I understand your work at Sage Prairie Addiction Medicine Clinic focuses on adolescents. What a typical day is like for you?
I see patients via Zoom in a walk-in closet. Most of my patients are in late adolescence (18-25). I’d like to see more patients in middle school and high school. Substance use disorders (SUD) start in adolescence, and as with any illness, the prognosis is better when they are identified and treated early. All substance use disorders benefit from behavioral interventions, so much of my work involves increasing patient motivation to participate in treatment. I use my prescription pad to support the treatment of opioid use disorder, alcohol use disorder, and nicotine use disorder, as well as common mental illnesses associated with SUD. To patients, I describe the use of medication as helping to stabilize the physiology so that the individual can focus on the work of recovery, which is learning new skills and ways to think about the challenges of life. I also work on a Fetal Alcohol Spectrum Disorder (FASD) education project with Proof Alliance (formerly the Minnesota Organization on Fetal Alcohol Syndrome), and I am the AAP FASD Champion and E-Cig champion. When I am not seeing patients, I am working on educational materials, or educating myself.
What interested you in serving as the chapter’s e-cigarette champion and what kind of responsibilities does it carry?
Tobacco is our number one killer. In the United States, it is responsible for 480,000 deaths per year, and in the world, more than 8 million. This is more than HIV, malaria, and tuberculosis combined. Helping people quit smoking/vaping is difficult, but it is one of the greatest satisfactions I have. The e-cig champion role involves being available to teach clinicians, policy makers and the public about prevention and treatment of nicotine addiction.
You speak several languages. How did you come to learn French, Haitian Creole, and Spanish, and do you have a chance to speak those languages frequently?
I started learning Spanish when I was 13, when my father put us on a boat to sail the west coast of Mexico for six months, then a couple of years later I spent a few months in Chile. I studied French in college. Then I spent a year in Haiti between my third and fourth years of medical school. I have used Spanish frequently in clinical care over the years, although I don’t get much opportunity in my current position. I’m taking advantage of my new comfort with video communication to improve my Spanish with a tutor in Mexico. I travel to Haiti from time to time to work and teach, using my French and Creole then. My favorite French story came when I was working on the east side of St. Paul. I was working with a Hmong family, but I realized that while the Hmong interpreter was translating my English to Hmong, the parents were translating Hmong to French for the children. They had lived in France before coming to the United States.
What are your interests outside of medicine?
Family, hiking, writing, keeping up with old friends and reading. I’m currently obsessed with a Mexican telenovela which I watch in Spanish with Spanish subtitles, to learn more idioms.
What would a perfect day look like to you?
In medicine? All my patients are happy and productive, stable in their recovery, children getting along with parents, parents caring for their children, everyone’s Hep C cleared spontaneously, teeth all fixed, everyone quit smoking. No one overdosed, no friends or family overdosed. Plus, it’s warm and sunny, no ice on the ground.
What advice would you give medical students or trainees today?
Substance use disorders drive morbidity and mortality in the U.S., and they affect all other diseases we care for. Know the spectrum of disease and how to diagnose it. Believe that you can help people quit smoking. Know alcohol really well. Know the difference between low-risk drinking, risky drinking, heavy drinking and alcohol use disorder. Know the metabolism of alcohol, and all the pathologies associated with it.