Archives for September 2015

What does it mean to be a Davidson Impact Fellow?

“So what exactly do you do?” When I first started here at OrthoCarolina (OC) I struggled to answer this question when my friends or even coworkers would ask. As a collective, the Davidson Impact Fellows share similar values and sometimes even the same goals, but individually, our job descriptions differ greatly. I found that each time I was being introduced to someone new, my title would change slightly or my responsibilities would broaden to encompass the work of many different departments within the hospital system. Clearly, I was not the only one who was unsure about my role. OrthoCarolina is a large, orthopedic practice and for ease of understanding, with most job titles, it is generally easy to infer what that certain job entails. But not for an Impact Fellow, and while at first this was an uncomfortable feeling, it is something that I have grown to absolutely love.

Beginning my fellowship, I was fortunate enough to have the former fellow, Megan Garzon ’14, by my side to guide me through the introductions, to help integrate me into the workflow, and to ultimately, teach me what it means to be an Impact Fellow at OrthoCarolina. She has helped me to realize that the learning experience laid out before me is truly one in which I have the opportunity to develop geared towards my individual interests and one that will evolve over the course of my fellowship year. She has also helped me to realize the ways in which I can explore the areas in healthcare that are important to me and my journey to becoming a physician (thanks Megan!).

For those of you still reading and interested in health care, the rest of this article (I hope) is going to be very insightful. I am going to talk about patient needs, community values within the healthcare system, and a few other efforts towards sustainable healthcare solutions that I have stumbled across while working at OrthoCarolina. I’m going to describe to you what my ever-changing job description actually looks like at the moment. (And to those readers I lost at the first mention of ‘health care’, I bid you farewell and hope that you will take the time to read about the amazing experiences of the other Davidson Impact Fellows!).

So right now I am working on a number of innovative patient care initiatives with the Value Based Services team here at OC. I want to stress the importance of value-based as it is a huge part of my role and because it is a relatively new concept in healthcare that honestly, for the first several months of working here, I did not fully understand. The basic idea behind value-based services is to focus on patient values and aspirations rather than just expressed needs in order to better plan, monitor, and evaluate specific program initiatives.

The problem with focusing on needs rather than values is that in most cases solutions to these problems are neither sustainable nor empowering enough to create ever-lasting change. Essentially, you want to make sure you are asking the right questions (whether it is to your patients or fellow health care administrators, etc.) in order to provide answers that lead to practical actions and improvement. I help determine how to improve the health care process and patient experience, whether it is asking the right questions, creating new and innovative solutions to improve physician and patient reported outcomes as well as overall satisfaction scores, or simply helping to elevate the preexisting community.

Over the course of this year, I look forward to further involving myself in the community that is OrthoCarolina and also, updating you on the progress of the array of value-based projects that are quickly taking over my post-Davidson life. By the end of this year I hope to not only be able to give you a better picture of my role as a fellow is, but personally, to confidently answer the big, open-ended question, “Why do you want to be a Doctor?” A question that I am excited to see how OrthoCarolina and my mentors, including those supplied to me through the Davidson Impact Fellowship program, help me to answer. Until next time!

 

 

 

Justice is not so simply dealt out: walking with kids who cause sexual harm

My name is Grace Watt. As I transition into my new job, which I will describe later, I have had to ask some complicated and emotionally distressing questions.  The following essay is part of an ongoing, maturing conversation with myself as I process what I am learning and how I might more effectively respond to the issue of sexual offense. This essay contains heavy and unsettling material; humility, an open mind, and hope are a good tools to tackle it all…

Let me begin with a thought experiment:

  1. Think about the worst thing you have ever done to someone.
  2. Go find someone in the room with you right now and tell them about that event.
  3. Have them ask you more specific questions about that experience. Specifically, have them ask you questions about your selfish underlying motives and the way your actions affected everyone around you.
  4. Now, role play the situation; except I want you to take the role of the person you hurt. In that way, you can more fully explore the consequences of your actions and how you made that other person feel.
  5. Only one more step! I want you to take that event, a brief description of the worst thing you have ever done to someone, and put it at the very top of your resume. Be ready to provide full disclosure to all future employers and friends and family about why that situation happened.

It does not matter that there may have been a reason for your actions. Maybe your best friend was shot. Maybe your daddy beat your momma. Maybe you are just doing what your older brother’s friend taught you to do.

That was a sexual offense. You are a sexual offender. A danger to the public;  despised by society. You should not have a job. You cannot be at parks. When you travel, find routes that avoid all schools.  You are disgusting.

With these common responses to people labeled as “sex offenders,”  we should not wonder why it might be difficult for someone to admit to a sexual offense. If they admit they did something, will they find support? Or will they become something less than human with a one dimensional story?

