Fall Break in Iceland

This wasn't our exact route, but here's a rough idea
of the road trip we took around the island.

Photo from: http://www.misswanderlust.ca/category/iceland/

Several of my Loyola classmates and I spent our Fall break in Iceland. We rented two cars and went on a road trip around the island, spending each night in a different hostel in different cities/towns.

Reason for going to Iceland? To take a break from our demanding studies to see the majestic beauty of this country, and it truly was majestic. We saw waterfalls (I can’t even count how many), geysers, hot springs, a glacier, several black sand beaches, and much more.

We experienced nearly every weather pattern during our stay, including snow (a blizzard), pouring rain, and powerful winds. On our trip to Dalvik in the North, we hit a winter snowstorm in the mountains, and we passed two cars that were overturned just off the road. It was horrifying to see. It didn’t look as though there were any deaths, thankfully, but we couldn’t imagine having such a traumatic experience in a foreign country.

Thankfully, we arrived safely to and from all of our destinations, and we have returned home.

The beginning of the trip, quite frankly, was stressful. Out of the 9 of us, WOW Air (which, by the way, is an airline that I do not recommend to ANYONE) did not load FOUR of our luggages. They were left behind in Chicago, and the four of us did not have our own changes of clothes, toiletries and other necessities for most of our trip. FOUR OUT OF NINE. We did not find out that our luggage was left behind in Chicago until about 2 days after our arrival.

We finally retrieved our luggage at the airport after not having it for nearly 5 full days. I spoke to another woman at the Baggage Service desk who said that on her flight from Baltimore, WOW Air left behind the luggage of many people on that plane as well. She said she was never flying with them again. I too am never flying with WOW Air again. I don’t think I will ever understand how an airline can be so incredibly irresponsible. This is a level of incompetence that I have never before experienced (or heard of!) on my previous travels.

The luggage situation was stressful but I was still grateful to be in such a beautiful place. I spent my 24th birthday in Iceland with wonderful classmates who made the experience a great one.

Our original plan was to drive around the entire island, but a bridge collapse and poor road conditions on the way to Vagnsstaðir (in the South) forced us to change our plans, cancel our booking at the hostel in that town, and instead travel back the way we came in the North.

Here’s a very quick rundown of the things we saw:

 Sunday – Arrived in Keflavik (airport), drove to Reykjavik (the capital), grabbed some food and explored the city little bit (as well as other attractions on our way to our first hostel in Saeberg): the church, Leiff Erikkson statue (given as a gift to Iceland from the U.S.), a waterfall, and Deildartunguhver (no idea how to pronounce that), Europe's most powerful hot spring.

Monday – On the way to our next hostel in Akureyri (AH-KOO-RAY-REE: not 100% sure if this is the correct pronunciation haha, but we’ve been calling it this the entire trip), we stopped at Húnaþing vestra to admire the pillar rocks, grabbed lunch at a homely restaurant (the seafood soup was delicious), stopped at a black sand beach where we saw jellyfish stuck in the sand, seals, another waterfall, and a huge, picturesque rock (whose significance we don’t know).

That night we grabbed dinner in Akureyri at Fish and Chips. Some of us ordered fermented shark :O The meat was very slippery; it was hard to eat it on its own, so it's typically consumed with Brennivin, a special type of Icelandic vodka.

Tuesday – On Tuesday, we stayed in Akureyri for a bit to grab coffee, check out the local gift shop, and visit a small botanical garden before heading out to Reyðarfjörður (one of the locals taught us how to pronounce this town correctly, but we forgot it, so we continue to call it by the much easier and endearing name: Rey-ferger-burger). On our way to Reyðarfjörður, we stopped at Myvatn Nature Baths for a dip, smaller hot springs (which all smell like sulfur [rotten eggs]; some of the showers in the hostels also smell like eggs because they’re geothermally heated), and we explored the entrance to a cave (where a couple of us swore a love scene in Game of Thrones took place).

