Rebecca Strafella

Submitted 2022-07-11

After my second undergraduate year at Western University, I volunteered on a medical service trip to Guatemala where I worked with a team of local physicians, nurses, translators, and students to help provide access to primary health care in underserved communities. In Solola, Guatemala, we set up our clinic in a classroom and watched as locals lined up for healthcare services. One encounter with a patient particularly stuck with me. As I was completing a patient’s check-up, he shared startling news with me: there was a woman in the town who was too ill to travel to the clinic and required emergency care. Unfortunately, we knew nothing about where she lived, and I was worried that a search might be futile and a waste of valuable resources. However, I was driven by the hope that we might be able to find her and make a difference. To this end, I decided to go door-to-door with some other volunteers to find the woman’s home. We were relieved when we finally found the right house, but our hope soon faltered as we learned more about her condition. The patient had uncontrolled diabetes, which had resulted in diabetic neuropathy and an infection occasioned by the loss of a toe. She was bed-ridden, with only the aid of her young son who was trying his best to meet her needs. However, the story the woman shared sadly was even more disheartening. She told us that she had had to choose between her insulin medication or food for her family, a common issue for many of the locals we met in the region. Based on her condition, the decision she had made was clear.

Although the situation seemed very dire, I learned to collaborate with my rotation team to decide the best course of action to help the patient in this emergency situation. Together, we assessed the severity of her condition, and concluded that providing medication and emergency transportation to the nearest hospital would be most helpful. In medicine, working with your colleagues to come up with solutions for your patients is a daily occurrence, and I am thankful for the opportunity to have experienced this situation with my peers.

This experience also taught me that leadership can involve making tough decisions, like my decision to search for the woman despite limited information. Specifically, I had to decide whether it was worth it to take time away from the clinic to attend to this potential emergency. In this case, I was able to weigh the potential benefits of these choices and strengthen my decision-making skills alongside the clinic staff. As a physician, I will be better prepared to make decisions in high-stress situations such as in emergency medicine.

A final skill I learned was how to mediate a multitude of emotions and maintain composure in difficult situations. On this trip, I was excited to apply my knowledge from my pre-medical courses to real-life situations by leading patient assessments, recording vital signs and symptoms, and then presenting cases to the physicians and team. However, I felt sadness for the people frequenting these clinics, who were burdened with poverty and preventable infections. Being able to put these feelings aside and focus on helping patients was key to achieving the best outcomes and will be essential to being an effective physician interested in emergency medicine.

To conclude, here, I present a moving example from my time on a medical service trip, showcasing how limited access to healthcare and resources can unfortunately lead to preventable emergency situations. If the woman in this scenario had access to primary care, medication, and the resources she required, her prognosis would have likely been more favourable and an emergency could have been prevented. This situation highlights how emergency care goes beyond providing acute and immediate relief. Rather, it also involves collaboration with an interdisciplinary primary care team to prevent these unfortunate circumstances. Importantly, these issues are not only limited to underserved countries such as Guatemala, but are prevalent across the USA and Canada, as well. During my medical education at New York Medical College, I plan to work with my peers and mentors to learn how to bridge the gap between preventative and emergency care to achieve an integrative program that provides the best support for my future patients. Thus, I would be extremely grateful to receive the ACLS Scholarship for Health Care Providers to help support my medical education to achieve these goals, and also to help inspire others about emergency medicine initiatives.

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