Speak English Please

Part of my job is helping translate medical speak into understImageandable language. While simple in theory, this can be more difficult than it seems. The practice of medicine requires learning tens of thousands of new words. Some of this is critical for communicating with other physicians: precision of language is critical when trying to explain nuances. Some of it, however, is simply the terminology of a sometimes elitist in-club and a way to further separate doctor from patient.

I have often been told that if you can’t simplify something- you don’t truly understand it. And this year has certainly put that to the test for me. On my first day on the job my producer jokingly told me that if I ever used the phrase “all-cause mortality,” she would fire me. And I like to think that since that day I havImagee grown leaps and bounds in my ability to explain medical research to a lay audience. Because honestly, this is a skill I will use constantly when speaking with patients- many of whom have limited education and may be intimidated by needlessly complex terminology.

Today I was called upon toimage(1) photo condense two complicated medical histories into 30 second script “bites” that would be understandable for a morning TV audience. Bacterial endocarditis, infarct, PICC line, complicated sepsis… to the untrained eye these charts basically read like a different language. I worked with the producers to translate this into a more understandable narrative.

The premise of the segment was two young ladies with medical issues who were going to their first big school dance, thanks to a charitable organization called Garden of Dreams. While this wasn’t breaking news, it was exciting to hear my (hopefully simple) words read on-air and it was so great to meet these two young women and see their excitement at being normal teenagers despite their medical issues.

And hopefully, when I return to clinical care I will be reminded to, quite simply, “speak English.”




My first NBC bylines and 15 minutes of fame

I’ve been working up a storm here at 30 Rockefeller center- NBC’s headquarters in Midtown, NYC. I do a lot of “vetting” medical studies- looking at the “embargoed” research that is going to come out in the next few weeks and help decide which ones might be “newsworthy” for the general public. But I’m also a sort of jack or all trades when it comes to medical research: I might be asked to write up a list of heart healthy foods, dispel some myths about concussions or summarize the current research on treating headaches.

bullyingBut I’ve also found some time to keep writing. I have a regular gig writing about healthy aging and palliative care for a Stanford website. I also have written two pieces so far for NBC.com:

In general it’s a lot like medical school. Mostly studying and research but with some moments of excitement mixed in. In med school we have something called “pimping” where a superior puts you on the spot and asks you a question in front of everyone while you are rounding on your patients. “Hayley, what are the reasons that we need to thin a patient’s blood with Heparin before just keeping them on Coumadin?” They might ask. It’s hardly surprising that I love it- I love having to think on my feet. Here it’s no different, except that the “attending physician” in this case might be NBC Nightly News anchor Brian Williams and he might be asking you in front of the whole team whether or not something is new in the medical community or constitutes breaking news. But the thrill is essentially the same thing.

I also needed to share a project I had been working on last year with the University of Pennsylvania- and my good friends in the alumni office (shoutout to LSK)- it was a video created for the “Making History” Campaign and I was asked to represent the medical school. It was certainly a shock: do they know I’m the girl who lost her keys a grand total of 3 times year? Or the one who forgot her white coat on the first week of rotations? I’m also the girl who essentially subsisted on Trader Joe’s frozen edamame and trail mix while my classmates cooked gourmet dinners, raised puppies and ran marathons– but obviously an honor. Most importantly it was an honor to be featured alongside my mentor Dr. Kovarik. So here is a little sneak peak:

Study Shows that Smart Phones Can Help Skin Docs Consult on Patients in the Hospital

One of the things I’m learning is how to best describe scientific research in simple terms. Below is piece I wrote about a new study from some of my Penn Derm mentors that was just published in JAMA Dermatology:

Doctors consulting using a smartphone “app” might be just as good as an in person visit from a doctor, according to a new study from the University of Pennsylvania. Many patients in the hospital end up with skin problems but most hospitals don’t have dermatologists to evaluate them.  A possible solution may lie in a an “app” that lets doctors look at pictures of the skin problems and tell hospital staff whether or not the patient merits an in person visit.