Wednesday – The hostel we stayed at in Reydarfjordur has the best view and accommodating owners! The hostel was actually a huge house with an amazing view of the mountains:

That morning we grabbed coffee and some breakfast at a local shop. I was craving scrambled eggs, so I ordered an egg and cheese sandwich with white garlic sauce. Once I received it, I saw that the eggs were cut up pieces of hard boiled eggs, the cheese was not melted, and the garlic tasted a little strange in the sandwich. Once our server set my plate down in front of me, one of my classmates started sniffing wildly and looking all around him. “What smells like sulfur? Do you guys smell that?” We just stared at him. “It smells like eggs. It’s following us everywhere!”

Dettifoss 

Solheimajokull glacier 

 

On our way to the next hostel in Dalvik, we went to see the most powerful waterfall in Europe (Dettifoss) and another waterfall. On this day alone we drove through a blizzard and pouring rain in the mountains. After the second waterfall we decided to head straight to the hostel for fear of the weather getting worse.

Thursday – Four of us left early to drop off one of our classmates at the airport (~6 hour drive) and pick up the luggage that WOW Air left behind in Chicago. For the rest of the day we drove around the Golden Circle to see geysers and another waterfall :) That night some of us went out in Reykjavik 😊

Friday – On our way to the small village of Vik, we saw an old Icelandic house made of stone and grass roofs (built years and years ago), a tall waterfall (Skogafoss) that you can see from the top after walking 527 steps, the Solheimajokull glacier(!), and a black sand beach, Reynisfjara, Iceland’s most dangerous beach (bottom right). 

Skogafoss 

Saturday – Headed back to the Keflavik airport from Vik

~*~*~

Shortcomings of the trip:

Gas. We spent hundreds of dollars on gas this week. They charge per liter, not per gallon like in the U.S. A gallon has 3.78 L. On average, gas prices are 204 Kronas (which is about $2). So to fill up our tank, we’d have to spend around $100 (split 3-5 ways, depending on how many people are in the car). 

Prices. Iceland is expensive. We'd spend around $12-15 just for a burger. The fancier meals could be as much as $50. On average, if you want a good, fulfilling meal, even at the places that aren't fancy, you’d have to spend around $20-30. Other things: coffee/chocolate (~$6), regular, plain, no-name brand woman’s T-shirt ($12), a pair of thin, plain socks ($10), hot dog (~$4-6), etc. You get the idea. The cost of things is ridiculous because wages are higher over there. (Income taxes are also significantly higher as well).

Trip highlights:

The beautiful sights. You might be able to see bits and pieces of the incredible landscape in other places, but Iceland has it all.

The warm, friendly people we were able to meet (from Iceland and other countries). At one of our hostels we actually met two sisters who are from Peoria, IL, nearby our own homes. The diversity of the tourists was amazing. Most of the tourists visiting Iceland were Asian, but there were many others from Europe and the states. 

It was wonderful spending a week in one of the most beautiful countries in the world with 8 other enthusiastic, fun-loving medical students.

Thanks for reading :)

Takk fyrir! (“Thank you!”)

June 2017: A Month Volunteering and Studying in Bolivia

I spent the month of June as a student/volunteer with Sustainable Bolivia, an organization located in Cochabamba that offers Spanish and Quechua classes, and is partnered with many non-profits in Cochabamba and surrounding areas. Sustainable Bolivia hosts volunteers from all over the world. Throughout my trip I met volunteers from all over the U.S., as well as France, the UK, Norway, Australia, Italy, and Argentina.

Mano a Mano Bolivia ("Hand in Hand" Bolivia)

Photo taken from here

I lived with a homestay family, took Spanish and Quechua classes, and volunteered for the non-profit Mano a Mano Bolivia (MMB). MMB is committed to serving marginal populations and improving conditions in the sectors of health, education and road infrastructure in Bolivia.  Bolivia is the poorest country in South America with the highest rates of illiteracy, school dropouts, and maternal and infant mortality. There is also a shortage of doctors and nurses. In his book "Bolivia in Focus: A Guide to the People, Politics, and Culture", Robert Werner shares, “At 6.6 doctors and 3.4 nurses per 10,000 people, Bolivia’s health staff is about half the Latin American average....there is a geographical imbalance, with many urban areas having sufficient staff of doctors (but still a shortage of nurses) but too few of both in rural areas" (76). MMB’s efforts to address these issues are incredible. The picture below shows what MMB has accomplished thus far since they were founded in the early 1990s. I’ll give a few examples: 

