WIMEZINE

The difference between who you are and who you want

to be, is what you do. . . . Follow your heart, and do

something every day that your future self will thank you

for. —Bill Phillips

As I reflect on the conversations I had with scholars

during the summer of 2016, I am reminded of Bill

Phillips’ inspirational discourse on how we can nurture

our future selves. For nine years, I have interacted with

some of the most intelligent, passionate, and motivated

students in the United States and have read compelling

personal statements that exemplify Phillips’ theory.

These statements expose the paths that aspiring

physicians take to prepare for a career in medicine.

My mind spins when I sit and muse on the impact that

Writing in Medical Education (WiME) has on scholars’

and teachers’ lives. WiME is a place where aspiring

physicians apply and further develop their critical

literacies. WiME is also a place where my colleagues

and I cultivate leaders.

I appreciate the educators who helped me deliver the

2016 writing curriculum: Matthew Spencer, Whitney

Wingate, and Joan Nambuba.

I am forever grateful to Dr. Armstrong, Dr. Wigfall, Ms.

Cullins, and Ms. Coward for creating spaces for me to

engage with scholars who “do something every day that”

moves them closer to their dream of becoming

healthcare practitioners and change agents.

It is my hope that you enjoy the stories that are captured

in volume two of WiMEzine.

—Dr. Shirley E. Faulkner-Springfield

Inside This Issue

Message from the Editor 1

Gabriel D. Perez-Cordero 2

Bianca Aguilar 3

Rosanna L. Escobar-Spadina 4

Claudia Rodriquez 5

Candace Barr 6

Samuel Portillo 7-8

Duke University Summer Biomedical Sciences Institute (SBSI), formally the Summer Medical and Dental Education Program (SMDEP), will accept applications until March 1, 2017.

The 2017 Institute dates are June 10-July 21, 2017.

The following is a link to the SBSI website: https://sbsi.duhs.duke.edu.

Our Name has Changed, but not our Mission!

Newsletter Date

Volume 1, I ssue 1

A Message from the Editor

WiMEzine is a yearly publication that celebrates scholars’ accomplishments in Writing in Medical Education (WiME)

Volume 2, Issue 1 December 2016

For two years,

I have been involved

in orofacial malformation

research at the University of Puerto Rico, Medical

Sciences Campus. My job as a recruiter requires me to

effectively deliver information to potential participants

who become cases or controls. Most families are

reluctant to confide in me, a young aspiring doctor.

Nevertheless, each day, I recruit eight or more families.

To fill the recruitment sheets, I exhibit characteristics

that I expect health providers to possess: honesty and

compassion.

My most memorable participant was a three-month-old

female Puerto Rican infant who had a cleft lip with a

cleft palate. Her parents’ first visit to the clinic was

stressful, and I was intimidated because they were my

first clients, though I was well-trained and worked

among well-trained medical experts. The child’s parents

could not accept the fact that their baby was born with

an anomaly. After briefly talking with them, I learned

that they were hopeless and lonely, so I put the

recruitment sheet aside and sat with them in the waiting

room.

After spending more time with them, they changed their

attitude about their daughter’s birth defect and about the

study. The disheartened and confused parents asked if

the anomaly was hereditary, a question that

demonstrated their interest in learning more about their

daughter’s condition.

I addressed their concerns, offering as much

information as I could about the anomaly, the surgical

procedure, and the specialist who would perform

surgery on their child.

While my interaction with them produced hope and

trust among us, I also experienced anger and happiness.

I was angry because their initial reluctance to

participate in the study was due to their sense of

isolation and their misunderstanding about their child’s

anomaly. I was happy because I was there for them,

and they gave me a purpose for recruiting participants

who benefited from the study.

One month after their visit to the clinic, a nurse told me

that a couple was looking for me. I found them and

learned that my first potential client would participate

in our research study. One year later, the couple’s

beautiful angel got her first surgery. After working four

months as a recruiter, I became the group leader of

fourteen undergraduate recruiters whom I trained how

to interact with potential participants, as I had

interacted with my first participants.

