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Child in a wheelchair and child using an assistive walking device are on a running track with a coach encouraging them
2017 Special Olympics Spring Games Photo by Aaron Hines (public domain image)

Students at GW are doing great things both in the classroom and outside of it. For our ongoing series of spotlights on student organizations, I spoke with Arinze Okeke and Nikki Karri, both of whom are first-year med students, and also the co-presidents of KEEN at GW.

KEEN stands for Kids Enjoy Exercise Now, and the chapter at GW is part of a larger organization which has provided free programs for fitness and recreation for youth with disabilities since 1992.

Volunteers from GW, who are known as coaches, sign up on KEEN’s email list, and then volunteer one of three Saturdays a month to help out with the program. KEEN invites youth between the ages of approximately ten and 20 years old with all types of disabilities to come to a gym or pool and be paired with a coach or coaches. Students from GW’s KEEN chapter, as well as other area universities, serve as coaches for the activity selected by each young participant.

Arinze explained how participants join the KEEN program: “To get involved, kids fill out a profile stating their likes and dislikes, what activities calm them down, and what they like to do for fun. Sometimes their parents are involved in helping complete the profile.” 

Nikki explained how coordination occurs between the coaches and the participants in KEEN, who are known as athletes. “After we recruit our coaches, we work with the KEEN Greater DC area program director, who’s in charge of both us as coaches, and also the athletes.” KEEN provides a list of athlete abilities and activity preferences, based on the first-hand account collected in the athlete questionnaire. “Beth [KEEN’s program director] knows us and the athletes, so she’ll pair us up based on how well she thinks we’ll fit.” With newer coach volunteers, Nikki continued, “Beth will pair them with the athletes she thinks will be a good fit.” Each Saturday session lasts three hours, during which coaches cycle through working with different athletes and different age groups on an hourly basis.

The range of disabilities represented by KEEN athletes is wide, Nikki reported. “Some of them are nonverbal, and a lot of them have intellectual or physical disabilities.”

Once athletes have been matched with a coach, Arinze says, “We hang out with them, play sports with them – whatever they want to do for the hour we’re together.” Nikki elaborates, “Athletes are new to the activities, and they can try things out. While our involvement is solely with coordinating volunteers for the sport and swim activities, KEEN is not only sports. There are different activities offered throughout the week.” 

Before each session, the coaches gather, and Beth or one of her coordinators will hand coaches their papers. Arinze describes what happens next: “We have some time to read through the first-hand account of each athlete’s characteristics, and maybe talk to other coaches who’ve worked with them. Because typically there are people who have worked with them before, who know their likes and dislikes.” 

I asked Nikki whether there is a constant flow of new athletes joining KEEN. “Most are repeat athletes. Some of them even come with their siblings, so that’s very fun. And there are people who won’t come on a given week and then you see them later and say, ‘Oh my gosh, I missed you!’”  Occasionally new athletes also join the program.

In terms of coach volunteers, Nikki explained that a maximum of ten students can sign up for each weekend’s session, in order to ensure a correct ratio of coaches to athletes. “Depending on whether it’s a heavy week with tests and stuff, sometimes we’ll have six or eight people, but sometimes if it’s a test-heavy week it will be [fewer].” Arinze says that the ratio of coaches to athletes is either one on one, or sometimes more than one coach is assigned to an athlete.

Coaches participating in KEEN come from GW and other area universities. Arinze has met KEEN coaches from Howard University’s medical school. Additionally, coaches from area schools may come from undergraduate programs and disciplines other than medicine.

I asked Arinze and Nikki what drew them to becoming involved with KEEN. For Arinze, mentorship is something he has always been drawn to. During his gap year, he had a unique opportunity to be a second grade special education teacher in Southeast DC. He appreciated “being able to spend time with the kids I had on my caseload, day in, day out, [understanding] what each of them specifically learns, what each of them specifically needs to flourish, because it will look different from the full class, but it will also look different across each individual kid on the caseload.”

