Leaving the Davidson Bubble | Starting my Davidson Impact Fellowship at Matthews Free Medical Clinic

Here’s a list of some of my biggest challenges while attending Davidson College:

  • Receiving a 45 out of 100 on my first biology exam (when the range of scores was 45-96)
  • Living with the nickname “sack of potatoes” freshman year, though that was mostly self-induced due to infrequent laundering and a lack of personal grooming enthusiasm
  • Having to attend 8:15am courses
  • Walking into a tree after staying up all night to study for an exam
  • Missing Steph Curry’s campus visit while studying abroad in Shanghai
  • Getting strep throat five times

Adversity for me was walking a few hundred feet with a fever to the College Health Center. Once there, I was able to enter without an appointment, get tested immediately, and subsequently receive medication and a goody bag of chocolate pudding and Gatorade upon diagnosis. Living in Davidson’s bubble, I didn’t think much about how privileged this was. Now having graduated and begun work at Matthews Free Medical Clinic as a Davidson Impact Fellow, I am much more aware of the reality of healthcare access in the Charlotte area, and the superficiality of my “trials and tribulations” as a Davidson College student.

North Carolina is one of the 19 states that decided against expanding Medicaid to childless adults and families with income levels up to 138% of the federal poverty level. Instead, North Carolina’s Medicaid eligibility is reserved for families with income levels at or below 45% of the federal poverty level. Though childless adults and families in North Carolina may be eligible for subsidies if their income levels are between 100-400% of the federal poverty level, there are North Carolinians left in a healthcare coverage gap because they do not qualify for Medicaid or these subsidies. Of non-elderly North Carolinians living under 200% of the federal poverty level, 29% were uninsured as of 2015 (according to Kaiser Family Foundation’s estimates based on the Census Bureau’s March Current Population Survey (CPS: Annual Social and Economic Supplements), 2014-2016)). To put this into perspective, below is the annual income of families at 200% of the federal poverty level:

200% of the Federal Poverty Level

  • Family of 1: $24,120
  • Family of 2: $32,480
  • Family of 3: $40,840
  • Family of 4: $49,200
  • Family of 5: $57,560
  • Family of 6: $65,920

Matthews Free Medical Clinic specifically focuses on this population of uninsured North Carolinians, the uninsured and non-elderly (ages 14-64) individuals of Mecklenburg and Union Counties that have family income levels at or below 200% of the federal poverty level. Our Clinic currently provides free healthcare services to over 300 active patients at any given time. The Clinic is not walk-in, and applicants must meet specific criteria to become accepted as patients.  It is important to note that although the 200% federal poverty level is representative of the Clinic’s ceiling for patient admittance, the average annual income of our patients is far below this. As of early August 2017, the average annual income of Matthews Free Medical Clinic patients was at only 79% of the federal poverty level.  These North Carolinians are financially desperate for healthcare assistance – and Matthews Free Medical Clinic serves them.

Despite being a free medical clinic, we strive to give our patients the same experiences as those received at any other medical facility. Not only does Matthews Free Medical Clinic provide primary care, but with 28 different volunteer providers, the Clinic is able to offer services ranging from cardiology and gynecology, to physical therapy and acupuncture. Patients at Matthews Free Medical Clinic are given consistent care through a permanently assigned primary care physician, who can also provide referrals to specialty and ancillary services.

Within my first two months working at the Clinic, I have analyzed demographic clinical data and presented to the Clinic’s board members, supervised and led renovations of the Clinic during Elevation Church’s Love Week, assisted in the screening process for new patient applications, updated the new patient and recertification screening sheets, assisted in the hiring of a certified medical assistant and more.

It is rewarding to know that my work is helping an organization that is making a difference in the lives of those in my own community. Access to healthcare is a real challenge for so many in the United States. It is a real challenge in North Carolina. Sometimes it takes stepping out of your own bubble to gain perspective. I am very excited about my future as a Davidson Impact Fellow and my remaining time at Matthews Free Medical Clinic.

Leaving the Davidson Bubble | Starting my Davidson Impact Fellowship at Matthews Free Medical Clinic

Understanding trauma and resilience through research, real stories and reality… my reality

I’m sure you are all well aware that social factors affect health. This framework was not unfamiliar to me when I first started working at Mountain Area Health Education Center (MAHEC). I understood that social experiences can influence health, but I didn’t realize to what extent until I began a research project at MAHEC on childhood trauma.

