In the chaos and uncertainty of a new life in a new country, medicine – in its most compassionate and humanistic form – was at the center of my family’s experience. I was 6 years old when my family escaped Yugoslavia’s violent Civil War with two suitcases in hand and not a word of English in our vocabulary. My mother, with a translator by her side, received a diagnosis of cervical cancer within months of our arrival to the US. I recall being at my mother’s bedside, baffled by the nurses and doctors speaking an unfamiliar language. But throughout the process—from my mother’s diagnosis, through both of her surgeries, and into her recovery—my family and I developed relationships with nearly every member of her healthcare team. It was these clinicians’ practice of medicine—compassionate, holistic, solicitous medicine—that changed my entire perspective on healthcare. We were immigrants. We had no medical background. We did not speak the language. Yet these people were able to form bonds with all of us through their empathy and compassionate guidance during such a vulnerable time. The doctor-patient relationship was at the root of this experience and I will never take for granted its vital importance in the practice of medicine. From then on, my answer to “what do you want to be when you grow up?” was met with one of the few English words I knew… “Doctor.” Throughout my family’s journey, and often times struggle, as new immigrants, I began to recognize the importance of access to care and the needs of the most vulnerable among us.
“Throughout my family’s journey, and often times struggle, as new immigrants, I began to recognize the importance of access to care and the needs of the most vulnerable among us.” writes Pehar.
My pursuit of becoming a physician also became a pursuit to support human rights and the dignity of such underserved populations. I became enthralled with the intricacies of social justice and poverty, which motivated my involvement in the University of Notre Dame’s Center for Social Concerns and my choice to pursue a Minor in Poverty Studies. The four years I spent at Notre Dame immersed me in an environment of not only academic excellence but also one that is cognizant of spirituality and the pursuit of one’s calling.
My involvement in the Center for Social Concerns led me to the Shepherd poverty internship – which was truly one of the most formative experiences I have had. I spent my Shepherd internship at So Others Might Eat (SOME). SOME is an interfaith community-based organization in the District of Columbia. It offers a holistic approach to caring for the needs of the homeless and extremely poor. Seeing the inner workings of the influential role SOME plays in the lives of the homeless and having the opportunity to gain hands-on clinical experience was life changing. Most rewarding of all, however, was the chance to interact with the patients, hear their often heart-breaking stories, and provide them with the healthcare that they truly needed. I developed compassion for patients’ afflictive pasts and became committed to playing a vital role in their recovery—both as a source of support and in providing the medical services they need. My passion for medicine as an art of healing and a life of service was reignited at SOME. Beyond this, I also took to heart every heart breaking story I heard and began to recognize the true issues in the healthcare system. Seeing the vicious cycle of poverty in the District, the direct effects of policy on individuals, and the pervasiveness of devastating diseases among the homeless shifted my perspective and impacted my future goals.
“During my time at SOME, I saw the crippling effects of HIV in the District, and knew that I wanted to be a part of addressing this epidemic during my time at Georgetown,” writes Pehar.
When making my decision about where I would attend medical school, Georgetown University School of Medicine (GUSOM) was at the forefront of my choices due to the opportunities I felt I would have to address the very injustices I saw at SOME. During my time at SOME, I saw the crippling effects of HIV in the District, and knew that I wanted to be a part of addressing this epidemic during my time at Georgetown. Early on, I got involved in Georgetown’s Medical AIDS Advocacy Network (GMAAN). GMAAN was founded in 2008 to address the need for HIV screenings in the District.
Through an initiative with the DC Department of Health, GMAAN has been able to provide routine HIV screenings in the Georgetown Emergency Department, making it the only student-founded, student-run program of its kind in the country. I have held one of the few leadership positions for the group and served as its Outreach Coordinator.
As I spent more time working with GMAAN, I recognized the need to reassess current HIV screening practices. This sparked my Georgetown Dean’s Scholarship funded research project this past summer. The Emergency Department is often the only point of care for homeless and impoverished individuals. It serves as a particularly important environment for disease screening and health maintenance. With the high rates of HIV/AIDS in the District, I thought it imperative to assess not only the patient’s risk of HIV infection but also to understand factors associated with this increased risk to better provide recommendations for improving early detection of HIV. My study has shown promising results, indicating a need for outreach efforts to provide HIV testing to lower income communities and those with impaired access to health care. I hope that these results will demonstrate the need to empower the most vulnerable and lowest income populations with access to disease screenings.
Georgetown has allowed me to pursue the passions I developed at SOME. Not only have I been able to play a role in addressing the HIV epidemic, I have also been able to stay involved with the homeless population, which has been the cornerstone of my love for service. Georgetown’s Hoya Student Run Clinic serves the homeless population at DC General. In addition to my time volunteering as a student doctor at Hoya Clinic, I have also been fortunate enough to become a research specialist. As such, I have been able to provide patients with the medications they need and the referrals for further specialty care. I am able to follow up with patients moving forward and remain a vital member of their healthcare team. It is extremely fulfilling to be a part of the longitudinal and holistic care of these patients. A great proportion of the patients at Hoya Clinic say they wouldn’t have sought out care if it hadn’t been provided at Hoya. This further exemplifies the importance of addressing the issue to care for those stricken by homelessness and poverty.
My time at SOME, although short, was truly the stepping-stone to all of these amazing experiences. During my time with the organization, I developed my vision as a physician. I still hope to provide the best, most compassionate care to my future patients, but I now also know I want to be a part of lasting change through involvement in healthcare policy and public health. I have been accepted into the Health Justice Scholars track at GUSOM and hope to pursue a Masters in Public Health through the dual-degree partnership with John’s Hopkins Bloomberg School of Public Health. I aspire to use this education to gain the skills necessary to effect lasting change for vulnerable patient populations – the very populations I worked with at SOME. The patients at SOME are the root of many of these aspirations. I see myself working domestically and abroad with underserved patients and I hope to be involved in global efforts to increase access to healthcare and make quality care a reality for even the most impoverished and vulnerable populations. With each passing day at SOME medical clinic, I became more aware of the importance of healthcare and the indispensable role clinicians play, especially in the lives of the underprivileged. I want to continue to serve this role in the most effective way I can.
I cannot thank the respected members at the Shepherd Internship program, Notre Dame’s Center for Social Concern and my mentor, Jennifer Warlick, enough for the indispensable experiences I had working at SOME.
Andjela Pehar received her BS (Cum Laude) with a major in Science Pre-professional Studies and a minor in Poverty Studies in 2014. She is pursuing an MD at Georgetown University School of Medicine, receiving Special Distinction as a Health Justice Scholar and anticipates working on an MPH at the Johns Hopkins Bloomberg School of Public Health in 2017-18.