Since it’s the New Year, I will do a New Year’s Post. While I’m not much for resolutions, I will often apply a theme to the year. Something I can go back to when I’m feeling directionless and/or stressed. This year, the letter B called to me. Be Better, Be Balanced, Be Bold.
Be Better. Part of my purpose in life and one of the purposes of this blog is to live my best life and to help others live theirs. The only way to do that is to constantly try to make myself better. Please don’t get that confused with perfect. Perfection is not a goal of mine. Instead, I try to do the right thing, be nice to people, help out where I can and when I make a mistake, try to do better next time. Having grace for yourself and others will go a long way.
Be Balanced. Work hard, play hard right? Or maybe, work enough, play enough, might be more appropriate. Living on the extremes can sometimes get you in trouble. I don’t believe you should work yourself to exhaustion or party yourself to destruction. It’s always great to be that “good tired’ after a day at work. Or managing to achieve the perfect tipsy with no hangover after a night with friends. Just enough…
Be Bold. To me, being bold means not limiting yourself. Employing the adage “nothing ventured, nothing gained,” I often push my comfort zone. Partly to push myself to grow and partially because I get bored easily… It’s difficult to be great without taking any risks. So this year, I will push my comfort zone some more. Try things I’ve never tried before. Go places I’ve never been before. Of course, in 2017 I decided to live in Kenya for 6 months. Not sure how I will top that in 2018, but I’m up for the challenge.
So with that, I implore you all to find your theme or themes for 2018.
One of my colleagues in Mutomo asked me what I was doing for the holidays. I said, “I’m going home, to see my family.” He responded with a quizzical look, “I thought you didn’t have a family.” Now, I was confused. Did I imply that I was an orphan…? Maybe something got lost in translation between my English and his? He quickly followed with, “You told me that you didn’t have a husband or kids.” Oh…now it was clear, his concept of family only included marriage and procreation. Another physician in the room piped in, “Maybe you need to broaden your definition of family.” Indeed, I would agree.
My biological family is great! And, all four of my parents have been there along my journey, even when they didn’t understand what I was doing or why I was doing it. They trusted me to believe in myself and follow my purpose. My extended family has continued to grow over the years. I posted a few weeks ago about how I love my friends. And truth be told, I consider most of my friends, family as well. I make friends for life so, I make an effort to maintain and strengthen those relationships.
In my professional role, in order to provide good medical care, I need to understand the community in which my patients live and my co-workers work. On the residency interview trail, I asked one of my interviewers where most of the residents lived. She responded, “well you can’t live around here.” My feelings were hurt and I wasn’t even from that city. Needless to say, they slipped to the bottom of my rank list. On one of my other residency interviews, I laughed so much at dinner, I thought, “I feel at home; this feels like family.” And, I knew that was where I was supposed to be. When I moved to Pennsylvania for my first job, I asked for recommendations on where to live. The response, “well if you want, why not live around here?” I moved into an apartment less than 2 miles from the hospital. One of the toughest decisions leaving that job was leaving my Montgomery work family. I still love them dearly and they have continued to be there for me. That’s what family feels like. As I traveled doing locums before venturing to Kenya, I liked to take assignments that lasted long enough for me to a get a sense of the local community. I accepted invitations to dinner and church, to potlucks and to happy hours. I didn’t want to just work there, I wanted to live there.
I have those feelings from time to time, that fleeting, intangible moment that you know you are at the right place at the right time. I have had that feeling in Kenya. One weekend I found myself sharing a meal playing cards with my Mutomo work family, and I knew I’d found my tribe. I don’t know how many of you have had the experience of traveling to a new city, and one of your parents says, “call so-and-so when you get there. She’s your cousin…” A cousin that you’ve never seen before, met before, heard of before. But you call as instructed, and that cousin takes care of you like she’s known you since birth. Similarly, a friend introduced me to a friend of his who’s American but lives in Nairobi. She invited me over for dinner shortly after I arrived a couple months ago, and if you saw us today, you would think we had known each other forever. In the same vain, my CMMB family has been incredible in making my time here as comfortable and rewarding as possible. It was only fitting that I celebrated Christmas with them, before returning to the states for the Holidays.
Family to me, are the people around you who support and encourage you to be your best self. I look forward to spending the holidays with my family, all of them, whether related by blood or by spirit.
Kuzaliwa kumoja, maisha mengi = Swahili Proverb, translated: The same birth, but many lives. Human beings are born in the same way but their lives may be different.