 The study, published Wednesday in JAMA Dermatology, took 50 patients from the Hospital of the University of Pennsylvania who needed to be seen by a dermatologist. Researchers took a picture of the skin problem using a smartphone and sent it virtually to dermatologists (“teledermatologists”) who provided an opinion. Another dermatologist saw each of the patients in person and recorded his decision: did the patient really need to be seen that day, the next day, sometime during their hospital stay or could it wait for an outpatient visit? He also wrote down whether the patient needed to have a biopsy (skin sample).

When the in person dermatologists decided a patient be seen the same day, the teledermatologists agreed in 90 percent of cases. And they agreed in 95 percent of cases where the in-person dermatologist had recommended a biopsy. The doctors completely agreed on a diagnosis 82 percent of the time, and partially agreed in 88 percent of cases, which is the standard variation expected between doctors.

This is encouraging news in a time when many areas of the United States have very little access to dermatologists. “In addition to addressing physician shortages from a clinical standpoint, teledermatology programs are very important for vulnerable citizens in the United States and abroad,” said Dr. William James, author in the study and past president of the American Academy of Dermatology. “It is wonderful that the impact of these teledermatology consultations continues to expand.”

Journalism roundup

IMG_8285It’s been strange to be out of the clinical world for this long. Sometimes I find myself striving to remember the name of a disease or drug that would have been second nature to me last year. On the other hand, it’s been great to look at medicine from the outside in – it’s given me a perspective that is hard to achieve when you are mired in the thick of it.

Here are some pieces that I’ve recently published. Any thoughts, suggestions and comments are welcome!

  1. Flu shot story + podcast/slideshow
  2. An opinion column on the Affordable Care Act (aka “Obamacare”) and medical students
  3. Cost containment in dermatology. I got to interview the president of the American Academy of Dermatology! 
  4. Local forum on the Affordable Care Act
  5. Superheros at the children’s hospital!

In case you missed them: there are also a few pieces that I published while in IndiaIMG_4202

  1. Living with leprosy
  2. Unhealthy eating in college campuses
  3. Leprosy in the modern world

Seat-mates and the Zombie Apocalypse- putting my public health work into practice

Sunset in New Delhi Airport where I met scores of interesting people

Sunset in New Delhi Airport where I met scores of interesting people

Sometimes being friendly and non intimidating can be the worst- you get roped into weird conversations that seem to go on forever. But sometimes it really serves me well. My journalism school friends have observed that I can get pretty much anyone to talk with me. This is clearly a boon for a reporter or a doctor. I’ve also exploited that skill for fund raising, networking but also just for fun.

Sidebar: On the plane back from LA a few years ago I was seated next to Tony Shalhoub (actor in the TV series “Monk”). He struck up a conversation after seeing my college physics textbook (wow am I glad not to be a pre-med anymore). We ended up talking the entire flight about life, acting, germaphobia and Martha’s Vineyard. Turns out he has a daughter my age. We shared an Emergen-C and he gave me his email in case I ever needed a place to stay on the vineyard. Random but very fun.

Fast forward to now: Flying back from the Tropical Medicine conference on Sunday I ended up with the trifecta of airline badness: middle seat, last row, close proximity to crying baby. Curse the fates! But I was seated next to a young air force engineer/pilot who was making hysterical wisecracks about our flight delay. We ended up talking the whole flight and he taught me to play Candy Crush (still don’t understand the appeal) and helped me with my Crosswords. The flight flew by. On the second leg of my journey I struck up a conversation with my seatmate who literally could not have been more of an Oregonian- he was friendly, wearing a plaid shirt and had a hipster mustache with waxed ends. I was just waiting for him to pull out a banjo and some sort of artisan pickled food item. He was reading World War Z so we started talking about zombies and he casually mentioned that the CDC has a plan for the zombie apocalypse.