You might be wondering how traumatic experiences from childhood are related to clinical medicine? Trauma lives in not only the mind, but also the body. There is a rapidly growing body of evidence to support this. In 1998, Drs. Anda and Feletti published a study, which found a significant correlation between health outcomes and childhood traumas (referred to as “ACEs” or adverse childhood experiences”). Adverse childhood experiences include physical, sexual or emotional abuse, physical or emotional neglect, and household dysfunction, such as losing a parent or immediate family member to death, witnessing domestic violence, or having a parent with mental illness or substance abuse. Even when controlling for variables like socioeconomic status, the researchers determined that a person who has more than three ACEs has an increased risk for liver disease, diabetes, chronic obstructive pulmonary disease, and heart disease among other medical conditions.

After reading the 1998 ACE study, I asked myself, how does this happen? How do childhood experiences from 30 years ago have such a lasting physical imprint on a person? My curiosity prompted me to dive into the medical literature. I yearned for a scientific explanation. Luckily for me, since the initial 1998 study, scientists have made tremendous progress in understanding the physiology and neurobiology of trauma. A lot of the research has explored the role of the fight-or-flight response, which, as many of you probably already know, is an adaptive system in our bodies to help us in threatening or dangerous situations. This response sends energy to your muscles when you need to suddenly slam on the breaks to avoid a car crash. It increases your heart rate and respiratory rate when you see a bear in the woods and need to run. But imagine if that bear was your physically abusive father… imagine if you felt a sense of danger every night when “the bear came home from work,” explains pediatrician Dr. Burke Harris in her Ted Talk on ACEs. When a child is repeatedly exposed to trauma, his or her system of alarm will be continuously activated. The expert psychiatrist Dr. van der Kolk states, “Long after the actual event has passed, the body may keep sending out signals to escape a threat that no longer exists”. These excess hormones, like cortisol and adrenaline, can cause toxic stress and have a lasting impact on the brain and the body. ACEs are both a social issue and a medical concern.

Learning about ACEs flipped a light switch inside of me. I reconsidered my approach to medicine and  began to think about addressing the underlying cause of disease, which involves addressing trauma in many instances, instead of only treating the symptoms. I started seeing connections between childhood trauma and many other public health issues. During my time at MAHEC, I have witnessed the devastating impact of the opioid crisis on individuals, families and communities in western North Carolina. After I learned that opioids and other substances act on receptors in the brain and essentially numb the neurobiological effects of trauma, I began to examine our opioid epidemic with a different lens. What if we also have an ACEs epidemic?

My research on ACEs greatly influenced the way I approached my clinical work at MAHEC. I began to comprehend why people engage in certain behaviors. My mentality shifted from “what’s wrong with you?” to “what’s happened to you?” I began to ask patients more questions. I made a deliberate effort to learn about their backgrounds, to listen to their stories in order to understand. Hearing patients’ personal narratives transformed my abstract understanding of trauma into a tangible reality. ACEs were not a phenomenon in an academic journal anymore; they were real, raw human experiences.

After listening to some truly astounding stories, I felt overwhelmed and helpless. What can I do to address trauma? There isn’t a miracle medication to erase the past. Although there is no magic pill, I learned that experts have developed many specific strategies that can boost patients’ resilience and reduce the effects of trauma. There is currently a movement in public health to teach doctors and other allied health professionals about how to promote resilience strategies and provide “trauma-informed” medical care. Through MAHEC, I learned about an innovative approach called the Community Resiliency Model, which aims to educate not only the patient, but also the surrounding community about the effects of trauma and empower them with the techniques and skills to boost resilience. Some of these resilience techniques can literally reset the nervous system, mitigating the physiological effects of trauma. The Community Resiliency Model is based on the notion that “it takes a village” not only to raise a child, but also to heal one. Helping an individual recover from trauma requires bringing together community members to create a trauma-informed, resiliency-focused support network.

Several months into my fellowship, I gained a new perspective—a highly personal one— on trauma after my own adverse experience. During the fall of 2016, my older brother passed away very suddenly and unexpectedly. When I received the phone call, my fight-or-flight response was activated before my brain could begin to process what had actually happened. Trauma lives in not only the mind, but also the body. As I heard the words “he’s gone” uttered, I felt my heart rate rapidly accelerate. I began to hyperventilate inside the Asheville Target. It was the strangest thing because I had learned all about the physiology of trauma from my research on ACEs. I knew exactly what was happening to my body, but I couldn’t do anything about it.

