Heart Health Bridge to Care

Penn Med offers a plethora of community outreach opportunities, including several health clinics serving a diversity of communities in Philadelphia. Today, MS1 Sanford Roberts shares his experience as a volunteer for Heart Health Bridge to Care (HHBC).

5pm rolls around. I’m tired from waking up for 8am Brain and Behavior lecture. I don’t usually go to 8am lectures, but I can’t afford to get any further behind and I know the final is going to be tough. I run off to grab another coffee (thank goodness for coffee).

Our clinic group huddles near the library, a mix of undergraduates, nursing students, social work students and med students. As we divide into carpools, we share what we’ve been going through inside and outside of school and clinic. The cars arrive and we pile in, and after traversing through half of West Philadelphia, we arrive at First African Presbyterian Church.

Once we reach the basement, our group disperses and gets to work: some grab charts, others set up the waiting rooms, while others organize the patient-provider assignments. The basement is old, the walls are bare, and in general it’s not exactly what you’d expect when visiting the doctor’s office. But the place provides history, character and most importantly, a place our patients know and are comfortable in.

Once everything is set up, the undergrad coordinators give us our patient files. I’m seeing two patients tonight. I begin to review their charts and make notes about what I think needs to be done during their visits. In what feels like a few short seconds, I’m told that it’s my turn to present in “circle up”. Circling up is a time when we orally present patients to each other in order to plan the upcoming encounter. It’s low pressure, really just a chance to chat about ideas and fill each other in on new information that might not be in the chart.

One of the undergrads walks over and informs me my patient has arrived. My heart rate increases a bit, and I try to remind myself that there’s nothing to be nervous about. I’ve been seeing patients on my own for several months now, but still, this whole med student thing is relatively new. I walk out to see my patient and we head into a room for the visit. We chat for 20 minutes, his hypertension is well under control, but now he has a cough and wants advice. I get uneasy; we haven’t had pulmonology yet and I have no idea what should be on the differential. The rest of the visit goes well, and I tell my patient that I’ll be back as soon as I chat with the doctor.

I head back to the main room and begin to look over the notes I just took. I begin organizing it into Subjective, Objective, Assessment and Plan sections (commonly called a SOAP note); it’s how we’re expected to convey information to residents and attendings. I find an attending sitting and chatting with a resident. I interrupt and ask if I can present. They oblige and begin to listen. Deep breath, here we go, I begin “Mr. JB is a 62 year old male with a past medical history of hypertension presenting today with a new productive cough…” I continue on telling the details of our visit. Finally we get to the topic of the cough. “It’s a cough producing yellow sputum, worse in the morning…”. The attending stops me; he asks when the cough began.

Shoot. I hadn’t asked. I forgot to ask when the cough began! That’s really not acceptable, but okay everyone makes mistakes. I admit to the doctor that I forgot to ask and they kindly smile and let me continue. We keep talking. “Is he a smoker?”

Shoot. I hadn’t asked if he was a smoker either! In retrospect these questions really seem like common sense, but during the visit they hadn’t crossed my mind. I had never had a patient with a cough or lung problem before. Again I admit I forgot to ask, the attending reassures me that it’s fine, I’m still learning. We head back in to see the patient, who ends up having mild viral infection. After another several hours, seeing my second patient and charting up the visits for the day it’s time to go home. I arrive back around 10pm and proceed to immediately fall asleep in bed.

Volunteering at Heart Health Bridge to Care (HHBC) has been an incredible learning experience. I’ve learned about hypertension, diabetes and many aspects of primary care. I’m beginning to learn the language and practice of clinical medicine. I’m getting exposure to the huge host of medical issues plaguing underserved areas of West Philadelphia. Most importantly, volunteering keeps me humble and reminds me why I’m in medical school. I’m here for the people, for my future patients. I’m here to learn how to ease pain and to heal. It’s easy to forget this when much of our current lives seems to revolve around learning the basic sciences as preclinical med students.

Sure LEAPP and our Intro to Clinical Medicine course provide great opportunities for us to briefly step into the role of clinical providers, but somehow I feel like it’s not quite the same as going to clinic every week. Since we follow up with patients continuously at HHBC, I’ve had the opportunity to develop personal connections with my patients. I get excited when they’re doing better, and I feel responsible for developing solutions when they’re doing poorly. There is something really special about sitting across from someone as a health provider; people open up about their lives, their struggles, worries and pain. Sometimes all we can do is just be a supportive ear to listen, but many times we are able to take action to help and to treat. And who knows if we’re making a difference, I hope we are, even if it’s just to a few people. The thing I know for sure is that I’m different for being at clinic; it’s been an invaluable part of my Penn Med experience.

Sanford Roberts is an MS1, originally from San Antonio, Texas (Go Spurs!). He graduated from Stanford University in 2013 majoring in Human Biology. In his free time Sanford enjoys pick up basketball, Netflix and exploring Philly’s vibrant restaurant scene.

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