Taken behind my house in Mutomo
A friend and colleague forwarded me a story from NPR this week. You may have seen the article circulating about a mother who recently died soon after childbirth. Maternal mortality is defined as the death of a woman during pregnancy, delivery or shortly thereafter. In the United States, it represents the 6th leading cause of death among reproductive age women from 25-34. Recently, the rate of maternal mortality has been on the rise in the United States, with the rates among black women being 3 times as high as for white women. And, according to JAMA, “Even if you look only at white women in the United States, the rates of mothers who die is greater than those in other developed countries.” In the developing world, the statistics are even more startling. The WHO reports, “The maternal mortality ratio in developing countries in 2015 is 239 per 100 000 live births versus 12 per 100 000 live births in developed countries.” Here, in Kenya the number is 510. Reading this article made me reflect on my evolution as a physician, and how stories like Shalon’s motivate me to continue the work that I do.
Going into medical school my plan was to be a forensic pathologist. I’ve known I wanted to be a doctor since I was seven but this particular aspiration grew from reading novels in high school in which the main character was a forensic pathologist. The field intrigued me for many reasons, one was that it functioned between two worlds, the law and medicine, it allowed me to work with my hands and avoid a traditional clinical practice… I have been described as quiet, shy, reserved, introverted or all of the above at different stages of my life. For this reason, I was nervous about how I would be able to cultivate the doctor-patient relationship. Pathology gave me a way out. Those patients didn’t talk back. You can only imagine how devastated I was first year of medical school, when I discovered, I did not like pathology or histology, or the microscope really. I would fall asleep looking at slides…
As with this lesson, I learned a lot about myself in medical school. I now credit my personality as an asset to my bedside manner, not a hindrance. Thanks to that revelation and to a few other serendipitous events, I found my way to Obstetrics and Gynecology. And without a doubt, it is the field for me. But old dreams sometimes die hard, so my fourth year, before submitting my Ob/Gyn Residency applications, I signed up for a forensic pathology rotation housed at the Metropolitan Government of Nashville and Davidson County Medical Examiner office. And I loved it of course! But it was time to let it go. In order to merge my old interests with my new ones, I presented on Maternal Mortality for my Externship project that month. As I was learning to articulate my interests in public health and health disparities, this subject underscored both and I have carried it with me through the rest of my training and into my career. I encourage you to read Shalon’s heartbreaking story, which tells the story far better than I can.
The first time I spent Thanksgiving away from home was my senior year of college. I wanted the opportunity to soak up a few more precious moments with my college friends and to experience the Bayou Classic weekend in New Orleans. Fortunately, a couple of my friends had an off campus apartment and they were willing to host us. We all chipped in and cooked a potluck style dinner, most of us contributing to a Thanksgiving meal for the first time. I remember listening to Maxwell’s new album Now in the days when we still had a CD player. We attended the battle of the bands in the Superdome and probably went to a party or two… nothing fancy, just food, friends and fellowship.
Since that year, I have spent more Thanksgivings away from my family, sometimes because I had to work on the days around Thanksgiving or sometimes actually being on call in the hospital. On those occasions, I would celebrate with the closest friend I had to the area. Most of the time preparing a dish but sometimes showing up empty handed, when time didn’t permit me to cook. They welcomed me graciously either way.
Over the past few years, one of my friends has officially hosted Friendsgiving. Usually the Friday after Thanksgiving, to give those of us away from home the opportunity to enjoy the holiday and for those close to home the benefit of not having to choose to spend the holiday with friends or family. The best of both worlds.
This year, I spent this week in Kenya, and I am missing the turkey, cornbread dressing, collard greens, macaroni and cheese, potato salad and, since I’m dreaming, chess pie! But I wanted to take this moment to say thank you to all my friends, around the globe, that have supported and encouraged me on my journey. I look forward to making many more memories with you!
5 Reasons why I love my friends:
1. They understand my punctuality. I have a strong desire to do everything or conversely the dreaded condition of FOMO (fear of missing out). This condition sometimes causes me to arrive early to the function, so I can leave early or sometimes I’m a little late to the party. But if I say I’m going to be there, I’ll be there. So thank you for not getting annoyed with my fluid interpretation of time.
2. They understand my love of travel. I have friends with whom I have literally traveled around the world. We’ve planned trips together and I’ve also inserted myself into a few already planned trips 🙂 I also appreciate those friends who host me when I show up on the their doorstep, suitcase in tow. To the question, “where are you staying?” My answer, “here…?” is always met with a gracious welcome. And in the same vain, thank you to those who host my belongings in my absence!
3. They understand my need to stay connected. This fact is especially true in Kenya. I was a little nervous about being so far away from family and friends for an extended time. Without skipping a beat, they have been supportive and responsive to my random text messages, facebook messages, whatsapp messages, emails… even when I lose sight of the time difference…
4. They understand my need to be entertained. I love activities and I enjoy new experiences. From house parties to canoeing to kickball games to whitewater rafting to attending the Kentucky Derby to skydiving to tattoos to dinner 1150 feet in the air, to staying up until sunrise (more times than I can count) we’ve done them together!
