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Photo: Russell Ledet
Russell Ledet in his job as a security guard at Baton Rouge General Medical Center in 2010 and as a medical student there in 2020.

As readers know from my post on Shagufa Habibi, I am one of a group of people who believe in this young Afghan immigrant and her dream to end child marriages, first by gaining relevant skills. It doesn’t matter that the dream seems impossibly big. After all, when people believe in you, big things do happen. Young Greta Thunberg may not have ended global warming, but you know she won’t stop until there are serious changes.

Today’s story is about a young man from a poor family in Lake Charles, Louisiana, who had people who believed in him.

As Kellie B. Gormly wrote at the Washington Post, “Russell J. Ledet spent four years patrolling the doctors’ parking lot at Baton Rouge General Medical Center, where, as a security guard, he watched people in white coats come and go from the building. He fantasized about what his life could be.

“In a moment of bravery one day, Ledet was walking with a doctor and asked: ‘Hey, do you think I could shadow you?’ To Ledet’s surprise, the doctor, a surgical resident, replied: ‘Yeah, why not?’ Ledet recalled.

“Whenever Ledet had free time over the next several months, he was in the operating room and visiting patients with Patrick Greiffenstein.

“ ‘It just so happened, God put me in the right place at the right time, and it worked,’ said Ledet, 34, of Gretna, La.

“Now, seven years after he was a security guard at Baton Rouge General Medical Center, Ledet is assigned to the hospital as a medical student. He is doing his pediatrics rotation at the Louisiana hospital and is in his third year at Tulane University School of Medicine. …

“He sometimes runs into people he used to work with when he was a guard. Once when he was recently in the emergency room, one of them yelled out: ‘You did it! You actually did it!’

“Ledet grew up in Lake Charles, La., with a single mother who worked as a certified nursing assistant. They relied on food stamps to eat. After high school, Ledet joined the Navy and was stationed in Washington, D.C., from 2004 to 2007. He entered the Reserves, and his wife — Mallory Alice Brown-Ledet, whom he met in high school — persuaded him to go to college while she worked at a bank. They moved back to Louisiana in 2009, and Ledet enrolled in Southern University and A&M College in Baton Rouge.

“Ledet initially thought he would become a social worker, like the ones who had helped his family when he was a child. But one day, his chemistry professor told him that based on his performance in class, he should major in biology or chemistry. Ledet took on both sciences as a double major. That same year, he started the security-guard job to help support his family — which included a new baby, Maleah. …

“The doctor whom Ledet shadowed 10 years ago — now is a trauma surgeon at University Medical Center in New Orleans. … ‘It’s hard not to like him right away,’ said Greiffenstein, explaining why, in part, he said yes when Ledet asked to shadow him. He said Ledet’s path to becoming a doctor has been ‘remarkable.’

“Ledet graduated from college in 2013 and … moved east with his family to attend New York University, where he earned a PhD in molecular oncology in 2018. … His research on prostate cancer earned recognition, but Ledet fondly recalled his shadowing days in Baton Rouge and felt called to the clinical, hands-on work of a physician. …

“About an hour after his second daughter, Mahlina, was born, Ledet got an email from Tulane University in New Orleans: a full scholarship to medical school. …

“Over the summer, Ledet started his third-year rotations, after indicating his location preference for Baton Rouge General Medical Center. He was thrilled when he got it. …

“He plans to open a clinic in New Orleans offering mental health services for marginalized communities. And to be a better business owner, Ledet managed to squeeze in one more project: He is working on an MBA while in medical school. …

“ ‘I’m just grateful, man,’ he said. ‘I’m grateful I made it here. I’m grateful that I didn’t give up. I’m grateful that people believed in me.’ ”

Read more here.

There are just some people who if they say they are going to do a thing, then you know it’s going to happen.

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Photo: Suzanne Kreiter/Globe staff
Jen Andonian and Matt Shearer, both epidemiologists, recently got married at Massachusetts General Hospital.

Where there’s a will, there’s a way. Many group events are being put off because of the war against coronavirus, but recently I’ve been learning how weddings, Passover feasts, funerals, conferences, and the like are probably managed in other kinds of war.

Here are two wedding stories from the Boston Globe.

