Discovering My Purpose

I'm sure that I've said this before, but I'm going to go ahead and say it again because it's sooo true:

Elective life is the BEST life.

I've spent the majority of this month rotating through my pediatric rheumatology elective, where I learned an incredible amount of useful information about rheumatologic conditions and how to manage them in the pediatric population. I spent most of my time in rheumatology clinic, where I met children afflicted with rare conditions such as lupus +/- lupus nephritis, juvenile idiopathic arthritis, and ANCA vasculitis, just to name a few. I was amazed at how resilient these children and teenagers were in the face of constant medical adversity and I marveled at how they continued to try and live their best lives even while on chronic medication therapy. These patients allowed me to practice the new physical exam skills that I was actively learning on the rotation, which primarily consisted of a thorough examination of the joints and the skin.

I also appreciated the high degree of overlap between rheumatology and nephrology while I was on the rotation, which was a big reason as to why I decided to rotate through this specialty in the first place. For example, a good portion of the patients that I helped evaluate and manage were also nephrology patients due to the kidney involvement of their respective chronic conditions (ex. lupus nephritis secondary to a diagnosis of systematic lupus erythematosus). I found myself intrigued by these disease processes and how a family's social determinants of health can critically influence the clinical outcome of these patients. I especially found myself drawn to the patients who were dealing with lupus.

Throughout my rotation, I was able to observe the wide spectrum of clinical severity that patients with lupus could experience. There were patients in clinic whose lupus was well-controlled with medications, and there were some who were in the hospital dealing with acute lupus flares with kidney involvement. I also learned that there have been few advances in new lupus medications over the past 20-30 years and that there wasn't a lot of funding that went into pediatric lupus research. Hearing that reminded me of how underfunded sickle-cell research is, which is another population of patients that I've found myself drawn to over time. I'm saying all this to say that I think I've developed an area of research that I'm going to dive into throughout my career. Improving clinical outcomes in patients afflicted with lupus and sickle-cell disease by trying to prevent kidney disease progression in these patients sounds pretty cool, don't you think? I could conduct clinical, translational and health services research in this domain, and use the findings of the basic science research found in the medical literature pertaining to these conditions in order to help guide my own research. I could then use research findings and my clinical experiences to conduct implementation science and to help influence health and public policies that would benefit these kids and their families. And then from there, those policies could potentially be extrapolated to benefit others who aren't afflicted with those conditions, but who also need help in other ways.

As you can see, I have a lot of ideas and goals lol. It's exciting to finally have a clearer vision of what my career could look like, but it's also a bit daunting at the same time. In order to do the things that I want to do in my career, I need to gain a LOT of additional experience in multiple domains and meet the right people who share a vision similar to mine. This is all very possible to do, but will take quite a bit of time and it won't be the easiest thing I've ever done. Fortunately, I have some fantastic mentors who are helping me figure all of this out! 🙏🏿

I completed my pediatric rheumatology elective last week and am now on my pediatric nephrology elective, that of which I'm thoroughly enjoying so far. I've already learned so many things in the three days I've been on service and I'm looking forward to learning so much more while working with the wonderful pediatric nephrology department at my institution. I really could not have asked for a better way to start off my third year of residency! 🤩

Speaking of starting off my third year, I was able to kick it off with a bang by giving two separate presentations to the residents and faculty of my department on the same day! With the help of the non-partisan Vot-ER organization, I gave a resident grand rounds presentation that focused on the impact that civic engagement has on the health of our patients and their communities. In the presentation, I shared evidence-based science that clearly depicted the relationship between civic engagement and a community's health outcomes, how racial and social inequities influence a community's health outcomes and access to the ballot, and why it is critical for us as healthcare providers to not only encourage our patients and their families to vote, but to also advocate for our patients by exercising our right to vote. It was a presentation that was very well-received by those in attendance, including both the Chair of our department and Program Director of our residency program, as well as the Chief Graduate Medical Education Officer! I was SUPER glad that people were engaged and loved the presentation, because I was lowkey a bit nervous about giving a presentation as big as this one. I want to harness the energy and enthusiasm that the audience had for this presentation and use it to bring about change in a positive way at my institution. It would be awesome to be able to implement voter education and registration processes that increase voter access and civic engagement in the communities that we serve! 🙌🏿

The other presentation I gave at noon conference was more focused on a QI project that my team and I are working on at our continuity clinic, where we are trying to better address the social determinants of health needs of our patients and their families. We are primarily focused on food insecurity at this time, but we are also working on ways to improve screening processes and community partnerships for other social determinants of health as well. It's a project that I'm excited about participating in, and it tied pretty well into the things I was talking about in my first presentation. We've already implemented some processes in our clinic that have been helpful for the families we serve, and I hope that our work helps to further fortify those processes!

Outside of work, I've been on a constant mission of trying to get my life together. I've been using my free time on my elective rotations to not only further explore my potential career interests, but to also recalibrate my involvement in all my extracurricular activities so that I'm not drowning in my commitments when I'm on more intensive rotations. I'm also continuing to prepare for this wedding coming up soon, which is very exciting but also involves a lot of work (my fiancée has thankfully been handling the lion's share of this preparation). I've also spent some time engaging with both pre-medical and medical students by participating in panels and giving presentations where I've shared my life experiences and some useful advice with them. And finally, I've made some time to link up with friends for my own sanity, to spend quality time with my fiancée, and to create a community between Black residents at UNC and Duke.

As you can see, I have a lot going on at any given moment. 😅

Sometimes I pause and ask myself, “What the hell are you doing man? Why do you keep doing this to yourself??” I never have a rational answer to that question. I just can't help but get involved in the the things that I care about. Because of this, I've been forced to learn how to restructure my time in order to maximize efficiency. Plus we all only live once and there's no guarantee of when your time on this world is up, so I guess that serves as a driving force for me too. I don't want to wait to do the things that I really want to do because tomorrow is never guaranteed. I'd rather at least take a shot of doing things now than waiting and potentially never being able to take the shot in the future.

I've been typing for long enough, so I'm going to go ahead and end this post here. I hope you all are as pumped for the Olympics as I am! However, I don't think anyone is as pumped as my fiancee is; she printed out a list of all the events and is trying to watch as many as she can. She's on a whole different level of excitement lol. Also on a random note, shoutout to the Bucks on becoming NBA Champions! The playoffs were so fun to watch and the Finals were thrilling! Never thought I would ever see the Bucks be as good as they have been for the past several years! And no I'm not a Bucks fan lol. I just appreciate good basketball.

You all make sure to continue staying safe and enjoying your summer! And if you still haven't been vaccinated yet, please do yourself a favor and get the vaccine! You really are only hurting yourself by not doing so and could also be a risk to your loved ones!

“Be brave enough to live the life of your dreams according to your vision and purpose instead of the expectations and opinions of others.” – Roy T. Bennett

– Black Man, M.D.

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