Community Grand Rounds: Equitable Relationships for Equitable Health Outcomes

good afternoon everyone and welcome to UCSF family and Community medicine Grand rounds excited to have everyone here today um today's session is a is a community Grand rounds uh entitled Equitable relationships for Equitable Health outcomes and I'm really excited to wonder welcome our wonderful team for this uh for this important session um just as a reminder before we get started um today's session is recorded um if you'd like to view review today's session or see any other Grand rounds that you might have missed you can check us out on the um UCSF family and Community medicine um website uh and while you're there um you might want to take a look at uh information about the upcoming um UCSF Family Medicine annual rodet colloquium which is coming soon to us in May uh we'll have a great uh opportunity to meet folks and hear about our collaborators across uh 11 different residency programs and from faculty students residents community members so we hope you can join us um there's more information on the website um as always I want to thank our fantastic Tech uh Tech Team we have Benjamin wallow oh sorry no we have Benjamin Wallen um arago uh Mitchell and Roy Johnston are helping us today and um uh if you have suggestions about today's Grand rounds or any other Grand rounds that you um would be interested in hearing about please fill out your evaluations we take them very seriously Roy will'll be putting them um into the Q&A session into the Q&A for you to fill out um and then last about the Q&A um we do hope to make this an interactive session so if you can if you have questions for our presenters today or just comments that you want to generally share please use the Q&A to really um uh enliven and rich in today's enrich today's uh discussion by sharing your thoughts with us um so uh again the title for today is community Grand rounds Equitable relationships for Equitable health outcomes um in today's Grand rounds presentations we're putting Community Voices front and center residents of the tenderloin which is San Francisco's most diverse neighborhood and Dr Monica Han will be in dialogue with each other and with you discussing strategies for creating effective supportive collaborations for institutional and structural change at UCSF um our team today began this work in 2021 amidst the chaos of covid and discovered in the process what it looks like to mutually honor the experiences of those struggling to access care and those Jud juggling inequitable resources and burnout as we provide care we will tell you or our today's group will tell you the history of this project and how it supports um our work as a community and as healthcare advocates and how you can find your place in similar communities um and be part of being a change agent uh today's speakers I'm excited to tell you a little bit about them they'll tell you more about themselves um we have sioban Allen um part of the Skywalker Watchers Ensemble a San Francisco artist and resident who's a community leader whose creative talents bring light to the needs of community and uplift the talents of all Sam Dennison um from faithful fools is a tenderloin resident and a community advocate who challenges UCSF to deepen Community Partnerships with unlikely allies for deep institutional change Freddy Martin a congre congregational life and Community engagement manager at Glide Memorial also part of Skywalker um uh wants to be here and share the depth of commitment that bring that brings people together and knits Community threads into vibrant patterns and Dr Monica Han uh who's an associate professor uh in the department of family medicine at UCSF um is a valued Community member collaborator and part of the liaison between UCSF and the community residents um who hopes helps and hopes both hopes and helps UCSF open doors to otherwise unheard Community Voices so I really want to thank our team for being here today today and turn them turn it over to them thank you we're going to hold everybody we're gonna hold everybody up we're gonna hold everybody we're gonna hold everybody up hold everybody up up up hold everybody up up up just because you look like you and I look like me doesn't mean we can't be friends I'm not your enemy we're going to hold everybody we're gonna hold everybody upep we're gonna hold everybody we're gonna hold everybody up hold everybody up up up hold everybody up up up thank you uh so if things go according to plan nothing will be as business as usual we would like to I'm going to start off with the land acknowledgement we want to acknowledge that this work is taking place on Stolen land an occupied land yamu everyone can say that with me if they like yamu originally and still inhabited by the ramatou aloney people this acknowledge is meant as one step toward the honoring and repairing of our relationship with indigenous people of this country we understand that such repair is necessary and tied to our work for the care and acknowledgement of all marginalized people currently living in this neighborhood and in neighborhoods like this throughout our country and the world who are displaced both physically and psychologically by the slow and fast violence of unbridled capitalism and systemic oppression so i' like everybody to um I know some of you are having lunch right now so if you can just um we're going to do um a little grounding exercise that I do for myself and when I'm out in the community as a tool to just kind of get recalibrated and um if you want to sit and just kind of soften your body and get in a comfortable pose you don't have to close your eyes but if you like to that's okay too and um what the intention today is is going to be um a theme that's unstated but is care if I can have you take a nice deep breath receive the breath of the gift of uh life receive the breath in deep breath in and then hold it and then let it out and what I would like your mind's eye to focus on is thinking about a time when you were cared for when you were saturated in love thinking about