• 158 Centros de Salud (health centers/clinics) have been constructed and established
• 59 schools have been constructed and established
• Over 37,000 patients have been seen in day/mobile clinics (what they call "jornadas") across the country (this does not include the patients seen in the health centers)
• 45 disadvantaged Bolivian students have been awarded a scholarship through Proyecto Soñar (Project Dream) to continue their education in a career of their choosing

My Volunteer Duties

It has been an honor working with Mano a Mano this month. During my first week, I met the office staff (which includes physicians, architects, engineers, project coordinators, a photographer, and others). My primary role as a volunteer was to assist with a few different projects:

• I helped set up for and organize el “Curso de Enfermería” (a course that MMB hosts for nurses from all across Bolivia for continued certification). At the end of the course, participants were asked to complete a survey about their experience. I organized the survey responses into a spreadsheet, making it easily accessible for Mano a Mano to analyze responses for quality improvement of the course.

• I volunteered at one of Mano a Mano’s clinics in La Maica Central, a rural community located about 45 minutes away by trufi from the center of Cochabamba. I helped organize medications in the pharmacy, fetched a few things here and there for the doctors as they examined and consulted with their patients, checked some patients into the computer system, and assisted a couple of doctors on their trips to set up day clinics and visit homebound elderly in nearby communities (that are a bit more resource-poor than La Maica Central). 

One of the odontologists attending to a Tsimane
patient in TIPNIS, Beni Department

• I joined three Bolivian doctors (one general physician and two odontologists, specialists in the structure and diseases of teeth) on a trip to TIPNIS (Territorio Indígena y Parque Nacional Isiboro Secure), an Amazonian Indigenous community located about an hour jet ride away from the center of Cochabamba. We were in the community for two days (6/17-6/18). On Saturday we arrived in the morning, set up clinic, and tended to about 60 patients throughout the day. On Sunday we continued seeing patients, and in the later morning the odontologists held an educational session with the community about proper tooth brushing. This session was translated to Tsimane by a member of the community.

• Upon returning home, I plan to continue a couple of small virtual projects for Mano a Mano, including translating a few documents and recording a voice-over for a publicity video for the organization.  

I had a wonderful experience working with MMB, but I hope to return with more medical training under my belt. I have only completed my first year of medical school; needless to say, I don't know enough to properly tend to a patient. During my fourth year, I would like to return to Bolivia to continue working with the marginalized communities across the nation that Mano a Mano is committed to serving.

Common sicknesses

The most common conditions seen in the clinic (La Maica Central) were fevers, colds, diarrhea (due primarily to parasitic infections and the water), tuberculosis, and UTIs (urinary tract infections). In TIPNIS, all of these illnesses were seen as well, but there were more cases of parasitic infection. We also tended to many with severe teeth damage and children with fungal skin infections.

Things I didn't like about my immersion experience

Streets of Cochabamba.
Photo taken from here

I'll open up my reflection on this experience to general negative impressions, then I'll end on a good note and talk about what I loved. Okay, first thing that comes to mind: the aggressive driving and lack of adherence to safety regulations on the road. Many cars also do not even have seat belts. When I got into a taxi for the first time with one of my friends, I automatically searched for the seat belt. She watched me look around frantically for a while then asked with a laugh, "Is this the first time you've been to a developing country?" I laughed off her teasing and realized that a lot of vehicles I've been in during my previous trips to the developing world also lacked seat belts: Guatemala, Jamaica, Panama.... (or perhaps this was mainly the case just in the cars I'd been in. Still....very dangerous).

The crazy driving on the streets of these countries is also similar to what I've seen in Bolivia this past month, but the aggression of many drivers bothered me much more this time around because I almost died four times (seriously): twice I was almost run over by cars that did not yield for me as I crossed the street (I quickly learned that pedestrians do not get the right away), once in a taxi with a young driver who nearly hit another vehicle as he weaved in and out of lanes like a maniac, and once in a trufi (mini-bus) with an elderly driver who I was convinced had no peripheral vision. He too almost collided with another car. The lack of safety on the roads became infuriating to me after a few weeks. Needless to say, there have been tragic stories in the news about people who lost their lives because of the insane driving.

