1OBLITERANTS
OBLITERANTSV O LU M E 2 | I S S U E 1 | FA L L 2 0 1 2
H U M A N I T I E S A N D S O C I A L S C I E N C E S I N M E D I C I N E A N D P U B L I C H E A LT H
DESTINATIONS
2 OBLITERANTS
Volume 2 | Issue 1 | Fall 2012
Front/Rear Artwork
WELCOME TO THE NEWLY-FORMATTED OBLITERANTS! As you can see, we’ve gone through a design overhaul. We believe that layout design is a work of art in itself, and as a “frame” it enhances the other articles and artwork within it. This issue was a joint effort between student editors at the regional and Miami campuses, with guidance from Dr. Agarwal and Dr. Lichtstein. As such, it is a truly collaborative creation and we are excited to share it with you.
The theme for this issue is “Destinations” and it’s par-ticularly highlighted in our “Features” section, where we’ve received submissions from students who did projects in various places around the world this past summer. The “At The Bedside” section showcases insights gleaned from the journeys we’ve taken with our patients. The “Education” section offers experi-ences and lessons from students on their passage through medical school from the first year all the way through graduation. Additionally, the pictures and paintings studded throughout the publication are meant to enhance the reader’s experience, and we hope that-- through the eyes of the artist-- they provide to you a window into another world.
Our vision for Obliterants this year is to publish three issues during the academic year, with the release of each issue coinciding with the changing of the sea-sons. Our next issue will be released in the Winter solstice, with a theme on “Diversity.” We are always accepting submissions year-round from students, fac-ulty, and staff on any topic, medical or non-medical, in any form and in any medium. If you’re interested in being a part of the Obliterants Team, feel free to e-mail us at [email protected].
We’d like to thank all the contributing writers, poets, artists and photographers for creatively sharing their experiences with the Obliterants and its readership.
Sincerely,Myra AquinoBrigitte Frett
Mary Lan
Front/Rear Cover Photo by Myra Aquino
about obliterantsObliterants is a journal published by students, faculty, and staff of the University of Miami Miller School of Medicine. Its mission is to
publish writings and artwork that promote the humanities and social sciences in medicine
and public health. Obliterants is not an official publication of the University of Miami School of Medicine. Expressed written opinions are solely those of the authors and artists and do
not necessarily represent those of the University of Miami, the School of Medicine, or the
Department of Epidemiology and Public Health.
SUBMISSIONSObliterants is published quarterly.
Faculty, staff, and students are invited to e-mail their submissions to
Letterfrom theEditorsOBLITERANTS
Journal of the Humanities and Social Sciences in Medicine and Public Health
Editors (2012-2013)Myra Jon Aquino
Brigitte FrettMary Lan
Editorial AdvisorGauri Agarwal, MD
Assistant Regional Dean for Medical Curriculum
Editors (2011-2012)Brian Garnet
Paul Rothenberg
3OBLITERANTS
CONTENTS
9 FEATURES PAGE 18
THIS ISSUE: DESTINATIONSThe summer after the first year of medical school
is the per fect opportunity to pursue research, complete a project, or simply relax. Turn to
page 18 to read and see what students did.
EDUCATION
FEATURES
AT THE BEDSIDE
ARTWORKPhotographs by Larissa Lester, Myra Aquino, Joanne DuaraPaintings by Jen Schwenk, Ekaterina Koustioukhina
13 I Wrote This Poem In Learning Community BY SHARI SEIDMAN
14 Nuns at Church BY MYRA AQUINO
15 Rose Ceremony Speech BY ALEXANDER KAPLAN
4 27 BY NATASHIA LEWIS
7 Creepy Cranial Nerve Exam BY CAITLIN HODGE
8 Abdominal Exam BY ANTHONY PARK D’ANDREA
11 Not Just Another Jane BY DANIEL LICHTSTEIN, MD
18 Summer, O Summer BY ISAAC LEE
Basic Combat Training in Fort Sam Houston, Texas
20 Privileged BY BRYAN STEPANENKO
22 Death by Powerpoint24 Butterbars BY ALEXANDER KAPLAN
25 Clinical Research in San Francisco, California
To Brain Or To Spine BY MAI TRAN
PHOTO GALLERY26 Public Health Research in Tikantiki, Panama ELAN HORESH, ANNE KIMBALL, ADAM CROSLAND
29 Public Health Research in Nyarushanje, Uganda GREG MILLIGAN
31 Public Health Research in Cornwall, England JASON HEFFLEY
Public Health Research in the Dominican Republic 34 NICK CNOSSEN, CARLY RIVET, BRANDON HENDRIKSEN37 RAMMY ASSAF39 KELLY GRANNAN
41 Public Health Research in Haiti JULIE LEVASSEUR
43 The Car Ride in Fall BY JOANNE DUARA
44 9 NEXT ISSUE: CALL FOR SUBMISSIONS
16 Forced Humanized Mice BY JOANNE DUARA
17 Enough With The Puns BY ANONYMOUS, ARTWORK BY MARY LAN
4 OBLITERANTS
AT THE BEDSIDE
27BY NATASHIA LEWIS
HE HAD JUST TURNED 27 YEARS OLD. A TALL, SLENDER, AND TALKATIVE YOUNG MAN, HE LOOKED OUT OF PLACE SURROUNDED BY THE ILL AND WEAK. Quick to laugh, and even quicker to tell you
about his mother’s home cooking that he had missed so much when
he was away. The man I met that day in the hospital, at first seemed
deceptively athletic and strong, but the tubes going in and out of his
body betrayed him. As he talked, I glanced down to the leads on his
chest and saw that his once powerful body was now frail and hollow.
