Social connectedness, volunteerism, and the remedy for COVID fatigue [PODCAST]

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“Social connectedness is the remedy to the COVID fatigue that is running rampant in the United States. We need to stay connected to those we love. At the same time, we must also recognize that life is going on in the age of COVID-19, which means what happened to Mariana is occurring in all of our communities. Vulnerable populations need our help, and in our case, NSRN is working to be there for them through this uncertain time. We encourage all Americans to seek out opportunities to become more socially connected through volunteering. There are opportunities all across the country to provide much-needed support both remotely and in person. Just giving a little of your time can be a game-changing decision for people like Mariana, especially during the upcoming holiday season.”

Ashten Duncan is a medical student.

He shares his story and discusses his KevinMD article, “Social connectedness, volunteerism, and the remedy for COVID fatigue.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Ashten Duncan. He is a medical student, and he wrote the KevinMD article “Social connectedness, volunteerism, and the remedy for COVID fatigue.” Ashten, welcome to the show.

Ashten Duncan: Thank you for having me. I’m glad to be here.

Kevin Pho: We’ll get into your article in a little bit, but first off, can you just share your story and journey to where you are today?

Ashten Duncan: I grew up in Oklahoma, and that’s actually where I’ve been for medical school and really all of my education so far. When I was young, I was an Air Force brat and moved around the world quite a bit. We actually lived in Japan for a few years when I was really young. Leading up to today, I think back on some of the support I’ve gotten over the years, and a lot of the people have really been dear mentors to me, because piecing everything together, I see a lot of relationships that really led to me being able to be successful and get to the point I am.

Plans down the line, I’m actually going to be heading off to Santa Fe, New Mexico, for family medicine residency, and I am definitely very excited about that. But in the meantime, I think it’s also important to continue to engage in the things I’ve been doing throughout medical school, and writing articles like this one is just one of the few things I think have been really important to me.

Kevin Pho: So we’ve been talking before this interview started about you matching into family medicine, so congratulations. What were some of the reasons that made you choose family medicine as a specialty?

Ashten Duncan: Yeah, so it’s going to be one of the tried-and-true answers: I couldn’t really commit to a specific system of the body, and there were too many things, I think, that caught my attention and really interested me as I went through. From the very beginning of medical school, I really thought it was going to be family medicine for me, for a lot of the reasons that I just mentioned. But also, on top of that, I’m in the National Health Service Corps, and I already had made the commitment early on to primary care.

And I think from there, as I went through some moments of introspection, really thinking about what I want out of a career in medicine, I think back to the times I had even on our psychiatry and pediatrics clerkships, where I found myself thinking, “Wow, I really enjoy this type of care. I really enjoy the types of services I might be able to provide in these areas.” But what was funny, it was around the time I was actually on labor and delivery with our OB/GYN clerkship where I realized, I think, it’s all the stuff pointing back in that direction of family medicine anyway. So a lot of it was really just identifying with a lot of the patients and the services that are provided across different disciplines. And there, I get back to family medicine.

Kevin Pho: Now, one of the themes on my blog and podcast over the years is the dwindling physician interest in primary care. For the most recent match in your medical school, for instance, approximately what proportion of your colleagues chose primary care as a specialty?

Ashten Duncan: So we have a smaller group where I go to school. At the OU-TU School of Community Medicine, we’re a branch campus from the University of Oklahoma College of Medicine that’s based out of Oklahoma City. Typically for us, it varies from year to year. A lot of the time, it does kind of stick around that half-and-half mark. Now, with that being said, that’s also those who are matching into primary care specialties like family medicine, internal medicine, and pediatrics. But we recognize that quite a few of my colleagues will likely go on to subspecialize, especially in the areas of pediatrics and especially internal medicine. So that’s at least what it looks like from the initial match of those who are matching to categorical specialties that are in primary care.

Kevin Pho: Did you have a lot of primary care mentors as you were going through your medical school journey?

Ashten Duncan: I did, and that’s been something that’s been really special to me. A lot of people I now consider either good friends, good mentors, or people I definitely want to stay connected with have been there to really mentor me through the process. Without going into any specific name, since I didn’t talk to them ahead of time about this interview, I will say, though, I’ve had really strong mentors across departments, too. One of my earliest faculty mentors is in the department of pediatrics. One of probably the greatest people I’ve worked with is in the department of internal medicine. All of them have been nothing short of supportive, and also really, I think, illustrative of the kinds of work you can do in primary care.

I think that’s definitely something that a lot of students don’t get enough exposure to. As we run into this issue of not as many people going into primary care, and therefore not as many mentors to show students the ropes, I think we do struggle in a lot of parts of the country to really give students that robust experience and to show them that you can really be a leader, you can really be a change agent in primary care, and still deliver some specific care depending on the needs of your community.