The weeks that followed my brother’s death are still a blur to me. But one thing I distinctly remember is having a loss of words. When I tried to speak, nothing came out. There weren’t words that could fully capture the horror of what I endured. I thought back to something I learned from my research: when experts used neuroimaging techniques to analyze traumatized brains, they saw that Broca’s area, the part of the brain that controls speech production, was shut off. This happened to me. My brain physically could not produce words (on a side note, I have found writing this blog post to be an empowering way to reclaim my words).

I was a living example of everything I had learned about through work. As a result, I was better able to grasp patients’ experiences of trauma. I felt a deeper sense of empathy for them. I had an urge to tell all of my patients, “Your pain is valid. I recognize and understand your suffering and I’m so deeply sorry for your trauma.”

When I returned back to my life in Asheville, I struggled… a lot. I could barely concentrate on simple tasks at work. It felt like my brain was surrounded by a fog of trauma. My grief felt like a heavy backpack full of bricks, an unbearable weight that I carried around constantly. I would frequently break down crying during the middle of the day. Whenever it happened, I would say to myself: Get it together, Natalie. Control yourself. But I couldn’t always. Trauma and grief are incredibly powerful. I felt overwhelmed. Above all, I needed support from the people around me, but I felt guilty and embarrassed asking for help. I prided myself on doing things independently. I can make it through this on my own, I thought. I was also very accustomed to helping and taking care of others, so it was deeply uncomfortable for me to become the patient, to acknowledge that I needed to be healed and cared for. However, once I admitted this to myself, it made all the difference.

With the Community Resiliency Model in mind, I began reaching out to the people around me—to my community in Asheville. Once I asked for their support and help, my trauma became less overwhelming. There were more people to help me carry my heavy load of bricks. Why did I ever try and do this on my own? My community has been unbelievably supportive and kind. I will never forget the compassion I received during this time. I also started using the resilience techniques that I learned about on myself. Over time, it has become easier to breath. Although I am still profoundly sad about my loss, I feel more resilient and connected because of my supportive community. It took a village to help me on my path of healing.

My raw pain is now the underlying force that fuels my passion for medicine, health and healing. After learning about and living through my own trauma during my Davidson Impact Fellowship, I understand that both health and healing are complex processes. Given that social realities impact these processes, I recognize that my situation is one of privilege. It greatly disturbs me to think about the fact that there are so many people, especially young children and socially vulnerable individuals, who experience horrific traumas with less resources and support than I had. I am more determined than ever to combat this injustice and serve as a supportive resource to vulnerable patients; to be present with them on their journey towards healing.

Ultimately, this year has left me inspired to provide trauma-informed care to my patients and to educate my peers (why I chose to write about it in this blog post), colleagues, family and friends about ACEs and resilience. I hope that by spreading this message throughout my medical career, I can help my patients and my community become more resilient. It really takes a village—a resilient, supportive, connected village—not just a person with a stethoscope, to help people heal.

 

In the shoes of a therapist for kids who have caused sexual harm

(For your information: the following stories contain potentially heavy or upsetting material. They are modifications and conglomerations of stories from nearly 200 kids and families throughout North Carolina. The identifying information and situations are fictional and could not be linked to our clients, past or present.)

Caleb, Stage II, Affect regulation and Attachment, Family

Caleb and his dad both report that they have never gotten along. Caleb’s older brother, Shawn, is currently incarcerated for selling drugs. Shawn coerced Caleb into watching pornography from the ages of 5 to 8 with him and would laugh when Caleb said he didn’t like the show or wanted to watch something else. Caleb was really close with his mother who died of cancer three years ago. A year after his mother’s death, he approached a classmate in the bathroom and touched him inappropriately. He has been in treatment for the last 5 months. Since Caleb’s offense, dad confided in you that he wants to be more involved in his son’s life. Caleb is currently living in foster care and he spends his time playing video games during home visits. Caleb’s dad does not want to stop Caleb from playing video games so there is little interaction during home visits. Family reunification is critical for treatment success and it is promising that Caleb’s dad is engaged in the treatment process.