One other dislike that comes to mind is the audacity of some men to use the bathroom out in the open (in the bushes, by a tree, etc). I witnessed this one too many times and was disgusted. I remember seeing a man instruct his son (who was young, probably about 5 years old) to pee by a telephone pole in front of traffic! I couldn't help but give the father a searing glare. "Seriously?" I wanted to say to him. "You're teaching your son that public indecency is okay and that he can use the bathroom wherever he wants whenever he wants? That's what dogs do!" I just walked past them, silently judging the father, but mostly the culture surrounding this indecency because clearly, many men were not taught properly.

Lastly, I wouldn't say this is something I didn't like, but I certainly found it strange (because I don't do it myself): it is common to cook and eat every single part of an animal. Recently, my Spanish instructor explained that many Bolivians eat the intestines, liver, kidneys, tongue, feet, heart, testicles, and even BRAINS of certain animals (chickens, cows, pigs, etc). (This isn't a complete list). I was shocked. "En serio?" (Really?) was all I could say when she finished listing the different parts that are typically cooked. "Siii," she responded, and continued describing how "rico" (delicious) these parts taste when they're cooked well. 

Things I loved about my immersion experience

Bolivia has a very interesting history and a beautiful culture. I'm very grateful I was afforded this opportunity to be immersed in it for a month. 

Me and one of my homestay sisters
out dancing

• My homestay family. I lived with two parents, two sisters, and a grandfather. I grew close to everyone, especially one of my sisters who introduced me to her friends and invited me out with them. My family and I had conversations about everything under the sun - Bolivian culture (especially in Cochabamba), religion, my hair, previous volunteers who lived with them, Evo Morales (Bolivia's president), medical school, and much more. My homestay mom was an incredible cook.

Pique macho made by my homestay
sister (who is on the right)

The food. My favorite Bolivian dish is Pique macho, which consists of boiled eggs (that are cut in half and decorate the outside of the dish), small pieces of beef, potatoes, onions, locotes (bell peppers), mustard, and mayonnaise. Other popular dishes include Picante de lengua ("spicy tongue"; I haven't tried it), charque de llama (llama meat; haven't tried this either), salteñas (which are delicious and stuffed with whatever you want, including vegetables, meat, eggs, etc), quinoa (a grain crop), and picante de pollo ("spicy chicken").

• Talking to Bolivians about my hair. I found myself answering the same questions repeatedly about my braids, including, "Por cuánto tiempo te duran? Cuánto tiempo se tarda en hacerlas? Cómo las lavas? Cuánto te costó hacerlas? Cómo las mantienes? Cómo es tu pelo natural?" etc. (How long do they last? How long does it take to get them done? How do you wash them? How much did it cost you to get it done? How do you maintain them? What is your natural hair like?) I didn’t mind answering these questions. I really appreciated their interest in my hair, which is an important part of me. Whenever I’ve gone abroad to Latin America I have certainly experienced more curiosity and appreciation from people about my type of hair than I do from non-African Americans back home in the states, ironically.

This is a brief snapshot of what we learned in one of my Quechua
classes. Here were went over a few common verbs (left of board)
and how to say baby, boy/girl, man/woman,
and elderly man/elderly woman.

• Learning Quechua. I learned the basics of Quechua in private one-on-one classes during my short time here. Quechua is the most widely spoken Indigenous language in Bolivia, and it has had a strong influence on Bolivian Spanish, especially in Cochabamba. Many speak “Quechuañol”. Many primary schools in Cochabamba are also teaching kids the basics of this Indigenous language (I’m not sure about the rest of the country). Recent medical school graduates are even required by the government to serve and continue training in rural communities to learn the more commonly spoken Indigenous languages (Quechua, Aymara, and Guaraní, but mainly Quechua) before they begin practicing elsewhere.

I didn’t find Quechua terribly difficult to learn, since its structure is in many ways like English. What I did find hard was getting used to seeing long words/sentences that are short words/sentences in English (i.e. kimsa chunka iskayniyuq means 32, Qam Cochabambamanta kankichu? means Are you from Cochabamba? etc). It just takes practice. 