what that feels like in your body what it sounds like what you feel like and if you can't think of a time you can just make up one because our brain doesn't know the difference between real or imagined so thinking about that and then using your mind's eye to scan from the bottom of your feet while continuing to breathe then on up and if your eyes are closed when you get to the top of your head I would like for you to imagine yourself feeling all of this love and care saturated ation of care and drawing a circle around yourself in your mind's eye a nice Circle and in that Circle will send out love from our heart and the wonderful thing about that is every direction we send it will receive it back let's take a nice deep breath and feel all that love and care being returned to us and then I ask you to draw one more Circle and this one is around Community you can think about who's in your community who needs care in your community well in this circle you send it out one more time and everybody's going to receive that love back and that's our grounding exercise for today um and one thing I would like to leave you with is this is not a question you have to answer but asking yourself how can I serve and contribute to a better world and this is a question to empower not to blame or find out who's wrong but to empower how can I contribute and better serve the world thank you thank you sioban thank you so so much so we are here to do community Grand rounds U my name is Sam Dennison I live and work in the tenderloin um Grand rounds in its traditional form is often dactic where we call in experts to teach us something and it can be a passive experience Community Grand rounds we change the learning environment so it's collaborative and engaged all of us are involved in one way or another and we view all of us as experts in our own right and in our own experience we are about to watch a video that we often include videos within Community Grand rounds this particular video is to introduce you to the experience of what it is to be in Grand rounds to be listening to One Another whether we be Community residents or medical professionals or students nurses other people who work in the context of healthcare so Benjamin I would or Aragon I'm not sure who but who's ever got the button I would say Now's the Time to play our video all right give me one second let me queue it up my name is Freddy Martin I am a skywater my my name is Reginal Meadows so hi my name is Kim hi my name is Rita Whitaker also known as proud Rita rolling and walking in her wheelchair hi I'm sioban Allen and I'm going to talk about my first and only son's birth couldn't F my legs you know and there were and I said I was just under the impression that the anesthesia hadn't worn off and um they had some kind of a question um look in their face and they went out into the hallway skywatchers is a community of artists connected to each other by life in the [Music] tender many Sky Watchers have experienced medical trauma that can be traced directly to Medical racism and classism legs of the poor dispensable part from bodies and souls already thrown away we believe our stories will help doctors administrators and students critically reflect on racism and classism in their work and careers had Dr Bouvier looked at me as if I was his brother his son his father or someone his mother someone that he really cared about I would not have been treated and would not have had the consequences or the impact of his actions as I had in these presentations Community residents take their rightful place as experts in the harms they have experienced within the medical system uh with all this you're not getting this and this and I said what I said I had two is why I felt like I might have died the last time I was dealing with y'all people and I said I don't feel safe around y'all and I said even getting simple care um I said it's just being unprofessional and y'all I said y'all can feel what you want but I don't want to feel that by the person I'm being treated you know it's affected my whole life as a as a black mother as a black woman and um and now I you know as you say I'm using my story as an example I'm able to talk I'm so grateful to have this opportunity this platform to be able to um process and become more aware of some of the the things the struggles the traumas because I didn't realize a lot of that that I was holding it in until I shared [Music] it I would like to propose or think about what is the next step after we tell a story of harm sometimes when we tell a story of harm it doesn't change anything so the question I have for you is what is required for a story of harm to create a relationship or a change that will begin to repair the harm and you know I wanted to add something that's really important about that Not only was it the doctor was all the nurses were involved because they didn't say anything and they watched them they watched watch them do it silence is violence so in this one again invite yall to be really mindful of what comes up for y'all um particularly around discomfort because I think it's really uncomfortable to be part of a system that caused harm and not have all the tools to fix it um but we do have some and we can create more at least for me it's like we see this all the time and as a trainee you're a witness to it but like in no time in these like four years of med school has it ever been named so explicitly and I think you you can kind of feel crazy a lot of the time when you're you're working on these teams and you're just like um cuz everyone's so nice to you as a trainee and you see them inflicting harm on patients and sometimes you you stiff up for things and sometimes you're not sure if you can throughout the year I just became progressively more unhappy like I would come home and even if I had a day where it was like my patience got better I had this really deep seated feeling of like did I do more harm than good today by like being part of this system because you see it all like once you see it you can't unsee it the word that really stuck out to me in