What might be some barriers to changing harmful behavior? How do our natural stereotypes, preconceptions, and attitudes create another insurmountable obstacle for people already trying to tackle the daunting task of change?  Putting ourselves in the shoes of a person who has committed a sexual offense helps us imagine what it would be like if we were defined by the worst thing we’ve ever done; if we had to wonder whether our mistakes were so big that we’re never allowed to move on from them.

The answer is not to go easy on sexual offense. Sexual offense can cause long term and multifaceted damage to the victim; the goal is not to delegitimize the necessary and potentially arduous healing process for survivors of sexual harm.  If you are a survivor of sexual offense, efforts to help offenders should not take away your dignity or self-worth. My hope is that these two separate, but related conversations would prevent further harm and lead to full life for you as a past survivor and also for anyone who might be a past perpetrator.

In order to prevent a person from causing further sexual harm, we must patiently try to understand the dynamics behind minimization of offenses and the mechanisms that could motivate someone to change their behavior. Many people who commit sexual offense might stop hurting others and also avoid the ostracization from friends and family if they knew how to stop the thoughts and situations that can lead them to harming other people.  They might not know how to cope with life because few people beyond mental health professionals have more than a basic understanding of what causes a person to sexually harm others and what could help them change. People who know that they committed a sexual offense may believe there is no hope for love and acceptance if anyone else knew. They might be right until we can better respond and listen without reducing them to their offense.

People who cause sexual harm are not just sex offenders.  Yet, we don’t swing to the other extreme and remove all responsibility by blaming their action entirely on past abuse done to them. They are human and we are all a complicated mix of victim and perpetrator. We all cause harm to others and we ourselves are hurt by others. It would be much simpler if there was one evil person and one victim. Then we could just get rid of the evil person.

As I have spent the past two weeks learning about the development of the TASK Program (Treatment Alternatives for Sexualized Kids), it has become abundantly clear that justice is not so simply dealt out.  The stories and lives of these kids are complex.  When the mug or paparazzi shot of an adult sex offender flashes across the screen, that person is dehumanized and met with little compassion.  As the age of the offender drops below 18, we are often more willing to ask what extenuating circumstances might have led a child to commit an act.

My role at Children’s Hope Alliance

I am working with the TASK program at Children’s Hope Alliance. Children’s Hope Alliance offers a wide range of services beyond TASK including foster care, adoption, and outpatient therapeutic services throughout North Carolina. Since it’s founding date in 1891, CHA has provided hurting children and their families with a safe place to heal and have hope for the future.

TASK is a more recent addition to Children’s Hope Alliance that meets the particular treatment needs of youth who have committed offenses and require sexual harm specific treatment.  In it’s 10 years of existence, TASK has successfully reduced rates of reoffending and allowed kids to have a meaningful relationship with their community and their family. Because there are few effective programs available for this population, we are hoping to expand our program nationally and internationally.  In order to do that, we will demonstrate TASK’s effectiveness and validity by being identified as an evidence based practice. My job is to coordinate this effort and I have just completed my second week in this role.

The Impact Fellowship Program

This opportunity is part of the Impact Fellowship program offered through Davidson College that places it’s graduates in substantial roles at non-profit organizations. The program is allowing us a front row seat in dealing with questions of considerable complexity, urgency, and potential for significant systemic changes in society.  It has been humbling to see that our supervisors have confidence in us as demonstrated by the scope of our projects and our clearance and autonomy.  The daunting nature of this project could lead to anxiety and paralysis. However, I have a renewed sense of power and control in a role like this because I have tools to tackle a project of this scale. Davidson equipped me to problem solve by breaking down large goals, being relentless in finding the necessary resources, and leaning heavily on other people’s collaborative expertise. Instead of fear, the size of my project excites me because  I know it will have substantial and lasting impact.

This is the first taste at how Davidson prepared me to handle real world situations. At the time, I lacked confidence and security because I rarely felt finished and always was more aware of how I could improve than of what I had done well.  I became more convinced I could not handle nor had any control over the problems and tasks required of me.   Yet because I lost a sense of self-understanding and self-empowerment that worked for me as I child, I now have a clearer view  of a world greater than myself. I have increased capacity to understand problems beyond my limited personal experience and skillset. I am more aware of a rumbling, sturdy foundation under my feet, made up of the vast community of people addressing similar problems from different angles with different experiences and expertise.  I step without hesitancy into a battle bigger than myself because I understand that sustained strength must come outside of myself.  In order to face inconceivably difficult problems, I must find a source of inconceivable wonder and hope.

As I undertake this fellowship, I lean upon the resources, wisdom, and support of many others and with that, I am excited to share with you in this adventure.

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