As I'm returning home I’ve been worrying about losing a chunk of what I learned. After searching online I was only able to find a few Quechua speakers (native and non-native) in the Chicago area with whom I could continue practicing. While in Cochabamba, I wanted to learn the basics to communicate with some of the patients in the rural clinic I volunteered with. The physicians regularly encounter Quechua speaking patients who don't speak much Spanish (particularly the elderly). By the end of my trip I could only speak the very very basics. When I return to Bolivia I hope to be able to have full conversations with native Quechua speakers.

~*~*~

There is much more that I loved about the trip, but I don't want to write a book on here. I hope to return to continue working with Sustainable Bolivia and Mano a Mano. There is so much more to learn and contribute. I'm beyond grateful for this opportunity.

Plans for the rest of my "last full" summer

For the remainder of my summer vacation in July, I'll be back in the Chicago area chilling and working on a few things here and there, including a mini-project with one of Loyola's neurologists, catching up with a bunch of friends and family on FT and Skype, hanging out with friends in the Chicago area, watching Netflix, and reading reading reading. I don't want to even think about starting second year at this moment. I'm not ready to get hit with a ton of bricks yet.

Thanks for reading! :)

Addiction Medicine in Center City, MN: One-week program at the Hazelden Betty Ford Foundation

Hazelden Betty Ford Foundation
Women's Recovery Center
Center City, MN

I finished my first year of medical school. We had our final Immunology exam a couple of weeks ago, and I left that weekend very excited for a unique one-week Addiction Medicine educational program in Minnesota.

I spent last week in Center City, MN at the Hazelden Betty Ford Foundation, a world-renowned center for chronic alcoholics and drug users. Thanks to the tremendous generosity of the Hazelden Betty Ford donors, the Summer Institute for Medical Students (SIMS) was able to host 15 medical students this past week in Center City, MN from schools across the U.S. (and one resident from the University of Minnesota), and another group of medical students at the other site in Rancho Mirage, CA. They placed us in a nice hotel in Chisago City ("SHI-SAGO"), about 10 minutes from the treatment center.

The picture above shows only one section of this large center at the campus in Center City. Hazelden is a co-ed treatment center that is fully committed to the recovery of alcoholics and drug addicts. 

We spent one week attending lectures and presentations by professionals in the field of Addiction Medicine. These presentations touched on topics such as the neurobiology of addiction, the process of SBIRT (Screening, Brief Intervention & Referral to Treatment) to screen patients for a substance use disorder, and medications for addiction. We were also assigned to different treatment "units" where patients were staying for the duration of their recovery. Most were completing the 28-day program. Each unit is either all male or all female. I believe only a couple or so are co-ed. I was assigned to an all-male unit with another medical student. It consisted of about 25 men, all ranging from ages 22 and up. I'll talk a little bit more about the demographics later in this entry, because I found this aspect of the experience shocking.

How do we define addiction? Drug addiction, in particular, is a chronic brain disease that causes continued use of a drug in spite of harmful consequences (i.e. physical impairments, health risks, brain changes) (Elite Rehab Placement).

It is important to reduce the stigma associated with addiction. The biggest goal of SIMS is to educate physicians-in-training about the bio-psycho-social complexities of this gripping disease, the recovery and treatment process, and the impact of addiction on patients and families.

I could write an entire reflection paper on this experience, but I'll focus on four main highlights.

1) Addiction is a chronic disease

There are a couple of people within my own family who struggle with alcohol and substance use. This personal experience with addiction was the main reason why I chose to apply to the Hazelden SIMS program. I also wanted to be immersed in the experiential learning atmosphere of this program. What better way to learn about a disease than to actively engage with patients who are living with it? We receive very little training on addiction during our medical education despite the reality that it is a crisis in our nation, as it affects 1 in 10 Americans. 