Arinze found it rewarding to learn “the small things that make a huge difference in the kids’ learning, their confidence, and their experience of school itself.” Having a disability of any type, he reflected, “can get really discouraging. You can get down on yourself. So I was really glad that I was able to encourage them through the process.”

The mentorship aspect is also one that drew Nikki to become involved with KEEN. Throughout high school and her undergraduate studies, she had volunteered working with the elderly at a nursing home. Eventually, she made the transition to working with children, “doing equine and hippotherapy – working with kids and horses.” She saw how their interactions helped make kids’ days better, and shaped and improved their overall well-being. 

In terms of their involvement with KEEN and its influence on their eventual choice of specialty, Nikki said that working with KEEN “pushed me towards pediatrics. I’m between peds and other fields, but I think KEEN really solidified my choice of peds as one of my top contenders.” Arinze is thinking about family medicine: “That would incorporate working with kids and adults. Just because I definitely feel drawn to the mentorship aspect, being a positive adult influence is important.” 

While some other KEEN coaches are interested in pediatrics, Nikki says, the activity is also a draw for students because it carves time out of the week to “do sports, do something completely different than medicine, but still being able to use your skills and build your people skills.”

In terms of what KEEN’s co-presidents are looking for in potential coaches, Arinze emphasizes, “Just being interested in helping the kids is what we need. Being interested and enthusiastic is what we’re looking for at KEEN.” Nikki adds, “All coach volunteers are provided training prior to their first session. We are open to everyone – be self-motivated and willing to help.”

Photo of a record on a record player.
Photo by Elviss Railijs Bitāns: https://www.pexels.com/photo/blue-vinyl-record-playing-on-turntable-1389429/

Music, broadly defined, is vocal, instrumental, or mechanical sounds having rhythm or harmony. While it means different things to different people, one thing is certain: life is much better with a soundtrack. Medical evidence points to music having an impact across the lifespan, from birth to old age. The members of the SMHS student group Musicians in Medicine feel this perhaps more deeply than others: as medical students and musicians, they have incorporated music into their past work, and plan to continue to weave music throughout their careers.

Musicians in Medicine co-president Spencer Bennett finds singing to be a “great creative outlet through a stressful journey through school.” He has also found that music can help mitigate the lack of sleep endemic to students in the program. As a singer, his preferred genres are R&B and pop.

Co-president Rachel Furman, a classical violinist who is learning to play pop music on the piano, is focusing on hematology/oncology in her studies. She has observed that every patient she works with listens to music, and adds, “I try to find out what kind of music they like, as a way to connect with them.”

Naiya Osiyemi, Musicians in Medicine vice-president, plays piano and guitar and sings. Her preferred genres are R&B, rock, and classical. In her high school days, Naiya played music in hospitals. She mentions that she may pursue music therapy once she is further along in her career. She is particularly interested in the link between music and the treatment of specific conditions, such as traumatic brain injury.

The social media chair for the group, Sarah Nanziri, is a singer who likes R&B and pop and likes to spread positive messages through music. She listens to music while studying, and loves its healing and grounding properties. In her former work as a medical assistant in a pediatric office, she would sing kids’ favorite songs to reduce their anxiety when receiving shots.

Members of Musicians in Medicine occasionally incorporate music into mnemonics (to remember Lynch syndrome, think about Ross Lynch), but most often, they see music as a way to ease their stress and anxiety, and they consider ways to incorporate music into their professional lives, because music can be linked to virtually any specialty. As Spencer notes, “Music is not considered to be a part of medicine. But in Brain & Behavior, the importance of therapy & support networks is emphasized. Music is great for these purposes, and it is very patient centered.” Music helps people focus, but also offers a welcome escape from reality.

Himmelfarb's Healthy Living Committee hopes to host Musicians in Medicine for a lunchtime concert after the winter break. Stay tuned!

In the meantime, take a study break with one of these medically indicated tracks!

