Karam Hamada, Class of 2024

 

The KU School of Medicine Class of 2024 started medical school virtually due to COVID-19 pandemic. They were the only class for whom the white coat ceremony was held virtually. Most students got to know each other through the class GroupMe chat, and other than that, there were not too many chances to get to know people outside of small groups. One way through which students connected with each other was student interest groups led by several students in the class. One of these groups is the KUMC Student Community Providers, which organizes student volunteers to help with actionable ongoing needs in Wyandotte County. The group is currently managed by several students in Class of 2024, but it was initiated through the efforts of Sophia Leonard and Karam Hamada. This is a conversation between Karam Hamada, a second-year medical student at KUMC, and Kimia Memar, one of our Med Intima Narrative editors from the same class. 

• How do you describe yourself?

I consider myself to be different if that makes sense. I have a fascination with not fitting in, and I have an issue with doing the same thing repetitively for long periods of time. So that’s why I always need to be doing different kinds of experiences all the time and meet different people.

• From personal experience, I know not fitting in the mainstream is not easy. However, I see how you are embracing that and letting it liberate you.

I think part of it could be that I bounced around many different schools growing up. I went to 8 different schools, and every one of them was so different with regards to its identify, with students ranging from very low to very high socioeconomic statuses. Having to switch and adapt my identify to each of them was really taxing on me. So in college, I decided to be myself because I would never be able to fully fit in. I want to help my family and everyone around me, but I also want to uplift them to feel comfortable in doing what they want to do. I’m really big into service and that is not just community service: it is giving back and inspiring others to give back.

• Tell me about some of your current work.

Before college, some of my peers and I realized there wasn’t really an emphasis on urban or local outreach at KU–students seemed to be isolated to campus activities. Working with some local groups in Kansas City, Kansas before college, I figured it would be nice from a medical standpoint if we could get some students out into the community, for example trying to help explain things to teens and young adults about things we learn in school. Unfortunately, that was really challenging during COVID, so we switched our aim to direct local community outreach.

We got in touch with the local chief medical officer from Wyandotte County, who was very helpful, and some more contacts through KUMC also helped us out. Our motto is Listen, Learn, Lead. We Listen to see what are the most pressing needs in our community. We then Learn how we can help while making sure we sure we don’t overstep our boundaries, and what’s the best way we can really make an impact. Finally we help Lead change either by directly joining an ongoing initiative or finding an unaddressed need and creating a way to address that.

So far, because of how hard it has been to organize things around COVID, our main focus has been food insecurity because Wyandotte County has the highest rates of food insecurity in the country. We have been organizing food drives, and we are trying to install some community fridges. We are hoping to expand on that in the current year. Also, we are trying to help develop medical clinics, such as the back-to-school fair that helps students provide some medical services.

• Can you tell us more about the platform that you are organizing in relation to the work you are describing?

During undergrad, I was part of the Center for Community Outreach. The organization had a home base volunteer website where a dozen different initiatives were going on; and each of them was assigned to find events in the community, organize them using local contacts, and display them on the website for interested students. I was surprised that KUMC does not have something similar.

We decided to create a website meant to be a home base where students can see every single event coming up on the calendar organized by initiatives. For example, if you are interested in fetal infant mortality, you can see local events at telehealth clinics that you can join. This would involve all medical students, nursing students, and other health professions across the 3 campuses. They could see upcoming events in each initiative and keep track of them with notifications and reminders.

• It is amazing that you recognized what was lacking and pursued it. Can you think of any personal experiences that helped you do that?

I believe it has been multiple experiences. For one, during my gap year between college and medical school, I worked for an orthopedic surgeon as a scribe. I accompanied the physician before, during, and after the visit; and I got to see the entire decision-making process. I saw other issues on top of the medical process that impacted the patient’s care, but the provider did not have the time nor training to deal with those issues.

Some examples I observed are someone going through a mental health crisis, or struggling with payments, or other social drivers of health like food insecurity or transportation that impact care at a high level. Social workers really help in these situations, but social work is hugely under-served in this country, especially here in Kansas. So I believe medical doctors can get trained with the bare minimum to know how to get people connected with those resources.

On the same note, I also worked with a group called Made Men here in Kansas City. Their goal was to provide training and resources to help people find jobs. For example, GED training for people in Kansas City, Kansas, or helping with basic resources such as transportation so that they can get to the nearby hospital. Sadly, this group was understaffed and underfunded. I have discovered that lots of other similar local initiatives are struggling and don’t get the attention they need. This is why we cannot solely rely on other groups to do this work for us. As a medical doctor, you have the power to assist, even though you may not want to think about it. The patient looks up to you in a way. Not everyone has access to a therapist or social worker. Most individuals don’t even have access to a doctor. Hence, when they make a visit to the doctor, that might be the only opportunity with someone who can help them. Therefore, I think our generation of physicians need to have an understanding of our local community, its urgent needs, and some ways in which we can help.  By creating the Community Providers Group, I wanted KUMC students to find what are the best way to immerse in our community and help our patients.

