My DIF Experience with Winship Cancer Institute

By Claire Sibold ’20

I can’t believe I’ve been working in this role for almost five months now. When I started working at Winship Cancer Institute back in August, everything felt so foreign; it was hard to believe that I would be overseeing an ethics research project for a full year, writing papers that would be submitted for publication, and collaborating with such impressive people at Winship. Five months later, I still find myself in awe that I’m lucky enough to have had these unique experiences become familiar and part of my everyday routine. As I reflect on my time thus far, one theme that has emerged as central to all of the interesting projects we’ve worked on, which is the multiple layers and voices that work together to achieve one overarching goal: improving the patient experience.

This theme became apparent based on how many Oncologists, nurses, and other healthcare providers cared about our ethics projects. It’s been an amazing opportunity to work with healthcare professionals in such a collaborative manner and to see how engaged they are in our ethics projects, hoping to contribute in any way to improving the patient experience. It’s encouraging to see the value that’s placed on the patient voice at all levels of care at Winship–a philosophy I will strive to embody as I work towards becoming a physician. I’m so grateful for the time remaining in the fellowship to continue these meaningful and eye-opening collaborations.

Additionally, I have also been amazed at patient willingness to participant in ethics studies that may help a patient have a better experience in the future. As my main project, I’ve been interviewing patients enrolled on clinical trials for treatments that have never been tested in humans before. We are interviewing patients to get their input on how to structure these informed consent forms so the information is accessible and understandable for the patients as they consider enrolling in the trials. I have loved being a part of this project because I feel it represents Winship’s commitment to quality patient care: that it starts with informed consent, even before the patient has started treatment. This has made me aware of just how multi-layered and collaborative healthcare improvements are. I continue to be inspired by such encounters, and look forward to continuing to engage with patients and providers as we all strive to improve their cancer care from different angles.

Working Together… Apart

By Emma Blake ’20

In the past several months, I’ve done a lot in my Impact Fellow Role at MAHEC. I’ve helped give presentations to doctors about novel treatment options. I’ve written and prepared an article for publication in a major journal. I’ve familiarized myself with the complexities of maternal healthcare and treatments for substance use disorders. And I’ve done most of these things from home.

Working from home has come with a unique set of benefits and disadvantages. On the positive side, I’ve had more control over when to do my work, and I’ve been able to avoid many of the small frustrations of office life like a morning commute or someone microwaving fish in the break room. On the negative side though, working from home often leaves me feeling disconnected from the work I’m doing, my coworkers, and the community that my work is supposed to support. Zoom meetings are fine for updating the research team on the latest developments, but they can’t replace the small daily interactions between team members that build up our sense of communal support and camaraderie.

What I think I’m missing most is a feeling of community and shared purpose. At Davidson, most of my work was grounded in the community and the feeling that other students and professors had my back. Working from home has led to me only knowing my coworkers as coworkers, not as people with unique stories, interests, and personalities. Even though we’re all working towards the same goal, we’re doing so separately and individually. It’s been a jarring feeling and a challenging adjustment.

The major exception to this feeling is when I go into the maternal healthcare clinic on Thursdays. On those days, I get to interact with patients and talk to my coworkers face-to-face. It’s such a different feeling from a digital meeting. When I work with the patients, I’m reminded that my work is really helping people and making a difference in my newly adopted community of Asheville. I became interested in healthcare generally and the Davidson Impact Fellowship at MAHEC specifically because I wanted to help people and create positive change in my community. Working from home has left me feeling disconnected from that purpose, but my time in the clinic constantly reminds me that my work has value and is serving to benefit people in need. I can’t wait until I can go back to the office, engage with my coworkers in a supportive community, and feel that shared sense of purpose every day.

Eli Abernethy – DIF Winship Cancer Institute of Emory University

This blog was written by Eli Abernethy ’19, 2019-2020 Davidson Impact Fellow for Winship Cancer Institute of Emory University.

