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My Summer with the Medical School Garden

There is a three-by-eight-foot raised garden bed nestled between the Cardiovascular Center, the Cancer Center and Med Sci I. It is the Medical Campus Garden, and this year it is host to a crowd of tomato plants, lettuce, kale, basil, peppers, marigolds and chard. A plaque explains that it is maintained by medical students, but encourages passerbys to pick whatever is ripe or ready. At this point in the summer, the lettuce and chard are well picked. There are bunches of green cherry tomatoes that unfortunately won’t be ripe until after I’ve left Ann Arbor for our short summer break. The basil has had no problem outgrowing the aggressive reach of the tomatoes and makes the garden smell good with each watering.

The garden plot!

Here in Michigan, the garden is a project of late spring and summer. The winter – my first one in Michigan — was long this year with snow well into spring. To celebrate the change of seasons, the Medical Campus Garden, a hodgepodge of students who have gardened or like the idea of gardening (me), organized a spring planting event as part of the April Wellness Week. Students tilled, fertilized, and then planted seedlings while enjoying salami, cheeses and fresh fruit generously supplied by the Wellness Pillar in M-Home.

The author with Annie Minns M1.

It is quite shocking how different life is in Michigan in the summer versus the spring. Thunderstorms, humidity, evenings spent swatting mosquitoes on my patio have all certainly defined this summer for me. The weather and its milieu of activities – going on runs, walks (to the ice cream store), reading outside – certainly make school more manageable. Thunderstorms roll in in the afternoons and rain gives relief. A couple times a week I water the garden, pull weeds, and nibble on the one or two ripe tomatoes.

Brycin Riley M1 and Garden Club member enjoys snacks during Garden Club-hosted Wellness Week.

This week marks my 52nd of medical school. It’s been a year since my white coat ceremony and I’ve taken dozens of quizzes and tests at this point, streamed many, many hours of lectures, and spilled coffee on my white coat five or six times. It is a blur of a year, strung together by organ sequences and the change of weather. We planted the half-foot seedlings sometime in April – in the middle of our Neurology sequence when dementia, movement disorders, and locating lesions were of utmost importance. I made a Waldorf salad in mid-June with the lettuce from the garden. We were in Infectious Diseases then, perhaps learning about parasites or maybe fungi? Last week we finished Psychiatry, our last sequence before we begin our clinical education, and the tomatoes had just begun to ripen.

Rachel Bergman M1 and Maria Santos M1 examine the lettuce.

In September we’ll return as M2s and after a month-long bootcamp begin our clinical rotations. While I won’t be tending to it, the garden will grow on until it gets cold and the last of the tomatoes have been picked. Hopefully, we’ll find some M1s to retill and replant in April or May next year. I’ll be in my internal medicine rotation and perhaps stop by the garden on my way home after clinic. I hope volunteers from this year’s crop — from the seeds of fallen fruit, basil, milkweed and parsley — populate the garden and carry a little of this summer into next.

Learning the Art of Medicine

We’ve (almost) done it! Only 1 more week left in M1 year! Here I am reflecting back on what has been a challenging but amazing ride and looking forward to starting my first clerkship in October. I can honestly say that I am less terrified and more excited to see patients next year based on my experience in the Clinical Reasoning Elective or as we call it “CRE.” CRE is an elective offered to M1 students during the Winter Term that assigns pairs of students to physicians throughout the hospital to practice their skills in a clinical setting. This elective is limited to 90 students, with two students per physician. Students get the opportunity to practice taking histories from patients and function in a similar manner as a clinical student without being graded.

Striking a pose with Big Bird, a rite of passage when in Mott Children’s Hospital!

Throughout the fall semester we learned how to take a history and complete a focused physical exam through the Doctoring course. However, the only patients I had applied this knowledge to were standardized patients as part of the curriculum. I was excited to be accepted into CRE and practice my clinical skills in the Pediatric Emergency Department. I am no stranger to the Peds ED, as I spent the previous year before medical school working at Children’s National Medical Center as a Clinical Research Coordinator. Enrolling children and families into research studies was a great clinical experience for me, but I was nervous to take on the role of student doctor and put to use the new set of skills that I have learned thus far as an M1.

