Reflections on the jail

I am ending my rotation at the Cermak Health Center - affiliated with Cook County Jail. Tomorrow is my last day. :( I wanted to do a quick reflection to clear my thoughts in my head and simply share.

It was a really good month. If residency was like this the entire time...wow how amazing would that be. I loved that I was a balanced person in life. I've realized I really love balance. I want to be able to determine how I spend my time and allocate a little bit of time to all of the things I'm passionate about. At work...I loved what I did. I learned so much this month. I was really glad to learn a lot more about HIV and feel so much more comfortable in taking care of patients with the disease. I think there is so much to learn about each patient with HIV. Even asking the simple, yet so personal, question on how one got the virus has led to so many glimpses of people's lives. Some have said a partner gave it to them unknowingly, some say drug use, some say they don't know. Each person takes the news differently and is in various forms of acceptance/understanding of the disease. There is a huge correlation to people of color and in general people that lead "riskier" lives having a higher chance of having HIV. There is a definite disparity in access to care that exists as well. It ties in all aspects of life. In general, all health care should tie in all aspects of life but this disease especially, you have to look at everything all the time. I found out about this program called MATEC from one of the attendings that I am going to look into. Its a series of lectures, conferences and practical information and at the end of it, you get a license saying you can practice HIV in your clinic. At Rush, I don't get the best exposure to HIV patients in general. At Monte, definitely got a lot more. This program if it pans out would be good learning.

I also finished my Bupe training. Finally! For those that don't know, buperenorphine, is an alternative to methadone. It is basically meant for those people that are addicted to heroin or any sort of opioid substance such as prescription pain pills. I first started getting involved with addiction medicine at Monte working with a harm reduction organization called Washington Heights Corner Project. I got to learn about what addiction means, see people that the "heroin addicts" but learned so much more about them then just the label. I could get into a lot of detail on this but maybe some other time. Buprenorphine helps people that want to quit heroin or their addiction to pain pills and does it in a less stigmatic way. It puts people more in control and allows them to be treated in the office instead of an organization that dispenses methadone on a day by day basis. You need to have a special license to prescribe it and it took a little over a year for me to finish a stupid 8 hour online course. But it is finally done! I got another connection at the jail to possibly work with this other doctor at the CORE center and actually practice prescribing the medicine and working with people that want to quit.

All in all, I just felt like I was with like minded people again this month and it helps my perspective so much. At Rush, sometimes I feel like I'm drowning in subspecialty, fellowship driven medicine and I want to scream out at the top of my lungs. While there were definitely people at the jail that saw people as "criminals" and nothing more...for the most part people cared and just wanted to work with people. I got to network and have 2 things that I can continue to pursue. Especially now that the end of residency is in sight..(basically 1 year and 1 month!!!!), I have been thinking about next steps a lot. I want to continue to work with the community, I want to continue to build relationships and go deeper. Its hard to do while in residency. This month has made me realize I really like HIV. And then the long term picture would be how can I integrate holistic health in all of these subtopics of medicine. How can we take a step back from all the disease labels and look at a person as a whole and make connections to live happier, healthier lives?

Some final thoughts...I am apprehensive about this next rotation. It is infectious disease which I've always found interesting but it is in the setting of the hospital that always brings me down. My balance will be taken from me and I never do well with that. Who knows how much I will be blogging. I am thankful for these months because they are always a breath of fresh air. I had one last ah ha moment but its slipped my mind. Till next time! Would love to hear people's thoughts! Or any other suggestions for next steps.