Report date
November 2021
Learning Log

With the start of Summer 2020 here in South Minneapolis I began to try and reconcile my passion for public health practice and epidemic control, with the sudden global spotlight on social injustice in my own backyard. That convergence of circumstances led me to reexamine some of the most important lessons I thought I had learned over twenty years working in emergency medicine and global health. I started to wonder about some of the stark similarities in human behavior I had observed among populations under duress but living on the most extreme ends of resource-rich and resource-limited society, both domestically and abroad. And I saw the repercussions of these dynamics play out daily with my patients in the ER, as well as on my commute to and from work.

Frameworks I learned in grad school like “the social determinants of health,” or in med school like “standards of evidence-based approaches” seemed to fall short in a novel pandemic context. At the same time that these bedrocks of my years of training and practice began to falter, I started to question my own sense of resilience gained from living and working in austere environments by seeking to help other people manage their major crises. I thought I had earned a certain type of toughness, only to be surprised at the level of my traumatic stress response from the events of that summer.

This was the setting that my learning journey with the Bush Fellowship started, even before I submitted my application. I began to reflect on the undeniably large gaps in my own mental model of the world, and question my personal capabilities to effectively deal with problems I found myself immersed in. I realized that I needed new frameworks to help me better understand the complexities of human systems and service delivery around me, along with new knowledge and skills to advance my career goals around health equity. It became increasingly clear that another diploma or credential wasn’t the answer.

After carefully reviewing all the online Bush application guidance, I was inspired to think through some interesting and creative ways in which I could explore professional enrichment and personal development. I started conversations with old friends to bounce ideas off of and trusted mentors to seek advice. Then as I progressed through the different stages of the fellowship application process, I found myself challenged by different stakeholders in the Bush network to broaden my scope, see a bigger picture, and aim to work with a bigger canvass as I developed my goals for a potential fellowship opportunity.

As a result of those conversations, I began to explore emerging paradigm shifts like trauma informed care. I've begun to enrich my own understanding of human biology of the stress response, and how our modern society has outpaced it's evolutionary advantage. Given the direct link between unmitigated traumatic stress and brain health I'm starting to see my ER patients and work environment with a much better appreciation of challenges like mental health and addiction services. Relatedly, I'm pursuing a more comprehensive understanding of the idea of safety, and how this operates both simultaneously and interdependently on five different levels; physical safety, psychological safety, moral safety, emotional safety, and cultural safety. Beyond the therapeutic environment of a hospital, I'm curious about implications of these concepts in our society more broadly.

I'm excited about learning strategies of how regulating our innate stress response can transform it from a potentially debilitating threat into a performance enhancing asset, similar to how professional athletes get themselves into a headspace that allows clutch plays when the stakes are high. I'm learning about best practices like appreciative inquiry and design thinking that offer new ways of questing assumptions, re-framing problems in human-centric ways, and designing durable solutions within complex systems like healthcare. The Bush Fellowship has afforded me opportunities to learn by doing and provided for the invaluable resource of world class coaching and mentoring as I set on my learning journey.