Alcoholics and chronic drug users have significantly
fewer dopamine receptors in the brain
Photo taken from here

Addiction is NOT merely a choice. It is a chronic disease, much like Type II diabetes and cancer. There are 2 primary factors that can increase one’s risk for addiction: 1) genetic predisposition and 2) early environmental exposure to the alcohol and/or drugs. A patient with a substance use disorder or drinking problem has a disease of brain reward, motivation, memory and related circuitry. This dysfunctional circuitry can be a risk factor for chronic drinking or drug use, and has likely been influenced by the individual's genetic makeup (i.e. the parents struggle[d] with addiction) and the environmental circumstances in early childhood (i.e. social, economic, geographic, etc).

The abnormal neurological functioning can also be a consequence of drinking or drug use. The "Hijacked brain hypothesis" states that addictive drugs are more powerful in activating the reward center than "biologically essential ways" (i.e. food, sex, socialization). 

"Why can't addicts just quit?" society asks. "Just stop drinking or taking the drug." Nancy Reagan's "Just Say No" billboard messages are not that easy. Addiction changes brain circuits. The reward of the drug/alcohol overrides the brain's control center (prefrontal cortex), thus creating a greater drive to acquire more alcohol and drugs. 

I'm refraining from going into too much detail about the changes that occur in the brains of addicts. If you're interested and would like to learn more, I highly recommend Dr. Gabor Maté's book "In the Realm of Hungry Ghosts: Close Encounters with Addiction". This book is one of, if not the best introduction to addiction medicine, the neurobiological changes seen in addicted patients, and the psychosocial complexities associated with this chronic disease.

2) Addiction does not discriminate

I admit that before I came to Hazelden I had the stereotypical image of an addict in my mind: homeless, from a broken home, abused during childhood, of a low socio-economic status, etc. However, I now understand that that is not always the case. The Hazelden Betty Ford treatment center cares for patients who have private insurance or pay out of pocket. Needless to say, the demographic is quite different from what I expected to see. There is no ethnic diversity at this center. It's safe to say that the majority of the patients are white, insured, and of a higher socio-economic status.

For a couple days this week I struggled to understand how someone who grew up with loving parents in a privileged, well-to-do home could fall into the awful clutches of alcohol and drugs. I just didn't get it. It made sense to me why individuals with more traumatic experiences (i.e. abuse, financial adversity, addicted parents, etc) became addicts. But how does someone who lives what seems like a decent life turn to artificial substances for relief?

Photo taken from here

The answer isn't that simple, but in his book "In the Realm of Hungry Ghosts: Close Encounters with Addiction", Dr. Gabor Maté explains it well: "In short, the addiction process takes hold in people who have suffered dislocation, whose place in the normal human communal context has been disrupted - whether they've been abused or emotionally neglected or whether they're inadequately attuned children or peer-oriented teens or members of subcultures historically subjected to exploitation" (279). ("Attunement is, literally, being "in tune" with someone else's emotional states… It's not a question of parental love but of the parent's ability to be present emotionally in such a way that the infant or child feels understood, accepted, and mirrored" (249).)

Given this information, it sounds like nearly anyone can become susceptible to the disease of addiction. This includes anyone who, in summary: was abused, neglected, not attuned in their upbringing (i.e. raised by caregivers who could or would not adequately connect with them emotionally), peer-pressured (which we've all been at one point in time), or part of a community/ethnic group that has suffered deep oppression for generations in our nation (i.e. African Americans, Native Americans).

All of the aforementioned sources of stress can adversely affect one's brain development during childhood, and thus increase addiction risk later on in life.

Addiction does not discriminate. Not only the poor, disheveled, and abused are alcoholics and druggies. They can also be the rich, kempt, and coddled.

3) Addiction is a disease that is not only seen by psychiatrists 

Psychiatrists are not the only physicians to encounter addiction in their practice. This is a disease that covers all specialties. A pulmonologist may see a patient with degenerating lung function due to many years of smoking (i.e. nicotine addiction). A primary care physician could certainly encounter an alcoholic after taking a thorough psycho-social history during one of the visits. A neurologist might see a meth addict who, after years of use, has a significant reduction in dopamine receptors in different areas of the brain. This occurs as the brain works to compensate for this hyperdopaminergic state that the drug induces. Chronic drug use and drinking affects nearly every major organ system in the body. Thus, any specialty is likely to encounter a patient who is struggling with an addiction.