It is hard to capture in such a short reflection the extent to which I have enjoyed my time as an ethics fellow at the Winship Institute. The fellowship has exposed me to a broad range of bright and driven people within the Emory community, many of whom I collaborate with each day. These include clinical researchers, nurses, residents, pharmacologists, radiologists, oncologists, and patients themselves. These interactions have been formative on their own: I have grown more comfortable working in a fast-paced setting and collaborating with others, regardless of their position or rank in the medical field.
Moreover, the fellowship has provided me with empirical ethics research experience on multiple topics while also offering an equal amount of time observing the characteristics of what good clinical practice looks like. This has provided me with a tremendous amount to learn (and hopefully one day emulate).

Most of our work involves exploring ethical issues in cancer care, and this involves interviewing both doctors and patients. Speaking with both groups is extremely interesting. We hear from experienced and renowned oncologists about how they practice medicine and the characteristics they find most important for a strong relationship with their patients. Interviewing patients allows for them to reflect on their condition and attitude towards their treatment plan, while we have the honor of hearing just a small part of their life story and witnessing their strength. Moreover, the time spent with both doctors and patients has allowed me to better appreciate the complexities of the doctor-patient relationship, namely by giving me opportunities to study the relationship from both perspectives.

Overall, the fellowship has provided me with an excellent foundation of medical ethics and an appreciation for the importance of patient advocacy. I look forward to the rest of my time here and continuing to advocate for positive changes in cancer care in a clinical setting, however small they may be.

Nature is Calling

This blog was written by Jon White ’19, 2019-2020 Davidson Impact Fellow for Catawba Lands Conservancy.

The outdoors have been a part of my life since childhood. Beginning with summer camps around Durham, at the age of 5 I was introduced to the Piedmont’s creeks and streams and the magical creatures that might live there. At 8 I learned to build a fire, and at 11 I went on my first backpacking trip. When I was stuck at home my senior year of high school without a driver’s license, I would ride my bike to the Duke Forest and search for crayfish and salamanders. This past summer I worked at a camp at the base of the Grand Tetons in Wyoming, and I concluded that the snow capped mountains were impressive and all, but the dank, swampy forest of the Carolina Piedmont is where I belong.

Yet my awakening to the wide array of social problems within the political turmoil of the past four years drew my attention away from environmental issues as I had previously conceived them. I switched my major from environmental studies to anthropology, and found myself with a dozen resumes submitted to legal jobs by the time the fellowship at Catawba Lands Conservancy crossed my path.

Living in a house, paying bills, and friendships with people outside my age demographic have all popped my Davidson bubble in expected ways, but my professional turn toward environmentalism–now in the “real world”, the world of creeks and trees but also a cubicle and fundraising goals–has required the crude reconciling of my romantic high school self and the socially-conscious, intellectual edge I gained at Davidson. From the reforestation of untended family farms to urban stream restoration and greenway construction, land conservation is a cause that cuts across many demographics and different issues in unexpected ways. As program coordinator, it’s my job to take people onto the land we’ve conserved and trails we’ve built. Though the content of the programs is always loosely educational, my primary goal is to foster a feeling of connection between people and places. In doing so, I aim not to dictate people’s relationship to the outdoors–I don’t think I could if I tried–and along the way I may uncover a greater understanding of how others appreciate and enjoy nature and outdoor spaces in diverse ways.

In fact, my cyclical return to environmental causes has further complicated the way I think of the interrelation of social issues, and their urgency. This isn’t even to mention how an individual land conservancy organization ought to find its niche within this grand social ecosystem (that’s something I hope to learn more about-and write more about-later). For now, I will keep my swampy woods and listen as both the cardinals and the winter program calendar calls.

Davidson Impact Fellow Jon White

Networking for Dummies

This blog was written by Jessica Moo Young ’19, 2019-2020 Davidson Impact Fellow for Habitat for Humanity International.