5. They understand me. They allow me to be unapologetically myself in all my forms. They provide encouragement when support is needed, reassurance when I doubt myself and honest reflection when I need a little, let’s say reality check. They keep me accountable and are instrumental in helping me be my best self.
Vanderbilt’s Medical School is housed in the Medical Center and shelters the training of both medical students and the biomedical graduate students. Lucky for me, half of my friends in medical school were graduate students. One of these friends is Kimberly Mulligan Guy. She has a dynamic personality and has never met a stranger. As smart as she is beautiful, she commands the room in professional and social situations. In June 2015, shortly after I had given my notice, we talked on the phone, just to catch up. During the call, she said, by the way, I’ve just been offered this opportunity to move to Abu Dhabi. She expressed her apprehension to moving to a new country, coordinating this move with her husband and transitioning her job in Nashville to the Middle East. Should she go, she asked… my response… Ummm, Yeah!
Dr. Mulligan Guy received her PhD in Molecular Physiology and Biophysics from Vanderbilt. After graduation, she took a position as a Resident Scientist in the Center for Science Outreach where among other duties, she investigated the impact scientists positioned full-time in a public school have on secondary education and student interest in science. These are the skills she carried with her to the students in Abu Dhabi. During her time there, she not only learned about the education system and culture in the United Arab Emirates, she had the opportunity to travel to Thailand, Egypt and Spain.
After her return to the States, she has accepted a position as the Director of Diversity and Multicultural Affairs in the College of Sciences and Mathematics at Auburn University. This position allows her to continue to make sure students have the best opportunity to seek their dreams and fulfill their life goals. We recently reconnected in Toronto and as with any good friend, it was if it was only yesterday (instead of two years ago) since we saw each other.
Today we talk with Kimberly Mulligan Guy about living and working abroad as a scientist and educator.
Tell us a little about yourself.
My father was in the army when I was young so I was born in Colorado Springs, however home is Columbia, SC. I’m the second oldest of five siblings. Both of my parents attended an HBCU and I loved A Different World (I actually still love it, the topics are relevant even in this day and time) so the only real decision was which one I would chose.
If you would have asked me in high school which college I was attending I would have said Xavier University in NOLA (we could have met in undergrad!). However, circumstances led me to make one of the best decisions of my life which was to attend Florida Agricultural & Mechanical University (FAMU) in Tallahassee, FL where I was a chemistry major. My original plan was to become a medical doctor but as a sophomore one of my professors asked if I would work in his laboratory. I needed some extra money (what college student doesn’t?) and it would look great on my medical school application. Little did I know I would fall in love with research and that one opportunity would change the trajectory of my career path.
How did you decided to pursue a PhD in Molecular Physiology and Biophysics?
Vanderbilt University has an Interdisciplinary Graduate Program which allows you to conduct research in different labs during your first year prior to deciding which department you would join. The one piece of advice I always give students considering graduate school is to choose your advisor wisely. I didn’t choose a field, I chose a mentor who would allow me the space to figure out what I wanted to do with my degree. I knew going into graduate school that the traditional route of academia might not be for me. The process of science excites me but what I find most fulfilling is helping young people, especially students of color, fall in love with science. My mentor allowed me the freedom to pursue activities which supported my passion. I’m grateful for his recognition there’s more than one way to be a scientist because I had classmates who did not have the same experience. My work with the Vanderbilt Center for Science Outreach during my time in graduate school directly led to my opportunity to work in Abu Dhabi.
How did you come across the opportunity to work in Abu Dhabi?
The Vanderbilt Center for Science Outreach has had several very successful collaborations incorporating “real-world” hands-on science into K-12 classrooms. Vanderbilt University already had a partnership with the Abu Dhabi Education Council for a leadership program and when they expressed interest in expanding their STEM programs our office was excited for the opportunity.
I wasn’t included in the original conversations, I don’t think anyone considered I would be interested in moving overseas. My husband was taking me to Barbados for my birthday in June and prior to my leaving I had a meeting with the Director of our office. In passing, I mentioned what a cool opportunity this was for my coworker. While on vacation, I received an email stating I would be perfect for the position but they didn’t think I would be interested in moving but let’s talk when I returned. Fast forward one month later (after numerous conversations with family and friends) I’m packing to move to Abu Dhabi.
What were the most challenging aspects of living and working abroad? What were the most rewarding aspects of living and working abroad?
Many of the challenges we experienced while assisting in getting a STEM program off the ground in Abu Dhabi resulted from preconceived notions. You devise a STEM curriculum (which is heavily dependent on what you assume the students have already learned), order your supplies, and train instructors the week before school starts. What could possibly go wrong with this plan? What didn’t is the better question! But I feel many of the issues resulted from not having a good grasp of the school culture going into the situation. I lived in Abu Dhabi full time with another co-worker. Because the people from our office who coordinated the efforts had only visited, I don’t know if they were aware enough to fully prepare us for the challenges we experienced. However, I loved every minute of it and if I didn’t learn anything else, I had a priceless lesson in the importance of being flexible!