Liz Kowalczyk reports on Jen Andonian and Matt Shearer, who “had it all planned: her burgundy floral dress, his matching checked tie. They live in Cambridge, but chose Ann Arbor, Mich., where they met as graduate students, for their simple courthouse wedding ceremony in March with immediate family. A reception for 75 guests would follow the next day at her parents’ lakeside restaurant.

“Then the fast-moving coronavirus began spreading through the world — and the United States. Andonian and Shearer, both epidemiologists on the frontlines of COVID-19 — she at Massachusetts General Hospital, he at Johns Hopkins Center for Health Security — knew they could not ignore the risk of a large celebration. …

“When she told her coworkers at the MGH Center for Disaster Medicine the next day, a colleague joked: What about just getting married at the hospital? Her co-workers turned the offhand remark into an actual plan, executed in the midst of exhausting 12-hour workdays.

During quick breaks from setting up coronavirus testing sites and expanding intensive-care units, team members ordered flowers and vanilla cupcakes and devised a music playlist. Nurse Eileen Searle applied for a one-day state certificate to perform a marriage ceremony. …

“On Friday, Andonian, 30, and Shearer, 36, were married before a small group of disaster medicine colleagues, all wearing surgical masks and sitting six feet apart to prevent the spread of germs, as the sun streamed in from the windows high in the light-blue dome. It was a welcome but brief break amid the relentless arrival of patients ill with a relentless virus; the number of patients sick enough with COVID-19 to be admitted to Mass. General had more than doubled over the course of the week, to 61 on [March 27] alone.

” ‘This may not have been the wedding you wanted, but it is clearly the wedding MGH needed,’ began Searle, whose job includes training nurses to properly put on protective gear. ‘Thank you.’ …

“When they told their families about the plan to marry at the hospital, Andonian said they had mixed feelings. ‘Everyone was sad, but after seven years, they were ready for us to get married,” she said. …

“The couple arrived about 15 minutes before the ceremony was scheduled to begin at 11 a.m., walking past a long table outside the Ether Dome set with cupcakes to share, a cake for them to take home, tiny colorful containers of bubbles, and a gift bag hiding a bottle of champagne. ..

“As Andonian waited in the hallway, Shearer stood between a white plaster statue of Apollo and a glass case containing an Egyptian mummy, part of a small collection of artifacts [in the MGH museum].

” ‘You ready?’ Searle asked.

” ‘Let’s do it,’ he said.” More.

Another Globe story detailed how a photographer that a couple had never met was determined to put together all the traditional pieces so that a soldier could “elope.”

Megan Johnson writes of bride Victoria Pass, “ ‘If you still want to get married, I definitely want to get married,’ said Victoria. ‘We gotta figure this out.’

“The couple decided they’d wed at Chicopee City Hall. But with none of their family and friends in the area, Victoria wanted to have a photographer capture the moment. They started making phone calls, and stumbled upon Dani Klein-Williams, a Northampton-based photographer.

‘They said they were just planning a very quick, no-frills elopement at Chicopee City Hall,’ said Klein-Williams. ‘I was like, “Okay, can you give me two hours? I’m gonna put something even more spectacular together for you.” ‘

“Klein-Williams called Blantyre, the Tudor-style Relais & Châteaux property in Lenox, Mass. … Within two hours, she got approval from Blantyre, which was already shut down for their annual winter closure. …

“Next, Klein-Williams called her favorite wedding planner, Tara Consolati, who also happens to be ordained. Though she had never performed a ceremony before, she was on board to officiate. Carolyn Valenti, a Berkshires-based florist, offered up a blend of snapdragons, hyacinth, and other blooms. ‘She said, “I have all these gorgeous flowers and they’re just going to rot and die,” ‘ said Klein-Williams.

By the end of the conversation, she discovered that Valenti had a house guest who could bake. Without her baking equipment on hand, however, they dumped the contents of an oversize can of tomatoes, sterilized the can, and used that as a frame for a small wedding cake, topped with berries and flowers.

“[Klein-Williams next] … reached out to Mike Murray of Summer Wind Wedding Films, who volunteered to live stream the event, so Victoria and Jerrod’s family and friends could follow along.” More.

Oh, the kindness of strangers!

Photo: Dani Klein-Williams
Victoria and Jarrod Pass eloped in the Berkshires after having to cancel their 60-guest wedding in Las Vegas. A photographer they hadn’t met, Dani Klein-Williams, was determined the couple should have all the traditional features of a wedding.