that entire film was intuition because in medicine I feel like you're trained your intuition trained out of you it's like you ask questions in this order if you hear a patient respond in this way then the next question you should ask is this thing and it totally erases like everything that I've ever known about talking to a human being heartwarming to be in this this space because something that's really resonated with me over the last year is the idea of Storytelling um as a tool um and not not just collecting stories but sharing stories and you know one of the pieces of advice I got kind of going into clerkship year was write down the stories of your patients and hold on to those um and and I've wrote down a few I didn't write down as many as I'd like to but one of the ones or a few that stuck out to me the most were simple things when patients weren't being listened to and I had the flu but he just assumed I was an African-American woman you know my nose was running I was a mess I must be on cracked so um if we can let go of assumptions which is really hard for everybody right but um if we cannot decide who people are be you know um before talking to them and and listening um I think that's huge and that is that's just a that's just a human to human yeah which I understand probably is gets muddied you know when you're seeing so many patients in a day you know and you've got five more minutes now so I get that but um have to take that breath and see that other person yeah sometimes just having the space and having a a person that you know is listening that in in and of itself is therapeutic to be able to tell your story um even if after this person receives your story nothing else comes about it it's just that there was a Ministry of presence of somebody there to hear it um sometimes that in and of itself is therapeutic and I don't want to Discount that what I do hope is that through the ability to share stories when harm has occurred um that we can be able to interrogate where then in not just in in that interaction with that one person where you were harmed and maybe the one other person that was doing the harming I hope that we could have these opportunities where we can hear like Truly Deeply listen um to stories and figure out where along the way in all the different levels where were their their failures in the system so where were their failures in the structures of the healthare system where were their failures in interpersonal bias um because not everything is just at the interpersonal level I feel like sometimes we just focus so much on like implicit bias training for doctors for instance because there's harm that happens um between doctors and patients um and really thinking in the level on the level of social justice and social change and what we need like we can't implicit bias our way out of systemic racism in medical care right and um structural problems absolutely necessitate structural Solutions you do not do this work alone and and I want to just say that again you do not do this work alone you don't treat a patient alone the patient never comes to you alone none of us are really alone it's really are we conscious of the people we're bringing with us so one of the gifts you have here are three people who will be with you now for ever in your career and I encourage you take them with you wherever you go in that internal space and know that they care about you and they are impressed by you and they want you to be your best self carry them with you I invite you to take a deep breath and just think about one sentence or one sentiment that you picked up from that video that you will carry with you we started this project back in 2021 um as the second year of covid was beginning um when Co began here in the tenderloin we experienced chaos that the rest of the city did not experience in the rest of the city you could walk down the streets and it was very quiet people were indoors um maybe people were walking occasionally but they were very distanced from each other here where I live in the tenderloin we went from having one tent on our street to having 18 and having maybe a dozen or two dozen people hanging up about during the day to having literally hundreds of people here the city had um let people go from the shelters had discharged people from the prisons and the only place that they were really allowed to go was here in the tenderloin so we experienced incredible crowding when we were told that we should be social distancing and that began a kind of Crisis for us and in the midst of that crisis members of the UCSF Community came to us medical students in particular whose classes were um no longer meeting because they couldn't meet in person as well as faculty and staff and they said what can we do to help and they they they were incredible they brought hand sanitizer water tents uh masks food You Name It We asked for it and and they would just say yes and they showed up with it but as that year went on um one of our our dear community members a member of the sky Watchers Ensemble passed away and he really passed away because he never got quite the care that he needed at the general there were many kind people there who worked with him um but it was clear that he just wasn't getting what he needed and his story hit all of us um the UCSF community and the tenderloin Community who had been meeting weekly we listened to the story of Dino and we thought we need to share this story a lot more and as we started talking about Dino's story we realized the there were so many other stories so skywatchers and faithful fools but primarily skywatchers began the process of collecting video testimony sitting down and talking with Freddy sitting down and talking with Siobhan and many many others to collect their stories of when they had been experienced harm within the system either due to neglect or blatant racism or transphobia uh heterosexual um D um gender Dynamics it whatever it was we documented their stories and we began to put them together in these panels to do in the context of brand rounds and as we started to