I was very fortunate that my husband had a career which allowed him to move with me. The move would have been much more difficult if we didn’t have the opportunity to share in the experience together. We had the opportunity to meet so many wonderful people from all over the world. It was interesting because I was there for the better part of the election cycle. To be able to discuss the rhetoric regarding the Muslim faith with the students and faculty I worked with, to experience the hurt with people I cared so much about, but also be a voice to reassure them all Americans don’t think that way gave me so much hope. The students and faculty I worked with were so inquisitive about my culture and always eager to share theirs with me. I was able to attend Mosque with a coworker during Ramadan, I experienced an Emirate wedding, and went to an iftar for my birthday with a group of friends. Not to mention the beautiful places we were able to visit for the price of traveling from Atlanta to San Diego.
How do you counsel your students on balancing life, work and adventure?
The lessons I hope the students I work with take away from their time with me are to find their passion and make it their career; surround themselves with people who have similar goals and push them to be better; never be afraid of failure; be fearless, especially when it comes to seeing the world; and don’t let money dictate your path. Mistakes happen, things don’t go as planned, but you learn from them and keep moving. I want them to live their lives with no regrets and remember to have fun!
National Museum of African American History and Culture
Through no coordinated efforts on our part, 3 graduates from my high school arrived in New Orleans, LA to attend Xavier University of Louisiana. When I describe my experience at Xavier to other people, I describe it as the first time I could be unapologetically myself. It was so empowering to look out on the yard on any given day and feel empowered by people who looked like me striving toward higher education and positive service toward others. Those four years became more important when re-entering the “real world”, remembering the support and guidance there, helped during the days when I was made to feel less than or underprepared or undervalued.
The fight for equality has been ingrained into my being for as long as I can remember. My grandmother was not shy in sharing her experiences growing up and prepared me for what we now call micro-aggressions when I started elementary school. I have no doubt this part of my informal education led me to medicine and then to public health, searching for my own way to level the playing field. With the current events that have engulfed our country over the past several weeks, I have been struggling to articulate my thoughts and feelings as it relates our country and our profession. Those feelings that range from anger to disgust to disappointment to despair.
My high school and college classmate, Ashley Harmon, a psychiatrist, made an eloquent statement the other day. She captured some of those feelings.
“No one ever speaks to the complicity within the medical community that tolerates racism. Do my peers understand what it means to be called a Nig–r while providing care to patients? Do you know how it feels to be seen as subhuman and still provide excellent care? Do you understand how I have to remain silent and continue to be unbiased? Do you understand that because I am the defacto leader that I have to provide an example at all times? Do you understand how traumatizing that is? Do you know that medical schools do not teach people of color how to defend themselves? These institutions also do not teach our white peers to defend us either. Administrations look past the person and to the bottom line. Racism and bigotry scream silently down the halls of medical institutions. And we wonder why there are health disparities? The medical community has not even developed a coherent response when one of their own is harmed. How then could the medical community protect others?”
I asked Ashley if she would mind sharing more on this subject today.
Tell us about yourself.
My name is Ashley Harmon and I am a board certified geriatric psychiatrist. Most recently I have been working at a VA on an inpatient unit as an independent contractor but will be coming into the VA as a full-time physician in the fall of 2017. I have been quite mobile since graduating from my fellowship at University of Rochester in NY. I have been blessed to work in several different health care settings including nursing homes, assisted livings, inpatient psychiatry and emergency psychiatry.
What led you to the field of Psychiatry?
When I entered medical school, I initially thought I would pursue neurology since I had a fascination with the brain and how it functioned after working as an aid at an assisted living facility. I will never forget an elderly resident that I took care of. She was a God-fearing woman who never forgot her evening prayers, but she was heartbreaking because she forgot her children’s names. I also could not reconcile how this praying woman could become irritable in a moment’s notice and be an adept thief that could rival any professional. We often retrieved resident’s belongings from her purse. I wanted to understand what was wrong with her brain, and why she lost her memory. But as soon as I stepped onto a psychiatric unit during my clinical rotations, I was hooked. It astounded me that someone’s brain was powerful enough to shape their perception of reality and it was wonderful learn about the person behind the illness once their symptoms resolved. I felt that through psychiatry, I would work with the young and old, including those with dementia and try to improve their quality of life.
Can you elaborate more on your comments above?
