"I am only one, but still I am one..."

“I am only one, but still I am one. I can not do everything, but still I can do something. And because I can not do everything, I will not refuse to do the something that I can do.”

~Vernon Jordan

“So what exactly are you two going to do when you’re done with all these degrees and training?”

Nearly 12 years had passed since I had seen Micah. We had been close all through high school, and I think it’s safe to say there was a definite school-girl crush. Micah is smart and savvy, and because he is also charming and very easy on the eyes, he gets to be direct. Really direct. More direct than most people would venture to be with a girl they’ve never met, and one they haven’t seen in 12 years. Truth be told, this is why I love Micah…the directness, but the locks of Patrick Dempsey hair don’t hurt.

Miranda and I were well into our second week of Ritualized Academic Hazing when I accepted Micah’s invitation to dinner. He lives not too far from the NIH campus, making the reunion too easy to miss. Plus, I had a sneaking suspicion that he and Miranda would be fast friends. I was right.

Over a cold and well-deserved beer, Miranda and I pondered Micah’s question, but not for long. Miranda and I are practiced at this response. It rolls right off the tongue and onto the pages of the numerous grants/scholarships/fellowships that ask the obligatory question, “So what are you gonna do with your life, anyway, and why should we care and give you our money?”

The reply goes a little something like this: As we continue to deplete natural resources, there is increased human encroachment into wildlife habitat. This provides increased opportunity for transmission of disease between people, wildlife, livestock and other domestic species. Altering ecosystems in this way threatens the health and well being of all species within the ecosystem, including people. Through increased productivity of domestic animals, it is possible to improve human health, and in turn, improve ecosystem health. As veterinarians specializing in the field of Global Health and Conservation, we aspire to apply our knowledge in a manner that will promote sustainable and efficient agricultural practices and preserve biodiversity. Through increased animal productivity, and resultant diminished human encroachment upon wildlife habitat, it is possible to reduce the threat of emerging and zoonotic disease in human and animal populations alike.

And that’s how we laid it out for Micah, but still something was missing. While I’ve uttered these words hundreds of times in as many settings, it always seems that the words don’t quite express what it is that truly compels me in my field. When I search for the words, I find instead I am drawn back to Loew Auditorium and May of my first year in vet school (2003 – the time flies). Dr. Pokras is at the front of the room, and in his usual way, he is inspiring my class just through his very presence. It’s Comparative Anatomy…the class where we learn what makes snakes, and turtles, and dolphins tick. That’s right; Dr. Pokras has actually brought in dolphins for us to dissect. We are all beyond excited, but no one is more excited than Dr. Pokras. He stands at the front of the lecture hall, leans into his crutches, and skillfully balances on one leg preparing to speak. Many years ago Dr. Pokras was diagnosed with bone cancer, and underwent an amputation. He has readily shared the story with us as a lesson on osteosarcoma and the horrible consequences of inadvertent extravascular administration of chemotherapeutic agents that are intended to stay inside of the blood vessels. He is an inspiration to us all on too many levels to count. He releases his grip on his right crutch, and props it against the podium behind him. He truns and faces us, raises his right hand, and waves it emphatically in the air. Loudly, “People, c’mon! Don’t think you’re not just as good as the M.D.’s. You are. Who cares? Who wants to be an M.D. anyway? How boring. I’m sad for them. They get to treat ONE species. They get to treat ONE species, and do you know what you get to treat? EVERYTHING ELSE! If you want to be a starfish doctor, you can be a starfish doctor. No one’s stopping you! Do it.”

That’s the thing…I want to be a starfish doctor. I do. I really really do. I want to save the starfishes, and the goldfishes, and the gold finches, and every other incredible species that makes our world wonderful, and beautiful, and magical. But I also want to save the people. I want to save them from disease and famine. I want them to be able to feed their goats, so they can breed their goats and have the protein from the milk. Sometimes I am afraid that I can’t, and sometimes people tell me that I can’t. There are times when I wonder why I am on a seemingly endless pursuit of degrees. There are times when I doubt the value of the alphabet soup behind my name. Sometimes I’m accused of being foolish and foolhardy. And if you aspire to a career in Global Health, you will feel the same way some days. When those days come, and they will…remember this…Do not be discouraged when naysayers tell you that you will never find a job, and if you do, it won’t pay nearly enough. You will find a job. You won’t be rich, but you will be wealthy, and everyone who ever told you otherwise will envy your wealth. Stay focused in your studies and remember that the degrees are important, but they aren’t everything. The letters behind your name don’t entitle you; they empower you. Use your knowledge and training to seize opportunities to make a difference. Respect is earned. At the end of the day and at the end of a career, the bank account and the alphabet soup won’t matter. Personally, I hope that in 30 years I can look back and there will be a woman farming goats in Nepal, a village elder, telling her neighbors about a community based development project I helped design - a project that saved her from losing her goats, her crops, and eco-tourism rupees; a project that helped her feed her family; a project that has brought income for medicines and school books; a project that saved the elephants and rhinos from extinction, so that her children’s children can hear these beautiful beasts feeding in the jungle, and know that they are real, and not just the fictitious heroes and villains of bedtime stories. It hasn’t happened yet, but maybe one day it will. And when that day comes, it will be clear that testimonies are more important than titles.