do brand rounds with different communities within UCSF one of the things we realized um was how much our friends and allies within UCSF were experiencing similar levels of trauma and struggle that the system as a whole was damaging everyone in a way and that what we were not able to do was to create um the kinds of changes that we wanted to and then we had the Incredible Gift of Dr Kamar Jones being at at UCSF as a visiting lecturer and one of the things that she taught us was how important it is to have relationships that grow and extend from within UCSF to the community and back again and that by having those relationships grow we literally create larger and larger gaps in the walls of the institution that allow room for Liberation and room for structural change because those walls can't tolerate having that many relationships go back and forth without creating change so that's what community Grand rounds has been about is creating those relationships sometimes we do it through mutual storytelling sometimes we do it through doing these U panels together and I I just want to say we have found some tremendous allies um at the center for Community engagement over at the general and the trauma surgery Department in family and Community Medicine Dr Megan Mahoney we we have so many thanks to offer you in so many different ways for supporting this work um it really is an extraordinary body of work that we're developing and we are working towards um offering it to as many different places as we possibly can and one of those that we'll tell you a little bit more about in detail later is we will be at the rodnick colloquium um as a full hourlong workshop and we're hoping to be able to do this in the engaged fashion that we're used to doing it rather than just talking with you and at you via Zoom um I wanted to invite Siobhan and ready to introduce themselves a little bit and especially Siobhan if you wouldn't mind telling us more about skywatchers and how it's a reflection of your experiences of community and connection um yes um thank you Sam so I am part of uh skywatchers um I came in as an ensemble member and now I'm an lead artist of community care and Sky Watchers is a Community Arts Performance Group and and um but not just that it's you know our our premise is that um you know conversational we're about um having meeting on a regular base being um in the community at a regular location and um we come together like once a week and we talk about things that are going on in our lives and we build trust over time um and it's it's a it's very important um space for people because many of us have lived in um you know had very complicated traumatic lives and being able to come into a space um especially coming from many of us come from the SRO single room occupancies and we suffer often times from you know neglect and the pandemic of loneliness so these relationships um are very important and when I say relationships I know when through some of these very intimate conversations I get to know when someone you know how when they've had a bad day because they've missed a court date or they um didn't get the paperwork in or housing is an issue or even the joys you know um and it's a place where we learn um through listening to one another and holding each other's stories deeply how we are connected to one another because change doesn't happen when you don't care about it you know each other and so it's a place where we commit we we learn about um things that are going on in our community Through um conversations talking and also through working with um collaborating with some of our Community Partners um and we're very involved in in um a lot of um organizing in the community um and I think that's about it for now yeah thanks and Freddy would you like to introduce yourself and say a few words yes thank you um thank you uh Sam and Siobhan my name is Freddy Martin and um I'm the congregational life and Community engagement manager at Glide Memorial Church however when I was first introduced to skywatchers it was actually through Glide I saw an announcement about an artist group and um like an a community group and I was like oh this this is my this is my chance this is my way to get back into creative performing arts and so I went to a series of workshops that they had um and just uh and that was about 2017 or 18 and just fast forwarding um the process that we have there for most things or any work that's created or any art that's created or performance pieces is we have conversations like shoban was saying we talk about things that are happening in our immediate environment in our community in our lives in our bodies and so there was a part where we were talking about racism and harms that are done and people uh you know whether Poli people believe you or not and being truth tellers so we were sharing we were sharing some things and I was asked to be a part of this and share my story so we went to Sam's beautiful building the purple building with uh at faithful fools and did these uh recordings I had not talked about some of the past medical harms that had happened um to me in quite some time so it was very um it brought back a lot of memories and I realized that there was so much more trauma that was still there that I was holding in my body and in my spirit and in my mind but um I'll just say as a Native America a native African-American man um my body has always been a Target because of my skin color um because of my background because of who I am um in so many ways and we all know this the systemically anti-black racist system that we're a part of has not cared about our health my health Siobhan's health or well-being um nor have they cared about my sustenance um only when it benefits them or when it benefits the capitalist system in some way so when I had this opportunity to talk about this um things that deeply affected me um I focused on one story because there were several um but uh the reality is is that that thing should have not happened you know it said something about that individual but um it was really important for me to