My CRE partner and I had the pleasure of being matched with Dr. Marie Lozon, our guide into this new clinical world who also happens to be a real-life superhero. Dr. Lozon is the Associate Chief of Staff for Michigan Medicine, which she balances with her many other roles in the hospital system and her clinical shifts in the Pediatric ED. While our preclinical year, referred to as the Scientific Trunk, taught us the science and pathophysiology of the human body, Dr. Lozon focused on the “Art of Medicine.” In addition to helping us learn how to apply the textbook knowledge that we had studied for hours on end, she sought to teach us clinical pearls of wisdom you cannot find in lectures, study guides or books. Specifically, she sought to teach us how to appreciate and be part of the art of delivering care. She explained to us how there is art in many aspects of medicine, such as “the art of sensing other people’s pain or anxiety, the art of listening to their story, and the art of working with a team to take care of the patient.” With Dr. Lozon we learned that without the art of medicine, the science of it cannot flourish.

And so, we started our journey. Despite Dr. Lozon’s busy schedule she always made time to help us learn and see patients, even when this meant going to the ED for 2 hours between meetings to teach us. My partner, Enze Xing, and I regularly planned shifts to work with Dr. Lozon and were incorporated into the clinical team to care for patients. Often we were among the first people to obtain patient histories and perform physical exams. Throughout this experience I have learned a lot about myself and grown as a person, but no experience has been more important than getting comfortable with being uncomfortable. Although I was nervous to dive into seeing patients, I found that embracing where I was and being confident in the ways that I could be helpful enabled me to positively impact the care of families in the ED, which made this experience so much more valuable. I know many more challenges await in my journey to becoming a physician, but I look forward to the road ahead and mastering the art of medicine.

Learning from Imperfection

I first heard about the University of Michigan’s Ceramics Club from my classmate Sylvia. We’d been in the depths of M1 year for several months at that point, and I was looking for some kind of creative outlet so it sounded perfect.

When I entered the studio up in North Campus for the first time, I was amazed. The studio had everything: bins of clay rolls, dozens of different glazes, multiple kilns, and all the tools and wisdom we’d ever need. The room’s walls and racks were filled with incredible works of art like blocks with faces expertly carved out of them, huge colorful vases, and something that looked vaguely like a didgeridoo.

Being surrounded by this much talent with the realization that the last time I had even touched clay was in elementary school art class, I was immediately struck with a feeling of worry and inadequacy. However, my feelings quickly dissipated as I met the other members of the club, like Hazel, a member of the Ann Arbor community who’d been doing ceramics longer than I’d been alive and taught me how to make my first bowl on the wheel. I also became friends with Avery, an UM alum who happily answered my endless questions and guided me through the art of glazing. I was amazed by how supportive everyone in the club was and how willing they were to share their skills and help anyone who asked.

With Avery on the last day of ceramics

After doing ceramics for several months now and absolutely loving it, I still find it difficult. Ceramics is very different from any art media I’ve ever tried before. Making something on the wheel relies just as much on how the piece looks as on how it feels in your hands. It’s a very physical art form; it surprised me how much force I had to use just to get the clay centered on the wheel, and some days I’d leave the studio with my forearms aching. I don’t think a single piece I’ve made has turned out 100 percent the way I intended, but I’ve learned to see the beauty in my happy accidents. For example, a bowl that I’ve trimmed too far with a hole in the bottom becomes a flower pot. When a vase I make gets too lopsided, I’ll just fold in the edges and give it a frilled edge.

Having an open environment in the studio to learn without consequences is a very enriching experience that has helped me learn not to get too bogged down in the mistakes. In the studio I’m able to play with the clay and explore different ways of working it, without the pressure of needing to have a perfect finished product at the end of the day. In fact, the club members encourage and celebrate mistakes. There are days where all my attempts on the wheel end up in the bin, but it’s okay, because I know that I can just come back the next day and try again, and whatever I accomplish is purely for the sake of enjoyment and learning.

While in medicine we can’t just come back and try again, I can still see some value in learning in such an open and fearless place. In a world full of pressures, this environment of unrestricted learning is one that I’ll strive to find more of, not just as I get better at making symmetrical pots but also as I learn to become a physician.

One of my favorite pieces from this year, before it was glazed!

Groundcover News: The Street Newspaper of Washtenaw County

In September of 2010, Shelley Deneve was 2 months behind on her rent. Shelley’s landlord told her that if she couldn’t pay rent by the end of the month, he would have to evict her.

With this in mind, Shelley visited a local food bank where she came across a woman named Rissa Haynes. Rissa was selling a newspaper called Groundcover News, a street newspaper that community members were starting to sell in Washtenaw County to earn money. Rissa asked Shelley if she would be interested in buying a copy. When Shelley responded saying that she didn’t have the $1 to spend, Rissa replied, “If you don’t have a dollar to spare, you should be selling for Groundcover News.” Shelley was trained as a vendor (Groundcover News vendors sell the newspapers out in the community) and soon thereafter began to sell newspapers out in the community. 