This man, who relied on his youth and physical strength to earn a
living, was working 12-hour days as a contractor only months ago.
Now, he could only reminisce about playing a pickup game with his
friends on the weekend. He was always good at basketball, kind of a
star in high school, but that was before it got so hard to breathe.
Aside from a back injury last year, which he treated at home, he
never got sick. So of course, he had not seen a doctor in years. Doctors
were for people who needed looking after, like his girlfriend. She was
living with him in Georgia 8 months earlier, when she found out that
she was carrying his child. He knew right then, he would have to work
even harder, since he had three people to care for now. His girlfriend
needed expensive prenatal vitamins and regular visits at the clinic to
5OBLITERANTS
monitor her high-risk pregnancy. When the poor
economy found him out of work, he had to find
a job immediately; never mind that he’d started
feeling sick. He came back to Florida to cut costs,
living with his mother while he worked and sent
money to his girlfriend. His worsening stomach
problems didn’t let him enjoy the food he’d missed
for so long, and his clothes were fitting a little
looser. But still, he managed to keep working, to
be strong for his girlfriend, who needed him to
provide for her care. How then, as she was set to
deliver any day, did he wind up as the patient?
Admitted to the hospital, on the telemetry
floor, surrounded by people two and three times
his age, his girlfriend had to fly in from Geor-
gia just to sit by his bedside. At a time when he
should be waiting for her water to break, there
they were, facing concerns that his liver might be
congested, and that soon he might be waiting on
a heart transplant. I heard the diagnosis from his
own lips. I had studied the pathophysiology, and
I understood the mechanism by which this could
happen to someone so young and alive …, and so
quickly. Yet as I stood there, the dissonance of the
scene before me resonated more loudly than all of
the monitors and alarms and noise of the hospi-
tal. It wasn’t the way in which his illness took over
his life without warning, the existential unfairness
of it all, or that he was fighting for his life as his
son’s life was about to start. It wasn’t even the
“PREP AND DRAPE.” EKATERINA KOSTIOUKHINA, OIL ON CANVAS
AT THE BEDSIDE
6 OBLITERANTS
fact that he was only a few months older than my-
self, that it could be any of my classmates lying in
that bed, struggling with a disease that was now a
“teaching case” for us. No… instead, I was struck
by how much strength he really had. What he
lacked in physical firmity, he made up for in mind
and will power. Even as he lay there, explaining
what led to the eventual diagnosis of his dilated
cardiomyopathy, his words carried a vibrancy and
determination. He was articulate and intelligent,
describing the tests and findings in a manner that
would befit an entering medical student. He talked
about how much he loved science, and that learn-
ing about his disease has made him think about
going back to school to work in a job related to
science once he recovers. Laughing with him, and
hearing him talk excitedly about the future and
his plans, it was hard to reconcile that this same
young man was supposed to be ill… seriously ill.
It made me question how I would react to similar
circumstances, how my classmates would respond
to such a life-altering diagnosis that could destroy
the fabric of your life before you even knew what
it was that was making you sick.
We are taught that resiliency aids the heal-
ing process, but the man before me was a true
example of forward-looking against all odds. He
maintained his positive outlook despite being out
of work and living at home, with a pregnant girl-
friend in another state, all while having his body
ravaged by a sudden and severe “stomach prob-
lem” that would later be revealed as anything but.
As we study to enter the profession of medicine,
we are often prone to thinking about how difficult
our present circumstances seem. It can be easy to
respond to life stressors in unconstructive ways,
by acting out, pushing others away, or being over-
whelmed to the point of giving up. Nevertheless,
we owe it to ourselves, moreover to our patients,
not to give up. Most of the patients we see will be
facing far greater challenges than anything we are
currently experiencing. Taking a moment to reflect
helps bring this into perspective. It is not enough to
just “get by”, no patient is “just another patient”,
and no amount of stress justifies an attitude that
makes you difficult to work with. Patients like the
27 year old expectant father, remind us that we
must take care to prevent burn out, and combat
fatigue, because we have a duty to do our best for
our patients and ourselves.
Although I cannot say whether I would be
able to keep such an optimistic disposition in the
As we study to enter the profession of medicine, we are often prone to thinking about how difficult our present circumstances seem. It can be easy to respond to life stressors in unconstructive ways, by acting out, pushing others away, or being over-whelmed to the point of giving up. Nevertheless, we owe it to ourselves, moreover to our patients, not to give up.