Welcome to our bi-weekly TASK (Treatment Alternatives for Sexualized Kids) Program staff meeting where we discuss case files of our clients. TASK is a treatment model designed to meet the complex, heterogeneous needs of youth who have caused sexual harm. As the newest member of the team, you will be presenting background information for your 4 kids and current barriers you are experiencing in treatment. We will offer guiding questions to develop an action plan that could overcome the barrier. Your current clients are Matthew, Samantha,  Albert, and Rashawn. Go ahead and tell us about how treatment is going:

 

Matthew, Stage V, Risk mitigation, Affect regulation

Matthew, age 17, is in Stage V and has led conversation and offered honest responses to others during group therapy. His primary caregiver, grandma, is supportive and cooperative. She has mastered strategies on how to enforce boundaries for Matthew while still encouraging him. He wants to get a job but his grades are well below average and he is skipping class every few days, a violation of his safety plan. He told you a neighbor offered him a job mowing lawns. You would like him to be able to get a job but know that he has a pattern of starting projects and stopping halfway. You are excited about the overall progress throughout the past year of treatment and want to set him up for success as we approach his program graduation date.

Questions and action steps offered by the clinicians:

Review his safety plan and utilize motivational interviewing. Does he recognize any connection between skipping class and the rigor involved in maintaining a job? What are some of his big goals? What obstacles, like poor grades, might prevent him from reaching his goals?

Does grandma have influence in his life? Is she able to challenge him to attend school?

Has he established supportive friendships since starting treatment?

 

Samantha, Stage III, Conflict resolution and healthy sexuality, Family

Samantha is 13. She called last week during school and told you she felt like she was going to have a panic attack. You deescalated the situation by phone and she was able to function the rest of the day. During this week’s family meeting, you realize that adopted mom and dad are unaware that Samantha has struggled with anxiety. Instead, they are upset that she has not cleaned her room every day and washed the dishes like they had discussed.  They spend the first 20 minutes of the meeting describing everything Samantha has not done since your last meeting. Based on your conversations with adopted mom and dad from early on, they have tightened up their discipline and increased Samantha’s chores considerably. After 40 minutes have passed, mom announces that they caught Samantha with inappropriate pictures on her phone 2 weeks ago. Since then, they have checked Samantha’s phone every night before bed. Lastly, Samantha told them she might be interested in a boy in her class but mom and dad inform you that she is not allowed to talk to him anymore.

Questions to consider:

Have you had a conversation with mom and dad about their perspectives around healthy relationships and attitudes towards sex?

Can you provide mom and dad with specific suggestions about how to handle crises?

At the end of the meeting, inform mom, dad, and Samantha that you are going to work together to review Samantha’s safety plan in the next family meeting. Provide time for all 4 of you to contribute and ask questions. Ideally, a reviewed safety plan will address the insecurity and doubt felt by her adopted parents, provide age-appropriate autonomy to Samantha, and ensure she is progressing towards her stage goals without causing harm.

 

Albert, Stage II, Family, Affect Regulation

Albert lives with his aunt and uncle. He is in Stage II and this is your 3rd family meeting. From the beginning, aunt has requested he be moved to therapeutic foster care, unaware that some of Albert’s mood fluctuations are a result of the family system. Albert has been diagnosed with ADHD and has broken a few dishes and a chair since you started meeting with the family. The uncle drinks frequently and Albert’s outbursts coincide with alcohol related outbursts. Additionally, Albert has a history of abandonment and his parents are no longer involved in his life. During individual therapy, Albert admits he is often unable to control his anger and has had trouble sleeping recently. He has a few friends but no one he is close with. When you try to gauge whether the aunt and uncle have motivation to change, they impatiently bring up the idea of foster care.

Questions to consider:

Are there pro-social opportunities in which Alex can get involved? Would he consider joining a sports team or other intramural activity? How can he gain a sense of belonging outside of home?

Have you tried talking to the aunt and uncle about their lives apart from Alex? Showing interest in them could foster an engaged relationship that would allow them to feel more comfortable participating in the treatment process.

Could there another diagnosis besides ADHD? Could you screen for other signs of depression or bipolar?

 

Rashawn, Stage II, Crisis at school, Trauma

At school this week, Rashawn got angry during class and walked out. He was not cooperating with his teacher and the teacher grabbed him and tried to make him sit down. Rashawn responded by screaming and cursing and nearly punched the teacher. The school called you after Rashawn had calmed down a little bit and was sitting in the principal’s office. Rashawn was verbally and physically abused by an aunt from the age of 7 to 9. He has no other trauma history as far as you know.

