Thoughts from the Chair
In October I had my first opportunity to participate in the URMC Department of Family Medicine/San Jose Partners delegation to San Jose, Honduras. I had long wanted to go, given my prior experience in Central America and ability to speak Spanish, but having small children and other faculty’s interest in going, precluded me from joining. This fall, Dr. Stockman found out about 10 weeks ahead that the faculty who was supposed to go, was unable, so I jumped in!
There are so many layers of teaming required to schedule and coordinate this visit, starting with Doug Stockman’s longstanding partnership with members of the community in San Jose. The number of ideas and projects developed and implemented has required ongoing dialogue and experimentation with the local community. The teamwork begins with Doug’s connections with the Hondurans “on the ground” team of interpreters. Each of the team has worked with Doug and the other volunteers at least several prior brigades, the Honduran term for international assistance groups. Local partners include an independent owner/operator of a bus company, who manages all transportation logistics, Melissa, whose skill in preparing delicious food that also avoids water borne illness kept us all fed and happy. Melissa and two village women prepared meals for 13 on the Fogon, an enclosed wood fired stove with flat metal cooktop.
Our group of new acquaintances, Rochester folks and the four other Honduran interpreter staff quickly joined forces to set up the clinic, including 2 medical consult rooms, one dental operatory, the pharmacy, and the sign-in area. The three residents and student worked closely with fantastic ideas, cooperation and positive attitude. Day to day in clinic, one Honduran member signed patients in, one worked closely chair-side with Dr. Roger Carroll, dentist extraordinaire, and one worked with each person doing medical consultations. Interpreters also flexed to the pharmacy to assist as needed as patients picked up their medications and learned how to take them. It was inspiring to see the FM residents and student work with patients, evaluating concerns, recommending treatment, and often providing the medications and counseling themselves. As the preceptor, I reviewed each patient’s care and fielded questions from the pharmacy team.
Each evening after dinner, the “talking stick” passed among all members of the team for check-in, a crucial time for team development, sharing gratitude, joys and some low points. Check in offered stories of interesting clinical situations, joyful moments connecting with another person, and questions or clarifications about processes and cultural learning. The evening talk followed check in and each person took a turn.
The poverty in rural Honduras was a reminder of the vast disparities in wealth in our global family, based on colonialism, racism and all the other ‘isms that have plagued humanity. One small example: Many, if not most, families have dogs. The dogs are “free range” so one dog visited our group nightly, hanging outside the kitchen waiting for scraps. Her name was “Bonita,” Spanish for “pretty” and that she was, also skinny enough to see every rib and intercostal muscle. She lives on the scraps from her family’s table and anywhere else she could get them. Contrast that with many areas of the US, where dogs are brought from state to state—‘rescued’—and coddled with various toys and dog-specific foods. When I purchase our dog his monthly large bag of store brand dry dog food, at about $35, I’m reminded of the fact that most children in San Jose, eat for the month for far less.
The experience in Honduras reminded me of the importance of teamwork, including team development, in every aspect of our work. In the clinical practice at Highland Family Medicine, we work on teams, and team meetings provide the forum for “check in,” ensuring all members are seen and respected as people as well as have what they need to function in their role, at the top of their scope. Our educational and research teams, likewise, are comprised of members who bring their experience and expertise to accomplish our important goals. In these challenging times of restitution after the peak of COVID, let’s all remember to check in with each other, as people and as team members, to ensure we all have what we need to bring our best selves forward.
4/2/2023
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