AT THE BEDSIDE
7OBLITERANTS
face of circumstances as difficult as his, I know
that I will think back on the 27-year-old man I met
that day, and how he chose to combat his chal-
lenges. I will think about the man whose inner
strength grew steadily as his physical strength di-
minished; choosing to engage all those around
him and participate in his health, instead of mere-
ly accepting his illness. I hope that as I face chal-
lenges of my own, as a student and a physician, I
will remember his limitless resolve and find with-
in myself the ability to stay positive and perse-
vere. Our patients can teach us so much more than
the process of disease. That day on the telemetry
floor, from a man not much older than I, I learned
that attitude really is everything. O
AS SHE WALKS INTO THE OFFICE, YOU SET THE MOOD WITH VANILLA CANDLES TO TEST HER OLFACTORY NERVE. You look deeply into her eyes,
and her visual fields are full, of you (optic nerve). Wide-
eyed (no ptosis) her eyes lock to yours without straying
(oculomotor). As she looks around the room, you assess
her oculomotor, trochlear, and abducens nerves. You gently
touch her face (trigeminal sensory), and she clenches her
teeth at the unexpected touch (trigeminal motor). She may
smile, frown, or wrinkle her forehead, but if her face remains
expressionless, it might not be you. It might just be that her
facial nerve is lesioned. You whisper in each ear, to test her
vestibulocochlear nerve. Dizziness or loss of balance would
suggest a lesion here. Or she may just gag, but then at least
you’d know that her glossopharyngeal nerve was intact. You
ask to check for symmetrical elevation of her palate. If she
whispers hoarsely that you make her stomach churn, she may
have a vagus nerve lesion. Fed up with this exam, she shrugs
her shoulders and turns her head towards the door (spinal
accessory nerve). As she leaves, she turns back toward you
and sticks out her tongue. It is midline. Her hypoglossal
nerve is intact.
CREEPY CRANIAL NERVE EXAMBY CAITLIN HODGE
AT THE BEDSIDE
8 OBLITERANTS
ABDOMINAL EXAMBY ANTHONY PARK D’ANDREA
YESTERDAY WE WERE TAUGHT THE ABDOMINAL EXAM (THIS IS ONE OF THE FIRST PARTS OF THE PHYSICAL EXAM THAT FIRST YEAR MEDICAL STUDENTS WILL LEARN). I have seen this exam performed
many times in the past as I have spent the year
before medical school doing research in colorectal
surgery. This training session was different,
however, because it was the first time it was
performed on me.
For training, our class of 52 students was
divided into groups of four (two male and two fe-
male students). We played “paper, rock, scissors”
to decide who would serve as the patient for ev-
eryone else. Three papers defeated my rock, and
therefore I was the one reluctantly lying on the
table with abdomen exposed. My shirt was lifted
up from xiphoid process to pubic symphysis. May-
be not everyone would feel as awkward as I did at
that moment, but I am not used to my belly being
UMMSM MD/MPH CLASS OF 2015.
AT THE BEDSIDE
9OBLITERANTS
poked, prodded, and talked about (and stared at).
The intensity of the overhead lights forced me to
shut my eyes. I could barely see by squinting. To
help relax my abdomen, I was asked to bend my
knees with the plantar surfaces of my feet facing
down on the table. Our trainer started by talking
through the four parts of the abdominal exam: in-
spection, auscultation, percussion, and palpation.
I waited there listening with my eyes never being
able to adjust to the light.
On inspection, my peers looked for pulsa-
tions and asymmetries. They immediately noted
that I was “very skinny” with “no abnormal hair
growth”. I also had a “visible abdominal pulse”.
The words “abdominal pulse” for some reason
grabbed the attention of nearby groups, and they
rushed to our exam room to see. My audience tri-
pled (or quadrupled) in size, and the chatter added
to my discomfort from the blinding light. I lay on
the table patiently and waited for the next part of
the exam.
The commotion died down, and the other
groups left. My peers continued with the train-
ing exercise. They now had to auscultate the four
quadrants of my abdomen. I felt the diaphragm of
a stethoscope being placed onto my right upper
quadrant and then my left. My body had no choice
but to acclimate to the cold piece of metal that
was touching my skin. As my peers took turns
listening, I wondered if they would find anything
abnormal.
The final parts of the abdominal exam in-
volved percussion and palpation. With each pair
of hands I could feel a different temperature, pres-
sure, and level of confidence (or timidness). The
girls’ were cold and shy, while the guy was warm,
clammy and pressed deeply. Then came the part
where they palpated my liver and spleen three or
four times. That was the most uncomfortable part,
but despite the pain, there were no findings of
spleno- or hepatomegaly.
Over the course of yesterday’s training ses-
sion, I thought about all the patients that I had
seen in this very same position. Some had a chief
complaint of stomach pain while others had al-
ready been diagnosed with colorectal cancer.
There were patients who were post-op and others
who were in the ICU. I remembered some hav-
ing a sense of humor during the exam, while oth-
ers were very quiet and apprehensive. Some were
even in great pain. I realized that whatever their
behavior, it was their way of coping with the un-
ease of being examined, touched, and discussed
over. I have never been a patient before, and this
was my first taste of what it was like.