Questions to consider:

Is the school and the teacher aware of Rashawn’s safety plan?

Have the teachers had trauma-informed training on how to handle crises?

Does Rashawn recognize when his emotions are escalating?

Does he feel comfortable or able to call you or another support person when his emotions start escalating?

 

After this meeting, you have time with Samantha and her family,  Matthew and his grandma, and with Rashawn, individually. Additionally, you have group tonight so after staffing, you get ready to hit the road to meet up with Samantha. You take a few minutes to make sure you and the other therapist are on the same page about the group agenda tonight. You are excited to hear updates from the kids. Looking forward to a full day!

Thank you for reading more about what the day to day is like for our TASK clinicians. The research projects are still underway. We are currently revising the project plan in order to incorporate more preliminary steps before a more rigorous investigation. The therapists, business team, data team, and countless others have become a cohesive, engaged working group as we bring together our questions, experiences, and expectations for this project!

Ramblings on a day's work as Program Analyst for Touch Foundation in Tanzania

I show up to work at 8:45 or 9:15, never 9:00 am. This is not company policy of course but rather what seems to be my keen unpunctuality; something ingrained in my character during 4 years of Davidson where “international students arrive to class late”. In 2001, the USAID head of the time proclaimed that

[Many Africans] don’t know what Western time is. You have to take these [AIDS] drugs a certain number of hours each day, or they don’t work. Many people in Africa have never seen a clock or a watch their entire lives. And if you say, one o’clock in the afternoon, they do not know what you are talking about.

I’ve learned though, in East Africa you’re never late, just delayed. My colleagues come from just about anywhere around the world, and feel much the same way about 15 minutes. Thankfully, the above sentiment is long since gone (in Tanzania, not Davidson), USAID is Touch Foundation’s biggest funder, and the patients who we work to benefit now receive AIDS medication.

To show up to work at 8:45 or 9:15, I have a) slept through my alarm (9:15), b) fallen asleep like a baby at 7pm when there was no electricity (8:45), c) met one of Touch’s local partners on the street on my way to work (9:15), d) ran from sudden rain on my way to work (8:45), e) bought shoes from a guy on the street selling shoes at 8:45 (9:15), f) thought I had time to iron my clothes (9:15), g) given up on ironing clothes (9:15), h) walked downstairs from my room (8:45), i) walked downhill (8:45), j) walked uphill (it’s a big hill) (9:15), k) walked across town (9:15), l) ridden a motorcycle across town (even though I’m supposed to only take car taxis, I, rebel) (8:45), m) looked for a café with wireless internet around town (9:15), n) ridden for 2 hours on a dirt road full of bumps and holes (8:45), o) taken a leaking ferry across a cove in lake Victoria to ride for 2 more hours on a dirt road full of bumps and holes (9:15), p) flown to South Africa (8:45), q), r), s)

There is no typical day working for Touch in Tanzania. I can’t even finish describing arriving to work in under 500 words, to try to do so for my workday would do it a great injustice. It’s really cool though.

Expecting the Unexpected

“Compassion is the sometimes fatal capacity for feeling what it is like to live inside somebody else’s skin. It’s the knowledge that there can never really be any peace and joy for me until there is peace and joy for you too.” – Frederick Buechner

At some point during each of the six audit projects assignments during the span of my fellowship with Habitat for Humanity International’s Internal Audit department, there has been a moment, if not moments, which have taken my breath away. These moments take on many forms – joy, heartbreak, discomfort – as I learned about the context in which Habitat is working. They are those moments that, while I can anticipate them coming, I can never quite be mentally and emotionally prepared. After this past year of service, I have learned to expect the unexpected.

As an Internal Audit department, our role distills to asking the right questions and observing the operations of each Habitat entity either domestically or internationally. Often, this involves analyzing financial statements, probing staff for longer answers, and most importantly, developing trusting and confidential relationships with each staff member. In addition to providing information on the Habitat entity’s operations, each individual provides critical insight as to the culture and socioeconomic situation of the communities and families Habitat serves. Anecdotes of her or his personal life pepper conversations, preparing me mentally for the homeowner visits.