Micah left Miranda and I feeling inspired that evening. He planted a seed, and his enthusiasm for our dreams and goals is feeding that seed. I have long dreamed of starting my own Global Health/Vet/Conservation/Epi consulting firm after I finally get the last degree, but always thought it was a foolish dream…but aren’t they all? I’ve mused about this with Miranda on occasion, and she always says, “Ok, Jenni, we’ll do it.” But how? When? And then Micah said, “Why not start now? You can easily start a non-profit. This is what you do…” And there we were. For now, it’s still a pie in the sky dream, but we’re committed to it, and to Global Health. While it may feel impossible, it’s not, and we need to remember that this year will bring us one step closer. And while we are just two intrepid vets, who are admittedly green, and a little naïve; we are also two sharp women, we’ve done it before, we’ll do it again. If we don’t have the answers, we’ll find them. We can not do everything, but we can do something, and damnit, we will!

(top: NIH Nerd Camp Prom, bottom: The Real World House, D.C.)

Notes from Bethesda

Many of the Fogarty Scholars are intending to keep professional blogs, though we are all fairly uncertain of what this should mean. Certainly its obvious what a professional blog should not contain; and yet so much of the personal benefit of keeping a journal (on the web or not) of your experience, is to voice you personal thoughts and impressions of a place, as naïve and unsophisticated as they may come off to others. I really enjoy observing the differences and similarities between places, and to make generalizations about cultures even though I know that is unwise. Furthermore, since we hope this blog to be of use to other students interested in international veterinary medicine and veterinary public health, a travel blog listing the sights we’ve seen will not fulfill this purpose. Likewise, lengthy diatribes about our research endeavors will likely not be read by many!

And so, please bear with us as Jenni and I determine what is appropriate to share here. Our two weeks in Bethesda were quite significant, and so I share my impressions from them here. As I mentioned previously, all 34 Fogarty Scholars, all 34 International Scholars (paired to an American scholar) and a handful of postgraduate fellows (both American and International) came together for global health nerd camp (or perhaps it would better be called boot camp considering the long hours of lecture!) at the National Institutes of Health. It was an opportunity for us to learn from leaders in the field, be taught the basics of conducting clinical research in developing countries, and, most importantly, to get to know our peers. The best part of this program opportunity to learn from the other students and to be inspired by what they’ve done and what they intend to do in the future. What was most inspiring was meeting the international students and researchers. We have a terrible habit here in the States of assuming that people in other countries are generally incompetent – or at least of assuming that we can do everything better. Well, the people I met who are doctors and researchers from developing countries were a really remarkable bunch. They are a very smart group – indeed we can be confident that there are very bright minds doing great work in all the countries that Americans seem to think need the most help.

All in all it was an excellent two weeks. I turned thirty in the middle and had a really fantastic birthday. I had traveled home for the weekend to see my grandmother who was visiting from England. I spent the morning of my birthday with her and my family, and we had a great day visiting the Boston Harbor Islands. I then flew back to DC in time to make it to a barbeque at the home of one of my fellow Scholars (who is also in my MPH program at Tufts!) where there was cake and singing. When I finally arrived back at our hotel room, Jenni had covered my bed with balloons and bought a Tiramisu from La Madeleine! I certainly got a lot of attention that day!

Ritualized Academic Hazing (aka the NIH training)

As a quick background, we (Jenni and Miranda) were both selected as Fogarty International Clinical Research Scholars for 2009 - 2010, and we were both placed in Lima, Peru. The FICRS program is for roughly 35 health professions graduate students from the United States. It is a program to train students in global health clinical research. The vast majority of scholars are third year medical students, but there are a handful of epidemiology doctoral students, one dental student, and two vets (us!). Miranda is a third year DVM/MPH student at Tufts University. Jenni already completed here DVM at Tufts, and is now pursuing more letters behind her name, as a PhD candidate in epidemiology at Cornell. Each student from the States is paired with a "twin" from the country we are going to be working in. Miranda's twin is Bruno, a veterinarian from Lima who studies (among other subjects) bird flu in wild birds; Jenni's twin is Jose, an expert in tuberculosis.

We're pretty thrilled to have been chosen for this program! We are both interested in pursuing careers abroad, and specifically on investigating the way that animal health (both in wild and domestic animals) impacts both human health and human livelihood. This field of veterinary public health ranges from bird flu to food security to wildlife conservation. Being part of this program will give us a fantastic opportunity to develop great research skills, and to be initiated into the global health world.

All of the American and International Scholars traveled to the National Institutes of Health in Bethesda, MD for two weeks in early July. We were also joined by post-doc fellows who are already have established research programs in developing countries. For these two weeks, we attended lectures from experts in the field, had plenty of opportunity to get to know our peers, and slept for approximately 4 hours a night.... The lectures were great, though certainly overwhelming, lasting roughly 8 hours a day! As a veterinary student, I don't have much of a background in HIV and other STD research, and so these two weeks were a fairly steep learning curve.

The best part of the experience, however, was to get to know our peers, both the Americans and our international twins alike! This was an exceptionally smart group of people, certainly this group will be playing a major role in addressing the health issues that plague the developing world! However, aside from being smart and savvy, this was a group of genuinely interesting, compassionate, and friendly people. Never before have I been in such a large group of people, all of whom I felt were really fantastic individuals!

Tales of debauchery will not be shared here, but trust that we managed to have lots of fun getting to know the people will we working with (for instance, there are roughly 12 of us working in Peru). We managed to eat our way through our per diems with no trouble, we toured around Washington DC, and we even stalked the Real World house!

Now, I have traveled on to Seattle for more intense HIV/STD training, and Jenni has returned home to pack! More to come!

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