If you're ready for a zombie apocalypse, then you're ready for any emergency. emergency.cdc.gov

I was so excited to go home and research this. Turns out that he is right: the CDC absolutely has published materials delineating how people should brace for the zombie apocalypse. I guess it helps encourage basic emergency preparedness. Turns out people are more willing to prepare for the zombie apocalypse than, say, a natural disaster (sigh). Suppose I shouldn’t be surprised given that there is apparently a commercial market for a $24,000 zombie apocalypse survival kit.

Get A Kit, Make A Plan, Be Prepared. emergency.cdc.govSo how does one prepare for the possibility of a siege by the un-dead? According to the CDC everyone should have an emergency preparedness kit and plan and stockpile basic necessities in your home.

From the CDC website:  “As it turns out what first began as a tongue in cheek campaign to engage new audiences with preparedness messages has proven to be a very effective platform. We continue to reach and engage a wide variety of audiences on all hazards preparedness via Zombie Preparedness.” Dr. Ali Khan, Director of CDC’s Office of Public Health Preparedness and Response, agrees: “If you are generally well equipped to deal with a zombie apocalypse you will be prepared for a hurricane, pandemic, earthquake, or terrorist attack.”

On the site is a virtual comic book, posters, a novella and even a lesson plans that uses the idea of a zombie apocalypse to help teach kids about pandemics.

Love the idea of making a public health message a little more fun. BRB gotta go stockpile some water, a flashlight and maybe some kind of zombie killing laser. If I had never sat next to the Oregonian guy I would never have known. The things you learn on planes.

My semi charmed life + a plea

It feels a bit inappropriate that I’ve been IMG_8627so derelict in my blogging given that I’ve been at journalism school. But the reason for my silence is not that I’ve gotten lazy, lost interest, or met a boy and eloped in the Caribbean. Rather, I’ve just been focusing on…well, journalism.

IMG_8745For those who don’t know. The second part of my fellowship entails spending Sep-Dec at Stanford’s journalism school. I attend classes with the journalism grad students and write articles for the Peninsula Press- a news website for jschool that has major media partners including KQED (Northern California’s NPR station) and SF Chronicle.

Let me just say that I have never been happier. Why?

School. It’s fun, engaging , challenging and I have unparalleled support from my professors- whom I regularly communicate with on a daily basis. I’m learning a lot about journalism and multimedia and I know that these skills will serve me quite well in my career. During the course of this semester I have learned how to record/edit my own audio and pictures/video. Most of all I have gotten to speak with and interview such interesting people: the head of the American Academy of Dermatology, a woman who will have health insurance for the first time in five years, a gay Assemblyman who is married to a doctor, a medical student seeing patients for the first time, a State Senator, the Chief Medical Officer of the AAMC. And tonight? Off to moderate a two hour panel about the Affordable Care Act!

Friends. It was almost weird how quickly I become comfortable with my colleagues. They are smart, funny, crazy accomplished (many are already established journalists- some at publications like the Wall Street Journal) and they welcomed me with open arms despite the fact that I will be leaving all too soon (a fact we like to collectively ignore).

Quality of life. So living in Palo Alto is IMG_8708like living in Disney World. It’s perfect. Sometimes too perfect but for 4 months it’s…well…perfect. I actually live on a couch in a professor’s house which is interesting because I have no door but she is lovely, it’s on campus and I get to walk an adorable dog every day.  I have been getting 8 hours of sleep, exercising, reading, staying in touch with friends from home, spending time with new friends here.

In med school it’s easy to forget about time for yourself. And so this hiatus has reminded me that personal care is not selfish- it helps me to be happier and thus more productive and a better citizen of the world. Hope I can import this back with me going forward.

I hope this wasn’t too obnoxiously smug. And clearly I’ve drank a bit of the uber perfect Palo Alto KoolAid. And trust me, things aren’t perfect. But I’m in a good place.