Kevin Pho: Well, I completely agree with what you said. I think that one of the things that I hear from medical students is that there aren’t a lot of primary care mentors for them to model after during their education years, and the fact that you’re giving a more positive slant on that is very encouraging to me.

Ashten Duncan: Definitely. For everybody listening in who has any interest in really getting involved, I really encourage you to look into what leaders in the greater medical community are doing. While we are very grateful for people like Dr. Fauci and others who have really, I think, risen to a level of visibility to the public, who are definitely noteworthy and really deserving of the highest praise, I do want to encourage you all to really reach out and look at what your local medical societies are doing. For example, coming from family medicine, I speak specifically to the American Academy of Family Physicians and, on the state level, our Oklahoma Academy of Family Physicians, because you’d just be surprised what you might find, and the kinds of mentorship that may not be available to you right at your medical school but may be available to you with just a phone call or an email.

Kevin Pho: So let’s transition now into the KevinMD article that you wrote. It’s titled “Social connectedness, volunteerism, and the remedy for COVID fatigue.” Now, for those who didn’t read the article, can you just walk my audience through it and share the story of why you decided to write it?

Ashten Duncan: Definitely. Going into this article, what I really wanted to present was actually a case for some of the work I was doing at the time as the director of community engagement and health equity for the National Student Response Network. So in the opening of the article, I go through what has become more of a norm for physicians and other providers today, which is a telemedicine visit, with a lady named Mariana who lost her husband not too long before the encounter and who had really been struggling with a lot of the social and the physical isolation that the pandemic has brought on.

We’re recognizing that our elderly population in the United States, and really across the world, the people in those populations have definitely been subjected to more hardships from not being able to see family and not being able to really engage in the later years of their lives. I think many of them have been truly, deeply worried on a level that, for the two of us, we may not necessarily worry about as much, because we recognize that we’ll do what we need to do, and if it’s just a year, that’s fine. But I say that because as we look across our community at different people, for some people a year is very significant.

And so, transitioning into the other parts of the article, I really wanted to present a case for why that social connectedness piece is really, I think, going to get us through a lot of the ups and downs of the pandemic. We’re now seeing a lot bigger light at the end of the tunnel when it comes to the vaccination rates increasing, and, I think, slowly but surely creeping toward herd immunity here in the United States. There is a good chance that maybe if we were to have this conversation later this year, we may be talking a lot differently about these things. But for right now, a lot of parts of the country are still experiencing these things, and I think it’s important for those of us either in the medical community, or those who are advocates for people who are being served by the medical community, to really be connected with those in our community.

For me, the National Student Response Network was actually just one of a few things I was trying at the time to stay connected myself. Even though I was still able, fortunately here in Oklahoma, to get back out to clinical care responsibilities and everything else not too long after the pandemic really took hold in the United States, I definitely recognized that there was a need to really engage long term, and that level of self-care, and also that kind of reciprocal benefit that you get from connecting with others.

So really, just to make a long story short, the biggest thing about it is that the National Student Response Network is just one powerful resource for medical students and other health professional students to get involved with their communities if they find themselves still struggling to find those kinds of volunteer opportunities, service projects, whatever the case may be, locally. There are other opportunities as well. What I really wanted to deliver out of all this is that in order to get through this, we need to recognize that we are social creatures. I think some of us have made a lot of concessions to get through this, but there are ways, just like we’re doing right now, that you can use the power of these virtual platforms and other similar methods in order to stay connected with people and serve people like Mariana.

Kevin Pho: Now, tell me some of the specific initiatives that your organization did to help maintain the social connectedness, especially in the elderly population.

Ashten Duncan: Definitely. I’ve been so excited to see some of the recent developments, so I’ll start with the biggest recent highlight that I saw from them, because I recently transitioned out of my role as one of the directors in preparation for residency coming up. Recently, they have actually gained a lot of traction talking with the Biden-Harris COVID-19 task force and some of the different experts who are on the task force in order to really push forward the role of health profession students in administering vaccines to the community. Now that we’re getting to the point, especially under this current administration, of opening everything up, if not now, very soon, for all adults in our community, there’s definitely going to be a need for a higher throughput, especially in more densely populated areas.

Seeing that is just one example, for our elderly population, of making sure that people aren’t, that access to vaccines remains as open as possible, and specifically making sure that we can actually get more people out there, needle to arm, that kind of thing, to make sure that we’re getting closer to herd immunity. Because for our elderly population, we recognize that’s one step closer to getting them back connected with the people who are most important to them, and then, for themselves, to also protect them from COVID-19 and just the dangerous infections that we’ve run into here in this country.

