By Wesley Saintilnord, Berea College (2016)
In spring of 2015, I was accepted to the prestigious Shepherd Internship Program at the Moses Cone Regional Center for Infectious Disease (RCDI) in Greensboro, North Carolina. Having the opportunity to work alongside experienced doctors, nurses, and medical assistants was something I had eagerly awaited as I finished my semester at Berea College. In the midst of my excitement, however, I was unsure what I would be doing and how much assistance that I, as an undergraduate student, would be able to provide to these highly qualified professionals. I was afraid that I would be more helpful being placed in an office going through patients’ medical records, calling them about follow-up appointments rather than being immersed in the clinical experience.
Wesley Saintilnord, Berea College (2016), worked in 2015 in infectious disease at Cone Health in Greensboro, NC.
My very first day at the agency, however, proved me wrong. I got there early and was given a tour of the facility and was introduced to everyone by my primary mentor, Dr. Hatcher. At that moment, I felt that I would be working in a friendly environment and my fears were partially gone. Dr. Hatcher, as he was getting his computer ready to access his first patient’s profile, told me that I would be shadowing him all day and handed me a copy of my schedule for the rest of the internship, during which I would shadow the other five infectious disease (ID) physicians. I was excited but nervous as I did not know whether or not the patients would agree to have me in their exam rooms. My fear completely vanished upon being granted permission by the first patient. In addition to shadowing, I also spent several hours toward the end of the internship assisting with support groups at Higher Ground, a communal retreat and resource center established by Triad Health Project for persons with HIV.
After eight weeks of working closely with the ID physicians at RCID, I felt more assured of my interest in becoming a physician. I now possess a deeper understanding of how poverty affects healthcare. The theories of the classroom came to life as I interacted with people of various backgrounds and from social minority groups—LBBTQ, drug addicts, former prisoners, etc. I observed a continuous display of excellent doctor-patient relationships, passionate care from nurses and medical assistants for individuals struggling with drug addiction and other mental illnesses in addition to their HIV.
Working at RCID has been invaluable for my understanding of healthcare accessibility. Although RCID provides healthcare services to underserved individuals in Greensboro and its surroundings, patients still struggle to make it to their appointments, or have their treatment of IV antibiotic delayed because of unstable living conditions. Listening to patients’ stories as they reluctantly refuse treatment because they do not have the money to afford the prescribed medications has led me to understand the multidimensional problem facing these individuals that needs to be addressed aggressively from different angles in order to make significant changes. There are assistance programs available to help individuals with the cost of medications and doctor visits, but the application for these programs alone could be a barrier to improved health. The application takes months to be approved, and patients are expected to reapply every six months. They must endure the same process again. The process requires a trip to the case manager or the program directors that the patients might not be able to afford. It requires a waiting period that could be long. Patients are oftentimes bound to their current living conditions, not willing to take on an extra job that would disqualify them for these assistance programs regardless of the fact that the extra money is necessary to meet their needs. These structural obstructions, unless addressed properly, hinder both the accessibility to and the effectiveness of healthcare.
I learned that social interactions and relational networks are often key factors in determining health outcomes. The lack of social support can be a disadvantage that precipitates the collapse of both physical and mental health in individuals. The presence of social support, on the other hand, can benefit individuals, whether they suffer from a disease or from coping with life stress. Although social support does not absolutely prevent someone from getting a disease, it provides a coping mechanism so that the patient feels cared for in the midst of his or her suffering. For example, one afternoon, a well-controlled HIV patient came to his doctor’s visit and started questioning the importance of taking medications, stating that he was no longer willing to try anymore and felt isolated from his environment. After a long session, the doctor advised him to continue to take his medications as it is the only way to keep the virus under control and maybe benefit from the next breakthrough in HIV treatment. He was also advised to see a counselor to help him cope with his depression. Talking to a counselor is undoubtedly an efficient tool, but it is important that we, as a society, help individuals in distress by creating more receptive communities. As much as it is of paramount importance to treat patients with the necessary drugs and therapy, mental and social factors, when taken into account, do have positive outcomes.
My experience at RCID taught me a tremendous amount about medicine, the infectious disease world, and life in general. It was inspiring to work with a group of doctors, nurses, case managers, and others who are passionate about what they do, and whose positive relationships with patients have shaped my way of thinking about the ideal mechanisms of caring for patients. It has been inspiring to have this hands on experience, interacting with patients from diverse backgrounds as they too incited me to think about medicine, not solely on the basis of caring for physical abnormalities, but in terms of providing a holistic care. As I continue my studies, I will utilize observations and knowledge acquired at RCID to become a physician who promotes and practices better healthcare experiences for patients. I encourage other undergraduate students to find outlets such as the Shepherd Internship to further their pursuits in the careers they are working towards.