Granted that I was not being examined un-
der the same dire circumstances as the patients
from my research job, but at least I can now relate
somewhat to what they must have felt. Although I
may or may never have the exact same feelings as
my patient, this experience made me conscious of
the fact that those feelings will exist in every
physical exam. I believe that communicating to the
patient or showing him or her that you are aware
of what they are feeling is a way of being empa-
thetic. That is just one thing I learned from that
training session. O
I also had a “visible abdominal pulse”. The words “abdominal pulse” for some reason grabbed the attention of nearby groups, and they rushed to our exam room to see. My audience tripled (or quadrupled) in size, and the chatter added to my discomfort from the blinding light.
AT THE BEDSIDE
10 OBLITERANTS
DURHAM, NC. LARISSA LESTER
AT THE BEDSIDE
11OBLITERANTS
JENNIFER SCHWENK, ACRYLIC ON CANVAS
NOT JUST ANOTHER JANE
BY DANIEL LICHTSTEIN, MD
SYSTEMS-BASED PRACTICE IN THE
1980S
IT WAS MY FOURTH OR FIFTH YEAR IN PRIVATE PRACTICE AND I HAD RECENTLY ASSUMED THE CARE OF AN EIGHTY-FIVE YEAR OLD WOMAN, JANE, IN A LOCAL NURSING HOME. She was ex-
tremely pleasant, and sharp as a tack. She had moved to
Florida from the northeast a few years before, was widowed
without children, and lived in a small home before suffering
a hip fracture as a result of a fall. After surgical repair, she
was admitted to the nursing home to continue her recovery.
The staff, including the social worker, did not feel it was
safe for her to return home alone.
When I met Jane, she was ambulatory and doing fair-
AT THE BEDSIDE
12 OBLITERANTS
ly well. She told me she wanted to return to her
home, but acknowledged that she would feel more
secure if she had an aide or companion living with
her. Several weeks later, I received a call from the
nursing home informing me that Jane was going
to be discharged to her home, and that one of the
employees of the home had helped her to find a
full-time aide. I asked the nurse to be sure that
Jane made an appointment to see me in the office
two weeks after she was discharged.
A few days after her discharge, I noticed
that Jane was scheduled to see me in a few weeks,
and I felt happy for her that she had been able
to return to her home. When the day of the ap-
pointment arrived, I was disappointed when she
did not appear, and was concerned. I asked my
office nurse to phone her to both check on her
and reschedule the appointment. My nurse spoke
with Jane’s aide who reassured her that Jane was
doing well, and made a new appointment for the
following week.
During that week, I periodically thought
about Jane but was not overly concerned. How-
ever, when the day of her rescheduled appoint-
ment came around and she again did not appear,
my anxiety increased. I called her home but there
was no answer. It was difficult to concentrate
on my remaining patients that morning as I was
thinking about my next step. My instincts told me
that something was very wrong. When lunch time
hit, I told my nurse that I was going to go to Jane’s
home, and would call her when I was there (this
was in the pre-cell phone era).
Jane’s home was in a quiet neighborhood,
a few miles from my office. When I arrived, there
was a car in the driveway, and as I approached the
front door, I could hear the TV on. I rang the bell
and knocked on the door without response. After
a few minutes, I walked around to the side door of
the house, and again had no response. My level of
anxiety was now extremely high. I got back in my
car, drove to the gas station down the block and
called 911. Although I could not say for certain
that anyone had been harmed, I shared my feeling
that Jane may be in danger.
The police arrived within a few minutes,
and when they identified themselves at the front
door, Jane’s aide opened the door. The police
found Jane locked in a bedroom, scared and di-
sheveled. Several dirty plates of old food were
scattered on the floor of her room. Upon further
investigation, the police discovered that many of
Jane’s belongings (including paintings) were in the
trunk of the aide’s car. It was clear that Jane was
being mistreated, and that many of her belongings
had been stolen.
When I entered the room where Jane had
been, she looked up at me and said, “Please take
me back to the nursing home.” We drove there
together shortly after. O
It was difficult to concentrate on my remaining patients that morning as I was thinking about my next step. My instincts told me something was very wrong.
AT THE BEDSIDE
13OBLITERANTS
EDUCATION
I spent the first six weeks playing cats cradle with a cadaver.
Looping my purple gloved hands and hesitant forceps around
the nerves and arteries of its brachial plexus.
I paid attention to our classes in empathy and practiced
listening to heartbeats, but as usual the only one I could hear
was my own.
I insisted on getting glasses.
I traded my point of view for an iPad and got a new cat.
Since last year,
I’ve forgotten how to cook.
And how to speak above a whisper
And the last time I picked up a pen to write a story, I found
that I no longer could.
Any chi or inner peace that I’ve ever pretended to have is gone
yet I’m more in tune with my body than I’ve ever been.
I feel the nerves of my lumbar spine compress after studying
for many, many hours.
My eyes have stopped accommodating like they used to
my skin has gotten paler,
my split ends wider,
and I can’t remember the last time I got a pedicure.
I’m exactly where I was last year and still, my biggest thrill is
in rearranging the furniture.
Waging war against the bathtub and declaring mutiny on the
couch.
I WROTE THIS POEM IN LEARNING COMMUNITY
BY SHARI SEIDMAN
14 OBLITERANTS
LARISSA LESTER
Within these gold dusky confines
Sit three women, pious on a pew
Pristine habits of pure black and white
Harsh as the smoldering thrum
of the neon blue sky
Soft as the wrinkle of a knuckle in prayer
Bent head, wearied eyes, pursed lips
Three women, dainty as candle tips
Steady as the summer flame’s kiss
If we dare to light one up
Will we receive:
A slow burn, simmering delicate and earnest
Nuns at ChurchBY MYRA AQUINO
A blast of blue torch, blithering,
from a slap of the hand
Or nothing?