When I took the Myers-Briggs type indicator four years ago, it told me what I already knew: I’m an introvert. So as I started to think about a career, the idea of networking loomed. Work-related or not, I was always unlikely to approach a stranger and start talking; throw in name tags, job descriptions and business cards and the situation seemed even more strained. Striking up conversation with the sole purpose of making a contact or landing a business deal was just too transactional. With this understanding, I went 21 years without attending a single networking event. After starting my fellowship at Habitat for Humanity
International, my hard-earned streak was quickly broken. Within a month and a half, I had networked everywhere from DC to Bangkok and back.

Though I’m still nowhere close to being a networking aficionado, redefining my approach has helped me to start building a meaningful community for myself. Rather than stepping outside of my comfort zone, I’m extending its range in many senses of the phrase. Before walking into any work function, I find time to compose my thoughts and set a tangible goal for myself, for example, to meet 3 or 4 people and engage in great conversation with each. (Reminder: still an introvert.) It might take longer to meet people, but it also allows more time to connect with them on a deeper level and in more personal settings. Instead of going with the usual what-do-you-dos and who-do-you-knows, I focus on questions that I’m genuinely interested in asking. My go-to is, “How did you get to where you are now?”—a question that tends to cover a person’s career decisions, changes, journey and growth. The answers are always inspiring and help me to understand different thought processes and pathways to success.

Growing up, I thought that a career meant finding a job and sticking with it ‘til death do you part. But in speaking with others across different sectors and fields, I’ve found that people are dynamic, change is inevitable and there is not one way to pursue a career—which can be made up of several positions at various organizations en route. With these new findings and the ones to come, I’ve opened myself up to a world of opportunities, arguably much more daunting than casual conversations with colleagues.

Reflections on Learning and Growing

This blog was written by Allison Cowie ’18, 2018-2019 Davidson Impact Fellow for the Salzburg Global Seminar.

As we are interviewing candidates for the 2019-20 DIF position at Salzburg Global Seminar, I can’t help but reflect on my past nine months here, and where I see the final three months of my fellowship going before I transition to a more permanent role at Salzburg Global.

When I arrived in Washington, DC, late last June, I was eager, optimistic, curious—ready to jump head-first into this phase of life. Barely a month out of college, suitcases still unpacked, I was surrounded by continual reminders of my newness to it all: my first lease to sign, a public transit system to figure out and a neighborhood to make my home, all to the rhythm of subway musicians and cicadas and city traffic echoing in the District’s heavy heat.

This sense of overwhelming wonder hit before I even showed up at Salzburg Global Seminar, which was the reason I had decided, three weeks earlier, to move to Washington in the first place. When I found out about the Salzburg DIF opening in the middle of taking my last set of final exams, immediately I knew I had just stumbled into the path of an amazing opportunity. To spend a year working for an organization committed to bringing together global leaders across generations, cultures and sectors sounded like a perfect fit: after tailoring my Davidson education to focus on international cultural studies and engagement experiences, I knew I wanted to continue to immerse myself in this world well beyond my four years in college.

The chance to learn from Salzburg Global’s uber-talented staff and contribute meaningfully to this organization’s work made it an easy decision to start life anew in DC after graduation. When I walked in that first morning, I was confident from conversations with Elizabeth, who held the DIF role in 2017-18, that whatever my day-to-day tasks ended up being, I would be working with a team of incredible people to support this organization’s valuable work. Throughout my time here, this has proven true even beyond what I could have expected: I not only find that the work I do substantially contributes to the organization’s success, but also feel like I have found a true vocation in which I can see myself continuing to learn and grow.

Thinking back to that time, nine months can feel like forever and a blink—since I first arrived in DC and at Salzburg Global Seminar, I have grown enormously both professionally and personally. In this past year of exploring who I am—in this job, in this city, in the many communities I now call home—my biggest realization has been that growth does not necessarily require constant change, at least not in the way I’d always approached growth before; that I can learn and grow while putting down roots instead of needing to move on right away to the next job, the next city, the next step. That’s why I’m especially excited to stay on with Salzburg Global after my DIF fellowship ends this summer: now that I have spent real time getting to know the organization, I am now ready and able to contribute to Salzburg Global in an even more meaningful capacity.