Knowing this, it’s important for all physicians-in-training to receive proper training in Addiction Medicine. Again, one in ten Americans struggle with addiction. 2.6 million people with an addiction are dependent on alcohol and illegal drugs. 100 people die every single day from a drug overdose (this has tripled in the past 20 years). We owe it to our patients to have a solid understanding of the complexities associated with the illness of addiction.

4) An alcoholic/drug addict is no less of a human being than a non-addict

During a conversation I had with one of the patients (let’s call him Patrick) on the unit, he told me firmly, "When you become a doctor, you need to treat everyone the same way." Earlier that morning he shared with the rest of the group his story. He’d been through hell during his childhood – he grew up in dire financial straits with a drug-addicted mother, an absent father, family members who abused and molested him... The community they lived in was of a lower socioeconomic status, with constant gangbanging and shootings… He told me later that these tragic circumstances just scratch the surface. I began to tear when I heard this. I couldn’t imagine what he’d left out.

Patrick had constantly been in and out of the ER during his addictions to meth and cocaine. The doctors knew him well and were fed up with him. “I get their frustrations,” he told me. “I completely get it. But I can’t help going back to the drugs. I’m addicted. I got a problem. But I’m still a human being. They treated me like I wasn’t.”

I listened to him share some more of his experiences in the ER. I understand the doctors’ frustrations as well. Who wouldn’t be fed up with a patient who keeps wasting your time and resources with these problems that could be avoided if they just stopped using or drinking? But let’s put it this way: what if that patient were our own brother, sister, father, mother? When Patrick shared his story, I thought immediately of one of my own relatives who has a substance use disorder. We should treat our patients like we’d want our own loved one to be treated: with respect and compassion.

Photo taken from here

In many ways, addiction is an illness like Type II diabetes and cancer, and patients need treatment to recover. Unfortunately, not all physicians (nor society) believe this. Despite the existence of research showing that addicts are neurologically impaired individuals, we still consider them execrable members of our society. We see the drunks and druggies as undeserving of proper care and treatment, as filth, the embarrassment of our nation’s image, and as individuals who choose the lifestyle that they’re leading. We’ve got it all wrong. We need to develop a more pragmatic, compassionate, and humane approach to handling this crisis in our nation.

The War on Drugs created more issues than solved them. Chemical addictions are exploding at an alarming rate in our country, such as the opioid and heroin epidemic. Further changes need to be made in public policy. We desperately need to attack this public health problem in a more humane and practical way.

“We really need… and I know it sounds kind of corny…we need to be very loving, very accepting, and very patient with people who have these problems. And if we are, they will have a much higher probability of getting better” – Dr. Bruce Perry, Psychiatrist, Adjunct Professor of Psychiatry and Behavioral Sciences at the Northwestern Feinberg School of Medicine

~*~*~

This experience has ignited a passion within me for Addiction Medicine, as well as motivated me to begin an Addiction Medicine Interest Group on my medical school's campus. SIMS has solidified my understanding that empathy and patience are critical components of the physician-patient relationship. It has also emphasized for me the importance of mobilizing support and galvanizing others into action to make a difference for desperate lives. I am excited to lead others in my university community to help tackle the substance use epidemic that is plaguing many lives in our society.

U.S.-Mexico Border Immersion Trip: Spring Break in Tucson, Arizona

U.S.-Mexico Border
Nogales, Arizona

Borderlinks

This past week I flew down to Tucson, AZ to learn about issues of the US-Mexico border with a couple of my classmates, a recent graduate from the Loyola University Chicago School of Nursing, a Jesuit Priest, and the Director of Loyola's Center for the Human Rights of Children. While there we also joined up with students from Loyola's School of Education and Social Work. I went on this trip through our school's ISI (Ignatian Service Immersion) program. We were sponsored for the week by Borderlinks, a phenomenal organization based in Tucson that educates groups about the border, immigration policies, and social justice. 

My deep interest in immigration and border issues stems from my previous work with migrant Latino farmworkers in upstate NY during college. I worked closely with the farmworker community teaching English, conducting needs assessment interviews, and reaching a new level of understanding and respect for this population. The biggest reason why migrants leave their home countries is for better economic opportunity. Violence, civil wars, and reuniting with family are other major factors that influence the decision of many to leave. This ISI trip allowed me to continue my previous engagement with this community and to deepen my understanding of the migrant experience.