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Photo: Andrew Nixon / Capital Public Radio
Tony Price, formerly homeless, grows tomatoes in his small patio garden and shares the produce with friends and neighbors. Now that he has permanent housing, he’s able to take better care of his health.

In the last decade, there’s been a lot written about how a small percentage of people use hospital emergency rooms on a regular basis and what could be done to stabilize them and save money. In today’s story, we find that providing housing for homeless patients can yield positive, long-term results.

From Pauline Bartolone and Kaiser Health News at Capital Public Radio: “Hospitals in Sacramento and around the country want to get [homeless patients] off the streets, to improve their health and minimize unnecessary visits to the ER. … That’s why many hospitals are stepping outside their role as medical providers to invest heavily in housing for homeless people.

“Dignity Health’s ‘Housing With Dignity’ initiative got Tony Price into an apartment, paid his rent for four months and set him up with a social worker who helped him become eligible for permanent housing. …

“A 2002 study showed that providing housing and supportive services, to more than 4,600 mentally ill homeless people in New York City dramatically reduced their presence in hospitals, shelters and correctional facilities. …

“Health insurers are starting to invest in housing, too. Dignity and other Sacramento hospitals have long funded ‘respite’ programs that shelter homeless people for a few weeks after their hospital stays, but the goal of ‘Housing With Dignity’ is to keep them from being homeless again. …

“Ashley Brand, Dignity’s director of community health and outreach, said the program is helping address the hospital chain’s longstanding challenge of ensuring that homeless patients get follow-up care after they’re discharged. …

“No matter how many times Tony Price visited Sacramento hospitals while he was living on the streets, he never got well. His diabetes was uncontrolled, he repeatedly lost the drugs he was taking for anxiety and depression and, he says, he regularly drank himself into ‘oblivion,’ sometimes consuming as much as half a gallon of vodka a day. …

“Price qualified for the services offered by ‘Housing with Dignity,’ which put him into a one-bedroom apartment in Sacramento’s sprawling North Highlands neighborhood in May 2015 and assigned him a social worker, Chris Grabe, who drove him to medical appointments. …

“He has been off the streets for nearly two and a half years, and he’s been to the hospital only once since January. … He now gardens, and he recently volunteered at a church and as a leader of an Alcoholics Anonymous group.”

At Capital Public Radio, here, you can read how Grabe stuck with Price through early relapses and what is needed to expand this effort to more people.

Hat tip: House of Hope CDC on twitter.

12/8/17 Update: Meanwhile in Boston, where one in four Boston Medical Center patients is homeless or in dangerous housing, BMC is partnering with local housing organizations and spending $6.5 million to help patients. This is the latest manifestation on BMC’s whole-patient approach to healing. Read about it here.

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Maybe I could be a clown. One of my brothers has clowned for years, mostly at his church in Wisconsin. He really enjoys it.

This story by Elianna Bar-El story at Good magazine makes me want to know the same satisfaction medical clowns get from helping sick children. But clearly, it takes lots of training.

“On a recent visit to Wolfson Medical Center on the outskirts of Tel Aviv, Israel, Yolana Zimmerman is met with audible sighs of relief.

“ ‘Great! You’re here! We need you,’ says a nurse.

“Zimmerman is not a medical doctor. In fact, she casts quite a contrast to the typical image of a doctor with her pink leggings, cupcake apron, and eyelet bloomers — not to mention the underwear on her head and the stuffed monkey in her hands.

“Yolana ‘Yoyo’ Zimmerman is part of a team of medical clowns called Dream Doctors. The pioneering organization started in 2002 with three medical clowns at one hospital and today facilitates the work of more than 110 clowns across 28 hospitals in a country increasingly recognized as the vanguard of medical clowning. After this past April’s devastating earthquake in Nepal, for instance, the Israeli government sent an envoy from Dream Doctors to Kathmandu to work with affected children. As you might expect, the medical community is taking notice of the tiny nation’s zany medical practitioners. …

“ ‘Medical clowning has developed in Israel in a different way than anywhere else in the world,’ says Professor Ati Citron, creator and director of University of Haifa’s Medical Clowning program. ‘Medical clowns were absorbed into the medical system as part of the staff.’ …

“Walking into [a] hospital room, without missing a beat, Yoyo directs her attention to a religious man sitting beside his daughter who is sleeping in a hospital bed. He is obviously reading from the Bible. ‘Is that a good book?’ Yoyo asks. ‘I think I’ve heard something about it. … Who wrote it again?’ The father looks up at her, grinning in surprise. In the same moment Yoyo doubles over with genuine laughter, igniting a cacophony of noises from a squeezable rooster in her apron. …

