Thank you so much for taking time to look at our blog! We are a group of edical students who are passionate about training and in underserved areas. This January and February, we are in Peru, the Dominican Republic and Costa Rica internationally as well as locally in Flint and Lansing completing volunteer service, rotating in hospitals and clinics, and learning about international medicine and local underserved health care. We appreciate any time you take to read our reflections and any donations you might offer.

Please click the “Donate” link on the side for more details on how to give directly to these communities.

Monday, November 25

Working in Flint Public Schools

     Working as an uninformed volunteer for a public school system in a Michigan city can be a little like a game of roulette.  Back before medical school began, I did some volunteer work in a public school for pregnant teenagers in Detroit.  Not long after my time there, the school was first closed and later chartered.  Since then other schools I've worked in have been closed, mostly in the Detroit area.  It is commonplace in Detroit that these institutions, mighty in the eyes of thousands before that walked through its doors, are regularly threatened into becoming scrap metal havens.  I knew when beginning my work at Bryant Elementary School that Flint is no different.  There was always a good chance we were on borrowed time and that the feeling of futility could once again surface.
 The work seemed simple enough- we would develop relationships with teachers, prepare science or health related curriculum on our own time, and have a fixed time once a week to work with the children.  Despite being busy and often overworked, we became regulars at the schools.  My fellow classmates worked on spectacular curricula mostly regarding health habits reinforced with our education of basic and biologic sciences.  I at first took a different route, meeting with children that had social issues and helping to keep them interested in school.  I later helped in the classrooms with the other medical students.
I began my handful of children with a lesson on the heart.  I knew they were assigned to me because they had issues at home, but I wanted to see where their interests lay.  All claimed to love science, and attentively followed my instruction on the anatomy of the heart.  It helped that we had set a future date to actually dissect a deer heart as long as they could retain some basic information that I taught them.  The first lesson was a hit, and they all left feeling excited about our weekly time.  The next week I arrived and one of the children was missing.  Apparently he had gotten into a verbal altercation with a teacher and was suspended.  I additionally noted that one of the other boys had very dirty clothes on him that day.  He told me his family had been evicted and he was living in a one floor house with 10 other people.  It was our second lesson and the rest of the world was already crashing in, making comments, disrupting the class.
It took about four weeks after that one until we were able to dissect the heart.  By some miracle of modern technology my freezer kept the heart anatomically sound, and by some other miracle of social grace my roommates did not object to a large deer heart being kept frozen in the freezer for so long. Week after week prior to this  there would be some issue or other.  Teachers and counsellors were entrusting me with dark family secrets with the hopes that I could somehow cater my 3 hours a week of science fun towards the complex and layered issues of the childrens' lives. The futility was creeping in on me, and my respect for the teaching profession gained even more deference.
The news that Bryant would be closing came some months before the end of the school year.  All the frustration of my prior experiences came rushing back, and a part of me even felt foolish for having tried to work in an inner city school again.  I believe it is common amongst many in medicine to feel like community outreach work is frustrating in comparison to clinical work.  Like in medicine, the work takes a large quantity of time and energy, but there is the large difference that outcomes are very difficult to quantify.  I could not point to improving lab values or see a healing wound- I will likely never be able to concretely tell if these children will stay in school, have healthy relationships with their community, go into careers they wished for, or even if they enjoy coming to class just a little more.  Furthermore, how could we have impacted the children of this elementary school positively when it was clear other forces were unstoppable?  Their class size would enlarge, many of the dedicated teachers would be let go, and important resources to their learning would be further rationed and diluted.  I was confused and could not tell how my presence would make any difference.
“DR. K!!!” I turned around to see the student who had been evicted running towards me.  It had been a month or so after knowledge of the future closing.  He was quite bright but not very confident about his future- something his grades showed.  I loved working with him because he had many questions, but was feeling skeptical to how our meeting time would really change the facts of his home situation.  He told me he had been talking to his aunt, a nurse at the hospital I work at.  He told her everything about the deer heart, explaining what he knew about blood and how it is pumped.  His aunt apparently showed him some more short lessons about anatomy using their dog.  He told me all of this is making him want to be an “animal doctor”.
I wish we could have stayed at that school for a longer time.  We had projects underway to assess the needs of that elementary school, and hopes in the future to conduct community directed research that could benefit everyone longterm.  The school closing was a major blow to what could have been an effective longitudinal relationship focused on public health.  After all, we are medical people and that is what we do best.  Our talents are employed wonderfully through classes and tutoring, but we do not compare to the amazing teachers that have dedicated their lives to it.   Still, I know that LMU will be in the community a long time and will once again work on developing these relationships with at need groups this year.
In Bryant,  as exemplified by the future veterinarian, I believe our role may have been more about planting seeds.  I think we worked hard to spread ideas, sometimes about science through science projects, at other times about health through classroom activities, and always about future possibilities by our own experiences of being physicians in training.  The circumstances that shortened our time there is exactly the type of negative influence we are trying to overcome with our work.  The hope of the children I met who continue to persevere despite hardship necessitates that I continue to work in community outreach.  I think that the feeling of hope pervades the LMU community, where hurdles like this only ask for reflection and improvement.  Quitting is not an option. 