Nothing but the wind, a whisper
A calling that murmurs your name
And disappears
One looks up and glares at me,
black eyes glowing
The second stares at her shoes
The other leaves
What a life. What maiden hair lies unglimpsed.
What secret is theirs alone?
EDUCATION
15OBLITERANTS
BY ALEXANDER KAPLAN
The Rose Ceremony is a special event that occurs after the completion of the Anatomy module. It was created by UMMSM
medical students several years ago to honor the individuals who participated in the body donation program, and to mark an
important passage in the medical education.
UPON ENTERING MEDICAL SCHOOL, people give you all sorts of advice – the best study
strategies, where to live, how to deal with the in-
timidating daily challenges. I was warned that the
anatomy lab would be a daunting place, where
students protect themselves from the shock, visu-
alizing machine more than man. I say, this cannot
be more untrue. From the first moment I met the
donors, I was given a sense of purpose and intent,
and granted a deep sense of connection with the
donors. This gift entrusted to me, to us, by men
and women who hadn’t even met us.
One of our classmates composed a poem,
and in that poem reflected: “The patient I never
knew made a conscious decision to give… And
what can be more dignified to give to what all
mankind seeks: knowledge.”
Some have said that this is a rite of pas-
sage, an act of tradition. No, this experience is no
rite, it is a transformation. For many of us, this ex-
perience provides an end to vague notions of the
human form and allows meditation on ‘what is hu-
man’. Once-avoided thoughts are no more. With
our newly-discovered Hippocratic eye, those empty
spaces of our minds are filled in by this wondrous
gift. This metamorphosis provides the student
with a compelling respect for death and cherish-
ment of life. In our first year fraught with passages
of text and the gradual unraveling of the yarn of
human science, we are reminded of humanity.
Some have said that this is a rite of passage, an act of tradition. No, this experience is no rite, it is a transformation.
ROSE CEREMONYSPEECH REPRESENT ING THE MD/MPH CLA SS OF 2015
EDUCATION
LARISSA LESTER
What a sense of responsibility to know this
body in ways the donor never knew. It’s a strange
and beautiful sensation to observe the true and
intricate workings of the human body. The almost
ethereal experience consumes you. You look at
the hands – “what did these hands hold?” You ex-
amine the lungs – “what air did you breathe?” The
heart, the brain – “what did you experience, who
did you love?” “What were your passions, your
dreams? And who else did you influence in your
life?” The face – “whose lips touched these? Who
stroked your cheek out of love?”
16 OBLITERANTS
EDUCATION
In your touching silence,
you were my teacher and my
first patient. You willed your-
self as your last gift, an ultimate
sacrifice, and we cannot thank
you enough. Through this ac-
tion, you’ve bestowed upon us
an amplified effect; you have in-
fluenced fifty-two future doctors
and their countless patients. In
our hearts and minds, let us give
our thanks to our silent mentors
and their loved ones. What a
privilege this is, and an impact
echoing into our future, a grate-
ful blessing.
On behalf of the MD/
MPH Class of 2015, thank you
all. O
“GEL ELECTROPHORESIS.” JOANNE DUARA
Forced
Smiles. Chatter. Ill-placed and clumsy quips.
Eerie creeks of silence and tautly strung
lapses in banter.
Every pause and lapse is fodder for internal
monologues
Actors on the stage within read lines and
look in mirrors
A fairy tale told beginning to end, murderous
and cunning throughout.
Humanized Mice
BY JOANNE DUARA
Here we have humanized mice
Made naïve and clean, coddled from misfortune
What symptoms do we observe?
in our most human of house pest
See, they have all they want for
And look, they are miserable.
BY JOANNE DUARA
17OBLITERANTS
ENOUGH WITH THE PUNS
WRITTEN BY UNIDENTIFIED STUDENTS
IN AN UNIDENTIFIEDSOCIAL NETWORKING
WEBSITE
ARTWORK BY MARY LAN
9 CONFESSIONS FROM THE CARDIAC MODULE
EDUCATION
18 OBLITERANTS
AT THE BEDSIDE
FEATURES
Summer, o summer
Per fect time to stay busy
Or to relive life
HAIKU BY ISAAC LEE
MYRA AQUINO
19OBLITERANTS
FEATURES
THIS FALL ISSUE FEATURES THE ACTIVITIES OF MEDICAL STUDENTS OVER THE SUMMER AS THEY PURSUED PUBLIC HEALTH PROJECTS,
BASIC OR CLINICAL RESEARCH, OR SIMPLY KICKED BACK AND RELAXED-- BOTH
IN THE US AND ABROAD.