References

Music Definition. Merriam-Webster. Retrieved 12/5/2023, from https://www.merriam-webster.com/dictionary/music

Spanish-English dictionary page showing translation for Latino
Spanish dictionary, by Abigail Luke on Flickr, shared under Creative Commons Attribution 2.0 license

In honor of National Hispanic Heritage Month, let’s spend some time focusing on SALUD!

SALUD is a student-run organization at GW which was founded about five years ago, and is dedicated to teaching and learning Medical Spanish. During the academic year, SALUD runs regular Spanish classes for medical students at three different levels: Beginner, Intermediate, and Advanced. The content of these sessions, which occur during the lunch hour, is keyed to vocabulary related to body systems students are covering in the Practice of Medicine course.

In class one day in early Fall, MS2 student instructors Emily and Giuliana ask the eight students attending the Advanced level class where they have learned their Spanish. Some speak it at home, while others have studied the language. There is a review of the vocabulary for the musculoskeletal system, after which the students partner up to practice patient interview skills. “¿Que le molesta?” (“Can you tell me what hurts?”) is one opening, whereas others might start with, “¿Necesita un intérprete?” (“Do you need an interpreter?”) Some students form groups of three, with one student acting as the interpreter. A student is curious about interpreting opportunities. While certification is required to be a medical interpreter, GW students are able to volunteer and use their language skills as patient navigators at the GW Healing Clinic, where about 80% of the clientele are Spanish-speaking.

Screenshot of slide on translating a 1-10 pain scale into Spanish
Screenshot of Advanced level Medical Spanish lesson on how to translate a 1-10 pain scale

Over in the Intermediate level classroom, students are reviewing musculoskeletal vocabulary, translating it from Spanish to English. The lesson follows the structure of a history of present illness, teaching students to seek information from patients on the location, quality, and severity of their pain, along with its duration, timing and context. The instructor points out synonyms, such as débil and tenue for weak, as well as words that have more than one meaning, like sordo, which can mean deaf, but also dull, which might describe a patient’s pain. In the Beginner classroom, a dozen students begin their exploration of the same vocabulary at a slower pace.

In addition to teaching Medical Spanish, classes aim to teach students the correct use of interpreters. SALUD also serves the Latinx community in DC through Bridge to Care, an initiative of the GW Healing Clinic. Because up to 80% of patients seeking care at the Healing Clinic are Spanish-speaking, the support of students with Spanish-speaking skills from across the MD Program, PA Program, and MPH candidates from the Milken Institute of Public Health is essential.

A few days after the first lesson of the year, I met with two of SALUD’s board members, Tammy Moscovich (MS2) and Alisha Pershad (MS2). While Tammy was raised in a Spanish-speaking family, Alisha’s interest in learning Spanish developed through school. Alisha sought to put her Spanish skills to use, and pursued official interpreter training to earn a certification. Through her SALUD teaching, Alisha hopes “to empower others” to combine their Spanish-speaking skills with patient care.

The curriculum used by SALUD comes from a Medical Spanish course from Boston University, which was adapted with permission by medical student Cecilia Velarde De La Via (MS3). The curriculum correlates to the system blocks students learn about in the Practice of Medicine course, and includes both vocabulary, sample patient interviews, and flash card decks. The Intermediate level class is “more conversational than technical,” according to Tammy, whereas the Advanced class focuses more on review.

Screenshot of phrases in Spanish and English suggested for patient interactions
Screenshot of a suggested script for interacting with Spanish-speaking patients

Are there SALUD success stories? Tammy and Alisha shared one: a current MS3 student who began Medical Spanish last year eager to practice her skills gained confidence through the classes. Now, in rotations, she feels more confident with her Spanish skills in working with patients. For Tammy, her time serving at Bridge to Care serves as a good refresher for vocabulary lessons. Then there are the finer points to learn when working with patients coming from different parts of the Spanish-speaking world, like the difference in terminology from one country to another, or learning the informal terms used by patients in a medical context, versus the clinical terms. Tammy commented that, “This is the word I use” is a valuable contribution to the Spanish lessons, helping to communicate the variations across borders. Alisha agrees, adding that classes are enriched by people bringing their individual experiences and sharing it.