be able to share that and to share it with the doctors and the healthcare providers in my community um to bring light to that and to bring truth to it and see what we or what we could do together um to bring about some sort of change within the system thank you Freddy thank you and um we also have Monica Han with us who has been with us in this journey pretty much from the beginning and has really well I I would just invite you Monica to talk about what it's meant for you as both a an MD but also as a member of our community to do this project absolutely thank you so much Sam and um everyone for for those who don't know me I'm monikah Han I you she her pronouns and as Margo mentioned I'm a family and Community medicine faculty here at UCSF um and my clinical practices are primarily at SF General Hospital um and it's just been such an honor to be a part of this pilot project for the past several years and um really my background prior to medical training was in ethnic studies and in community- based participatory research um and as a community organizer so I definitely see my role as striving to be a connector um and to really activate for social justice and all I do whether that's in patient care in building capacity for HIV programs or in being a medical educator and as my co-presenters have have so eloquently mentioned really yeah Community ground rounds has been so much more than a project it's really been like a labor of love it's been a circle of deeply trusting relationships and friendships and to me um often feels like an entire social change movement when we're together and where I feel we really deeply care for one another and are in solidarity with each other and for me just being aware of my positionality especially as a physician it really is a significant Community accountability Circle for me in my professional and personal growth um you know and as as folks were sharing before I was reflecting on how we first came into this project from a deeply you know troubled space um I'd say as Healthcare Providers during the covid pandemic in 2020 um you know the pandemic was really highlighting to the world the horrific Health inequities resulting from longstanding and deeply rooted systems of Oppression um and we were finally being able to have some long overdue meaningful discussions about structural racism and Reckoning with how our Health Care Systems have consistently failed marginalized communities and consistently devalued silenced and excluded minoritized and marginalized communities from adequate health care and from Key decision-making processes and you know I was just kind of sitting with this very uncomfortable acknowledgement for me and my colleagues that as healthcare workers no matter how nice we are as people no matter how good our intentions are we are absolutely at risk of being complicit in perpetuating medical harm and biases rooted in medical oppression uh every day unless we're actively and intentionally fighting to interrupt it so really coming from that perspective I was really searching for accountability partners and also for models of healing and restorative justice Frameworks that truly Center uplift and amplify Community expertise and um people lived experience and the holders of these powerful stories and to honor that expertise as much as we honor other you know academic Scholars on Health Equity and um yeah a question that kept coming up was you know what is the way that we can build trustworthiness with patients and communities that have been consistently harmed and continue to be harmed by our Healthcare institutions and so Community Grand rounds was really the space that we created where I felt like we could really have these honest and deep discussions um and create change from there and for me it really became a transformative learning space where I could really lean into interrogating especially my privileged identities as a physician in this system because I think especially for those of us who are in healthcare and we hold several intersectional marginalized identities um and we've had our own share of traumatic experiences as patients and um you know in our own medical training I think it's easier to identify and name all the ways harm shows up for us and our communities but I've learned that it's actually extremely important and harder really to um really examine and like introspect and like examine the power and responsibility that comes with our privileged identities in these spaces and I know that in my position and status as a UCSF you know physician on this team I know I hold immense privilege and that especially in these Partnerships I need to be hyper aware of that and be activated to use um every opportunity to leverage that privilege and so you know um briefly I want to to say that like often I've um reflected a lot um about the times I've sat in circle with my amazing Partners here and think about how I so wish that my medical education training that I could have had a safe and brave space to process the trauma I was bearing witness to so that's definitely a commitment that I have to myself and to my mentees now as a medical educator I feel a deep commitment to making things better for all the trainees that come after me and you know through this partnership we were able to Pilot several Community Grand rounds sessions over the past few years um for the prime us medical student Capstone course that I teach every year which is called um dismantling systems of Oppression building critical Consciousness and liberatory practice or practice in medicine and um the footage from the video that was just shown earlier was actually filmed during our um our pilot sessions during that course um we piloted two thre hour sessions um and also spent time at faithful fools in the purple building also walking around the community with Siobhan with the students and Our Hope was really for our students to get a chance to have this transformative learning experience um to offer space to debrief the many dehumanizing moments that come up in medical training because we truly believe that