Outside apartment 13C the street is empty. It is early in the morning, and yet sounds echo from the metal shop beside the lake, roosters crow, and the children upstairs patter back and forth across the tiles. I roll up my yoga mat, shaking dead cockroaches from its rubbery bottom. Through the grated windows I catch a glimpse of Lake Victoria, shimmering out from the cluttered shore of shanties and deconstructed docks to eventually blend with the blue of the morning sky.
In the spirit of the year of realizing things, I’m starting to think that the med school struggle of knowing/doing/being enough never actually ends. Even as physicians, the problem of “enough” persists, albeit in a form less easily remedied by additional time spent reading First Aid or viewing Pathoma.
With the future of the Affordable Care Act uncertain under President Trump, many Americans are left worrying how they will manage without health care. The Americans who must shoulder this burden are disproportionately people of color. It should come as no surprise to those familiar with the history of health care in this country that once again our system, purportedly built to protect and promote health, is systematically ignoring the right to health care for communities of color.
Physicians across many specialties are treating trafficked persons in their practice. Yet they are not trained to recognize human trafficking or know how to intervene. Studies have shown that 88 percent of US-born sex trafficking victims reported receiving medical care while being trafficked.
With the increased awareness surrounding mental health that has come over the course of the 21st century, many more people are aware of PTSD. Our understanding of it has come a long way from the earliest accounts of “soldier’s heart” during the Civil War era, or even what was termed “shell shock” during World War 1. However, there are still some common misconceptions surrounding PTSD, which I hope to debunk here.
Following the event, we resolved to dedicate our efforts to raising awareness at Einstein about domestic sex trafficking. We knew our colleagues might be just as uninformed as we had been. Later that year, we developed research on how to best teach sex-trafficking issues to medical school students.
As a medical student, I always carry naloxone in my backpack. Naloxone is the antidote for opioid overdoses, and is readily available at most pharmacies in Boston. My medical school, Boston University School of Medicine, is located near the epicenter of the opioid epidemic in Massachusetts.
On October 6, 2016, the National Institute of Health (NIH) confirmed that a new health disparity population has been designated for research purposes. Eliseo J. Perez-Stable, MD, the director of the National Institute on Minority Health and Health Disparities, released a message stating that sexual and gender minorities (SGM) will be classified as a minority population, which suggests health disparities exist within this population.
When I was six, a set of strawberry hair ties foiled my endeavor for independence. My mother had a way of twisting the plastic ornaments at the end of her operation so they sat together like two friends on a bus, neat and obedient at the crown of my head. Despite my assertions, (“I can do it myself!”) I could never align their orbits.
When many people hear about human trafficking and health care, they usually think about sexual health: sexually transmitted diseases, pregnancy, and so forth. However, the health problems of trafficking survivors are much more vast and complex. It is also important to note that not all trafficking survivors are trafficked for sex.
Delirium is a bread-and-butter presentation. The differential writes itself — stroke, infection, intoxication, electrolyte imbalances, shock, organ failure. The intellectual exercise this invites was practically invented for medical students, even if the final diagnosis (dehydration secondary to gastroenteritis) and its treatment (fluids) were relatively mundane.
In the five years that have passed since I met the 14-year-old girl who opened my eyes to the terrible crime of sex trafficking in the United States, much has changed. We have made strides in state and federal legislation to protect survivors, national human trafficking prevention months have been declared, and victims are no longer treated as criminals.