The increased arrival of migrants to the DC area is something the GW Healing Clinic is experiencing via some of the patients coming through its doors. Alisha reported that there have been more patients arriving with acute conditions, adding that “it’s gratifying to facilitate the encounter, and help them recover.”

From the classroom to the exam room, SALUD is helping students increase their confidence in both bilingual encounters and collaborating with interpreters, while helping patients in the community access medical care that speaks their language.

Get Naked, slogan from Melanoma Research Foundation.
#GetNaked campaign from the Melanoma Research Foundation

It’s nearly summer! When was your last skin check?

Malignant melanoma is the most serious type of skin cancer. For 2022, the American Cancer Society estimated nearly one hundred thousand new diagnoses of melanoma, making it the fifth most common type of cancer in the United States. Advances in melanoma treatment over the past decade have fortunately begun to make it a less deadly disease if caught early.

Melanoma is most often diagnosed by dermatologic exam and skin biopsy, but you can play a part in the early detection of melanoma by doing skin self-exams, and particularly noting any spots that meet the ABCDE guidelines:

  • A is for Asymmetry: One half of a mole or birthmark does not match the other.
  • B is for Border: The edges are irregular, ragged, notched, or blurred.
  • C is for Color: The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
  • D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.
  • E is for Evolving: The mole is changing in size, shape, or color.

While superficial spreading melanoma is the most commonly diagnosed type, there are numerous types of melanoma. Controlling ultraviolet exposure, including ceasing the use of tanning beds, is one action that can help to prevent melanoma from developing. However, childhood sun exposure remains an important risk factor in the development of the disease.

Acral lentiginous melanoma is most frequently diagnosed in patients with darker skin and those of Asian descent, and is most frequently found on the palms of the hands, soles of the feet, and under nails. It is not caused by sun exposure. The misconception that people of color cannot develop melanoma has led to delayed diagnosis of melanoma, which leads to poor outcomes for patients. Check out the Himmelfarb Library’s Diversity in Dermatology collection to explore dermatology resources which include representations of the full range of human skin tones.

Here at GW, two SMHS student dermatology interest groups are marking May with a couple of events focused on skin health. Learn2Derm will host an event on Saturday, May 13 from 2-5 p.m. at the Pennsylvania Avenue Baptist Church which will bring skin health topics, resources, and services to community members with limited access to dermatology. Students from GW, Howard University and Georgetown University will take part in this event.  This event will also feature a visit from the Skin Cancer Foundation's Destination Healthy Skin RV, which travels around the country providing free skin checks. Email learn2derm@gmail.com to volunteer to help out at this event!

Skin Health Fair event flyer. Details in text above.
Learn2Derm Skin Health Fair, 5/13/2023, 2-5 p.m., Pennsylvania Avenue Baptist Church

The Dermatology Interest group will support a nonprofit, IMPACT Melanoma, with a doubles tennis tournament at GW’s Mount Vernon campus on Saturday, May 20 from 10 a.m. to 4 p.m. This event, held  in conjunction with students from Georgetown University and Howard University, will raise funds for IMPACT Melanoma’s mission to bring education, sunscreen dispensers, and sun shelters to underserved communities.

Tennis tournament event announcement. Details in text above.
Serve Your Skin tennis tournament, 5/20/2023, 10 a.m. - 4 p.m., Vern Tennis Center at GW

Whether it's playing tennis for a cause, raising awareness about how to keep skin healthy, or just picking up the phone to make an appointment with a dermatologist, there are plenty of things you can do this month to take care of yourself and your community. When it comes to skin health, what's on the outside counts just as much as what's on the inside.

References: