Off the Streets® — Cincinnati Union Bethel

Codie-Anne Crew, Summer 2013

The journey to becoming a physician will take each medical student down a unique and didactic path. With each step, there is a new opportunity to learn new lessons or review those previously learned. Being a part the Urban Heath Project gave me the chance to do so at the Off The Streets site. The circumstances that surround the lives of the women in the program offer a teaching moment to any intern who is willing to step back and see the bigger picture. Changed by a past life of prostitution and substance abuse, these women not only learn and apply the tools they need to recover but their stories are those, which interns can learn from in the process. This is a learning experience for everyone involved. Just hearing about Off The Streets has the potential to place someone outside of his or her comfort zone. The pasts of these women are tainted with abuse, drug use, homelessness, addiction and abandonment. These have all led to their development of protective devices that present as barriers to a successful recovery they hope will be in their future. Each patient a student will see in the future might not have all these aspects that serve as compounding factors in the health care and treatment plan of that patient. However, having knowledge of how to approach patients with these factors can make the challenges that arise in patient care more manageable.

As I began my time at Off The Streets, I did not know where to begin. I knew that talking about their pasts brought up sensitive topics, but I also knew that talking through them was the only way to begin their journey to an honest and successful recovery. Getting these women off to a great start was something I could not rob them of. So, I sat, we read, they made their comments and I listened. I thought that by listening I was not doing enough but I gained a new respect for how important it is. As students we learn about interviewing a patient and we see the key role patient history plays in their care and treatment plan. But having this experience allowed me to solidify and practice this skill even more.

Addition to lessons on listening, came lessons on building rapport, working with varying personalities, knowing how to keep a conflict from escalating further, developing a stronger voice and being able to instill confidence in others as well as myself. A certain level of confidence is needed when faced with the possibility of relapse and the challenges of recovery. During our talks of codependency and other health topics, my time there also taught me the importance of empowering the women I worked with, which has motivated to empower the patients I encounter in the future. This experience was not only about listening and learning, but also about knowing what to do with what you have learned. It is humbling to have the opportunity to work with these women and I hope to only build upon all I have learned there.