The day I wrote this Facebook post I was quite frustrated and dismayed at the racial tensions and violence that were displayed in Charlottesville and the days after. I was especially alarmed that white supremacists had become so emboldened that they were proudly spouting their ideas and vicious rhetoric. This made me reflect upon the times, in various settings in which I had been called the n-word or my patients of color had to manage knowing another patient was using racist language. Though I deal with emotionally unstable patients, the majority will adhere to social norms despite their illness. And, the majority of cases where I had encountered racist language were not in the midst of psychosis or delirium. It reminded me of instances where even inside the walls of a hospital, a supposed place of healing, racial tensions could easily bubble to the surface. It is always below the surface, unspoken. If racists can proclaim their beliefs loudly in the streets, why must I remain silent in the halls of healing? Prior to taking a sabbatical from the VA, my team was dealing with a man who made racial slurs in front of others. Fortunately, this program had a policy in place to manage incidents like these so there was a feeling of empowerment. This is not the norm. But this made me think of other facilities where policies are not clear and in fact give no recourse for those who would be aggrieved, either patients or staff. And does this not reflect on the way we deal with race in a broader context? Essentially, what I have seen is the policy of reprimand without consequence. This can foster a sense of helplessness which can produce apathy. There is also an ethical argument to be made about not refusing to care for those who believe differently from you. But what if those beliefs could be harmful to others? I think this question becomes even more complicated when dealing with mental health. Ultimately, I believe health institutions encourage the silence because this is a difficult situation and hope it “goes away” along with the discharge of the patient. It is also true that this is the easy way out. But the experience never truly goes away for those who experience the insult. How do I protect my patients? How do I protect myself? Is no place sacred? Even in this place, where my patients of color are trying to obtain stability and healing, they had to deal with someone who thought of them in vile terms and less than human. Daily they had to interact with a person who speaks about them in vile terms, smile, and be appropriate, and all because this person hid behind the cloak of the name “patient”. And I realized that I have been taught to do the same. In all of my education and training, these issues had never been addressed in a formal manner or treated with any consistent seriousness. And I saw myself in the same boat as my patients. The ways in which we address culture and race can significantly impact patient outcomes or minority participation in the health care field. As providers, it can significantly impact our health and our spirit. So what are we to do?
How do you see change happening regarding racism in the medical profession?
Medicine tends to focus on patient outcomes (rightfully so) and there is a focus on racial/cultural health disparities. There is little in the medical literature that focuses on the experience of minority physicians nor is there much guidance in how institutions should instruct their providers to empower themselves or their colleagues in this matter. But if we are to truly address these concerns, they must first be discussed. They cannot be swept under the rug since it is indicative of a larger problem. In medicine, we are taught that to address a problem, we have to first correctly identify it. We have to acknowledge that our peers and colleagues of color have experiences which can be emotionally unsafe and at times traumatizing. I believe we should begin to document the experiences of physicians/practitioners in terms of racist interactions so that we know how prevalent this experience is. Unfortunately, I believe that this experience is quite common and occurs at least once during the career of a practitioner of color. Once we catalog the frequency and quality of these experiences, we can begin to develop an appropriate response. Medical students should have appropriate training and enter into their careers armed with tools and confidence to take care of themselves and others. Though we may not be able to refuse care to patients, we should have a coordinated and consistent response across facilities that lets patients know that this behavior and rhetoric is not acceptable within healing institutions. Our brethren should be empowered alongside us so that we carry a forceful message that will scream louder than the silence of racism.
As you know, outside of large cities, some of us may be the only face of color in the department or in the office or hospital. What advice do you have for our colleagues, those who encounter racism or witness racism in the work environment?
For now, I encourage my colleagues to consistently document these encounters and keep a log. Out of sight is out of mind. I believe that our counterparts may not actually believe that this occurs regularly and therefore does not warrant a coordinated response unless we have the data to prove it. Begin to approach administrators and ask them about what policies are already in place and gauge if they are open to improving these policies and re-educating staff on how to deal with these patients. We will be the only ones to bring this issue to the forefront. We will need to be the champions not only for ourselves, but ultimately for the ones we serve.
National Museum of African American History and CultureNational Museum of African American History and Culture
Last week was a special day. A holiday. A day I celebrate each year with pride. I love my birthday and each year I feel increasingly blessed that I have the wonderful opportunity to enjoy this day with family and friends. I find my birthday a natural point to reflect on where I’ve been and where I’m going.