DESTINATIONSSAN FRANCISCO, CA MAI TRAN
CORNWALL, ENGLANDJASON HEFFLEY
GENEVA, SWITZERLANDMICHAEL MAGUIRE
NYARUSHANJE, UGANDAGREG MILLIGAN
SAN BLAS, PANAMAANNE KIMBALL
ADAM CROSLANDELAN HORESH
n nn
DOMINICAN REPUBLICNICK CNOSSENBRANDON HENDRIKSENCARLY RIVETKELLY GRANNANRAMMY ASSAF
FORT SAM HOUSTON, TX BRYAN STEPANENKOALEXANDER KAPLAN
THOMONDE, HAITI JULIE LEVASSEURADAM CROSLAND
20 OBLITERANTS
FEATURES
BASIC COMBAT TRAINING IN FORT SAM HOUSTON, TEXAS
PRIVILEGED BY BRYAN STEPANENKO
I FEEL PRIVILEGED. But it’s not be-
cause I am a medical student in sunny
South Florida; nor is it because I’m a lo-
cal native to gorgeous beaches, indulgent
nightlife, and interesting people. I feel
privileged because I have an opportunity
to do what much less than 1% of the U.S.
population gets a chance to do… to serve
as a military physician and provide care
to our soldiers and their families. I am
excited to have joined such a unique or-
ganization of individuals, especially since
we share many of the same priorities, pas-
sions, skills and experiences.
n
21OBLITERANTS
FEATURES
This summer, I attended a six-week Army Basic Officer
Leadership Course (BOLC) at Fort Sam Houston, Texas.
This is where medical students, dental students, and vet-
erinary students (Army HPSP scholarship recipients) are
taught to be soldiers. We were introduced to the roles we
will play throughout our future careers in military medi-
cine. We learned about things like being a leader, march-
ing in formation, saluting, commands, military discipline,
marksmanship, navigation, convoy travel, and field hospi-
tal operations.
I have an opportunity to do what much less than 1% of the US popula-tion gets a chance to do... to serve as a military physician and provide care to our soldiers and their families.
22 OBLITERANTS
After surviving four weeks of “death by powerpoint,” our class
headed to a field camp to live in austere conditions, eat MREs (meal
ready-to-eat), and learn practical skills in the 100+ F heat. As a
person with an affinity for self-torture, I truly enjoyed the time we
spent at the camp.
FEATURES
Whitewashed walls, monotone voices
Four hundred bodies devoid of choices
Sea of camo, nodding heads
All the soldiers dream of bed
Unfitted suits, yet clean and crisp
One drill captain with a lisp
“Drink, drink water!” It’s only day three
But you must sit still, you may not pee
Yet a rising change flows throughout the room
No longer “I”, but “my platoon”
One fresh lieutenant whistles a marching tune
Death by PowerPoint
BY ALEXANDER KAPLAN
23OBLITERANTS
FEATURES
The most enjoyable
part of the experi-
ence, however, was
not training-related at
all; it was the people.
I made friends with
literally hundreds of
individuals that I will
encounter again in the
future, be it in a pro-
fessional setting dur-
ing a deployment or in
a social setting as one
friend enjoying the
company of another.
Needless to say, I am glad to be finished with training. The sun, the fun, the friends,
and the incoming medical students welcome me. Miami, it’s so good to be home! O
Death by PowerPoint
24 OBLITERANTS
FEATURES
The president has granted us commission
Training for our medical mission
Lieutenants, captains, high in rank
Have yet to see jet, copter, tank
Enlisted men from Middle East
Salute ME, who’s earned the least
Dripping with sweat, a sloppy formation
Must earn their right to represent this nation
Hooah Hooah, must lead by example
Support my troops, no medical gamble
For we represent the stripes and the stars!
We are Medcorps, we are Butterbars!
Butterbars
BY ALEXANDER KAPLAN
25OBLITERANTS
FEATURES
UCSF CLINICAL RESEARCH IN SAN FRANCISCO, CA
nIn San Francisco, at UCSFI shadowed two surgeons until I left
I saw an operation on the brainThose four point five hours drove me insaneIt was too lengthy, it was too boringI can’t help it if it got me snoring
I saw an operation on the spineFor that hour, the planets were alignedIt was so exciting, it was so funIt made me believe that spine was the one
In San Francisco, at UCSFI chose spinal surgery when I left
BY MAI TRAN
MAI TRAN
To Brain Or To Spine
26 OBLITERANTS
NUTRITIONAL HEALTH RESEARCH IN SAN BLAS, PANAMA
nFEATURES
BY ANNE KIMBALL, ADAM CROSLAND, ELAN HORESH
Elan, posing with a group of Kuna boys outside of Sherri Porcelain’s
hut on Tikantiki, off the coast of Panama. These kids were so smart,
curious, and fun. We built some great friendship in the two weeks we
spent on their island.
DETAILS Nutritional health analysis for the Kuna; measuring of vital signs and anthro-
pometrics, conducting oral lifestyle survey, and implementing basic nutritional
awareness. Conducted a community healthcare assessment and data collection
project in the San Blas Health Center Project.
27OBLITERANTS
FEATURES
Adam and Anne playing Uno and practicing Spanish with our
new Kuna little brothers and sisters. We were treated as part of
our host families during our stay on the island.
Elan with two
prominent elders
in the community
of Niadup, after
taking their blood
pressures. As part
of his public health
project, he went
hut-to-hut taking
vitals and asking
about dietary hab-
its.
