This post originally appeared on Good Med Science Blog.
Behind a group of old row homes in Philadelphia stands a garden. This garden appears much like an oasis would to a weary desert traveler. In the same way an oasis provides nourishment in a dry desert landscape, the garden stands in a “food desert,” a low socioeconomic area of the city where access to fresh foods is rare. Corner stores dominate the food shopping in this part of the city, providing residents with sugary snacks for cheap prices. Fresh vegetables are nowhere to be found. The health statistics in some parts of Philadelphia are comparable to many third world countries. This is the reason that the garden is such a miracle in this part of the city. And while it seems displaced in this location, the people from the community working in it seem right at home.
I learned about the Urban Tree Connection when I was studying in Philadelphia for my MPH. A project in one of my classes consisted of creating a community garden on paper and discussing the effects it may have on a neighborhood. The director of Urban Tree Connection, Skip, told me that he liked my ideas and invited me to learn more about his organization. He has been creating urban gardens in plighted communities throughout Philadelphia for over 20 years. He gathers the community together to teach children about gardening, healthy eating, and how to understand their own health through the things they learned in the gardens. This type of approach to health intrigued me, and I decided to work with the Urban Tree Connection for my thesis.
Through the two years I worked alongside Skip, I helped to develop a system that collected data in regards to how the garden connects to people, the beautification of a community, and what participation means for a person’s overall health. It was an amazing opportunity that created a new understanding of “medicine” in my head. I had always wanted to be a doctor to help people, but my perception of medicine had always been one of a patient and a doctor in a room together. Until obtaining my MPH, I never understood how social and behavioral aspects affect a person’s health, and how one’s community, barriers to quality food, and lack of education all create obstacles to healthy living. For this reason, as I finished my MPH and entered medical school, I had my mind set on a career in family medicine.
My understanding of medicine is one of prevention. Many diseases can be prevented by simply living a healthy lifestyle. This is not to say that diseases do not occur in even the healthiest of people; however, this foundation is paramount to healthy living. To me, being a doctor means sitting down with a person, understanding his/her goals in becoming and staying healthy, and helping that person achieve those goals. After working through all of my rotations during my third year, I realized that I wondered what my patients were up to after they left the hospital. Most of all, though, I wanted to be able to speak with them for more time than was allowed during the usual, busy day. I could not help connecting with patients and seeing them as people I care about, just as I do my own family. This became especially difficult when I had very sick patients, or patients who passed away. I was told that eventually I would become “numb” to these feelings; otherwise I would not be able to practice medicine because it would become too draining. I do not want to be numb.
I believe the way I feel about patients only strengthens my desire to pursue family medicine. My perception of medicine is to help prevent disease. I want to empower my patients with knowledge about their own health. Much like a garden in a blighted part of a city represents a new approach to health, I believe that the US healthcare system is in need of new approaches to primary care. While we have access to the best technology in the world, our outcomes seem to be lacking. I believe this is due to our lack of emphasis on prevention over treatment of disease. The garden made me understand medicine in a new way. It showed me that “public health” is paramount to primary care; without placing an emphasis on the health of the overall community, prevention of disease on an individual level cannot be achieved. I want to take the lessons that I have learned from the garden with me as I pursue a career in family medicine.