“In Israel, medical clowns are involved in over 40 medical procedures, including accompanying patients to CT scans, X-rays, MRIs, chemotherapy, radiation treatment, physiotherapy, and rehabilitation. Clowns in Israel also work solo to initiate a more interactive, one-on-one relationship with patients. … Dream Doctors, which works closely with Israel’s Ministry of Health and the University of Haifa … also hosts monthly workshops for the clowns where medical staff provide them with a range of medical knowledge and training on hygiene, vaccinations, before-and-after procedures for entering a room, role-playing, case studies, and more.”

Read all the details at Good.

Photo: Ziv Sade

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I was first drawn to Joseph P. Kahn’s story about clowns in children’s hospitals by the cute pictures — and the fact  that my brother sometimes performs with a clown troupe at his church.

But what I especially appreciated learning from the article is that hospital clowning today is not just about getting a laugh out of a sick kid, important as that is. It’s also about giving children a little bit of control — to point out that the clown is doing something wrong, for example, or even to say the clown is not welcome and should go.

Kahn writes, “For hospital clowns Joyce Friedman and David Levitin, no two tours of duty are quite the same. Which is just how they like it.

“During rounds at Boston Medical Center, Friedman (a.k.a. Frizzle) and Levitin (Toodles) showed off their improv skills room by room, careful to assign an active role to each young patient they visited.

“At the bedside of 10-year old Cheyanne, the pair held a mock marriage ceremony, prompting Cheyanne to exclaim, through her oxygen mask, ‘You forgot to exchange vows!’ …

“Handed a joystick, a child might be encouraged to ‘control’ the clown as he or she chooses. Another patient, nervous or scared, might not want a visit at all. Either way, something positive comes from the encounter.

“ ‘Being empowered is really a key component of the healing process,’ says [Children’s Hospital endocrinologist Dr. Michael] Agus. ‘The more passive you are with an illness, the more challenging it is to heal.’ …

“Whatever a patient’s age or condition, said [clown Cheryl] Lekousi, she and her colleagues focus on the positive, even in the bleakest situations.

“ ‘Our message to the kids is, we’re a witness of you, of your childhood,’ said Lekousi.”

More here.

Photo: Dina Rudick/Globe Staff
Christopher reacts to the entrance of Cheryl Lekousi (a.k.a. Tic Toc).

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I learned something new about gratitude today.

It seems that years ago the people of Boston sent emergency aid to Nova Scotia, and now every November, Nova Scotia sends Boston a Christmas tree.

Geoffrey Agombar writes in Canada’s Annapolis County Spectator, “All Nova Scotians are familiar with the legend of Boston’s speedy and heroic support when just week’s before Christmas 1917 two ships collided in Halifax Harbour leaving 2000 dead, thousands injured, and flattening surrounding buildings. Every year since 1971, Nova Scotia has sent a big thank you card to the city in the form of a 12-16 metre tall Christmas Tree.” More.

Canada Online has a story by Susan Munroe: “For more than 40 years it’s been a Christmas tradition for the province of Nova Scotia to ship one of its biggest and best Christmas trees to Boston to thank the people of Boston for the emergency assistance they provided after the Halifax Explosion in 1917. Relief from Boston was the first to arrive the day after the horrendous explosion which killed 1,900 people and wounded another 9,000. The New Englanders were also the last to leave.

“The 2012 Christmas tree is a 70-year-old, 15-metre (50-foot) white spruce donated by Paul and Jan Hicks from Jordan Bay, Shelburne County, Nova Scotia. On November 13, hundreds of children from local elementary schools attended the Christmas tree cutting ceremony, where Nova Scotia storyteller Bruce Nunn read from his book Buddy the Bluenose Reindeer and the Boston Christmas Tree Adventure.

“The tree was loaded onto a flatbed truck and made its way to Boston. It arrived on November 16, and was escorted by the Boston Police Department to the Boston Common where it is being installed. The Christmas tree will be the focal point of the annual Boston Common Tree Lighting Event on November 29. The ceremony will be televised and is expected to draw a live crowd of about 30,000. The ceremony will feature two performances from the Nova Scotian percussion ensemble Squid, and remarks from [a representative of the ailing] Boston Mayor Thomas Menino and the Deputy Premier of Nova Scotia, Frank Corbett. The RCMP and Santa Claus will be on hand, and there will be fireworks too.”