Tuesday, November 19

Monika's Reflections of Flint

Flint, MI 2013

What is a reflection but the picture I see in the puddles? The picture is filled, edge-to-edge; I am there, looking back at myself. Around me is the background: the living city, the events happening around me, the people on the street. The water gathers on a foundation, without which it would have washed away. I ponder Flint, and how the images that are echoed to me have changed since my way here was made.

Ask me to stand on shaking ground
my feet will falter
but I could stand firm
on peaceful earth, strong, still and good

There was a time, I have been told, when this city shone in the glory of a booming car industry, in wealth and success, and in a strong middle class. The brick was freshly laid and the sidewalks were smooth. Elaborate fountains fed off the Flint River, and new buildings boasted in their grandeur. This is not the Flint I have made my way through in the past year and half, or which has changed me. The rain falls on cracked pavements, and this is the foundation.

A few months after I had established Flint as my home, I was invited to volunteer for an enrichment center a few miles north of downtown. We spent the morning in a park next to the center, two friends and I, picking up trash that had collected over the past year. The trash consisted of many different items, which mostly fell into two broad categories: alcohol containers and fast food wrappers. So new to Flint, and not a native, I had been feeling distinctly like an outsider to the city. What was my role, and how could I really tangibly contribute? As I walked through the grass, trash bag in hand, I had the greatest sense of satisfaction. It was a rush. Here was this park, beautiful, big, full of opportunity. It was so littered, so covered in the probably years' worth of trash and abandon. All it took was picking up a vodka bottle here, a McDonald's wrapper there, and within a few hours, in my eyes at least, it was gorgeous! We spend the afternoon handing out vegetables that had been donated to the neighborhood around. The experience was a relief: not because I felt I had made any sort of major difference in anyone's life, but because I think I made a step forward in understanding Flint. The park was already there... it just needed some work.

Many months later I had a slightly different opportunity to work in the earth of Flint. Friends and I spent a few hours working to plant a community garden in a lovely old neighborhood with dusty mansions and run-down houses all around. I love the idea of a garden. It takes soil that has always been there, enriches it, uses it, and the result is nourishment for everyone around, what is not to love? Flint is poor, and much of it abandoned. I have seen scores of roofs with massive gaping holes, from flames that have licked there way through. There are so many porches, warped and bent in shapes fit only for a Dr. Seuss book. Liquor stores have supplanted grocery stores, and brush has defeated lawn. So yes, perhaps I appreciate gardening more than ever before. I think I am better able to recognize the value that is growth from a tiny seed, and my responsibility towards helping it grow. Nothing but weeds will grow if it is not planted; what a shame, if it doesn't?  

Fire in Flint

The tree is silent unless heard
resounding nothing;
moreover am I
if you aren't there for me to smile

In the shimmering puddle, filling up the image, is everything around me. This city is not Flint without the people here. They change my reflection as much as the foundation, as much as myself. They are constantly moving in and out; some spend just a second, others linger in the background, and each change what I see looking back at me. They are my background.