Related-ish plea: Does anyone know of any leads of an apartment/couch/sublet/cardboard box I can call my own in NYC from Jan through May? Needs to be convenient to 30 Rock (Rockefeller Center) for my next gig at NBC News. It’s getting down to the wire for me. Many thanks in advance.

Tropical Medicine and Twitter

ImageI was invited to travel to DC to attend the American Society of Tropical Medicine and Hygeine’s annual conference in Washington DC. I was delighted because my clinical interest is skin disease and global health/tropical medicine. So I left sunny Palo Alto and flew across the country to re-immerse myself in some good old fashioned medical learnin’.

The conference so far has been incredibly exciting. I gleefully texted friends that I was psyched to see several sessions solely dedicated to helminths (parasitic worms). Only I would be that big of a nerd but, hey, as Popeye would say “I yam what I yam.”

To be honest, this conference is very technical in many ways: lots of really cool basic science and research about malaria, dengue fever and other global health issues. I understand bits and pieces from the clinical side but a lot of the science goes straight over my head. It was admittedly fun listening to clinical content- I didn’t realize that I would long for the days of hearing “thrombocytopenia” casually dropped in a conversation.

What has been new and excited for me is approaching this from the angle of a reporter. I walked into the press room with a bit of trepidation. But, to my shock, I am a reporter now and people do take me seriously- partially because of the title of my fellowship. I loved reading the press releases and seeing what the conference organizers felt would be newsworthy: everything from a study comparing dengue fever in two parts of the country to new vaccines for malaria.

The other fun thing has been engaging in social media. I am fairly new to twitter but am really starting to appreciate how it keeps me connected to people in journalism and health care who curate and amass content that keeps me interested and on top of the news.

During MedicineX (a medicine and technology conference I reported from in September) it seemed like everyone was on twitter. (Here’s a clip from a video interview I did about this subject:

Here the “twitterverse” has been markedly more limited. Less than 10 people seem to be regularly tweeting about the conference. For those who don’t know- it’s possible to have a conversation on twitter by including a hashtag (denoted by the # sign) in your tweet. Then, when you click on the hashtag- you see everyone who is talking about that subject. In this case the hashtag was #TropMed2013 so a sample tweet might be “Now we can protect kids from Japanese Encephalitis. This year a JE vaccine safe for children was rolled out #TropMed2013″

I ended up meeting a bunch of like minded people during these conversations and we got to meet in person and talk about global health and science and reporting.


The other highlight was a panel entitled “Global Health and the Media: From Shoe-Leather Reporting to Television to Twitter” that was moderated by the amazing Dr. Michele Barry- one of the heads of my fellowship and an amazing mentor. On the panel were Donald McNeil (NYT global health reporter), Michaeleen Doucleff (NPR global health producer/reporter), Emily Judum (from Global Post) and Penny Duckham (from Kaiser Family Foundation).

The whole panel was fantastic. I won’t rehash everything but there were a few key highlights:  McNeil started off talking about his experience reporting on polio in Pakistan and how he did a story regarding how vaccinators were being killed. His experience reflected deep, old fashioned  investigative reporting and it was riveting. Ducleff spoke mostly about social media and she was incredibly optimistic (not something you get a lot of in the journalism world): “it’s easier than ever for scientists to be published” she told the crowd. Clearly there are no excuses why scientists (including doctors) shouldn’t be communicating their work to the public.

The night ended with a real treat for me: dinner with the whole panel. I got to hear about McNeil’s experience with the CIA, the work that the Kaiser Foundation is doing with the ACA, what it’s like to work at NPR. We talked about pay structure for journalism and what journalists owe their sources in terms of anonymity. I was honored and happy to be included in the conversation.

Not only that- but tomorrow there is a panel on tropical dermatology. Pretty sure they designed this conference just for me. In the meantime, text me if you want live updates on parasitic worms!