Update 4/20/13 — After the Boston Marathon tragedy, Nova Scotia is making a $50,000 donation to Massachusetts General Hospital. Read.

Photograph: The Spectator

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I’m happy to see some long-neglected murals being restored in Harlem. Robin Pogrebin has the story in the NY Times:

“When the Works Progress Administration [WPA] commissioned murals for Harlem Hospital Center in 1936, it easily approved the sketches submitted by seven artists, which depicted black people at work and at play throughout history. The hospital, however, objected, saying four of the sketches focused too much on ‘Negro’ subject matter … .

“Protesters rallied around the art, though, lodging complaints as high as President Franklin D. Roosevelt, and the murals ultimately prevailed.

“Over the years, those wall paintings deteriorated or were obscured by plaster. Now they have been restored and brought front and center as part of a new, $325 million patient pavilion for the hospital, on Lenox Avenue at 135th Street that will be unveiled on Sept. 27. …

“The artists — the last of whom, Georgette Seabrooke, died last year — were not well known and their murals portrayed ordinary people going about their daily lives. Vertis Hayes’s ‘Pursuit of Happiness’ panel traces the African diaspora from 18th-century African village life to slavery in America to 20th-century freedom; from agrarian struggles in the South to professional success in the industrialized North.” More.

The WPA cost money, but it put a lot of people to work. And look at all the great things that were created! I especially love the idea that unemployed people were paid to paint murals, write and produce plays, interview ordinary Americans for the National Archives, and record folk music. I know it was a stressful time, but thinking about the art makes me almost nostalgic.

 

Photograph: Karsten Moran for The New York Times
Elizabeth Kolligs works on restoring Vertis Hayes’s “Pursuit of Happiness” at Harlem Hospital.

 

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In the hospital waiting room, the Family Liaison is handing out a toy packet (feather included) to a two-year-old with sparkles on her shoes.

The toddler’s father is saying, “Why is my pocket all wet? Oh, it’s the water bottle. I thought my water broke.”

There’s a tank for tropical fish provided for our entertainment by Something Fishy Inc. The Family Liaison shows a little boy where Nemo the Clownfish is hiding and points out his cousin, the Tomato Clownfish.

I wish I had video because the tank is full of waving creatures that look like plants but aren’t. Coral? Anemone? If you know what they might be, please leave a comment.

A children’s playroom is in the works. Not sure if Wolf Blitzer on the television is educator-approved, but the nautical theme works nicely with the fish tank.

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Dr. Paul Farmer, the subject of a great Tracy Kidder book called Mountains Beyond Mountains, has spent many years delivering medical care — and working to alleviate poverty — in remote areas of Haiti. His nonprofit organization, Partners in Health, takes the word “partners” seriously. The teams do not tell the locals what is good for them but makes a point of learning from them and helping them get what they need.

In recent years, Farmer has been in demand in other countries, too. One focus area has been Rwanda. I liked a recent Boston Globe article on the approach to building a Partners in Health hospital there.

“The designers quickly realized that the challenge was not simply to draw up plans, as they had first thought, but rather to understand the spread of airborne disease and design a building that would combat — and in some cases sidestep — the unhealthy conditions common to so many hospitals.

“Learning from health care workers that hospital hallways were known sites of contagion, poorly ventilated, and clogged with patients and visitors, MASS Design decided that the best solution would be to get rid of the hallways. Taking advantage of Rwanda’s temperate climate, they placed the circulation outdoors, designing open verandas running the lengths of the buildings. …

“When it came to building, MASS Design looked at the Partners in Health model of involving local poor communities in health care, and realized that they could apply the same ideas to the construction process. The hospital was built entirely using local labor, providing food and health care for the workers. Unskilled workers received training that would help them get more work; and skilled laborers, notably the Rwandan masons who built the hospital’s exterior from carefully fitted together local volcanic stone, refined their craft and found themselves in demand all over the country. The construction process also beefed up local infrastructure — new roads and a hydroelectric dam — creating more jobs and literally paving the way for future projects.”

To paraphrase what Farmer often says, the biggest challenge to health is poverty. Read more.

Update on the designers from the June 19, 2012, Boston Globe.

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