28 OBLITERANTS
Elan with Octaviano
and a bunch of kids,
after helping with
their weekly trash
pick up day. With in-
creased access to
mainland Panama
and the rest of the
world, the communi-
ty now has cell
phones, TVs, and a
packaged food-based
trash problem. O
FEATURES
“HAWAII.” JENNIFER SCHWENK, ACRYLIC ON CANVAS
29OBLITERANTS
FEATURES
PUBLIC HEALTH PROJECT IN NYARUSHANJE, UGANDA
nBY GREG MILLIGAN
This is a picture of the river nearby
the village that I went to. This was
the village population’s primary water
source.
We took this water and had it pumped
to a holding tank where the water is
then chlorinated for safety prior to dis-
tribution to the population.
30 OBLITERANTS
FEATURES
Of course, taking the
water from the river
to the tank required
quite a bit of work to
dig and lay pipework.
While I was in the vil-
lage, students at a lo-
cal school heard of
my project to bring
safe water and they
were inspired to help.
So about 12 students
came out for 3 straight
days to dig trenches
for the pipework.
These are children and local nurses
carrying water jugs from the river
(women and children typically collect
the water in Uganda). O
31OBLITERANTS
FEATURES
ENVIRONMENTAL HEALTH RESEARCH IN CORNWALL, ENGLAND
nBY JASON HEFFLEY
Cornwall, a peninsular county in the most southwesterly part of England, is a prime
location for conducting research in understanding the positive health of effects of
human interactions with the sea.
At low tide, as in this picture, the sandy beaches seem endless.
DETAILS European Center for the Environment and Human Health, Cornwall, United King-
dom. Jason worked in the UK this past summer on investigating pharmaceutical
toxins in the environment and evaluating their potential impact on human health.
32 OBLITERANTS
The Knowledge Spa at the Royal Cornwall Hospital is home to the European
Centre for the Environment and Human Health.
Next page: The Euro-
pean Centre for the En-
vironment and Human
Health is located in
Truro, Cornwall in the
southwest of England.
The narrow streets lead
up to Truro Cathedral,
the centerpiece of the
city.
The European Centre for the Environment and Human Health aims to conduct world class in-
vestigations that focus on the interaction between human health and the environment. The
multidisciplinary centre fosters an environment of intersectoral collaboration amongst the
many researchers and students. O
FEATURES
33OBLITERANTS
JASON HEFFLEY
34 OBLITERANTS
ORAL HEALTH ASSESSMENT IN THE DOMINICAN REPUBLIC
nFEATURES
BY NICK CNOSSEN, CARLY RIVET, BRANDON HENDRIKNSEN
The group with all the community health workers from Puerto Plata.
Brandon and Nick with the
children of Los Hoyos.
35OBLITERANTS
FEATURES
DETAILS
A group shot in front
of a hospital in La
Romana.
Brandon, Carly, and Arelis
on the beautiful beaches
near Santo Domingo.
At seven in the morning, the
weary travelers head to the
local bar for a few Presidentes
prior to clinic.
Medical Students in Action,
Dominican Republic. Nick, Carly,
and Brandon have been traveling to
the Dominican Republic working on
completing a baseline assessment
to see if it would be feasible and
acceptable to implement an oral
health intervention aimed at
decreasing decay and extractions
through the application of fluoride
varnish to children.
36 OBLITERANTS
INTERSECTORAL COLLABORATION IN THE DOMINICAN REPUBLIC
FEATURES
DETAILS
Nick attempts to imbue enthusiasm in an unimpressed patient.
Carly chillin’ with children from a rural immigrant Haitian village. O
37OBLITERANTS
FEATURES
INTERSECTORAL COLLABORATION IN THE DOMINICAN REPUBLIC
nBY RAMMY ASSAF
Batey Relief Alliance mobilizes its STD prevention team and leads a culturally sensitive
workshop among Haitian agricultural workers by their farmland.
DETAILS
Rammy traveled to Peru and Dominican Republic to gain insight into how to support the health of impoverished
populations, while working along the lines of political disenfranchisement. Farmworkers in the Bateyes face
severe discrimination from the Dominican government and often lack citizenship documentation. He also hoped
to gain a direct perspective of what it takes to operate a humanitarian-based umbrella organization, which
incorporates the work of NGOs, governmental agencies, religious groups, and international aid. Additionally,
his service in the Kausay Wasi clinic provided first-hand experience in intersectoral collaboration: between the
fields of medicine, public health, and local small-scale businesses that draw support from the clinic.
38 OBLITERANTS
FEATURES
Kausay Wasi clinic worker takes a break
from work to prepare a meal for the rest of
the staff. Pachamanca, Quechua for “earthen
pot” is a tradition in which coals are heated
and meat, potatoes and other goods are kept
inside. It’s covered with earth and bakes for
about 2 hours - then the food is dug out and
served. O
Kausay Wasi clinic’s rural nurse checks the blood pressure of
an indigenous Quechua woman while her children watch. The
nurse makes weekly hikes to provide continuity of care to
rural communities in Peruvian mountain ranges.