Navigating the Transition from a Free Clinic to a Community Health Clinic

This blog was written by Clay Resweber ’18, 2018-2019 Davidson Impact Fellow for the Charlotte Community Health Clinic (CCHC).

This might seem obvious, but one of the best parts of being a Davidson Impact Fellow is having the opportunity to integrate yourself into an organization and participate in its operation. In my experience at Charlotte Community Health Clinic (CCHC), I feel like my fellow coworkers and leadership team have taken many steps towards teaching me about the mission of the clinic, our operating procedures, and the history of our organization. The clinic’s mission and operations are on the minds of our staff every day as we find ways to better treat and relate to our patients, but one aspect that often gets lost in the daily routine is the story of where are our clinic came from. This history is interesting in itself, and helps to explain the obstacles that our clinic faces today.

In the world of healthcare, there are a few different types of practices that are designed to cover different populations of people. On one end of the spectrum you have private practices, clinics run by physicians which have a lot of freedom in deciding what procedures they treat, who they want to see, and what insurance types they will accept. Hospitals also exist towards this end of the spectrum, but often have restrictions and guidelines on how they can operate that provides them less freedom than a private practice would. On the other end of the spectrum exist free clinics, which, from my understanding, exist due to the virtues of volunteers and are designed to treat uninsured patients. The nature of their target population means that the clinic will not be fully reimbursed for the services they offer their patients, which restricts the types of procedures they can provide, their hours of operation, the number of patients they can see, and a multitude of other factors of which I am unaware. These types of clinics exist because of the stewardship and service of dedicated staff and providers, which often reflects in the quality of care and atmosphere found within them.

Somewhere in between a free clinic and a hospital or private practice is the world of federally qualified health centers (FQHC), often referred to as community health clinics. FQHC’s first appeared in America in the 1960s and were inspired by the health clinics of South Africa, which experienced more effective outreach and treatment by integrating themselves into the communities they served. It took a while for a system inspired by these South African clinics to take off in the US, but eventually, under the governance of the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services, the government set up a program to follow the example of our South African counterparts. These FQHC’s receive grants from HRSA to help fund the cost of their operations. Further, HRSA offers many other grants for specific programs that FQHC’s can apply for based on their specific services and patient populations. Since they are designed to integrate themselves within the communities they serve, FQHC’s can and do serve patients of any payer type, including uninsured patients, Medicaid patients, Medicare patients, and 3rd party insurance patients. Uninsured patients are responsible for a copay based off of their federal poverty level (FPL) designation to provide them with some investment in their healthcare. The grants that FQHC’s receive from HRSA are designed to offset the cost of these patients, but it is important to emphasize that community health clinics in America are able to provide primary care and references to specialty care to patients of all payer types.

What makes CCHC’s situation unique is that before becoming an FQHC 2 years ago, they operated as a free clinic for over a decade. This means that the clinic had a large population of uninsured patients using their services, used volunteer providers that completed services as they could, and had no federal reporting requirements. Since community health clinics have to report to the federal government and offer a wider range of services than a free clinic, the transition caused a large turnover in providers and staff which has now stabilized. However, one aspect of the change that we still grapple with today is in the payer mix of our patient population. Although we receive grants, both from federal and private sources, to help offset the cost of serving our uninsured patients, FQHC’s need to have a diverse payer mix including Medicaid, Medicare, and privately insured patients in order to be sustainable. Due to our history as a free clinic, we maintained a large percentage of uninsured patients that persists years after the switch.