Besides that, some of the other efforts, especially when I was still around, were around really getting involved with certain populations where serving elders is really important, so with some of our Native American tribes in the United States. That has been another focus of the organization, in order to really, again, push toward trying to stay connected, trying to get students involved, and building capacity within our health professions students, who will later become part of our workforce. And I guess above all else, helping people develop an appreciation for one another and helping health professional students see themselves as change agents and more, in a way that extends beyond just direct patient care.

Kevin Pho: Now, give us a sense of the relief that some of these elderly patients had when you helped them with social connectedness through the various initiatives that you did.

Ashten Duncan: So I think back to some stories I heard from some of our volunteers, and there was one story that stands out to me about an elderly gentleman, kind of like Mariana in the article, whose wife had passed away. It was a couple years before the pandemic, so he had just been getting used to what was becoming the new normal for him, because his children live on the other side of the country. Even in pre-COVID times, it was still difficult to stay connected. For them, it was checking in, I think more in the context of auxiliary help for intake and stuff for a community health center that was trying to reach out and make sure they were getting their elderly patients set up with these types of telemedicine visits, like what Mariana had.

And I just remember hearing about how grateful he was just to talk to somebody else, somebody that showed care. I think in a lot of ways, even if you feel like you can’t provide a service that might seem like it would have some substantive benefit to a patient like this gentleman, just reaching out, being connected, that human touch, even over something like Zoom, is so powerful. For people like that gentleman, it meant the world to him. I heard he had this huge smile on his face the whole time and was very animated, and I can imagine that it must have been a huge change from where he was probably at before that. So again, small things like that, just making a call, connecting over a Zoom like this, these things really matter to our elderly and also to others who feel isolated during this time.

Kevin Pho: We’re talking to Ashten Duncan. He is a medical student, and he wrote the KevinMD article “Social connectedness, volunteerism, and the remedy for COVID fatigue.” Ashten, as the pandemic is slowly getting better, as we get more vaccines into the arms of more and more people, can you just reflect on this last year, especially your emphasis on trying to address social connectedness? How has that impacted you as an upcoming physician?

Ashten Duncan: Definitely. I appreciate this question, because I think in a lot of ways, we can all relate to this. Just as a world, we’ve gone through a lot of changes personally that have been a reflection of the environment we’ve really had to work within. For me, what this has meant is becoming a little bit more in touch with some of the creativity that’s always been kind of the journey for me, and the things that really have kept me going, both during medical school and before. During this time, I’ve actually found it very powerful to connect with the works of other people. I actually have my phone sitting next to me, which reminds me of the Audible app I have on there and all the great books I’ve been able to listen to during this time, because that’s a part that I’ve really been able to engage in in a meaningful way, which has translated into some of the writing, too.

As I look toward the future and think about what kind of position I want to be, and the things I even want to get out of my training and residency, I really consider that creativity to be so critical. I want to just tell everybody listening in to this podcast interview that it’s something that is so easy to lose. I see it with my colleagues sometimes, and I see it with others across the board: In a lot of the health professions, we find ourselves giving a lot of ourselves and becoming emotionally, spiritually, physically exhausted. You have to have a way to recharge that battery, and you have to have a way to stay in touch with yourself, because I think it’s easy to lose touch with who you are in favor of just getting the work done day to day.

For me, that’s become a cornerstone, and I’ve actually started to incorporate more and more pieces of that into some of my research and the stuff I do on a regular basis, in order to understand more about some of the therapeutic value of what we’re talking about today, that social connectedness, building up people’s capacity for change. And in primary care, to kind of call back to that, I think we struggle with that, and we’re going to, I think, struggle with it majorly in people who are so taxed from the pandemic. I think going forward, that’s going to be a central piece of the work I do: helping people stay in touch with themselves, helping people stay in touch with others, and making it clear to people that they do have the capacity for change, and if their health goals are at the top of their list, I’m here to make it happen.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Ashten Duncan: Definitely. I think the biggest thing is be bold, be brave with yourself. For me, I know it sounds cheesy, and I know those were often just used as platitudes, but to back it up, I think oftentimes in medicine, and I think in other areas of life where people are working with others who are just really engaged, very intelligent, very motivated to produce changes in the world, it’s hard to find a place for yourself. For me, this has involved really just taking one step at a time. Write that one article. Get your message out there.

One thing I will say is that there’s a role for the words of medical students, physicians, and other health professionals, and really make sure you get your voice out there. It can take a while sometimes finding it, but again, be bold, be brave, and stay in touch with yourself and stay in touch with others.

Kevin Pho: Ashten, thank you so much for sharing your time and insight, and thanks again for being on the show.

Ashten Duncan: Thank you so much for having me.

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