The excursion to visit partner families in Madagascar is one that, five months later, I continue to have the same reaction. As the team piled out of the Habitat truck and proceeded to follow the GPS coordinates to the reported location, we set off on foot to traverse ragged dirt pathways. We zigzagged between half-finished houses, outdoor latrines, and buckets of standing drinking water as well as passing by families, children, and the occasional barnyard animals in the scorching 90°F heat of the January summer. I was reminded of the world’s deep need for more solutions for whom the fundamentals of daily life are missing – food, water, and shelter. Peering around a corner, I knew we had reached our final destination as I saw a home that was complete with a roof overhead and panes in the windows. That was the model Habitat home – a decent place to live.

During our conversations with the homeowners, who spoke only French and Malagasy, we learned that the mother and father felt that the Habitat home had provided a stable and dry structure in which to raise their three elementary-aged children. In addition to the primary goal of stable housing, the homeowners had been welcomed into the Habitat network of their rural community which provides additional non-quantifiable opportunities for support and friendship. The community formed in that village has brought deep joy to the partners and kids alike, and owning a decent and simple home has brought peace to the parents.

Each individual home I have visited this past year across the world – ranging from Madagascar to Malaysia – has provided joy, but only temporarily. It reaffirms the necessity of organizations such as Habitat to be working in locations of extreme need and poverty in order to empower partner families and provide sustainable support to these communities. But each project further stirs my intellectual and personal discomfort not only in the moment but months later as well. As my fellowship with Habitat for Humanity International draws to a close, I know that I will carry these moments forward which will prevent my own real peace and joy until the world’s deep needs have been met.

Preparedness

The recent months have been a whirlwind. With changing seasons, new jobs, and big hopes, I concluded my Davidson Impact Fellowship and embarked on a new journey. I have yet to have time to sit and think about the things I worked on and contributed to over the past year. So as I pause to write my final DIF post, an overwhelming amount of emotion and gratitude floods in.

What had I done in the past year? What can I say I accomplished? The first question is a bit easier to answer: I had worked with the first art museum in North Carolina. I led a team creating programs for young adults to engage with the museum’s collection. I trained a group of almost 80 older adults on touring strategies and special exhibition materials. I contributed to the museum’s newest initiative to bring area teens to connect with and learn from a beautiful collection of art, craft, and design. Frankly, I had been a part of more than I had hoped.

For the answer to my second question, I had to think a little harder. From writing resumes and cover letters for my next opportunity, I knew that I had accomplished a lot professionally: experience, ability, ingenuity, patience, dedication–all made easier by working for a cause I believed in. But what does all of that mean in the grand scheme of things? Yes, I am more qualified now, but why does that matter?

It matters because I am now prepared to move forward in the art world, helping to bring individuals of all ages, economic backgrounds, and ethnicities to an institution that speaks the universal language of culture: art. Art, as I have further discovered in the past year, can do more to teach us critical thinking, communication, creativity and collaboration. This amazing resource, which is housed in institutions across the world, should be advocated for. Every person should have access to educational programs at museums; everyone should have this chance to learn. This is what I am now more prepared to support because of my Impact Fellowship.

What the Impact Fellowship Program provides young graduates, in its most basic sense, is an unbelievable opportunity for a first job. On another level, it offers the chance to be part of a greater Davidson community that gives back. It provides the basic, yet invaluable, support of someone believing in you. At the highest tier, it provides preparedness–what I have come to learn as the most valuable trait that an individual can possess: the preparedness to jump into the greater community and work for what you believe in.

My Impact Fellowship has done exactly that: fully prepared me to take my next step toward accomplishing my career goals. It has led me to accept a position working for an art museum in New York advocating for free educational programs so that any visitor that might walk through the door–and individuals interested globally!–may have the opportunity to learn from the amazing cultural history we have available. Spending the past year in hands on experience in arts education has given me the material with which to support a wide variety of initiatives.

From the bottom of my heart, thank you to The Mint Museum, thank you to Davidson College, and thank you to the wonderful Impact Fellow Program. This incredible opportunity has given me more than I could have hoped for in a first job and has better prepared me to take on the challenges of working for a nonprofit, and a cause that I believe in.

Thinking Pink: Ladies Night Out and the World of "Breast Cancer Kitsch"

We’d talked for about a minute and a half when Wanda yanked an extra chair closer to her computer monitor (perched amidst hallmark figurines, inspirational slogan magnets, and family photos) in her gray health department cubicle. She pledged:

“Now this is guaranteed to make you cry.”

She was talking about Ladies Night Out, a monthly program that provides uninsured women below a certain income level with annual bloodwork, mammograms, and breast cancer screenings. The date was July 29th, 2014.

