brain surgery, brain tumor, community service, craniotomy, Duke, Duke University School of Medicine, enhancing patient care, follow-up care, mental health, North Carolina, North Carolina Schweitzer Fellows Program, Obesity, patients, Preston Robert Tisch Brain Tumor Center at Duke, Social support, surgeries
When Brian Choi was conducting research and completing his rotation at the Preston Robert Tisch Brain Tumor Center at Duke, he noticed that due to the high risk of post-surgical hospital-acquired infections, many patients receiving surgical care for their brain tumors were being discharged one to two days after their operations.
“Many of them were being discharged to local hotels or temporary living spaces—close enough to ensure that if any complications were to occur immediately postoperatively, they would be able to return to the hospital to receive care,” Choi says. “However, I found that in many cases, patients were coming from great distances to receive care”—and as a result, they felt displaced, isolated, and confused in their temporary post-surgical limbo.
So as a Schweitzer Fellow, Choi—a doctoral degree candidate at Duke University School of Medicine working in brain tumor immunotherapy—developed a service project that provides these patients (and their families) with social support during their time immediately post-discharge.
Why did you decide to develop your particular project?
Prior to applying to the Schweitzer Fellowship, I visited a handful of patients shortly after discharge to gauge the potential opportunity for intervention. During my first trip out, I met a patient who was about to leave his hotel earlier than recommended to make a two-hour drive back home—just because he couldn’t find a good place to eat. I spent a couple of moments with this patient and his family and had the opportunity to listen to them share their experience coping with glioblastoma [the most common and aggressive brain tumor in humans]. Before I left, I gave them some simple information about restaurants around the hospital, which they greatly appreciated and thanked me for in an e-mail message days later.
For my Schweitzer project, I wanted to create a group that met the needs of such patients immediately post-craniotomy at Duke. Sometimes, in addition to finding out about restaurants and businesses in the area, patients are curious about relatively simple facts regarding their medications and other postoperative complications.
I think providing some of this information is a great way to get medical students involved early in their training to follow up with patients after they leave the hospital—promoting the idea that treatment for such a debilitating disease does not merely consist of a simple series of chemotherapies and surgeries, but that much more can be done to ease the process of coping during the transitional period as a patient returns home.
What do you hope will be the lasting impact of your project on the community it serves?
Ultimately, I hope that this project will help to promote additional programs designed to enhance follow-up care for patients immediately after discharge from the neurosurgery service. There is always room for improvement in patient care, and I hope to advance opportunities for medical students, in particular, to participate in these activities.
What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?
Aside from the ostensible debate over healthcare reform, the most pressing health-related issue in our society is perhaps obesity. Aside from its influence on cardiovascular disease, diabetes, and other chronic morbidities, obesity undoubtedly affects emotional and mental health as well—the latter of which, as an aside, I believe could be considered a close second in terms of a major health-related concern of our time.
What is most concerning about obesity is that so little has been done to reverse the trend of this epidemic both globally and in the United States. The best results will most likely come from increasing education and awareness about lifestyle and diet changes, as well as improved dissemination of information about the negative long-term consequences of obesity. The most effective population to focus these efforts on is probably our youth, as well as their parents, insofar as parents influence their children’s future decisions and development.
What has been the most surprising element of your experience as a Schweitzer Fellow?
The most surprising part of my Schweitzer experience so far is the great response and general interest in our project, both by fellow students as well as the administration at Duke. The number of students that have contacted us about our project is significantly greater than what I expected, given that, in general, relatively few students are interested in pursuing neurosurgery as a career. The level of faculty support for our project has also been phenomenal.
What does being a Schweitzer Fellow (and, ultimately, Fellow for Life) mean to you?
Being a Fellow for Life means capitalizing on this year by allowing it influence my future in medicine as I eventually train to treat patients with brain-associated malignancies.
Throughout all the classes involved in my joint-degree program, I never took a course on “how to integrate service into your career.” My time this past year with the Schweitzer Fellowship certainly comes close. Over the past year, there have been many opportunities to combine my experiences at work in the hospital and in the laboratory with my Fellowship activities. I hope that the skills I’ve developed towards that end will weigh heavily on the way I choose to spend my time in the future.
Bryan Choi is a Schweitzer Fellow in North Carolina. Click here to read more about The Albert Schweitzer Fellowship (ASF)’s North Carolina Schweitzer Fellows Program and the Fellows like Choi it supports in creating and carrying out yearlong direct service projects that improve the health and well-being of vulnerable people and communities. To make a gift to the North Carolina Schweitzer Fellows Program—which is supported entirely by charitable grants and contributions— click here.
Each week, Beyond Boulders delivers a new installment of “Five Questions for a Fellow” – an interview series with Schweitzer Fellows across the country and in Gabon, Africa who are leading the movement to eliminate health disparities. For an archive of previous “Five Questions for a Fellow” interviews, click here.