I look forward to becoming a part of a team that not

only sustains and prolongs life, but that also improves

the quality of life for people who cannot afford quality

healthcare.

What are Scholars Doing to Nurture their Future Selves? 2

Gabriel D. Perez-Cordero Chemistry Major Class of 2019 University of Puerto Rico

“To fill the recruitment sheets, I exhibit

characteristics that I expect health providers

to possess: honesty and compassion.”

As an anatomy and

physiology major at

the University of Arizona, my days are filled with

science courses. My education has taught me that

science is important; it is the backbone of the medical

profession.

In Writing in Medical Education (WiME), I learned that

there can be no science or medicine without critical

thinking, reading, listening, speaking, and writing

skills. Another important lesson I learned in WiME is

that the liberal arts and the sciences are more alike than

I thought and that I do not have to choose between the

sciences and the humanities. The most important lesson

I learned is that writing can help me effectively

communicate who I am to medical school admissions

committees, communicate with patients, and

communicate my research to my colleagues and to the

public.

So, yes, pre-medical and medical students should study

communication.

The assignment that convinced me that premedical

students should study communication was a literature

review. I used two sources to complete the assignment.

The first source was a 2016 editorial titled “Case

Reports in Medical Education: A Platform for Training

Medical Students, Residents, and Fellows in Scientific

Writing and Critical Thinking” by Aleksandra G.

Florek and Robert P. Dellavalle. Florek and Dellavalle

assert that case reports have numerous benefits. Case

reports prepare potential doctors for a career in

medicine and teach them how to review literature, how

to present clinical data to physicians, and how to

publish their findings. Case reports also document rare

diseases and disorders, write Florek and Dellavalle.

The second source I reviewed was a 2014 research

article titled “The Clinical Case Report: A Review of its

Merits and Limitations” by Trygve Nissen and Rolf

Wynn. Nissen and Wynn’s article appears more objec-

Bianca Aguilar Anatomy & Physiology Major Class of 2019 University of Arizona

Should Pre-Medical Students Study Communication? 3

tive than Florek and Dellavalle’s editorial because

Nissen and Wynn identify the benefits and the

shortcomings of case reports. Similar to Florek and

Dellavalle, Nissen and Wynn maintain that case reports

are descriptive educational tools that identify new and

rare symptoms and illnesses, generate new theories, and

are “natural experiments that solve ethical constraints.”

In contrast, according to Nissen and Wynn, case reports

do not offer quantitative data or prove cause and effect

relationships, are often misunderstood, are written after

events occur, and reveal patients’ private health

information.

The literature review taught me that case reports are

complex, risky, and valuable, and they improve students’

communication skills. Even though I did not write a case

report, writing the review changed how I write. After I

returned to the University of Arizona, I applied my new

skills to my organic chemistry lab reports so I could

produce clear and succinct two-page lab reports. Much

like I structured the literature review, which is a research

story, I synthesize information, organize my ideas, and

present details that show how experiments are conducted

and why certain results are produced. By structuring lab

reports like a story, I deepen my understanding of

experiments and create a balance between the sciences

and the humanities.

Despite the skills I learned in WiME, my writing is not

where I want it to be. I still overwrite, and my writing is

repetitive. I rewrote this article four times before I

condensed it enough for it to have a solid focus.

In many ways, learning how to write is like learning

medicine—there is always more to do, more to learn,

more to achieve. Doctors should always strive to be

better for their patients. By becoming a better writer, I

will become a better thinker and learner. And at the end

of the day, these skills will make me a better doctor. That

is why effective writing and speaking skills are important

in medicine.

“So, yes, premedical and medical students

should study communication.”

“Writing is Painful!”

4

I never knew writing

could be painful. When

I began writing a personal statement to medical school

admissions committee members at Duke University

about how my brother has influenced my life, I

experienced pain.

