I want to welcome you all to our panel. As Professor Townsley said, Summarizing Medicine, Animals, Inmates, and HPV. Thank you all for coming, and thank you to Professor Townsley for taking the time for moderating our panel. I'm Maria Saraf, I'm a senior at Mount Holyoke studying biology and politics. 

So first day I walked in feeling intimidated and completely out of place. I told myself to stand tall and look confident even if I didn't feel that way. I wasn't sure what to expect when I walked into the men's medium security correctional facility in Rhode Island, but confidence, even faking it, can take you a long way when it comes to new situations and new places. I'm doing it right now. I don't know if you can tell or not. 

So over the summer, I interned in a medical clinic at a correctional facility. I found this opportunity through connections. The person I work with, the physician Dr. Clark, is a researcher at the Memorial Hospital of Rhode Island. And she's also a primary care physician for incarcerated individuals at the Rhode Island Department of Connections. 

She also happens to work at the same hospital as my dad. So he gave me her contact information. I contacted her, I gave her my resume. And then we met up a few times, we discussed my potential role working with her, and in the smoking cessation project, Seal the Deal. 

So I want to emphasize, never underestimate the power of an email, because you never know how receptive a potential employer or internship supervisor can be. So over the summer, my responsibilities including developing educational and training material on smoking cessation for the incarcerated individuals. Tobacco use is three times more common among incarcerated individuals than the general population. Given this prevalence and the increasing bans on tobacco use in correctional facilities, focus on smoking cessation becomes relevant and a worthwhile pursuit in this high-risk and under-served population. Especially because they've already gone through nicotine withdrawals, so the starting point is a lot easier than with people who are still smoking. 

So I work with another student. We developed a 32-page booklet with an accompanying video towards that end, and our reports relied on positive behavior modification and talked about skills to avoid trigger situations to alter former routines and to find alternative ways to cope. Our aim was to create an effective smoking cessation intervention that was easily accessible and could be easily disseminated to the targeted population. 

The project is still ongoing. And unfortunately, by the time I left, we didn't have enough data to see how effective it was. But I imagine it to have a sizable impact, which will hopefully be confirmed once I go back in December. 

So besides the smoking cessation project, I also shadow Dr. Clark in the clinic. I took vital signs of the inmates, from height, weight, blood pressure, and a heart rate. And then I observe the subsequent interaction. Subsequent interaction. 

So what I realize is that the patient-doctor interaction, which leads to mutual respect and trust, especially in the context of such extreme power imbalance is truly an art. You have to have the right balance of a professional, knowledgeable, and empathetic demeanor for your patients to be honest with you, and for them to actually follow through with your recommendations. 

I wish I had more pictures, but I wasn't allowed to take my phone in. So this is the only picture of the prison you'll actually see today. So I was in the men's medium security for most of the time. And once a week, I was in the women's facility. 

So in Rhode Island, the male inmates are housed in a minimum, medium, and maximum facility. And then there's intake, which is where the jail population resides. So for the men's medium security, most of the inmates have been there for a while, so you don't really see them struggling to adapt to their new environment. 

But in contrast, because there are so few women inmates, there's only one facility that houses all of them, and they all go through the same medical area. So while I was there, most of the patients I was exposed to were recent residents. And a lot of them were going through shock, and a lot of them were going through alcohol and heroin withdrawal, which was very sad to witness. 

So understanding these situations is a very important skill to have in medicine. Doctors have to be able to empathize and deal with the personal issues that patients are going through, because that is the only way that they can actually provide adequate health care. 

Life, and especially medicine, is not one dimensional. It is just as much about forming a connection with your patient as it is about excelling in academics. And that goes with anything in life. Academics can only take you so far. You have to learn how to navigate this social environment of whatever field you are in to excel in life. 

For me, I struggled with knowing where to set appropriate professional boundaries with the people I interacted with, because those interactions differ significantly from the nurses, to the guards, to the inmates. And it's important to recognize your place in the social hierarchy of whatever field you're in, and then behave accordingly to excel. 

So a lot of the inmates I encountered had very tragic life stories, and I'll just give two examples. There was one inmate, he had a dent on the side of his head, so I asked him what happened. And he showed me his palms, and there were two scars going across his palms, and he said that he tried to commit suicide by electrocution. And it was, obviously, as you can imagine, I was very taken aback and didn't know how to react. 

But one of the saddest cases I saw was an inmate who was suffering from delusions. So her thoughts were incoherent. She kept calling me the doc in charge even after the doctor told her I was just a student. 

And she was talking about being a master sergeant, and talking about giving recommendations to her officers. And it was very hard to keep up with her. And it was even harder to see if there was anything medically bothering her. 

So the point of that is that doctors have to learn how to listen to their patients' stories and pick out the important details while at the same time providing them with the comfort that they need. The inmate, the one with delusions, she actually teared up at a point and talked about how the doctor reminded her of her mother, and the way the doctor approached her was very empathetic towards her situation while still trying to ask for what was actually bothering her was a very informative experience for me. 

So I noticed the inmates' attitudes towards Dr. Clark. It was one of trust and mutual respect in a place where most of them don't get any. And she had taken the time to build it up that way. 

So observing the doctor deal with the unique circumstances of each inmate was very influential for me, and gave me a new perspective and respect for the humility that is demonstrated by doctors. It's important to know all the nitty-gritty details of the professions that you're interested in, because besides the glamorous part of what you tell people you're doing, it's really the nitty-gritty details that's where you're going to spend most of your time. 

So being at Mount Holyoke has been a huge help. This is going to be my MHC plug for the day. So take advantage of all the resources provided to you, especially the Lynk funding, because a lot of the internships will take you if they know that you already come with funding. The academic rigor of this institution also helped me with my research and writing, especially when I applied to present our research at the Annual Academic and Health Policy Conference on Correctional Health in March, which, fingers crossed, we find out within a few months if our proposals gets accepted. 

So my summer working at prison has made me realize that I want a hands-on experience and work with under-served populations. I'm particularly interested in Doctors Without Borders, which is an international humanitarian NGO that provides medical aid in over 70 countries around the world. It is extremely unfortunate to see how many people in the world lack even the most basic access to health care. And I want to be a part of a team that addresses that, because it is only after the basic needs are met, can people's ambitions soar. 

So I want to end my presentation with just a few thank yous. Thank you to Dr. Clark for taking me under her wing and teaching me a lot of valuable lessons over the summer. Thank you to the Lynk internship funds for being the financial backbone of my summer. Thank you to our lovely moderator, Professor Townsley, for being here and moderating. And thank you to the audience for showing up.