World Travels Reinforce Need for Rural Physicians

by Vanessa LaRouche

Mid-Michigan has always been my home: I grew up in Bay City and attended Alma College for my degree. Applying to medical school, I envisioned becoming a primary care doctor. I wanted to have an impact and build a long-lasting relationship with patients, help them through difficult times, and cheer them on through good times. My young mind also envisioned working in a small, tight-knit community – like Stars Hollow on Gilmore Girls. I imagined having opportunities to improve and educate the community on healthcare topics.

Alma College offered the small campus size and sense of community involvement that I desired. While studying Health Science at Alma College, I had opportunities to positively impact Gratiot County as well as travel abroad and learn about healthcare in other countries. Through these experiences, I realize that I was always imagining being a family doctor.

My community education work in Gratiot County focused on interactions with middle school students, and helped me understand the importance of listening, as well as teaching when caring for this age group. Apart from participating in the Mentor Plus program, I befriended, interacted, and tutored middle school students. I created an elective teaching nutrition to these students, bribing them with delicious healthy snacks while secretly teaching them healthy choices. I interacted with some of the same students while participating in the Heart Health Fairs that my class conducted at 8 middle schools in Gratiot County. I was able to speak with these kids and teach them about smoking, hypertension, exercise, the food pyramid, and start a conversation about their college goals. I still remember one young girl who was upset because her mom buys 2% milk and after the food pyramid exercise, she only wanted skim or fat-free.

Traveling abroad, I worked with two healthcare organizations in Quito, Ecuador while I took advanced Spanish language lessons at a local college and lived with a host-mom who forced me to practice my Spanish, dance merengue, and eat all of my breakfast. As a student volunteer, I provided refreshments, books, toys, and conversation to pediatric patients and their parents.

I remember one boy distinctly – he was 11 or 12 years old and had been in a public transportation accident. This boy was going to school one morning and his arm was caught in the doors of the trolley-bus. It had already been amputated when I met him. He pleasantly chatted with me and told me about school and his family. When I asked how he was feeling or if I could get him anything, he told me his arm hurt and he wanted it to stop hurting. This was the first time I witnessed something that I had learned about in classes: phantom limb pain. Suddenly, this topic was so real – right in front of me, along with a lifetime of sequelae to which this young boy would learn to adapt. I felt helpless in that moment and told him I would speak with a nurse, thanked him for speaking with me, and tried to keep my face neutral as I contemplated his predicament and my role in healing him. As a family doctor, I know I will have similar experiences with patients: some I can cure and some I won’t be able to. I understand the importance of listening to the patient’s desires and helping in the ways I am able.

Another wonderful opportunity I had was traveling to Sierra Leone, Africa. I stayed on site at a small, non-profit hospital in the town of Makeni. I rounded with attendings through the wards, worked in the outpatient clinic, assisted in the operating theater, and volunteered at the Under 5’s Clinic. I experienced many happy interactions with the patients, like the woman whose hand I held during a C-section and the young boy who was finally being treated for his abdominal pain. Walking through the wards, many men and women would grab my hand and thank me…I thanked them for allowing me to learn about their conditions and culture while remembering Ecuador and feeling so helpless. I asked myself, “Why are they thanking me? I can’t do anything!” But looking back on my four weeks in Sierra Leone, I realize I had impacted this community and recognized changes in myself from this experience.

The young woman whose hand I held during her first C-section was scared and alone. She had ten people standing around her and talking about her – not to her – dressed in green with face masks. I grabbed her hand to soothe her when I noticed she was crying. She squeezed my hand and smiled at me through her tears. I whispered that she would be okay and she softly began singing a lullaby in Temne (native language), all the while squeezing my hand, relaxing just a bit. I didn’t let go until her tears were dry and she was able to hold her baby.

I met a father, upset that he couldn’t donate blood to his son. He explained to me that with the HIV epidemic still ongoing, the government hospital refused to “waste” treatment unless there was coinfection with hepatitis C…and even the co-infected citizens were waitlisted for treatment. He was afraid his son wouldn’t get the blood he needed, as many citizens believed that part of their spirit would be taken with blood donation. I donated blood that evening, wishing there was more I could do.

Before I left, I created a video explaining how to properly read a prescription and take medications. A common tale, many local citizens would stop taking their medication, an antibiotic for example, when they started to feel better, without finishing the whole prescription. Or, a patient would take the whole prescription at once. I had a script written in English which I read; it was then read in Creo by one of the lab techs; and finally a nurse translated into Temne. The goal was play this video in the central gazebo and educate the patients, families, and community about proper medication use.

I often reflect on and am eternally thankful for the impact Sierra Leone had on me. The opportunities I had to engage with patients and the community ignited my passion for community outreach and public health advocacy. I was inspired to continue working with the community through healthcare using my medical degree. I believe that by becoming a family doctor, I will be able to impact my community in a meaningful way, while learning and growing myself within that community. I hope to find a family medicine residency program that offers this community interaction. I imagine myself treating families in a rural community of Michigan. In addition to growing my skills as a family medicine practitioner, I hope to also establish roots with my community and continue being involved in public health events, integrating with, and educating the community in which I live and serve.