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Shriver Report: Amelia Clark, Medical Missionary

By Jesse Kornbluth
Published: Oct 21, 2009
Category: Health and Fitness

Last winter, as veteran readers of this site may recall, our community raised funds for a medical mission to Honduras. Now four students at Mount Sinai School of Medicine and a team of doctors — a general surgeon, one OB/GYN, one anesthesiologist, and possibly a radiologist — have committed themselves to another mission, this time to Liberia. They go in January. Once again, they need to raise $10,000.

Amelia Clark, who is one of the Mt. Sinai students on this team, has been a friend of my family for two years. For our daughter, it is a matter of some pride that, at 7, she knows a woman who’s a doctor. But then, “doctor” to a young kid is a simple picture. It’s more complicated for me, and the more I know Amelia, the more confused I am — there are so many pleasant ways to practice medicine. Why, year after year, does she choose the hardest?
 
If the Shriver Report and the Time Magazine story dealt with women responding to the idea of service — to a career as a calling — I missed it. Perhaps it’s because the stories are so personal, the motives so idiosyncratic. Or maybe it’s just awkward to be confronted by goodness and idealism; it’s hard to read Arrowsmith, the Sinclair Lewis novel about a committed doctor, or Tracy Kidder’s Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, without feeling small and selfish.
 
Both in the hope that you might want to help this group (to contribute, click here) and so you can meet a young woman who doesn’t fit into the neat narratives of these big media reports, I asked Amelia to share her story…..
 
It’s only now that I’m in medical school that I’m sure that I want to be a doctor. Growing up, my career goals hovered around the arts, I played the violin, I painted, sculpted, I designed and sewed my own clothing. But I also enjoyed my science classes, and I always felt inspired by the physicians I worked with during my summer months volunteering at a local hospital. One summer during middle school I was assigned to the OR, organizing the stock room. One day a surgeon invited me to watch him do a hip replacement — a large and physically involved procedure — followed immediately by a delicate microsurgery to reattach the fingers of a factory worker whose hand had been lacerated in an accident. I was struck by the artistry of this surgeon’s work, and by the wide range of procedures he was able to do. It was the first time that my interest in the arts and in science/medicine seemed able to coexist in a single career.
 
In college, I took a double major: Biology and Art History. I loved the challenge of looking hard at a piece of art, to deconstruct and reinterpret it, to see a piece both as the artist wants it to be seen, but to look beyond and to understand it in the context of the artist’s life and the history of art. I never knew at the time how much I’d be able to apply these observational skills in the field of medicine. Meanwhile, I kept my hands busy in the sciences, working in a research laboratory that studied liver disease by doing surgical procedures on mice.
 
In medical school, I finally had the opportunity to participate in surgery — a small bowel transplant for a young man with a crippling congenital disease that had left him unable to eat and dependent on nutrition fed through his veins. As with most transplant surgeries, the procedure took place in the middle of the night. (In transplant medicine, the timing of an organ becoming available is unpredictable, so the surgeries must begin late at night when the ORs are not already booked up with their regular daily schedule of work.) I got to the hospital at about 8 PM. By 10, I was learning the surgeon’s ritual of how to scrub and gown. By 11, we had started to operate.
 
Around 2 AM, a second team of surgeons swept in. They had just arrived in New York on the medical jet and had a cooler in hand containing the new bowels, iced and fresh from the donor in Georgia. Around 5, everything was ready, I held the grey and bloodless bowels in my hand while the surgeon carefully attached the blood vessels. The new organ was ice-cold from the cooler packing; it was almost impossible to believe it could be of any use to our patient. But when the vessels were connected and the clamps were removed, I experienced one of the most incredible moments in the OR: the cold grey bowel that I had held in my hands slowly bloomed pink with the newly flowing blood. The iciness warmed, the organ was alive. When we finished the operation at 8 AM, I had been on my feet all night long but I wasn’t the least bit tired.
 
After a year of operating with the transplant team, I was eligible to apply for a weeklong, student-run surgical trip to Honduras, a country with only 6 physicians for every 10,000 people. The hospital in San Pedro Sula was a collection of disconnected buildings in varying states of decomposition set in a dusty lot and surrounded on all sides by a high wall. We met our patients in a large barracks-style room, and had to wheel them on gurneys outside through the tropical heat to bring them back and forth from the operating rooms. The ORs were small but tidy, with outdated anesthesia equipment and scraps of blankets used as curtains. Despite — or more likely because of — the lack of modern supplies and equipment, operating in Honduras was educational, inspiring, and career changing. It was the first time I worked with Dr. J, an incredible physician, teacher, and mentor.
 
On our first day, Dr. J, another surgeon and I were doing a case together, removing a patient’s gallbladder. It was a challenging surgery, and I could feel the tension in the room — something wasn’t right, there was too much blood loss. Suddenly the second surgeon had to run to another OR for an even greater urgency, leaving me alone with Dr. J. I could have easily panicked, but Dr. J was completely calm. Without ever raising his voice, he expertly led me through the rest of the steps of the procedure. As we reached a calm moment, Dr. J stopped and said to me, “No matter what happens, you are a doctor who can operate.”
 
While this moment with Dr. J sealed my dedication to surgery, one of my patients deepened my interest in global work. She was a tiny frail woman from a rural mountain village who had a gynecological condition so severe that she had difficulty walking. Despite her situation, she was always smiling her toothless smile and telling stories about her life — I remember her telling me how she taught herself to read by sheer force of will when no one in her town would teach her. After her surgery, she cried in gratitude and kissed me on the cheek, but I felt grateful in return to have had the chance to be a part of changing this woman’s life through a simple surgical intervention. 
 
It is experiences like these that attract me to global surgery — even when it’s midnight in the OR with lizards on the walls, no running water, and only fish-head soup waiting for you as a cold post-procedure dinner. Where else can you impact a person’s life so tangibly and substantially as giving back the basic functioning of the human body? Nowhere is this truer than in those underserved communities to whom this care is otherwise unavailable.
 
Liberia promises to be a much more intense experience than Honduras was. One in 4 children doesn’t live to age 5; the average lifespan is 40 years. For 3 million people, there are just 29 doctors. Compared to Honduras, there is much less infrastructure and the cases are much more advanced and urgent — complete with gunshot wounds, power outages, and a dearth of running water. But over the last few years, we’ve built a good relationship with a hospital there. It’s a long and challenging road, but the physicians and students involved continue to show inspiring dedication to this work, and as Dr. J says, we continue to do the best we can.
 
To read more about the mission to Liberia, to watch a video and/or to contribute, click here.