This week, two years ago, marked the last week in my full-time job and the beginning of my journey as a locums physician. It represented a re-birth, if you will. The start of an adventure that in 2017 has led me to embark on a 6 month volunteer assignment in Mutomo, Kenya. Many people as me, “Why Kenya?” There is no short answer to this question. I have wanted to live and work abroad since medical school. Working with the underserved has always been a part of my mission and purpose in this country and working in a resource poor environment in another country feels like a natural next step as part of my growth as a person and as a physician. CMMB is an organization that focuses on improving the overall health of women and children in many countries. Our Lady of Lourdes had a specific need for my skill set and I was matched for a position in their mission hospital. I have never been to Kenya. I have only lived out the country for five weeks as a part of a Spanish immersion course in college when I studied in Guadalajara, Mexico. I lived with a host family and my roommate was a young woman who taught Spanish in Kansas City. I saved every extra dollar for two years to afford the classes, my dad gifted me his airline miles, my aunts and uncles slipped me fives and tens on the holidays… “to help me get to Mexico”. It does indeed take a village. I was grateful for that opportunity and I am grateful for this one.
My village has once again surrounded me in support. I hope that you will keep me in your thoughts and prayers and I look forward to sharing this experience with you. I hope that as you approach your birthday, you ask yourself are you living your best life? You only have one. Make the most of it!
Building and maintaining relationships is important to me. As an introvert, one of the ways in which I work on professional relationships is by attending professional conferences each year. One organization that is near and dear to my heart is the Student National Medical Association. This organization was pivotal to my success as a medical student and consequently as a physician. When I became an attending, it was imperative for me to volunteer with this organization and I had the awesome opportunity to serve on their Board of Directors for four years. During my term, I re-connected with Dr. Renee Volny-Darko, a kindred spirit in Obstetrics and Gynecology, a believer in student mentorship and an advocate for health equity. As part of her practice, Renee had worked as a locums physician while transitioning from one position to another. It should be no surprise that when I started to consider a career doing locums tenens that I reached out to her to share her experience. She was straightforward, honest and encouraged me to follow my path.
A little over a year later, I received a call from Renee. She and her husband had decided not do only work as locums physicians but also to start their own locums company! She asked me if I wanted to work with them and I said, “Of course!” They offered me a position in Altoona, PA. I’ve traveled to Altoona a few times now. Historically a railroad town in the middle of the state, the town is one of many working to redefine themselves now that the major industry has changed. It is still the home the historic Horseshoe Curve built by the Pennsylvania Railroad. However, the corners are now populated with Sheetz, a convenience store chain who house their corporate headquarters in Altoona. Two hours from Pittsburgh and 4 hours from Philadelphia, Altoona has its own unique and inviting personality.
For that reason, the Darkos have decided to stay in Altoona as they work to grow their business. They have focused on recruiting physicians who are patient focused and team players with the goal of optimizing the experience for the physicians and the employer. Working with Renee and Nii is like working with family. And recently, the couple grew their family of two to three… Not only balancing practicing medicine, running a company, they are now the proud parents of a bouncing baby boy!
Today, I would like to learn more from Renee and Nii, partners in love and work, about how they are living their best life.
Tell us a little about yourselves and your family.
We have been together for almost 15 years and married 4 years this November. We’ve accomplished many things together, but our greatest accomplishment is our soon-to-be four-month-old baby boy. Nii grew up partly in Queens, NY and Irvington, NJ. Renée grew up in Brooklyn, NY. We met in Kansas City, MO, where we attended and graduated from Kansas City University of Medicine and Biosciences and obtained a Masters of Business Administration from Rockhurst University. Nii trained in general surgery at the Morehouse School of Medicine in Atlanta and trauma/critical care in Miami. Renée trained in OB/GYN at Robert Wood Johnson Medical School in NJ.
We decided to work in Altoona after Nii had a locums experience there. Being newly married, it was important to us to be at a place that we liked and to be at the same hospital so that we could see each other even if our work schedules got busy. We did not want to live like two ships passing in the night. It has worked out very well for us!
What is the most rewarding aspect of medicine for you?
Medicine has been a wonderful way for us to contribute to society both nationally and globally. Having worked primarily in underserved areas of the US, we are happy that we are helping to fill the gaps of medical care in communities in need. We have also done medical missions in Ghana with an organization called the International Healthcare Volunteers (IHCV). IHCV is a very rewarding experience because of its focus on educational exchange between US and Ghanaian doctors. We love to teach the Ghanaian doctors, residents, and medical students, but we learn so much from them as well. The impact of any mission is not measured in the number of patient encounters, but in the improving health of a nation as a result of education.
How do you balance career, advocacy and parenting?
That’s a tough one! Being deliberate about balance is key. It won’t just happen organically. Early in our marriage, we established our family as our first priority. Nii worked full-time and Renée worked part-time, again, so that we could optimize our time together. If something interferes with our ability to live happily as a family, it’s not an option for us. Starting our locums company, Equal Access Health, has played an important role in giving us the balance that we need to be doctors, advocates, and parents. Working strictly as a locums physician allowed Renée the flexibility she needed during her pregnancy and now for us both to be home with our son as often and as long as we want. We’re also more free to spend extended visits with our parents and siblings. We have more time to work with IHCV on future plans to provide more continuous care and education in Ghana. We’re always reassessing our balance to ensure that we don’t over-extend ourselves.