My brother was diagnosed with Autism when he was

two years old. While my mother became his primary

caregiver, I also cared for my brother. When we were

younger, I helped my brother complete his homework

assignments, and I still help him improve his social

skills. When we go out in public such as to the movies

and the mall, I often have to defend him and his

behavior. Too many people do not understand and do

not try to understand how his environment affects his

behavior.

Having to share my experiences, my burdens,

frightened me. I was frightened about what my

audience would think: Would my audience feel pity?

Would my audience relate to my situation? Would my

audience believe me? Should I write about another

topic? All these questions ran through my mind.

The thing about writing is that it’s permanent. Writing is like having a conversation with people, but not knowing whether their intentions for reading your words are to be informed or to be critical. So I feel anxious when I write because I struggle to find the perfect words to express my ideas to people who might misinterpret my words and judge me. There is nowhere to hide when I write: I bare it all. I put a part of my soul, a part of what makes me me into my writing. To know I can be judged by my writing, by my thoughts, by being me . . . What could be more painful than that?

Eventually, I realized how I could ease my pain and

diminish my fright.

“I want to show them how my brother has made me a

better person,” I concluded.

With this in mind, I started writing a revised statement

about how my brother is a blessing, not a burden. He

helped shaped me into the person I am today. The

moment I began writing about him as someone who

inspires me I felt free. I felt like a burden had been lifted

off my shoulders because I was able to share my story

with a committee about my brother and share my story

with my brother.

Although I feel better about my personal statement, I

still believe writing is painful, regardless of the topic.

One of the most important lessons I learned in WiME is

that before I painfully scatter parts of myself on the

computer screen, I must read the requirements that a

medical school admissions committee has created for

me so I can understand my audience and do a better job

of meeting my audience’s expectations.

As I think about my experiences in WiME, I believe I

was afraid to tell my story to my peers and professor,

although they were exceptionally nurturing. WiME

helped me learn how to tell my story, which helped me

learn how to write my story.

My advice to premedical students who do not plan to

become professional writers or to study writing is:

Write. Write everything. Write with passion and without

fear of being judged. And most important, write with

pain. Do not deprive the world or yourself of who you

are. Share your pain. Share your triumphs. Share your

story with an audience of committee members who will

determine whether you will become a medical student in

their school of medicine.

Rosanna L. Escobar-Spadina Molecular Biology Major Class of 2018 University of Puerto Rico

The Summer Medical

and Dental Education

Program (SMDEP)

exceeded my expectations. I was told about SMDEP by

one of my cousins who completed the program at

Columbia University. Therefore, I expected rigorous

classes and unique shadowing experiences.

Biochemistry and organic chemistry prepared me for

challenging science classes at my home institution. Not

only did the program prepare me academically, but it

also prepared me socially and psychologically, as I

learned how to interview for medical school, how to

interact with patients, and how to cope with stress. The

most important takeaways are how much I grew and

how much I learned about myself.

My growth involved answering one primary question:

Why do you want to be a doctor? It seems like a simple

question, but in reality, it is one of the most difficult

questions I have ever answered. Before I became a

SMDEP scholar, my answer to the question was “I want

to help people.” Although this is true, every physician

wants to help people or should want to help people.

Thus, I had to discover the answer to several questions

and three of them were: What makes me unique? What

will make me an outstanding physician? Why do I want

to help people? Discovering reasonable responses to my

own query took six weeks of exploring, thinking,

listening, and writing.

In Writing in Medical Education, my peers and I were

asked to construct a personal statement to one medical

school that we selected. I chose Duke University School

of Medicine (DUSOM). In my first draft, I discussed

my struggles as an immigrant. After I read my draft

aloud in class, Dr. Faulkner-Springfield urged me to

change my narrative in ways that might better express

my reasons for becoming a physician. I walked out of

class frustrated, furious at my professor. I asked myself:

“What would I write about? What is my story?” My

experiences as an immigrant have made me who I am.

I felt like I had nothing to offer Duke University.

Through a learning process that included feedback from Dr.

