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Vital Signs

The rest of the story about sleep medicine

By Jennifer Durgin

Cigarette burns dotted the man's chest because he kept falling asleep while smoking. He was overweight, had a family history of heart attacks, and had stopped working three months earlier. He spent 16 hours a day sleeping, he said, but never felt rested.

Although Narath Carlile, DMS '09, was only a first-year medical student, he knew the man needed a sleep evaluation. Carlile had been a sleep lab technician, so he recognized the symptoms of a sleeping disorder immediately. But sleep evaluations, or sleep studies as they are also called, are expensive—and this man had no insurance. Neither Carlile nor his preceptor, a physician in Newport, N.H., knew where to direct the patient for assistance.

Search: Frustrated by the situation, Carlile went looking for a way to help such patients. He enlisted his classmate Gerard Carroll in his search, and together they applied for an Albert Schweitzer Fellowship. Each year, dozens of Schweitzer Fellows around the country work on projects to address unmet health needs in their communities. Carlile and Carroll are among 10 DMS students awarded fellowships this year. Now, with some basic funding and support, they are finding out what resources are available for patients with sleep disorders, identifying the steps required to access those resources, and working to streamline the process.

"The goal is to have the Good Neighbor Clinic be the knowledge center" for people seeking information about sleep disorders and treatments, says Carlile. The Good Neighbor Health Clinic (GNHC), in White River Junction, Vt., offers free primary-care and outreach programs, and DMS students and faculty volunteer there regularly. Carlile and Carroll will shepherd GNHC patients who may have sleep disorders through the process of getting an evaluation and possible treatment. And they've begun a recycling program, too, for continuous positive airway pressure (CPAP) machines—which are often used to treat sleep apnea. One of their mentors for the fellowship, Dr. Carla Nordstrom, an adjunct assistant professor of community and family medicine at DMS and a volunteer physician at the GNHC, set up a similar CPAP recycling program in Philadelphia. The team will draw on her experience, as well as Carlile's technical expertise, to get the program up and running.

Carroll brings a different kind of perspective to the team, having worked as a paramedic in New York City for six years. "There were so many holes in the health-care system" in Manhattan, he says, but "here it seemed fairly well put together." So he was surprised when Carlile alerted him to the "huge, glaring hole" around sleep medicine. "Well," Carroll recalls thinking, "this is something we can do" something about.

Network: While Carlile and Carroll, who are both 32 years old, joke that they are "the old fogies" in their class, they have no lack of ambition. "We both want to continue to do service work, locally and internationally," says Carlile, who grew up in South Africa. "With the Schweitzer Foundation . . . you join this fellowship. . . . So you have access to a network of people who've demonstrated service to their communities." Both anticipate tapping into that network throughout their careers. "I think that is very exciting for both of us," adds Carlile.

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