Something funny happened on the Peds Community Advocacy rotation.
All of a sudden, I was… different.
Well, technically, I am a little different. At the beginning of every rotation, it’s the same: “Hi, I’m Mariah, the lone intern in Child Neurology, let me see, what’s something unique I could say about myself…” as if the first bit wasn’t really a distinguishing point.
The great part about being in a combined pediatrics program intern at IUSOM is, although we have and support a number of these programs, we really, truly care about being great pediatricians first and foremost. My first two years, I’m part of the pediatric cohort. The main difference is on our name-tags–well, that and I also get the distinguished pleasure of eating Jimmy Johns the last Thursday of each month at the peds neuro case conference with all my wonderful child neurology friends, and I have been known to wink and fingergun at other CN folks in the hallways of Riley. But that aside, it’s felt like the expectations were always the same.
Until this rotation. This time, starting out with “Hi, I’m Mariah, the child neuro intern–” eyes got a little wider, understanding nods were nodded, and a number of times parents and advocates thanked me for the work I would do in advance, and shared personal stories of their own experiences with child neurologists.
I had been excited about the community advocacy rotation in advance, don’t get me wrong. Organizing community resources and practicing sensitive, patient-centered medicine are my jam. Plus, being a transplant to Indy from Kentucky, I was eager to get a closer look at the resources on offer in my new hometown.
During orientation, on the very first day, I realized that I was different from my categorical peds friends–they get two exciting, experience packed rotations with community advocacy whereas as a child neuro resident, I would have only half that. I was resolved to make the best of it and make note of as many useful groups and people as I could, and generally throw myself wholeheartedly into all the experiences on offer.
But those looks, those nods, those stories–they really hit home how important the community advocacy rotation is for us combined folks, especially the budding child neurologists. When parents and advocates were talking, I often found their eyes upon me in specific, and I made sure to take note of what they were saying with particular care; inevitably it felt experience-based, and drove me to read and research more. Discussing IEPs vs 504s? I’ll need to master this information, I’ll be doing a lot! Guarding children against sexual abuse? Special needs kids are potentially going to be a lot of my patient base, and they’re more vulnerable, so I really have to be attentive to the signs. Parent advocacy and support groups? Legal rights as patients age out of childhood with chronic conditions of childhood? Coordinating care for kids with multiple conditions? Supporting refugees and immigrants whose children may need extra help and support but moms and dads are afraid to even use CHIP and Medicaid? Finding safe spaces for play and places to stay with a disabled child? There was so much to learn!
All good pediatricians need to have resources for all of these things, of course. Only a tiny fraction of child health is covered by medical care and vaccinations and sick visits. We must all be advocates for the health and wellbeing of our patients in all aspects of their lives, including ensuring safe communities, access to food and resources, and support and education for families. But I felt different this rotation–because those looks and nods told me, it mattered just a little bit more, for me, and for all of my patients to come.
The wonderful thing about the community advocacy rotation is that it’s just a beginning. It helps you frame your motivations–what are the issues you are passionate about? Where can you be most helpful? What avenues are available to you to make a difference?–and then links you with some of the resources for those that will help you accomplish great things for your patients and your community.
This is especially crucial for combined program residents. Our patients and parents are going to have more specific, and sometimes just more, needs. In half the time of the categorical residents, we need to learn and do as much or more as they do, to link our patients with community resources and practice good advocacy and community care.
No small task! Luckily, this rotation lays the foundations to get us there.