you can't learn how to be a humanistic and compassionate healthcare provider through just studying and memorizing facts in medical textbooks alone right like experiential learning outside the lecture hall is so powerful spending the day immersing yourself as a student walking around the tenderloin with Siobhan hearing stories from tenderloin residents um and debriefing in circle um these are truly transformative experiences that you cannot just read in a book or learn learn in a lecture this is liberatory pedagogy and critical Consciousness raising in action um it's iterative it's lifelong learning practice and so um I'll just end by saying my hope and invitation is that everyone who participates in these sessions feels a sense of community accountability and Collective care and feels moved to action and we hope that Learners can be moved at the personal level by listening to stories and then through critical reflection and dialogue be moved to make systems change and culture change and so I know that that has happened for me and my students and um it's been so important for our growth and development as health professionals um and as a believer in Collective Liberation I truly believe that being in community and holding Circle together is a way we collectively get free thank you thanks for letting me share my perspective oh that's wonderful I'm wondering Freddy or Siobhan would you like to share I mean Monica has talked about her hopes for what comes from this I've talked about some of my hopes what are your hopes for your involvement in community Grand rounds what changes do you hope to see and what do you hope to experience um so change it oh go ahead no um go ahead Freddy no ladies first you were gonna speak um well I was just thinking that you know um being part of the the community Grand reals the the person that that you see here before you today um I the first ever revealed my story um being um the trauma that I experienced being um a healthy woman and then coming out um with um being paralyzed and a new mother um I held that deep down inside of me and not until um and I I think I had some feelings about the medical industry and just not um being on the outside and not having a voice and not feeling confident to be in in certain spaces and voice what was going on with me but my experience I'd like to say that um being in in community with um with Sam and and Dr Han and other medical professionals um I began to understand like like learn the value of what my experience was and that it wasn't in vain and not only that I was able to kind of connect the um the fact that um that a lot of you know being I come I'm not my my people did not immigrate here I was you know there's a difference between um being a um um Force to migrate here forc immigration kidnapping and then the whole um enslavement and being considered three-fifths of a person and carrying that within me and all the the harms and the traumas that other black women have traditionally um you know historically faced and being able to put that connect that history with the things that I experien and being able to um witness other women in the community and it's very important for me to learn um to use my my um uh my experience um the things things that I learn and the stories I hear in the community to be able to hold those stories and I believe that I'm a Healer as well that we're doing your healing inside of the your um inside of the the medical industry I'm on the streets as um as a Healer in holding stories and that when we work together I hope that um that the the shame of not seeing or acting becomes greater than the fear of doing something different and that you know Partnerships will be formed um and and that we will we can follow um Sam and and Dr Han and and Freddy you know these are Visionaries people who um had the the sight to see something different and want to do something different and have the courage to do so and then other people have been able to follow along along like myself um and um I know that I'm in the midst of friends yeah Freddy how about you well that's that's amazing Siobhan what you just said and Monica um I I feel I feel you know similar I think that the the first it is about building relationships um and I think uh everyone's spoken on that so far you know it's about building relationships for uh a specific purpose and specific reasons so I want to continue to be a part of that what I would like to see come out of this it's B it's already happening some ways like doing this but um for it to expand and for more people to get involved for more Community experts and um patients and people who are in the Health Care system to get involved and hear these stories this was a p this is a powerful medium um especially in this day and age using the Arts and using the community using video using these forums um to create that relationship and understanding and Trust which can then create the change that we want to see um I've said this from the beginning I was very intentional I want um I want Health Care Providers to humanize us to see us as family to see us see us as people that they care about um treat us like you would want to be treated or you would want your family member or your dearest loved one to be treated I want Equity I want Justice you know there was even talk about you know at one point maybe being able to talk to the doctor I never got an apology I never got any resolution I never got any acknowledgment from what was done to me and the harm that it created to my life and my body I didn't get any resolution so this is a way to do that for people that may be going through it now or may be able to get that that's one of the things that I want to see come out of it but more importantly I want to see you all the doctors that are practicing now the students the residents whatever the languages that you all use for for that I picked up on some I just can't remember right now but you know I I I want um I I I want you all to be able to understand the true scope of the power that you have and how you use that power and what place it