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Sizing Up Success

At a medical school interview last week, my interviewer asked how in my future medical practice I would define success. His question made me think about my current AIDS United AmeriCorps service, doing HIV, STI, and pregnancy testing at the Latin American Youth Center via the Washington AIDS Partnership. How, I wondered, should I gauge success in my current position?

Prior to this year, I had been taught to measure success quantitatively. My understanding and competence were measured in grades and countable facts. But there are no letter grades in AmeriCorps. As a quantitative thinker, I knew this would be a challenging adjustment for me this year.

One way to measure success, I reasoned, was via clinical outcomes. I could count how many of the youth who came back for repeat testing stayed negative for HIV, STIs, and pregnancy. However, in order to have positive clinical outcomes with the marginalized population I am serving (and hope to continue serving as a physician), I would need to combat all of the social determinants of health that make it difficult for my patients to improve their sexual wellness. While in an ideal world, I would be able to counteract peer pressure; poverty; stigma; and lack of family support, this isn’t realistic. Does that mean that I can’t be successful in my service? On the contrary, it means that I have to redefine success qualitatively.

As I sat in the interview room, contemplating how to answer the interviewer’s question, I recalled a recent experience testing a young man at the Latin American Youth Center. He had come in for testing with a panicked look in his eyes.

“Is there anyone I can talk to?” he asked.

“I’ll do my best to answer any questions you have,” I told him.

He explained that he had symptoms consistent with a diagnosis of herpes. He spouted worries and wrung his hands as he spoke.

“How will I ever be intimate with someone again? Will I ever be able to have children? I’m so stupid.”

I talked with him for more than a half hour, explaining that even if he did have herpes, he would still be able to live a long, healthy life. I explained to him that most people have herpes, and that while it isn’t curable, medications are available to treat outbreaks. I tested him for gonorrhea, chlamydia, and HIV and referred him to a nearby clinic for a physical exam. Finally, we discussed his sexual behavior and created a risk-reduction plan for increased condom and lube use. When he left, he stopped me.

“I just wanted to thank you. You have such a great energy, and you really helped me feel better,” he said.

This was a successful interaction. I didn’t diagnose him, prescribe medications, or relieve his symptoms, but I relieved his anxiety. He left the office with increased knowledge about his health, motivation to improve it, and greater peace of mind.
These factors, I told my interviewer, are how I will measure success in my career in medicine.

Posted By: Lily Gage, AIDS United AmeriCorps Team DC - Monday, February 08, 2016

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