Gone!

Student auction raises $26,000 for New Haven service organizations.

An electric scooter, a week in a London townhouse and a squash game with the director of admissions were among the items that raised more than $26,000 in the seventh annual Hunger and Homelessness Auction on Nov. 19.

Dean David A. Kessler, M.D., one of the event’s auctioneers, set the tone for the levity to follow when he addressed a spirited crowd from the stage. “There are four of us,” he said, resplendent in black tie and tails, “and we get graded by how much we raise.”

As in past years, the auction is as much a fund-raising event as a chance to have fun. Kessler ruthlessly cajoled bidders into upping their own bids. When Special Advisor to the Dean Lawrence S. Cohen, M.D., HS ’65, bid $250 for a plane ride over New Haven, Kessler asked him for more money. “I can’t bid against myself,” Cohen protested. “Yes, you can,” the dean replied.

Joining Kessler as auctioneers were Admissions Director Richard A. Silverman, Associate Dean for Student Affairs Nancy R. Angoff, M.P.H. ’81, M.D. ’90, HS ’93, and Deputy Dean for Education Robert H. Gifford, M.D., HS ’67. Gifford entertained the crowd by donning a leather helmet and mounting the electric scooter for a ride to the foot of the stage. “You’ll do anything for a laugh,” scolded Margaret J. Bia, M.D., professor of medicine. Kessler bid $1,200 for roles in the Class of 2002’s second-year show for himself, Angoff and Assistant Dean for Administration Ruth J. Katz, J.D., M.P.H.

Second-year student Nduka Amankulor and first-year Susan Rushing, both accomplished opera singers, performed a duet from Don Giovanni. The Ultrasounds, an a cappella group comprised of students of medicine, nursing, public health and the Physician Associate Program, sang Van Morrison’s “Moondance.” Amankulor, second-year medical student Hung Nguyen and public health student Betsy Luo organized the auction.

Proceeds will benefit Columbus House, Youth Continuum, New Haven Cares, Rachel’s Table and St. Luke’s Services.
 

Getting things done in the field

Downs fellows return from their travels with an appreciation for the practical.

Foreign fieldwork sometimes requires seat-of-the-pants skills beyond drawing blood or crafting a health survey. During assignments that took them to Africa, Asia, Latin America and Russia last summer, students learned, as medical student Vivek Murthy put it, “who you need to know to get things done.” Good communication is also important, Murthy found when he asked villagers in India to participate in a study of iron-deficiency anemia among teenagers. As part of the study he requested matchbook-sized stool samples. “That information got lost,” Murthy said. “We went to one school and found students bringing in bags of stool. In another, we had students bringing in stools that you sit on.”

Murthy and 14 other students traveled under the auspices of the Wilbur Downs International Health Travel Fellowship Program. They presented findings from their investigations in October at the annual fall symposium and poster session of the Committee on International Health.

For 31 years, students in medicine, nursing, public health and the Physician Associate Program have received Downs grants for studies abroad. Topics presented in October included the use of female condoms in Kenya, the involvement of Egyptian men in reproductive health decisions, interventions in South Africa to reduce vertical transmission of HIV, women’s health in Mexico City and the impact of sanitary sewage disposal on children’s malnutrition in Kosovo.

Erik Hett learned to improvise in Kenya when a sudden electrical failure sent him scurrying in search of a generator to power his centrifuge. Without power, hours of work dissecting and preparing tsetse flies for analysis would be lost. Hett, a student in public health, hoped to determine whether the Wolbachia bacterium could kill the tsetse fly before the fly grew old enough to transmit the parasite that causes sleeping sickness. (His faculty advisor was Scott O’Neill. See related story, To the vector go the spoils) Hett and co-worker Rhoel Dinglasan, a doctoral candidate in public health and previous Downs fellow, finally found a working electrical generator in a local hair salon and, despite language barriers and quizzical looks from patrons, secured permission to plug in their centrifuge.

The two trapped their flies in the bush, where they learned another lesson not taught in school. “The flies tried to follow the buffaloes,” Hett said, “so we had to make sure the traps were close to the buffaloes.”

Murthy, who enjoyed collaborating with health workers in India, including doctors and nurses, said it was important to weigh his priorities and needs against those of the local population. “It is always a struggle to find a balance between them,” he said. “Listening to the local people was a critical part to making this successful.”
 

Healing after torture

A Yale student looks at the link between scar and symptom. Shadowing clinicians at Bellevue Hospital in New York City last summer, medical student George Lui heard questions most doctors never have to ask their patients.

“Who tortured you?”

“Where and when did it happen?”

“Can you tell me more about it?”

Lui worked in the Bellevue/NYU Program for Survivors of Torture, which offers multidisciplinary services to people who have experienced physical or psychological torture. The program provides long-term treatment to patients and their families, combining medical, psychiatric, psychological and social services provided by a variety of health professionals. Working under program director Allen S. Keller, M.D., Lui’s task was to review charts of the approximately 250 active patients in the program and look for correlations between specific forms of torture and individual symptoms. Such information could help clinicians develop more effective strategies for working with victims of torture.

His apparently straightforward review took some twists and turns, Lui said. Cultural and religious habits and beliefs often dictated how people responded to torture. Tibetan torture survivors, he noted, do not often meet formal criteria developed in the west for a diagnosis of post-traumatic stress disorder because they don’t avoid thoughts or activities associated with the trauma. Avoidance, however, is one of the three pillars of PTSD diagnosis.

Clinicians often were unable to distinguish between symptoms that resulted from torture and psychosomatic symptoms resulting from psychological distress. Lui cited the case of a 57-year-old woman from Sierra Leone. Trapped in her village during a battle, she watched as rebels burned her house and murdered her relatives. After receiving death threats, she came to the United States. “Once this summer she came to the clinic complaining of abdominal pain,” Lui said, recalling the medical consultation he observed. “Is this a sequela of her trauma history or an unrelated medical manifestation?”

In his report, funded by the David E. Rogers Student Research Fellowship from the New York Academy of Medicine and the Yale School of Medicine Summer Fellowship, Lui listed forms of torture applied, countries of origin of the survivors and how the trauma was manifested. Beatings were the most common form of torture, followed by deprivation of food and water. Imprisonment was the most common psychological torture, followed by murder of relatives. Most survivors in the program, 39 percent, were from Africa, followed by Tibet, 34 percent. And most, like the woman from Sierra Leone, suffered from PTSD.

“She started to talk about her trauma history and she broke out in tears,” Lui said. “It’s really important to listen to these stories because that could greatly influence how you treat torture survivors.”