is that you're coming from because as a patient or a Community member who's coming I'm coming to you I'm coming to your hospital to get healed to get well to get made whole or to get better and that is you know I think that can most likely happen and has a better chance of happening if you see me or if you see us as equals so that some of these things that have happened in the past or to us and these harms that have been done don't continue to happen to Future Generations so that would be the thing for me that would be like the most important thing um and to see what you do with this like how you act I I'm just gonna say really quick I know we're running out of time or do I not have time just I'll shut up good I will say this now I'm gonna brag on myself a little bit I don't do this often but from this one of the doctors she'd been practicing for a while saw a presentation that we did as part of this amazing Community Grand rounds um this new thing she saw and heard what I was saying about patient empowerment and the things that I had to go through to learn how to have a better relationship with my doctor and understand that it's it is a a relationship just like any other relationship and if things aren't right or if I need things I I it's important for me to communicate that so there were you know there were just tools that I had learned so I shared this and from that she connected me with someone else at UCSF um I think it's in the health and learning or education department um and I got funded we got funding together me and the healthc care providers got funding to create this pilot program um to uh Empower patients to learn strategies and tools as to have a better uh relationship with with their doctor things to add things to you know boundaries to St or whatever but um I've been able to do that and so when I look at you all who are on the inside who are doing this every day it's like oh my God if you all were to do like what Monica is doing and Sam and Siobhan with skywatchers I mean just imagine how many people can be reached and how many people can be healed and how much can be changed that's it oh thank you Freddy that like really brings us to that key point right that um what what this project ultimately is about is bringing um those of us who are aren't day in and day out inside UCSF into relationship with people who are day in and day out inside UCSF and really making structural changes we develop the relationships we speak about our truths whether it's the truth of what it is to um feel frightened as a patient or to feel burnt out and exhausted as a provider and be able to say what has to be different and how do we make those differences happen um and that's where when we do our work we often and you heard this in the video just say never go into a decision-making space alone you know whether it is Freddy who is developing a program at Glide or it's um you who are going to make decisions about how XY or Z is going to happen at a clinic you should never make those decisions without taking someone from the other place with you that is Freddy needs to have health care providers who go with him either in his heart or actually by his side as Glide is developing programs and you need to have one of us or one of the many other people who are Community experts with the community Grand rounds project or maybe somebody from your family maybe somebody from your old neighborhood it doesn't have to be you know from the tenderloin but someone who is outside of your day in day out medical life who will remind you what it is to make decisions with us in mind because then those decisions will be just by definition different um um and maybe they will slow down a little bit maybe they will pay a little bit more attention to what accessibility really means or what it means to resist because I also know that you have constraints that you want to resist and sometimes you need to know that Siobhan is right there with you holding everybody up right and you need Freddy with you reminding you that we are your family right so I I think we're almost out of time I want us to take one more moment to follow the practice that I think all of us should learn but we certainly do this a lot here at the the purple building at faithful fools is we start with a song or with a moment of quiet to bring ourselves into this space and then we also come to a conclusion not with a sudden stop oh we've got to go but by taking a breath and giving ourselves a chance to remember the people we've just spent the hour with in my case it's very much with Siobhan and Freddy and with Monica but also with Roy and the others who have supported this program Megan and um Margot and then in addition to that I try and remember what is the strongest piece of wisdom that I'm caring forward and I would encourage you just to remember what you've heard or even what arose for you in your heart and in your mind what what were you reminded of as you listened to us as you watched the video and then finally I want to remind you that we will be together again at the rodnik colloquium um I encourage you to to come and join us when we do our community Grand rounds there but we can also do this pretty much anytime anywhere so if you've got a clinic where you'd like us to come and spend time with you if you're teaching a class if you're working with residents we are available so you can get in touch with us through Monica or through Megan or through whoever else so one more deep breath and then we will carry ourselves out is that all right okay thank you thank you thank you for holding this space it's great to be in space with you all yes thank you everyone thanks everyone we appreciate you all now this is kind of one of those awkward silences do I click off

Channel: UCSF School of Medicine

Views: 125

Keywords: ucsf med school, ucsf medical school, university of california san francisco, med ed, ucsf medical student, uc san francisco school of medicine, doctors, physicians, ucsf, medical education channel

Id: Tm-Bv9ncB6k

Length: 53min 1sec (3181 seconds)

Published: Mon Mar 04 2024