Although all of us here at CCHC are happy to serve all types of patients, the fact remains that in order to remain sustainable and grow as an organization, we must find ways to attract other types of payers. Doing so has proved to be challenging, but we have undertaken many initiatives that will hopefully help us accomplish our objective of diversification. Learning about these projects has provided an interesting opportunity to learn which populations usually have different types of insurance, which paints a telling image of the American healthcare map. We have partnered with the local Men’s Shelter and Urban Ministries to place one of our nurses in Charlotte’s homeless shelters and provide us intimate access with the city’s homeless population, who often have Medicaid coverage. CCHC has also pursued partnerships with different elderly organizations in an attempt to reach a population of people that are provided with Medicare coverage. Initiatives to establish our clinic in schools allow us to attract more school-aged children, who enjoy Medicaid coverage under CHIP. Meanwhile, our uninsured patients are largely Hispanic adults, but represent a diverse population of Charlotte citizens.

Having worked in the clinic for 6 months, learning about these initiatives and operations has made a huge impact on informing me about America’s healthcare situation. The government programs we have in place show some of our most vulnerable populations, many of which all of us have some connection to, and the lengths that our representatives have taken to provide for them. Our uninsured patients show another part of the picture, of those who are vulnerable and do not receive assistance. Figuring out how to reach each of these very different groups of people is a unique challenge, but one that lies close to the heart of a clinic such as CCHC, which is dedicated to serving people in a city such as Charlotte. I quickly realized that understanding the vision and initiatives at CCHC requires an understanding of our history and free clinic roots, which has been fun and interesting to learn about in itself. Using these lessons to connect CCHC to the larger picture of American healthcare has been a real privilege, one that I hope to take with me in a career as a healthcare provider.

Embrace the Task, No Matter the Scale

This blog was written by Meredith Hess ’18, 2018-2019 Davidson Impact Fellow for the Habitat for Humanity International.

If I have learned one thing about Habitat for Humanity since starting my fellowship here in July, it is that there is always more to learn. Sometimes, that can feel daunting. Habitat for Humanity operates in over sixty countries, all fifty United States, the District of Columbia, and Puerto Rico. Our programmatic approach varies based on country and community context (as all development should), and we recognize that there is no one-size fits all solution to providing safe affordable housing. It is impossible for one person, let alone someone like myself who has only been with the organization for five months, to know and understand all that happens within the organization. Our network extends farther than I am sure I will ever fully know.

Because our network is far-reaching, and my team works across various domains, there are days where my work feels spasmodic, and my tasks vary a great deal. For example, a few weeks ago my work load for the day included working on documentation for a grant application for an allotment of over $12 million USD, and working on formatting a PowerPoint presentation graphic for our updated WASH (Water, Sanitation, and Hygiene) strategy. Both tasks needed to get done, and both were within my domain by virtue of my position on the Global Programs Design and Implementation team. I couldn’t help but laugh thinking about how different these tasks were. It can be easy to lose sight of your purpose in an organization or your role on a team when your tasks feel disjointed and disconnected from other components of the organization. What I have learned, from watching my colleagues and talking with my mentors, is that it is powerful and necessary to take ownership of a task, no matter the scale.

Being entrusted with any task, whether it seems big or small in the grand scheme of things, provides an opportunity to demonstrate your flexibility, competency, and management capabilities. I have felt incredibly privileged here at Habitat for Humanity International, being given the chance to represent the organization at various conferences and meetings, both local and out-of-state. I am sure that in part I have been given the opportunities I have because I have embraced and executed smaller tasks with the same sense of responsibility as I have larger tasks. This is an incredibly important lesson to for anyone to learn in their first-year post-grad: embrace the task, no matter the scale. No work is beneath you when you are working towards a common goal with others, for others.

Reflections on the Professional Sphere

This blog was written by Helen Mun ’18, 2018-2019 Davidson Impact Fellow for the Georgia Justice Project.

As of November 2018, I am five months into my fellowship and seven months post-graduation, and I am still growing into the new world of professionalism. After riding many highs and lows in my role at Georgia Justice Project, I now find myself reflecting on how far I have come in my first professional job after graduating from Davidson.