39OBLITERANTS
HIV/AIDS INTERNSHIP IN THE DOMINICAN REPUBLIC
nBY KELLY GRANNAN
FEATURES
Market place in Santiago, Dominican Repub-
lic where I visited my host family and profes-
sor from study abroad during my undergrad.
This is me in front of
the logo for the HIV
clinic where I was
working at.
DETAILS
Kelly participated in
an internship with
International Family
AIDS Program in La
Romana, Dominican
Republic in summer
2012.
40 OBLITERANTS
FEATURES
This is me with all of the students
from the Columbia University
School of Medicine that were also
working at the clinic. The leftmost
person is the student coordinator
of the International Family AIDS
program.
This is Dr. Molina. She is an inter-
nist that I worked with for the HIV
knowledge surveys, and shadowed
for long-term maintenance therapy
for HIV positive patients. O
41OBLITERANTS
FEATURES
MATERNAL HEALTH RESEARCH IN HAITI
nBY JULIE LAVASSEUR AND ADAM CROSLAND
Our public health team
working with Project
Medishare in Thomonde.
From left to right- Adam
Crosland (MD/MPH
student), Dr. Chakhtoura
(MD/MPH), Geralda
Duverny (ARNP/MPH),
Julie Levasseur (MD/MPH
student), Michelet Desire
(translator), and in front,
Jean Baptiste (translator).
“Off roading in Haiti”-- During our trip out to do community outreach, our jeep
got stuck in the mud. This shows how in general roads in the central plateau
of Haiti are non-existent. If our 4 wheel drive vehicle had difficultly with
transportation, one can imagine how difficult it is for people of the community
to travel down the mountain side in search of medical care.
42 OBLITERANTS
MD/MPH students, Adam Crosland and Julie Levasseur, working
with the medical staff at Project Medishare’s Maternal Health
Center. The center is located in the central plateau of Haiti and
offers pre-natal care, family planning, and a safe place for wom-
en of the community to deliver their babies.
A Haitian grandmother and her two grand-
sons gracious enough to show us their kitchen
and how they prepare the family’s meals. O
FEATURES
DETAILS
Through the Center
for Haitian Studies,
Miami, Florida & Project
Medishare, Haiti, Julie
used her field experience
to evaluate the differences
in pre-natal care and
maternal health between
the immigrant Haitian
population of Little Haiti
and the Haitian women
being served at the
Medishare Hospital in
Haiti.
DETAILS
In Haiti, Adam Crosland assessed
the efficiency of their mobile clinics
that extended to rural parts of the
community in the Central Plateau.
He surveyed women of child bearing
age that looked at the difficulties
the local women faced in obtaining
care in their community and how the
mobile clinics assisted in addressing
these public health concerns. The
survey also inquired about infant
mortality rates (IMR) and community
perceptions concerning maternal
delivery methods and maternal
healthcare.
43OBLITERANTS
“ALASKA.” JENNIFER SCHWENK, ACRYLIC ON CANVAS
The Car Ride in FallBY JOANNE DUARA
Slumping behind the wheel
the mist and grime of Autumn and colorless sky
Room made for vibrancy in orange, gold brown red
and fading, cowering greens
Fish-scales trim the houses, their comically colored
facades withstanding the dreary slight of rain
Two leaves, two Burnt Siena leaves, stay pinned and
wind-whipped to the car
FEATURES
n nn
44 OBLITERANTS
DDIIVVEERRS TYS TYID VERSIIITYOBLITERANTS
OF THOUGHT. OF BACKGROUNDS.
OF LIVED EXPERIENCES.
The next i s sue of Obl i terants w i l l cover the theme of “Diversity ” and we are currently accepting submissions-- essays, op-eds, s tor ies, poetr y, ar twork, photographs, mus ic, v ideos-- that go beyond s tereotypes and “ the s ing le s tor y ” , and ins tead celebrate the r ichness and complex i ty of our l ives and exper iences, w i th in and outs ide of heal thcare. We especial ly hope to br ing to l ight perspect ives, s tor ies, and express ions that are usual ly m isunders tood, underrepresented, or even rendered “ inv i s ib le. ”
N O V E M B E R 1 6 , 2 0 1 2 , F R I D AY D E A D L I N E
s e n d t o o b l i t e r a n t s @ g m a i l . c o m
9W I N T ER I SS U E 2 0 1 2
45OBLITERANTS
YYY
o b l i t e r a n t s @ g m a i l . c o mN o a ppli cati o n r equ i r ed. J u st b r i n g yo u r fac e. :)
S h o o t u s a n e - m a i l at o b l i t e r a n t s @ g m a i l . c o m by O c t o b e r 1 0 , 2 0 1 2 .
W e a r e a lways i n n e e d o f b r a i n s t o r m e r s , e d i t o r s ,
d e s i g n e r s , a n d c o n t r i b u t o r s w h o c a n c o n t i n u e t o h e l p u s
p u s h t h e b a r a n d p r o p e l
O b l i t e r a n t s i n t o a h i g h - q u a l i t y j o u r n a l c o v e r i n g
t h e h u m a n i t i e s a n d s o c i a l s c i e n c e s i n m e d i c i n e a n d p u b l i c
h e a lt h .
JOIN THE OBLITERANTS
TEAM!
46 OBLITERANTS OBLITERANTS
Recommended
