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Vital Signs

New Yorkers experience skunks and starry skies

By Matthew C. Wiencke

Ihave a skunk living in my backyard, and somehow I've grown accustomed to the smell," says DMS third-year student Barry Ladizinski. Ladizinski is one of five longtime New Yorkers—all graduates of the city's Sophie Davis School of Biomedical Education—who are finishing up theirM.D.'s at Dartmouth. And enjoying some of the quirks of rural living.

At Sophie Davis, students complete a B.S. degree and two years of medical school in five years, then transfer to a partner medical school to finish their M.D.'s. Dartmouth is the first partner school outside New York State for Sophie Davis, which encourages its students to pursue careers in primary care in underserved areas. The DMS affiliation gives the New Yorkers experience in a new locale and adds to the diversity at DMS.

Turmoil: Yasotha Rajeswaran, another member of the Sophie Davis group, is from Sri Lanka; she left that country with her family during the civil war there and moved to New York City when she was 13. The turmoil in her own life helps her empathize with the patients she is seeing at Dartmouth.

The Sophie Davis students, like their fellow DMS thirdyears, are working their way through a series of six-week clinical clerkships. During her family medicine clerkship, Rajeswaran shadowed a visiting nurse on a home hospice visit to a patient with Parkinson's. "He was a sculptor," she says, "and all his artwork was beautifully displayed throughout the house. Seeing him at his own home with his family reminded me what a major impact a terminal illness has on family members. . . . It is often easy to forget when we see a patient in clinic or hospital. It was enlightening to see the family members struggle to make decisions with the patient's best interest at heart."

Another member of the group, Shahla Syed, did a research project at Sophie Davis on health risk behaviors in American Muslim youths. She is interested in international health and plans someday to work with DoctorsWithout Borders. She has taken medical Spanish, is interested in Hispanic populations, and did her DMS primary-care clerkship at one of the largest family-practice clinics in Florida's Middle Keys.

Three of this year's five Sophie Davis transfers to DMS pause for a photo at DHMC—from the left, they are Lilian Chen, Yasotha Rajeswaran, and Katherine Walia.

She shadowed a nurse on a hospice visit to a patient with Parkinson's.

A physician she shadowed there saw up to 60 patients a day—many of them uninsured, like a construction worker with a pain in his eye. "It was pretty amazing to watch Dr. O'Connor remove this speck of metal by scraping part of the cornea . . . with [the patient] lying there wide awake," Sayed says.

Triggers: Back at Dartmouth for her psychiatry clerkship, Sayed enjoyed working with Dr. Donald West. He "cares about students and their situations," she says, and emphasizes "both the biological and social triggers of psychosomatic illness."

The chance to do family medicine in a rural setting was an aspect of coming to Dartmouth that Katherine Walia found particularly appealing.

Ladizinski, too—when he's not learning to appreciate the aroma of skunks—has been enjoying family medicine. "I worked with some great [teachers]," he says, "such as Drs. Don Kollisch, Lou Kazal,

and Joel Lazar. It is truly amazing what these docs are able to accomplish in 15 minutes and the amount of issues that they are able to balance simultaneously."

His first clerkship was in psychiatry. Beforehand, "I thought New Hampshire would be lacking in terms of psychiatric patients," Ladizinski observes. "But I soon came to realize that people everywhere have psychological issues, even in the #2 place to live in the U.S.A.," he adds—referring to the fact that Hanover was judged by Money magazine to be the nation's second- best place to live.

Air: Ladizinski seems to agree with that assessment. "I love it," he says of the area. It's "peaceful" and "slow—sometimes too slow, particularly on [Route] 120 in the a.m.," he admits. But he finds many other things about the area to his liking, especially the "good air."

Clear skies also top Lilian Chen's list of the joys she's discovered inNewHampshire: "For the first time," she says, "I saw a sky full of stars and was actually able to see constellations!"

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