What advice do you have for young physicians as they start their careers?
Allow yourself to dream beyond the traditional practice of medicine. We are seeing very tragic repercussions of physician burnout. We are only human. It’s ok to be unconventional in your practice (like locums, part-time, or concierge) to fulfill your basic needs. We also encourage docs to have interests other than medicine. Our non-clinical ventures include the locums company, a podcast, a pre-med consultation service, and a lifestyle blog. We enjoy being doctors, but we have other talents that we’d like to explore.
Mentorship is important to both of you. How would you encourage professionals to stay connected to those still in training or early in their careers?
Remember that receiving and providing mentorship is lifelong. We both have mentors and we both continue to mentor. Like life balance, making a deliberate effort to maintain mentoring relationships is the key to staying connected. Continue to stay involved with your alma mater and student organizations. Look for opportunities to teach or precept residents.
One of the many great memories I have from my eight years in Nashville, is the diversity of my friends. I was fortunate to not only make fabulous friends while I lived there, we have continued to keep in contact and often see each other several times a year. A Saturday in Nashville could go in many different directions from paintball to canoeing to a hot chicken festival. One such Saturday, a friend and I went to a pool party where we met a young lady who had recently relocated to Nashville to start her law career. The inviting bunch that we are 🙂 she soon became part of our weekend adventures in Nashville. Now looking back, it’s hard to remember a time in Nashville when Kinika wasn’t there as we have become great friends and frequent travel partners.
As with any great friendship, we spend time talking about our careers, our personal goals and reflecting on our true purpose in life. Though younger than I am, Kinika has more working experience than I do, as when we met she was starting her first year at a law firm, while I was starting residency. As an incredibly intelligent, organized and detail oriented person, she quickly made her mark and accelerated through the ranks to become Partner at a prominent firm. However, we both came to a similar roadblock in life. While our jobs were fine, and technically, we could do them for the next 30 years, would we feel like we were fulfilling our purpose, living our best lives?
Soon after I embarked on my locums journey, Kinika started to explore other options as well. She was fortunate enough to be offered an opportunity to be the Director of Children’s Health at the Tennessee Justice Center (TJC). This position offers her a chance to fight for one of our most vulnerable populations. Social justice work can be painstaking, slow moving and frustrating. It is also necessary and rewarding beyond measure.
Today, I would like to talk with Kinika Young about her inspiring transition.
Tell us a little about yourself.
I was born and raised in Montgomery, Alabama. I moved away for college and attended Florida A & M University in Tallahassee, Florida. My decision to attend FAMU, an historically black college/university, took my classmates and teachers by surprise because, as a National Achievement Scholar, I pretty much had my pick of schools. They didn’t consider FAMU to be “good enough” for me, but I’m so glad I didn’t listen to them. I chose FAMU because I received a full scholarship and because of its pre-law program. FAMU has been a top feeder school for sending black students to law school. It turned out to be a great learning environment, where I gained the perspective, confidence, and fortitude that helped me going into law school and the real world.
My first choice was to attend Vanderbilt University Law School. I earned a spot during early admission and received a partial scholarship. But, I couldn’t pay the remaining costs. So, I went to Tulane University Law School on a full scholarship. Again, I lucked upon a great school. I enjoyed New Orleans, and it remains one of my favorite cities in the world. During law school, I decided to focus my job search on a few cities based on size, career opportunities, and cultural scene (like art, music, sports, etc). Nashville was one of those cities. I had never even visited Nashville until I came for interviews. I got a summer clerkship at a firm in Nashville during the summer after my second year of law school.
At the start of my third year of law school, Hurricane Katrina hit New Orleans. I evacuated safely, and while I was home in Montgomery trying to figure out what to do, I received a phone call from the hiring partner at the firm where I had clerked. He called to check on me and to inform me that the hiring committee had just met earlier that day and decided to extend an offer for me to join the firm after graduation. The firm found housing for me and arranged for me to attend Vanderbilt University Law School as a visiting student during the fall semester, while New Orleans was recovering. So it all came full circle. I ended up at my first choice law school under circumstances that no one could’ve predicted. Many people at the law school and the law firm were incredibly helpful and accommodating. It was a testament to the kind and welcoming spirit that defines Nashville, which made me fall in love with the city. I ended up practicing at this same law firm for over 10 years until I left to join a non-profit organization.
What prompted you to consider a position at the Tennessee Justice Center?
