammograms, and specialists including ophthalmology, dermatology, and rheumatology. We offer an in-house dispensary of medications at no cost to our patients and have established a partnership with Seton Pharmacy at Ascension Columbia St. Mary’s to provide any medication we don’t have for a low-cost rate. We evaluate and address the social determinants of health for all of our patients, including food insecurity, legal assistance, and housing instability.


Goal Two: Improve cultural humility and clinical competence

In addition to its mission to provide comprehensive, patient-centered, and equitable care, SCU also aims to enrich the cultural humility and clinical competencies of its student volunteers. This second mission has certainly been achieved in my personal and professional life. Early in medical school, I was an eager learner of anatomy, pharmacology, and pathophysiology. While I certainly remain interested in these subjects of medicine, my experience at SCU has revealed to me the broader picture of medicine—to identify and critically examine the ways in which our patients, insured or not, encounter obstacles to receiving care. Whether the obstacle lies outside of healthcare, such as access to affordable transportation, or is an internal obstacle, such as racism in medicine, truly comprehensive care requires intervention on both a personal and societal level. 

SCU has taught me that providing patient-centered care requires grace to meet patients where they are, see the world through their eyes, and act accordingly. Providing equitable care necessitates intentional introspection and the evaluation of my own biases on a daily basis.

I believe SCU’s contribution to the Milwaukee community is difficult to truly measure. While direct patient care can be quantified by the number of patients seen or referrals sent, the impression SCU makes on its volunteers who go out and serve in their own way after graduating, although intangible, cannot be overlooked. I am becoming a family medicine physician because of my time at SCU, and I am only one of many volunteers in SCU’s long history who enter healthcare with a heart for service and dedication for justice. I am grateful to have worked at SCU and encourage all who are interested to volunteer there as well.


To learn more about the Saturday Clinic for the Uninsured, check out the website here.


Thomas Ritter, MD was a member of the MCW-Milwaukee Class of 2022. He followed his heart as is currently a resident in the MCW Family Medicine program at Columbia St. Mary's Hospital in Milwaukee.