Desert Walk

For me, the most impactful aspect of our programming was the desert walk in Arizona. Our guide had previously walked through the desert a number of times, so he was quite familiar with the migrant trail we followed. We walked for about 4 miles before we sat for a while to eat lunch and reflect. After that, we turned and continued back to the van. 

On our way back I couldn't bring myself to join the conversations that turned quickly from our reflections on border issues to school/work concerns back in Chicago. I couldn't stop thinking about the terror of walking through the desert at night. (On their journeys migrants typically rest during the day and walk at night). There was such a stark contrast between our mild 3-4 hour (~8 mile) walk in pleasant weather (70 degrees!) and the ghastly weeks-long hike that migrants endure in boiling hot or freezing cold night temperatures in the pitch black darkness of the mountains. Can you imagine? Margaret Regan, the author of "The Death of Josseline", shares the fear of one Mexican migrant, "The noises of the desert night – the snapping of tree branches, the calling of birds, the lowing of wandering cows – seemed louder than the car horns and street music back home in Mexico City. And scarier.” 

If you look closely you can see the lion's
print in the center of the photo

At the start of the trail our guide mentioned that there was the possibility of running into a rattlesnake (but he'd never seen one before on the walk, so that calmed me down a bit). But a couple of minutes in we encountered a fresh mountain lion print on the ground. The other students were fascinated by it and excitedly asked questions. My immediate thought was, "Nope, I'm out of here." I looked behind me to see how far away the beginning of the trail was. I was seriously ready to sprint back to the van, but once everyone took off again, I snapped back to my senses and pushed myself to keep going. Mountain lions are nocturnal, so chances of us running into one were slim. 

Migrant Deaths

It was horrifying to learn from the Borderlinks experts, our speakers, and in Margaret Regan's book the ways in which many migrants died over the past 20+ years. (The first wall was constructed in the mid-90s). Here are a few examples: 

• In May 2001, 14 migrants died in Yuma County, Arizona: “The travelers, all Mexicans walking in one group, died in agony, victims of extreme heat and coyote error, their bodies strewn across the infamous desert pass…”(158). (The "coyote" is the individual who guides groups of migrants through the desert).
•  “…In May 2003, nineteen border crossers suffocated inside a locked tractor-trailer near Houston" (158).
• "... Martín Olguin-Lozoya, a strapping six-foot-two native of Nogales, Sonora, died just minutes into his American journey....[He] lasted just a few miles on the Union Pacific Railroad..... he fell between two train cars and was crushed to death" (223).

I cried while reading this book. I even had to put it down a few times because the details were so harrowing. I don't mean to simply list out these deaths. I want to put a human face to these tragedies that have been occurring for years just south of our borders. Still, despite my previous work with immigrants who made these trips themselves, I'm embarrassed to admit I had no idea the extent of the adversities that millions were suffering on their journeys to the U.S. from Latin America.

Needless to say, our 3-4 hour experience in the desert did not compare at all to the deathly hardships that migrants suffer on their way north. Regardless, I deeply appreciate this opportunity to get a glimpse into the migrant journey.

Moving Forward

For the remainder of the week we heard from the author Margaret Regan, Professors from the University of Arizona, humanitarian activists, environmentalists, healthcare professionals that serve migrants in the area, a former Public Defender, and more. Admittedly, this educational experience was quite one-sided, as we learned from experts who are staunchly anti-border. That being said, though I am also anti-border and a strong advocate for immigration reform, I'm open to engaging with others who feel differently. 

This border experience blew me away. Regardless of our profession, background, and beliefs, we should always strive to understand the experiences of migrants, raise awareness about border issues, and fight to address the root causes of this crisis any way we can. The wall is merely a band-aid, not the healing treatment for this malady.

"You show me a fifty-foot wall and I’ll show you a fifty-one-foot ladder.”

-Janet Napolitano, Former Governor of Arizona and U.S. Secretary of Homeland Security

Gates Pass
Tucson, Arizona