Faulkner-Springfield, my classmates, and other professors, I

realized that my struggles did not define me. Instead, the

way I overcame my struggles has made me who I am. This

realization did not come easily.

My family and I immigrated to the United States from Cuba

when I was eight years old, and my parents and grandmother

never learned English. At a young age, I found myself

translating for my family and serving as a bridge between

our Cuban and American cultures. However, I never

understood that my role as a medical translator made me

love medicine and want to help people who feel

marginalized in the American healthcare system.

Furthermore, I selected DUSOM as the audience for my

personal statement, but I ignored my audience and its

personal statement guidelines. Dr. Faulkner-Springfield

asked me to reframe my immigrant story and contextualize

my experiences so I could demonstrate how I have

developed characteristics at home, at school, and in

healthcare settings that are preparing me for medical school

at Duke. She went on to deduce that my identity as an

immigrant is nominal compared to my identity as an

advocate for my grandmother who often misinterpreted her

doctors’ words and body language. When I became a

translator for my grandmother, sometimes I used Google

Translate to decode the complex medical jargon her

monolingual doctors used to explain her critical condition.

Before I received Dr. Faulkner-Springfield’s unanticipated

feedback and reflected on it, I could not imagine the

magnitude of my performance as a liaison between my

grandmother and her doctors.

I spent countless hours revising my statement that eventually

showed my passion for medicine. I have learned to persist,

listen, and be open to all suggestions, even if I do not accept

all of them. Dr. Faulkner-Springfield’s comment that I

considered harsh actually taught me much about myself and

about context-specific knowledge and skills.

In a few years, I will have more precise responses to my

questions. In addition to majoring in biology, I will minor in

Spanish and become a certified medical interpreter. Today,

one of my strongest qualities is being bilingual—my ability

to talk with and speak for Spanish-speakers whose voices are

not heard in the healthcare system. Without WiME and

SMDEP, I am not sure when I would have come to this

realization.

Claudia Rodriquez Biology Major Chemistry & Spanish Minor Class of 2019 Florida State University

Writing, Speaking, Listening, Thinking, Engaging, and Becoming . . .

5

I told my parents

I wanted to be a

doctor when I was in

elementary school. Their reaction to my childhood

dream made me feel like the job was important, so I hit

the track running. When I was in elementary school, I

volunteered at The Arch of High Point and interacted

with clients who had disabilities that ranged from

Autism to Down syndrome. I surrounded myself with

science, medicine, animal research, and great minds.

Fifteen years later, I was accepted into the Duke

University Summer Medical and Dental Education

Program, where I excelled in science courses.

However, I had not taken a writing course since my first

year in college, and I was a junior. I had been so

focused on excelling in science courses, the classes that

mattered to medical school admissions committee

members, that I could not remember the last time I had

read or written a literary text. Before WiME, I had

tunnel vision. I knew what I wanted to do, so I

programmed myself to meet the requirements that

would help me become a physician. Was I just going

through the motions—following a strict set of curricula

requirements—and forgetting that doctors work with

human beings?

WiME gave me an opportunity to reflect on who I am

and who I am becoming. During our large-group

meeting on the first day of class, Dr. Faulkner-

Springfield asked, “Who are you?” The adjectives I

used to describe myself related to the sciences.

“Without the sciences, I’m nothing,” I whispered to

myself.

After I was challenged by the question: “Why do you

want to become a doctor,” I became aware that the rela-

tionship I had formed with science was unhealthy. I did

not know why I wanted to become a doctor.

The personal statement assignment and writing

conferences helped me figure out how I had gotten to

that place and who I was outside of science. They

helped me see my multiple identities: a researcher, a

scholar, an advocate, and a humanitarian. Once I was

able to recognize my whole self, answering those

challenging questions with honest answers was not

difficult. I conduct research on animals, and I work with

human beings. I am the founder and president of a

nonprofit organization for homeless women; I volunteer

at homeless shelters; I talk with students at middle and

high schools about homelessness and health disparities.