Thinking Pink: Ladies Night Out and the World of "Breast Cancer Kitsch"

From 2013 NY Times article “Our Feel-Good War on Breast Cancer.” Photo: PR Newswire, via Associated Press; Tom DiPace/Associated Press; Gabrielle Plucknette/The New York Times (apron, sunglasses, flip-flop); Simon Fergusson/Getty Images.

This week I’ve been thinking a lot about breast cancer.

About 1 in 8 U.S. women (12.5%) will develop invasive breast cancer in addition to about 1 in 1,000 men.*

It’s a devastating disease with devastating implications I’ve seen echo in the lives of colleagues, friends, and family.

Yet even as I contemplate all that loss, the dearth of pink-themed products from my last Google Images search floods my mind: water bottles, key chains, backpacks, hair straighteners, Kit Kats, flip-flops, eyelash curlers, perfume, iPods, pepper spray, margarita glasses, compact mirrors, M&Ms, charm bracelets, hairspray, and snuggies – all pink and be-ribbon-ed.

What does all this stuff have to do with breast cancer? Is this awareness? Is this fundraising? Is this exploitation?

Seeking answers, I turned to Barbara Ehrenreich’s essay Welcome to Cancerland. In an incisive consideration of her own breast cancer diagnosis, Ehrenreich explores links between breast cancer culture and industry, the hyper-association of breast cancer with traditional femininity, and the infantilization of women living with the disease. She expresses the fury she feels at being met with peppy slogans of hope and survivorship and an expectation to adopt them as badges of her unwanted membership in the breast cancer sisterhood.

You can read her article here, and I recommend that you do.

Thinking Pink: Ladies Night Out and the World of "Breast Cancer Kitsch"

Barbara Ehrenreich. Photograph: Steven Voss

Back at the health department, Wanda clicked play on the YouTube video showcasing Ladies Night Out. Just like she predicted, I cried. And then I became a volunteer, translating once a month for the Spanish-speaking women who access the program.

Ladies Night Out is executed with an individual sort of aplomb that nearly a year in, I’m still grasping to understand – a juncture of gooey sentimentality, straightforward conviction, and needed services. There is not an ironic bone in the body of this operation – “Ladies! Flowers! Pink!” the program seems to shout, self-assured in its style and its mission.

When a “lady,” the name reserved for all program clients, arrives, a volunteer hands her a pink flower and a reusable pink bag. Sandwich boards with program information feature hot pink text and decorative stars. The satisfaction surveys are often printed on pink paper. Volunteers all don the same cotton zip-up printed with pink ribbons.

They’re the kind of details that make me roll my eyes in solidarity with Ehrenreich, but predictably, it’s just as my eyeballs have nearly finished their dramatic arc that I catch sight of a woman who’s grinning from ear to ear and staring at the carnation in her hand. It’s at that moment that the woman who I’ve just translated through a mammogram tells me how much she loves Ladies Night Out.

There’s a distinction to be drawn between “breast cancer kitsch” and the lived experiences of people. There has to be. Otherwise we’re left with a choice between either affirming merchandise in order to affirm the women who find comfort in their pink flowers and newfound sisterhood or disparaging real people in order to criticize an industry – a choice which seems as artificial as it is unkind.

The women who use Ladies Night Out are deeply grateful, and the volunteers and staff are deeply committed. I love translating here, and you’ll find me at Ladies Night Out next month, too.

Still, I’m not sure what to do with all this pink.

 

Musings from the Mountain

Musings from the Mountain  Musings from the Mountain

During my time at ASC, I have had the opportunity to attend two retreats with my team. Initially, I was very apprehensive about this experience and the thought of spending three days on top of a mountain with zero cell service and zero personal space.  Nonetheless, I packed up my car, and my work, and prepared myself for a few days of intensive analysis of our intersession camp at Wildacres. Although I returned home exhausted, I found that there was a major benefit to spending some time away from the office. Here are some of my reflections on the experience:

1.) In the modern workplace, technological tools have advanced our ability to organize, communicate and work. And while this technology serves to make us more efficient workers, many times the constant bombardment of email requests, calendar reminders and text messages can stall productivity. At Wildacres, wifi and cell phone service (not to mention LTE) is virtually non-existent. Knowing this from our Fall retreat, I chose to unplug completely and turn my cellphone off for the duration of our time. This decision certainly increased my professional productivity, but more importantly, I found this break from likes, swipes, and push notifications to be highly refreshing. NOTE: If you choose to do this, be sure to text your mom & let her know that you made it to the top of the mountain safely first.

