Project Healthcare at New York University Langone Hospital—Brooklyn, Brooklyn, NY
Every day for my internship, I would board the NYU Langone ferry along with other “purple shirt” volunteers, cross the East River, and get off at NYU Brooklyn previously known as Lutheran. Project Healthcare has been an annual summer opportunity at Bellevue Hospital for a number of years now, but this was the first year where a full Project Healthcare class has been graciously accepted by NYU Brooklyn. This has been a fantastic summer full of personal growth and I couldn’t have pursued this opportunity without the generosity of the Alumni Sponsored Internship Program.
A big component of the program involved me rotating through various clinical areas of the Brooklyn Hospital Center Emergency Department: Adult, Pediatric, and Psychiatric Emergency Rooms; Observation Unit; Pharmacy; Community Health; Operating Room; Cardiac Catheterization Lab; and the EMT Ambulance Bay. On my shifts, I would get the chance to interact with physicians, physician assistants, nurses, nurse assistants, pharmacy technicians, EMTs, and many others. All of staff took its time to teach me about their patients, their lives, and their path to emergency medicine.
For the past couple of summers, I’ve been involved with research which is a big part of medicine, but this summer, my internship offered me a view of a personal, unpolished, and human side of medicine. On most of my shifts, I got the chance to talk to patients, learn about their lives, and make sure that their stay was as comfortable as possible. The ED is a very hectic place and unless a patient is a level one trauma, they might have to wait hours before someone sees them. As a patient advocate, I relayed information between the patient, nurses, and physicians to make sure that the patients didn’t become restless or didn’t feel that their concerns weren’t being heard. I also made sure the patients were comfortable by bringing them food, blankets, and support. One of the patients told me that her ideal care provider is “someone who sees her as a person and not just her body parts.” This has resonated with me through my internship because medicine will always be about people, their preferences, and backgrounds—not just their diagnoses.
I am realistic that in a career in medicine, especially emergency, I might not have the luxury of time to extensively communicate with my patients, but this summer offered me the luxury to listen. I’ve listened to a man with chest pain and anxiety cry in front of me because his only daughter got caught up in trouble and now has substance use disorder. I listened to a man who comes to the emergency room every two weeks for pain management because he got diagnosed with two unfortunate and painful conditions: multiple sclerosis and chronic leukemia. I’ve listened to a homeless woman talk about how the ER is her home from the streets when she has nowhere else to go. What I took away from these stories and others is that a person’s physical and mental health is dependent on everything that happens outside and inside the hospital. What we need to do as pre-meds, volunteers, nurses, physicians, or other health care providers is be aware of how much of an effect social determinants of health have on a human being.
In order for us to learn about these social determinants more formally, we had social medicine meetings that we attended at Bellevue Hospital, the oldest public hospital in the U.S. These meetings provided us a deeper insight into how various factors impact health and healthcare. The major questions we tried to answer are: How can we prevent people from needing hospital care in the first place? And, How can we expand health access to those who do need it? Our meetings tackled topics such current healthcare system and insurance policies; substance abuse and methadone clinics around the city; environmental factors affecting health such as extreme heat, cold, or toxins; malnutrition; homelessness; and diversity in medicine. With other program participants, I learned about the need to destigmatize mental health and provide access to services, to address food and housing concerns, to destigmatize substance abuse, and to generate health reform that would expand access to required services without the fear of not being able to pay. My shifts with the community health worker showed me how much of an impact they make by addressing these social determinants and making sure the patients go to AA meetings if required, have enough food to eat, follow up on their appointments, and have an adequate support network. NYC is a very unique city due to its wide range of socioeconomic classes and ethnic groups. This city provided a great opportunity to be exposed to challenges for health equity between different social groups and also learn about the diversity in the healthcare field.
Another component of the program was also to collect data for an original research project, write a literature review on our topic, and present possible solutions for issues surrounding our topic. My group and I got assigned to a fall risk mitigation project that dealt with patients, especially those that are “high risk,” accidentally falling within the hospital setting which could potentially lead to additional injuries and costs. This research was very different from the bench research I was used to back in the lab, but I’m glad I got the chance to experience it. We also got the chance to host an all-day community health fair at Bellevue that educated the community on topics such as the flu, sexual health, cardiovascular disease, prenatal health, diabetes, and others.
Before this summer, I didn’t seriously consider a career in emergency medicine because I often though it was too hectic and the physician didn’t get a chance to spend time with their patients. However, after this summer, I have a new perspective on emergency medicine. I think it’s very special because it’s such a diverse place: with very different patients and limitless possibilities. It would also be very rewarding to be the first person that advocates and makes a difference in what could be the worst day of someone’s life. This summer, I’ve seen traumas, blood, tears, homelessness, minor cuts, and falls. I am so grateful for this internship; to have seen what I’ve seen and to confirm that I am eager to become a physician and work with diverse populations. Whether it will be in the emergency department or not is yet to be determined! Once again, I would like to thank the ’68 Center for Career Exploration and to Mr. William L. Chapman for this incredible opportunity!