To offer comprehensive, quality healthcare to people in

my community and to help eliminate health disparities

in my community are two major reasons I want to

become a doctor.

I must admit that I was reluctant to write a personal

statement about Candace the advocate and humanitarian

because I had always been told that I should write about

science if I want to be taken seriously.

WiME helped me understand that I do not have to

separate the sciences from the liberal arts.

Reading has become incorporated into my daily routine.

Now I read newspapers, short stories, and books.

Currently, I’m reading Sonia Nazario’s Enrique’s

Journey. After I completed my personal statement, I

also started an online journal. Writing has become an

outlet for me to express Candace’s voice, a voice that

does not include other people’s ideas and expectations.

Candace Barr Neuroscience Major Class of 2018 Georgia State University

“Before WiME, I had tunnel vision. I knew what I

wanted to do, so I programmed myself to meet the

science requirements that would help me become a

physician.”

Writing, Speaking, Listening, Thinking, Engaging, and Becoming . . .

6

Samuel Portillo Bioinformatics & Biology Major Chemistry Minor Class of 2019 Virginia Commonwealth University

Who should read Black Man in a White Coat?

Everyone should read Damon Tweedy’s memoir,

particularly premedical students, medical students, and

people who believe that we live in a post-racial society.

Regardless of your race, gender, or sexuality, you will

learn valuable lessons about how the American

healthcare system perpetuates inequalities and injustices

that are evident in the wider society. Equally important,

you will learn how one Black man uses racism to

motivate him to excel in medical school and in his

white, male-dominated profession. Readers cannot

immerse themselves in Tweedy’s 294-page book and

emerge unchanged.

At the graduation ceremony of the Summer Medical

and Dental Education Program (SMDEP), I became the

recipient of the Outstanding Performance in Writing in

Medical Education Award and received a copy of Black

Man in a White Coat: A Doctor's Reflections on Race

and Medicine (2015) by Damon Tweedy. The book is

separated into three parts: Disparities, Barriers, and

Perseverance. This non-fiction book explores Tweedy’s

journey to and through medical school at Duke

University, where he matriculated in 1996. He is also a

graduate of Yale Law School, an assistant professor of

psychiatry at Duke University Medical Center, and a

staff physician at the Durham VA Medical Center.

Dr. Tweedy was no stranger to me. He spoke to my

peers and me about halfway through SMDEP. I

remember listening to him talk about his story of being

among the few Black students in his medical school

classes, a story we had already heard from many

speakers at that point in the program. Dr. Tweedy also

discussed his own problem with hypertension, despite

becoming someone who should have been a model of

good health for Black people.

His story stuck with me for a while, but as my workload

increased and the life stories of minority pioneers in

medicine became a recurring theme, Tweedy’s story

eventually became just another lunch lecture.

Tweedy’s narrative did not begin to positively influence

me until I returned home to Centreville, Virginia. I used

the rest of the summer to reflect on SMDEP and to read

Tweedy’s book. As I travelled with him through his

journey, I began to understand his fixation on minority

health disparities and barriers that minority patients and

minority doctors face that are too often connected to

racial discrimination.

Additionally, I had heard the story of persevering

through medical school, but feeling and seeing the

challenges through Tweedy’s eyes in Black Man in a

White Coat are the closest I have come to understanding

the complexity of medical school and the American

healthcare system for Black people. Tweedy writes that

though he “had never seen any examples of a doctor’s

racial bias inflicting medical harm, . . . the scientific

literature was flooded with articles on the subject.”

From 1996 to 2002 (the literature he cites), “a plethora

of studies described racially disparate treatments and

outcomes.”

When I listened to his speech during the program, I was

barely fazed by his discussions on health disparities in

the Black community that went untreated and his

exposure to racial discrimination. Because I was

surrounded by my minority peers, I felt confident.

“I’m ready for this,” I thought to myself, as I listened to

him speak.

But when I read his recollection of getting mistaken for a

maintenance technician by Dr. Gale, one of his medical

school professors, I felt the anger, confusion, loneliness,

and betrayal that Tweedy felt.