I first learned of the Tennessee Justice Center when I did a leadership program for attorneys in 2013; one of my classmates worked at TJC. I believed in their mission (helping people get access to life’s necessities, particularly healthcare), so I handled a couple of pro bono cases and became a monthly donor. After seeing all the turmoil and civil unrest in 2016, I felt like I needed to devote more time to working on social justice issues and making a difference in people’s lives. First, I considered the financial implications of leaving the firm and all the perks that come with it. I was able to follow my heart (and not the paycheck) because I had no debt, I’m single, and I saved a lot from the beginning. Next, I talked to several friends about it, and one friend suggested that I reach out to the executive director of TJC. I did, and just like that, I made the biggest career move of my life!
What have you enjoyed the most in your new position?
Being the Director of Children’s Health allows me to immerse myself in health care policy and analysis, think creatively about ways to influence people, and advocate for a worthwhile cause–protecting and improving the health safety net for children. The work is extremely relevant right now. TJC has been at the forefront of the fight to save healthcare and defeat efforts to repeal the Affordable Care Act and slash federal funding for Medicaid. The few months that I’ve been at TJC have been the most exciting of my legal career. I hope the big threats are behind us now, but given the ongoing need for healthcare reform, I think this position will remain challenging and fulfilling.
What has been the most difficult part of your transition?
It’s been difficult to grieve the death of my brother in the middle of a job change. He was murdered around my last week at the firm. Learning about health policy issues like dealing with the effects of adverse childhood experiences (ACEs) has given me a different perspective into what may be the root of most violent crime and how health care (or the lack thereof) affects many issues facing society at large.
It’s also been rough adjusting to a set work schedule and limited paid time off. At the firm, I worked a lot but I pretty much set my own schedule, and I took time off whenever I wanted it or needed it. As long as the billable hours were met, no one cared whether I was at my desk by 9 a.m. or whether I took off 2 weeks to go to Australia. I love to travel, so it will be a challenge to reconcile my jet-setter-side with my help-the-children-side!
Do you have any advice for young professionals on how to practice law and live their best life?
Be authentic. Practicing law is challenging and can be consuming—no matter if you choose a large firm, small firm/solo, government, or non-profit. It becomes an integral part of your identity, so you want your practice to be a true reflection of you. At the end of a long day, if you can feel good about the work you’re doing and the reasons you’re doing it, then it will be time well spent. Whether you choose a practice to provide a certain lifestyle, to take care of your family, to help people, or to change the world, embrace it. There is no one size fits all; don’t judge yourself based on another person’s path. As long as you’re honest with yourself about what you value most and what you hope to accomplish, then your practice will be rewarding and will allow you to live YOUR best life.
My favorite pastime growing up was reading. I was the kid that looked forward to the summer reading list. I usually made my way through the list and read a few more. Each summer, I would challenge myself to something different… How many books could I read? How fast could I read one book? How many books could I read at the same time? (I’ve done five, but 2-3 is a more workable number).
Generally, I have always preferred fiction since it allowed me an outlet from my everyday life. I enjoyed the sense of adventure, the sneak peek into others’ lives and their trials and their triumphs. If I have to pick a specific genre, historical fiction would be my favorite. But I’ll read just about anything. As an adult, I am always reading something, though depending on my work schedule it takes me considerably longer. During residency, it was not uncommon for it to take me the better part of a year to get through one book. I often had to go back and re-read passages due to the infrequency of my leisure-reading schedule. (I should be clear; I did plenty of medical reading!)
It should come to no surprise that when I found myself at a transition point, I turned to my old pastime for guidance. (Though an avid supporter of the public library, it became increasingly difficult to get the books back on time…) I went into a local bookstore chain and walked through the aisles, looking for a title that jumped out at me. I found several books, sat on the floor and leafed through them until I settled on 4-5. In the past two years, my tenacity for reading has been re-energized. I have not reached to 60 books a year (or whatever the number is that successful leaders are supposed to read), but I’ve enjoyed this part of my journey. As you can notice from the list below, more non-fiction has crept its way into my life… I think I lost track of a few and these are in no particular order, but here’s my reading list for the past two years or so.
Fiction
The Cutting Season Attica Locke
River, Cross My Heart Breena Clarke
The Twelve Tribes of Hattie Ayana Mathis
Lazaretto Diane McKinney-Whetstone
Happily Ever After Elizabeth Maxwell
Non-Ficton
Blink Malcolm Gladwell
I don’t know what I want to do, But I know it’s not this Julie Jansen
The Tipping Point Malcolm Gladwell
Drink More Whiskey Daniel Yaffe
The Bogleheads Guide to Investing Lindauer, Larimore & LeBoeuf
The Art of the Bar Hollinger & Schwartz
Lean In Cheryl Sandberg
Outliers Malcolm Gladwell
Real Estate Investing McGraw-Hill
The 4-hour Work-week Timothy Ferriss
The One Minute Millionaire Mark Victor Hansen & Robert G. Allen
1000 Dollars and an Idea Sam Wyly
When Things Fall Apart: Heart Advice for Difficult Times Pema Chodron
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