Groundcover News is a monthly street newspaper written and distributed by community members of Washtenaw County, including those facing poverty and homelessness. Built on the idea of microenterprise, vendors buy the newspaper for 50 cents and sell them to community members across Washtenaw County for $2. In this way, vendors are able to save money and earn or supplement their income. Founded in early 2010, Groundcover News has been sold throughout Washtenaw County by over 450 vendors for the past 8 years. Shelley is vendor #22.

Susan Beckett, Groundcover News’ founder, says she initially had the idea for the newspaper after visiting her daughter in Seattle where she saw a street newspaper named Real Change. She was impressed by the idea, and after working many years as a volunteer lobbyist on issues of hunger and poverty, Susan was ready to execute this idea at home in Ann Arbor. Initially, however, Susan’s idea was met with skepticism. While the idea worked in Seattle, many doubted that a street newspaper would be successful in the much smaller city of Ann Arbor. Months later, after the recession hit, The Religious Coalition for the Homeless convened to discuss how to best support the homeless population of Washtenaw County. Here, Susan pitched her idea of the newspaper again. This time the idea stuck, and with the help of volunteers, the first issue was published in July 2010. A few months later, Shelley began to sell the new newspaper along Main Street and East Liberty.

While the paper was initially hard to sell, a few standout vendors started to spread the word. With each month, more community members around Ann Arbor had heard about the newspaper, and by the time the recession started to abate in 2014, the paper exploded. Many new vendors joined Groundcover News as a way to supplement their income and to become involved in a new community. In this excitement, Susan says she found great joy. “The most rewarding part of the process,” she recalls, “is the transformation the paper has had on people’s lives.” The initial amount of money saved is often what vendors need to pay off tickets and bills, get their chauffeur’s licenses, save, and get the tools and supplies to get a job. Shelley agrees, and recalls when she first started to sell papers, she was shy and found it hard to get people’s attention. With time, she notes, she was able to step outside of her comfort zone, become confident in professional settings, and even wrote articles for the paper.

As Susan, who will be retiring from her position at the paper this year, transitions the leadership of Groundcover News to a new editor, she states that the biggest lesson she has learned is the importance of direct giving. “There are many organizations that act as a middle party to distribute care to populations in need, but the act of direct giving is so personal.” With this, she encourages all to both give directly and to learn about vendor stories.

For me, this advice has held especially true. As an undergraduate student here at UofM, I often passed vendors selling Groundcover News on my way to class, and in an effort to make it to my classes on time, I found myself staring straight ahead hoping to not have to make contact. Only after I was introduced to Groundcover News by a friend (a medical student at the time) did I start to pay attention to the people calling themselves vendors and the newspapers in their hands. With time, I started to buy copies and encouraged my friends to buy them as well. I stopped to have conversations with vendors and read each newspaper completely, embarrassed to think of times when I had ignored vendors in the past. Now, as I end my 6th year of living in Ann Arbor (my second as a medical student), I feel lucky to contribute to the paper as a writer and am thankful that I live in a city like Ann Arbor that allows the paper to thrive. Although finding the time to write is challenging – especially during this past clinical year – writing for the paper and taking part in the Groundcover News community has allowed me to take a much needed break from the hospital complex and my shelf study books. Through writing, attending meetings, and speaking with staff members and vendors, I’ve learned so much about a community outside of my own, and I have even started to think about how writing could be a part of my career in medicine.

And as for Shelley? Thanks in part to Groundcover News, Shelley lives in the same apartment that she almost was evicted from 8 years ago. In addition, she works two part-time jobs and supplements her income by selling Groundcover News to three local churches.  

If you would like to buy a newspaper from a Groundcover News vendor, look for them at the Kerrytown Farmers Market Wednesday and Saturday as well as in front of the People’s Food Co-op all day Wednesday. In addition, there are almost always vendors on the corner of East Liberty and Main St. during the day as well as in front of the Ann Arbor Library. All vendors selling Groundcover News have certified vendor badges.

 

Susan Beckett (left) and Shelley Deneve (right) pose with newspapers in the Groundcover News office.

Knowledge Across Disciplines

The opioid epidemic. Universal health care. Drug availability. What do all these have in common? They are themes and problems in the current-day communities that I found constantly crossing my mind. The situation at hand is that no matter how much I thought about them, I seemed to always encounter a knowledge gap that “road blocked” my thoughts from advancing. This is due to the fact that today’s problematic situations are multifaceted, with each component requiring the input from experts found in various disciplinary fields. Now, imagine what would happen if you had a team of diverse individuals, spanning across a number of fields including engineering, business, law and various health care professions, all sharing their expertise and experiences to solve these problems. This is one of many approaches at solving multifaceted problems at hand. This is exactly what Launch I.V. seeks to build.

