HCASB

Greetings from Yakima! I wasn't sure if I was going to have the internet here, but it would appear that I do, which is pretty cool.

I'm here for Health Care Alternative Spring Break (HCASB), which is a student-run program at the UW to get pre-health students interested in rural healthcare. They send teams of students out to rural/underserved communities in eastern Washington where they stay with local families or at churches, shadow doctors/dentists/health professionals in their chosen fields, and learn about what it's like to practice medicine in a rural/underserved area.

My team is four people, all girls. Our team leader is Erin, a fifth-year senior who's graduating this year and has already gotten into med school. Then there's Catherine, who's a pre-med sophomore, like me, and Stephanie, who's a pre-pharmacy freshman from Taiwan. Oh, and there's me :).

We left the UW campus on Sunday afternoon in a rental car provided by HCASB. It only took a couple of hours to get to Yakima. The drive in itself was kind of an experience for me, since I've never been to eastern Washington before. I'm a straight-shot DC-to-Seattle transplant, so really, aside from Seattle and Olympia, I don't know Washington that well. I was amazed at how much the scenery changed after we went over the pass. Basically, it's like the primary color of the landscape changes from green to brown. On one side of the mountains you've got these seemingly never-ending forests of pine trees, and then you cross the mountains and you're practically in the freaking desert! Any longtime Washingtonian who's reading this will probably laugh at my ignorance, but it still kind of boggles my mind.

Anyway, we made it to Yakima in a couple of hours, drove around for a bit and got the lay of the land, met up with the other Yakima team and got some dinner, then went to our homestays (Catherine and I are staying in one house, Erin and Stephanie are staying in another). My host family, the Jennings, are so nice. The husband, Ron, is a pharmacist at the clinic where we're all shadowing (Steph is actually spending almost all of her time shadowing him, since she's pre-pharm), and the wife, Jeri, is a registered dietician who works mostly with patients on dialysis. They have really cute pets: Jammer the black lab, Boomer the pug-like mutt of indeterminate ancestry, and Duncan the gray-and-white kitty.

We're all shadowing at Yakima Neighborhood Health Services. When I got my assignment, I was a little bummed that I didn't get to go to some teeny-tiny, middle-of-nowhere town, just because that's something I've never experienced before and I'm all about trying new things. But I now realize that the upside of going to a slightly larger town like Yakima is that I get to shadow at a place like YNHS, which is a pretty big clinic, so I get to see a variety of different things. They have internists, pediatricians, family practicioners, an OB clinic, a pharmacy, a dental clinic, a WIC program (which provides information on breastfeeding, etc. to new mothers), a walk-in clinic, and a clinic for the homeless. I'm going to get to shadow at least once in most of those areas during my stay here. I'm pretty psyched.

Our schedules are divided up so that we're all separated and each of us is paired with one professional in the morning, and one in the afternoon. This morning, I shadowed Kelli, a nurse practicioner who works in the homeless clinic. I think the most striking part about that was seeing how important it was to most of those patients just to have someone to talk to, even for fifteen minutes (the allotted time for appointments there) about what's going on in their lives right now. I suppose this is true for a lot of people who go to the doctor, but many of the people I saw today don't have a circle of family, friends, etc. They don't often get asked "What's going on with you today?" or the equivalent, especially by someone who really wants to know the answer. Oh, the OTHER most striking part of the homeless clinic was the somewhat mentally-off-kilter guy who heard that I was from the University of Washington and decided instantly that I must be a doctor (he decided this despite Kelli clearly stating that I was a student). Of course, this guy also said that his job was "tracking various patterns around the state for the betterment of all of us" so I suppose deciding that I'm a doctor is not the least rational of his thoughts. Anyway, he started telling me all about how he wanted me to "pull strings" with my "connections" to get him in to see a doctor at the UW Medical Center (psshhh, I would be hard put to get myself in to see a doctor at UWMC). At the end of the appointment, Kelli told him she was going to leave and would be right back with his prescriptions, and he said "Leave me with her. I have a lot more that I need to tell her!" Fortunately for me, Kelli said "Sorry, she needs to stay with me today," and we left. I guess the poor guy thinks I'm the worst doctor ever.

In the afternoon, I shadowed Dr. Prier, a pediatrician, which basically just re-affirmed my belief that I want to be a pediatrician. I saw a lot of physicals, a few cold/flu/sick stomach/sore throat visits, and one obesity consult with a little girl who was seriously overweight. The doc said that obesity in kids is one of the main problems she encounters in her average day, and that thus far neither she nor any of her colleagues have been too successful in reversing the trend among their patients. One interesting thing about working with her was that all the patients she saw today were Spanish-speaking (at least the parents were. Most of the kids spoke English pretty well). I never took Spanish, and could not carry on a conversation in it to save my life, but I was pretty surprised at how much I can understand, just from context and cognates. I really want to learn Spanish now, though, it seems like it's really important. I mean, the clinic has translators, but it seemed like the fact that Dr. Prier knew Spanish and was able to go without a translator just added this whole new level of trust between her and her patients. My favorite visit of the day was a mom with two little girls, ages four and two, who were both there for their physicals. When the two-year-old was getting her physical, the four-year-old was being kind of disruptive, trying to get mom's attention while Dr. Prier was trying to explain something, climbing on things, etc, so I gave her my notepad to draw on (it helped that I happened to have a purple pen today). She talked to me in a mixture of English and Spanish, and I talked to her a little bit in English, but mostly just nodding, smiling, and hand gestures. She said something to me in Spanish that mom overheard, and mom said to her (I understood the Spanish but I won't try to write it here cause I'd butcher it), "She doesn't speak Spanish, you know." The little girl looked very indignant and said "Yes, she does!" We all burst out laughing, because I hadn't said a single word in Spanish since we'd walked into the room, and had been talking to the little girl only in English, but she was so positive I could speak Spanish. Lol kids are awesome.

We finished clinic at 5:30ish and went home, where Jeri fixed us delicious soft tacos. We've just been chilling out, and I'll probably be in bed before 10:30. I could so get used to this whole early-bedtime, eight-hours-of-sleep, normal-workday-hours type deal, but I guess I'd better not if I want to be a doctor. Anyway, I shadow in the OB clinic tomorrow. I've never done that before, so that should be exciting.