Georgia Justice Project is a legal non-profit organization, and our building is divided into what we call “the legal side” and “the social services side.” My workspace is on the legal side, among the offices of all of our attorneys. Everyone is busy and stressed, which is characteristic of the legal profession and of the non-profit environment, as we try to serve as many indigent clients as we can with our limited time and resources. The office environment is also relatively fast-paced and can sometimes be chaotic as new issues arise or clients drop in unannounced.

My first few weeks were dedicated to learning about Georgia’s criminal justice system and laws, the client base that Georgia Justice Project serves, and the various positions and roles of our twenty or so staff members, which include lawyers and paralegals, social workers, development staff, and others. I spent my first few weeks reading reports, listening attentively in meetings, asking plenty of questions, managing multiple projects, making mistakes and learning from them. I often felt overwhelmed by the steep learning curve, but I made steady progress and received support from the people around me. In October, I asked my direct supervisor and Legal Director of the organization for a three-month evaluation and was pleasantly surprised to hear her glowing positive feedback.

The recognition of my efforts to learn quickly and the initiative I took in certain projects buoyed me, and that newfound confidence helped me to become more proactive and independent in my roles on the policy team and on the legal team. My supervisor began to entrust me with additional responsibilities, and although I was excited at the prospect of contributing more, self-doubt and feelings of imposter syndrome began to settle in. I questioned whether I was qualified, whether I belonged in this space, and began to overthink even the small, relatively inconsequential decisions that I made on a daily basis.

I recently spoke with a trusted mentor and friend of mine about my struggles to adjust into this professional sphere. She shared with me that, although she has been in the workforce for many years, she sometimes feels similarly and constantly reminds herself that she earned her seat at the table. At her encouragement, I reflected on all the personal and professional milestones I have accomplished and all the changes and challenges I have faced in 2018. It is a long list, but after remembering all of these things, I realized just how well I have been doing at a new job in an intensive and fast-paced environment. I am proud of how much I have learned and adapted in my new role, and I encourage all who are enduring similar challenges to celebrate your accomplishments, take your mistakes in stride as learning opportunities, and to sit at the table like you belong there.

To be a Part of Social Change and Involvement in the Community

This blog was written by Evelyn Morris ’18, 2018-2019 Davidson Impact Fellow for the Matthews Free Medical Clinic.

Less than three months ago I was walking across the graduation stage; fast forward a matter of weeks and here I am standing in a conference room at the head of long table surrounded by an educated and powerful group of people giving a presentation on statistics that I had researched and compiled. Halfway through my fourth week at the Matthews Free Medical Clinic I presented a mid-year report on key clinic statistics to the board of directors at their annual planning meeting.

Leading up to the presentation I was grappling with a mixture of emotions: excited for this incredible opportunity, nervous about whether or not I belonged in a space like this after just graduating, and confident since I had spent weeks researching and preparing materials. In retrospect, I had no reason to feel intimidated by the opportunity presented to me, and in fact, my newness might have even been a strength because it gave me a new perspective to draw upon during my presentation. I drew many lessons from this experience but one I want to share with you all is that any student coming out of Davidson does in fact belong in these spaces more typically reserved for more experienced, higher educated persons and we are more prepared than we know.

As evidenced by the fact that I presented to the board during my fourth week of work, this job has already given me incredible autonomy and responsibility. I am currently writing a grant application for the clinic to secure continuous glucose monitors for our diabetic patients to wear. These devices take blood glucose readings every 15 minutes and store the data until their next provider appointment. Data from the monitors are then used to make more personalized treatment recommendations, ultimately increasing patient quality of life. I have been in charge of drafting the grant after initial collaboration meetings with our pharmacist who I will be working with to implement the program if the funds are secured. Being continuously given important projects that require me to learn new skills has really reinforced the fact that we as Davidson graduates are capable and able to tackle most any project to come our way.