Bryant Elementary sits now empty and abandoned, but last year it was the scene of some of my most formative times in Flint. More Wednesdays than not, I spent the afternoons in classrooms at the school. My first drive to Bryant, I wound around and through some neighborhoods, half lost, half curious. Where did I know this landscape from? Ah, yes. Quito, Ecuador. It was a snapshot of a developing country, somehow dropped in a "developed" nation. Bars on windows and doors, slathered paint weathered by decades, dilapidated construction sites interspersed between stores and churches. So when I stood in front of my first class, and looked at each of the little faces, it was with the understanding that many of these kids came from an environment and background very, very different from my own.

With class sizes in the thirties, with children 6 and 7 years old, and without good resources, it was not easy for the teachers to teach, and it was certainly a challenge for the novice medical student. Each child played a role in shaping my experience, whether particularly challenged and acting out, or bright, eager and curious but without enough attention. Yes, this nation is one of opportunity. We all have the opportunity to fight to the top, but some of us have to fight a whole lot harder than others. These little children, they will have to fight very, very hard, and from the moment they are born. So I am surprised when others are surprised how many of these little ones will turn into adults living in worlds of crime, homelessness, substance abuse, violence or gangs. Of course! It is the exceptional child who will begin to fight tooth and nail from such a young age. In a wealthy suburb non-exceptional means he will live a normal life; in North Flint, MI this means he will more likely than not end up in jail.

In a primary care office, when we see a child who we deem not to have the same capacity as her peers to function intellectually, socially or physically in her surroundings, we call this "handicapped." I had the wonderful opportunity to volunteer for a sports physical clinic at the Elmer Knopf Learning Center a while ago, where we saw 200-300 children so that they could participate in the upcoming Special Olympics. I loved working with these kids; they were each so unique from the other, each with their own challenges, each with their own ways of communication. One child, we'll call her Anne, was especially memorable to me. She ran over to me when it was her turn, cropped blonde hair bouncing around her smiling, enthusiastic face. She wore a long, flowered dress, which showed off her passion for fashion, which she expertly gathered before plopping down in the chair in front of me. It seemed, during our brief encounter, that she was as much trying to make me feel comfortable as I was for her. She smiled and laughed loudly at every joke I made, and the compliments were flowing. Perhaps she knew what alienation was like, so she tried her absolute best to make sure no one else would feel that way. It reminded me how intuitive and bright children can be. This experience solidified my desire to work with children in the future, and for this I am so grateful.

Children who are handicapped are at such extreme disadvantage, I am so glad there are resources out there for them, even if there could always be more. Children from poverty are also at extreme disadvantage, but I am not sure this is as widely recognized in our country. I don't know if this is because of our attitude of 'freedom,' which states that anyone can rise to top, which infers self-blame if you don't. Or perhaps there is just a lack of understanding: very few people will have the opportunity to stand in front that classroom like I did. Either way, Flint has given me a better understanding of what is important in my field. Brim to brim in my little puddle there are children, and there are many more I cannot see. They are all looking back at me, as I look at myself, and asking me: what's next?

Sometimes it seems I'm so solid:
bones, muscle, blood, skin;
but I shape like clay,
and the world keeps sculpting away

The puddle shimmers, and at times it is hard to see my own outline and features, to see myself. I have changed, certainly, from before Flint, MI, but how? A part of Flint has always been in me. My great-grandparents moved up from the South to Flint for jobs, and this was hometown to my grandmother, birthplace to my mother and three uncles. Hick's Portrait Studio, which I pass all the time on Corunna, was the origin of both the baby picture and high school graduation photo that I see when my mother reminisces. So certainly Flint must have already shaped me?

How? This question is as difficult to answer as truly seeing your own image without judgment. Maybe it is better to gauge when measured in my desires for the future. What do I want? I want to be somewhere with a population that is profoundly underserved. I never want to feel I am blind to the need that is around me. I want to feel I am contributing in some small way to the greatest needs of our society, because if it is there, how could I not? I take pleasure in the spirit of a city that is grappling out of the pit of poverty; it is the strongest spirit I have yet to witness. I want to surround myself with people who have it, in the hopes I myself can become stronger. I want to surround myself with people like the nurses and doctors in Flint hospitals, people like my patients.

The picture in the puddle distorts with every raindrop, every ripple, and every child's boot that splashes happily through it; Flint the city, Flint the people, Flint myself. I can't predict what will happen, just that change most certainly will.