A Reflection and A Review of Black Man in a White Coat by Damon Tweedy

7

“Tweedy concludes the book with a powerful

message. He stresses that the delivery of quality

patient care should not depend on the race of a

patient or a doctor.”

During his first year in medical school, Tweedy was

asked by Dr. Gale, “‘Are you here to fix the lights? . . .

You can see how dim it is over on that side of the room.

. . . I called about this last week.’”

Dr. Gale did not recognize Tweedy as one of his

students. Humor, writes Tweedy, became the medicine

that he and his Black classmates used to temporarily

sooth the pain of racial insults. Even more disheartening

is Tweedy’s discussions on white patients like Chester

who did not want a “n— doctor” to care for him.

Tweedy concludes the book with a powerful message.

He stresses that the delivery of quality patient care

should not depend on the race of a patient or a doctor.

This message embodies what SMDEP is about, which is

embracing diversity.

Tweedy’s writing is clear, and his stories are real, so

clear and so real that I felt like I was right there with

him. At other times, I felt like I was reliving some of my

own encounters with patients. His lessons are so open-

ended that they gave me an opportunity to engage in

introspection about my own positions as a minority

firefighter and emergency medical technician.

Black Man in a White Coat has given me a new

perspective on how racism, patient care, and racial

diversity should be addressed. While, as a medical

student, Tweedy did not challenge people whom he

perceived as racist, I believe his book has given me the

knowledge and courage to question what I perceive as

unethical behavior in healthcare settings.

I learned a lot from the author and the speaker. Tweedy

introduced me to some of the struggles that today’s

minority students might face in medical school and in

the healthcare system, challenges that I took lightly

during his verbal conversations with me and my peers.

Though sometimes depressing, Tweedy’s narrative is

hopeful and honest.

If I meet Dr. Tweedy again, I will thank him for taking

the time to articulate his honesty and his views on

difficult subjects such as racism and persistent health

disparities in the Black community. I will also thank him

for capturing my attention during my reading of Black

Man in a White Coat.

A Reflection and A Review (continued from page 7)

8

Duke University Summer Biomedical Sciences Institute Multicultural Resource Center, DUSOM

Sharon W. Coward, M.A. Program Coordinator, Multicultural Resource Center

Program Coordinator, Summer Biomedical Sciences Institute

Maureen D. Cullins, A.M. Co-Director, Multicultural Resource Center

Associate Director, Master of Biomedical Sciences Program Program Director, Summer Biomedical Sciences Institute

Delbert R. Wigfall, M.D. Professor of Medicine, Pediatric Cardiology

Associate Dean, Medical Education Co-Director, Multicultural Resource Center

Academic and Clinical Coordinator, Summer Biomedical Sciences Institute

Brenda E. Armstrong, M.D. Professor of Medicine, Pediatric Cardiology

Associate Dean, Admissions Principal Investigator, Summer Biomedical Sciences Institute

WiMEzine

Contact: Shirley E. Faulkner-Springfield, Ph.D.

Editor, WiMEzine

E-Mail: sfspring@duke.edu

Motto: Who are You?

Writing in Medical Education Faculty and Staff

Shirley E. Faulkner-Springfield, Ph.D.

Writing Program Coordinator, 2013-present Instructor, 2007-present

Matthew Spencer, M.A.T.

Teaching Assistant, 2007-present

Whitney Wingate, M.A. Teaching Assistant, 2015-2016

Joan Nambuba, M.B.S.

Teaching Assistant, 2016

Education as the Practice of Freedom

To educate as the practice of freedom is a way of teaching that anyone can learn. That learning process comes easiest to those of us who teach who also believe that there is an aspect of our vocation that is sacred; who believe that our work is not merely to share information but to share in the intellectual and spiritual growth of our students. To teach in a manner that respects and cares for the souls of our students is essential if we are to provide the necessary conditions where learning can most deeply and intimately begin. . . . Learning is a place where paradise can be created. ~bell hooks, 1994