Students discussing the Opioid Epidemic during the Launch I.V. Symposium

Launch I.V., founded by three medical students, is a student initiative that fosters and promotes multidisciplinary collaboration across the University of Michigan. Given that there were only a few groups around the UofM campus that offered opportunities to actively discuss and collaborate with other students outside of the classroom from the fields of medicine, pharmacy, dentistry, social work, engineering, business, social sciences, etc., this became the mission behind Launch I.V. During the first year, we chose to focus our efforts at Munger Graduate Residences because of our mutual goal to foster multidisciplinary collaboration. As a resident of Munger, I live with six other randomly assigned roommates studying biochemistry, aerospace engineering, philosophy, business management, accounting and public health. This provided me with the opportunity to network and build friendships with people I would not normally engage. The other Launch I.V. co-founders and I saw this as a growth opportunity for this community, thus, decided to organize several events over the course of a year to build an initial membership within the building.

One of my favorite activities is the bi-weekly Launch I.V. talks. Every other Saturday, a cluster of students across different fields gather around to discuss important issues over coffee and food. Some of the topics have included rural health care, wearable fitness devices, drug supply delivery, etc. Interestingly, I discovered that it is sometimes impossible to keep the discussion focused on a single topic. People are curious, and students all love to talk about their specific field. This means that sometimes I find myself listening and learning about lithium batteries, the European educational system, and classic movies when the initial topic was something completely unrelated such as obesity prevention.

Through my role and collaboration with the two other co-founders, we were able to organize a multidisciplinary symposium where students, faculty, and industry experts gathered to discuss the opioid epidemic. We designed the event to include a faculty panel, followed by an interactive case study. This was my first experience in organizing an event of this nature, which took a lot of time and effort. However, we partnered with the Munger staff and other groups such as the Interprofessional Health Student Organization (IHSO) under a common goal of promoting multidisciplinary collaboration. After many late nights of planning and countless cups of coffee, we were able to plan, organize, and execute a successful event.

Establishing Launch I.V. has truly been an incredible experience. I am passionate about our mission to foster multidisciplinary collaboration, and hope that others realize how important this is for a successful career.

All The World’s A Stage

“Gregory, remember thy ‘washing blow!”

That’s my cue to steal an apple and power-walk away, before the apple seller catches me by the shoulder and we enthusiastically join the brawl that has just erupted in the marketplace of “fair Verona.” A few scenes later, I’m peaceably circling my dance partner at the masked ball. Stagefighting, dancing and mastering Elizabethan English are some of the many perks that I enjoy as an ensemble member in this year’s “Shakespeare in the Arb” production of “Romeo and Juliet,” not to mention building up my stores of Vitamin D, since throughout May we’ve spent about nine hours a week practicing in the glades of the Arboretum. While I’ve been relishing all these parts of the Shakespeare in the Arb experience, I’ve also come to appreciate one part that I didn’t expect: practicing good scientific communication.

A recent dress rehearsal for this year’s Shakespeare in the Arb.

It’s my third summer in Ann Arbor as a grad student. While my former classmates are now transitioning into their roles as new M4s, taking on more clinical responsibilities but also exploring career interests through elective rotations, I’m finishing up the first year of my PhD in a basic-science-focused breast cancer lab. I’ve met a lot of new friends and colleagues over the past year, and of course in the process have been asked the age-old question: So, what do you do? When explaining my work in the lab, my answers range from “investigating the role of a highly-expressed small GTPase involved in actin cytoskeleton regulation” to “there’s this protein that we think might cause aggressive breast cancers to spread.”

My attempt at finding a swashbuckling look for my Shakespeare in the Arb debut… before our costume director stepped in.

Funnily enough, I’ve found there’s some similarity between explaining cancer biology experiments in layman’s terms and translating “Shakespeare-speech” into a performance that modern day audiences can understand. It’s not enough to rattle off phrases like “whose misadventured piteous overthrows” and “the serial dilution of the Src inhibitor”– my tone of voice, my body language, and the rest of the context I give should help both my audiences grasp my meaning. I find that when sharing something I’ve learned in the lab, stripping what I want to say down to its most basic components and building from there based on my audience’s response is an effective way to get my point across.

As our ensemble prepares for the upcoming performances in June, I’ll continue honing my communication skills in the hope that what I learn in the Arb can be put into practice in my everyday interactions, not only as I currently explain my research, but also in my discussions with future patients. After all, Shakespeare once wrote: “[Find] tongues in trees, books in the running brooks, sermons in stones, and good in everything.” And I intend to find as much as I can.