2.) Do not underestimate the importance of socializing with your team. Although I was admittedly anxious about sharing breakfast with my coworkers before at least two cups of coffee, I think the informal moments on our retreat were very beneficial to our team dynamic and rapport.

3.) The Arts & Science Council works to build appreciation, participation and support for the arts, sciences, history and heritage throughout Charlotte, with the hope of creating a vibrant cultural life for all. I have found that ASC is equally invested in fulfilling this mission and cultivating creativity within our workplace. On our fall retreat, I got to spend time in the lapidary studio cutting rocks. In the spring, we did evening multi-media and paint projects. In my opinion, opportunities to play and create help us become innovative leaders and creative problem solvers.

  Musings from the Mountain  Musings from the Mountain

 

Geitawi: Quick Sketch

 

Geitawi: Quick Sketch

Ink sketches and photo part of Geitawi Series by Paige Donnelly

 

 

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Ecuador: Ama La Vida (Ecuador: Love Life)

At the beginning of August I moved to Quito, Ecuador to begin my fellowship with Timmy Global Health. Before I talk about my fellowship, here is some background information on the organization I am working with and how I became their fellow.

Ecuador: Ama La Vida (Ecuador: Love Life)

About the organization: Timmy Global Health is a non-profit organization that expands access to healthcare and empowers volunteers to confront today’s most pressing global health challenges. Medical service teams travel to support 7 project sites in 5 countries by providing financial, medical, and human resources to the communities within each site. If you would like to know more about the organization visit www.timmyglobalhealth.org

How I became involved: My first year at Davidson I joined the college’s chapter of Timmy Global Health and it quickly became an integral part of my collegiate experience. Throughout my four years at Davidson I became more involved and dedicated to the organization’s mission to expand access to healthcare, including being the Davidson chapter President my senior year. Over winter break my last year I traveled to Quito, Ecuador on our chapter’s annual medical brigade. During the trip I was able to learn about TimmyCare (an electronic medical record system created specifically for Timmy Global Health) through using it in clinics and talking to the director of TimmyCare, Muz Ahmed. I left Ecuador knowing I wanted to go back to help expand TimmyCare; I just did not know how it could happen.

Ecuador: Ama La Vida (Ecuador: Love Life)

How I became the TimmyCare Fellow: When I was looking for jobs senior year all I could think about doing was returning to Ecuador to work with Timmy Global Health to improve TimmyCare. However, I would have had to go as a volunteer and did not have the means to do so for a long period of time. The new “Build Your Own” fellowship through the Davidson Impact Fellows program provided me the perfect opportunity to pursue my dream job for the year after graduation. By receiving this fellowship through Davidson I was awarded the opportunity to give back to an organization that is important to me, to develop my skills as a computer programmer, to learn about another culture through living in Ecuador, and so much more.

What I do: As the TimmyCare Fellow I work with the director of TimmyCare, Muz Ahmed, to help update and improve the system based on its functionality during clinics and feedback from the clinic volunteers. Most days involve researching ways to improve the system as well as changing the code to update TimmyCare. My background in computer science is a basic foundation through two courses I took at Davidson. Thus, a majority of my time is learning how to make the changes in the system – either through research or with the guidance of Muz.

Ecuador: Ama La Vida (Ecuador: Love Life)

Although my fellowship focuses on my work with TimmyCare, it also entails getting to know a new environment. The move from a small town in North Carolina to a big city in Ecuador has been the hardest obstacle for me to overcome so far in the fellowship. For example, before I moved I had never taken any form of public transportation. Now I use the public buses, the trolley, or taxi services almost daily. I still get lost on occasion, but I have learned that being lost is not always a bad thing. The other day I got to explore a part of the city I would have never seen otherwise because I went the wrong way to a co-worker’s house. Another big adjustment is the language barrier. I am conversational in Spanish, but did not realize how nervous I get when I speak it until I arrived here and in most situations, speaking Spanish is my only option. I have become more comfortable in Spanish conversations and have improved since I have been here. I still have a lot to learn during my time here – both through my work with TimmyCare and culturally. I had a slow start adjusting to living in Quito, but as I get accustomed to living here I am looking forward to the rest of my time as the TimmyCare Fellow.

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