• Can you tell us what inspires you and keeps you motivated? I am asking because sometimes thinking about anything other than studying can take a lot extra energy and focus.

I agree it is hard, and you don’t always have the time. Personally, I don’t think I would even be able to study if I didn’t have something like this to help remind me why I am doing medicine in the first place. Community outreach helps me keep going. Everybody has different reasons for coming into medicine, and for me it was always about trying to give back to my community.

Most of my family in America either did not have access to doctors growing up or it was every 10-15 years. On my mother’s side of the family, there have been multiple early deaths from preventable conditions. So it is important to me to try to make people and their providers feel comfortable enough that they would go to the doctor.

A lot of times, even when they had resources like Obamacare or Medicare, my family still would not go to see the doctors. I think because there is a rightful stigma that the physicians aren’t treating minorities and disenfranchised people appropriately, don’t provide the right care, or dismiss their concerns. This has led to mistrust in the medical community.

What keeps me going is the strong sense of family emphasized in my culture, sometimes even more than personal mental health, which does not sound right to say, but it is basically “family over everything.” I do this because I want to ensure my family and people like my community feel comfortable seeking care. I also want to inspire people from different backgrounds to get into medicine. This way more and more individuals will find a shared connection when they go to see their doctor because they will see someone with similar backgrounds and experiences on their healthcare team. I want people in the community to be able to get out there and find providers that they can relate to.

• What you shared about your culture is particularly interesting to me. When I came to the United States  around 12 years ago, I found the Western culture very refreshing because it played so much into my personal advantage, telling me I am the priority. The environment gave me the impression that me, my education, and my career are the most important things in my life. This facilitated a lifestyle that was forward and easy, so I took on this new life and made fast progress through academia and career. Six years later, I found many holes in this lifestyle. I personally realized it is too individualistic, way more than my level of comfort, and it causes some people in society to always be left out, no matter what. I saw too many in the elderly population who get left behind, and that is a big portion of the population who served society, their children, and the younger generation for a long time. People who had a hard-working honest life. I felt that something is not right. I realized that all these measures of personal happiness, such as money and career, are not really happiness, not for me anyway. My reasoning is, if you see so many communities who are underrepresented and unhappy, that says there might have been too much emphasis on individual growth. This made me go back to my culture and bring back the things that were instilled in me as I was growing up. I revived these values from my culture and started integrating that with what I have learned and experienced here. Like you said, it doesn’t sound right to say you are putting your family above your own interest sometimes, but personally I am much happier now. Everything in my career and education is a lot slower, but the balance of attention that I am giving my family and friends and the people in the community has put me at peace. I do not want to steal the spotlight from you, so I will ask another question: What is an obstacle that you struggle with?
  

Going off what you said earlier, what I struggle with is knowing all the different horrible things going on around you, and the prejudice against many communities including your own people, inequality, and access to healthcare, which has led to a real distrust in the medical community around the world with issues that people used to just easily accept decades ago, such as vaccination. Now everything is being questioned because people do not really trust their providers anymore.

With rising poverty rates and every corporation trying to pump the buck in this capitalistic society, as well as with ongoing wars and the perception of many in America against those who are abroad, the hardest thing is being able to spend my time in school when I know I can be actively somewhere else helping someone. It is hard for me to look forward to long term results. I see someone struggling and I want to help now, but I cannot because I am a medical student. I understand in the future I will have the power to help, but who knows how many people are going to suffer until then because I will be in school and residency seemingly forever.

Being able to go to school and study every day is a challenge when you see pressing recent issues like police brutality and protests all in different cities. You want to be involved, hear people’s thoughts. You want to listen in, but you have a test on Friday. It is difficult to be on a constant schedule as a medical student because you get excluded from what is going on.

• What do you appreciate about this work?

I will say from doing this work I am learning a lot about different people. Even before, I believed the best way to make a good medical provider is to encounter people of different backgrounds all the time and have as many different experiences as you can.  Because then when you see a patient who speaks a different language, like our local Latin communities, or is from a different geographic area with a different setting, such as our rural patients, you can apply your previous experience to connect with them through a shared experience. This helps them be more comfortable to seek care from you and trust your medical knowledge.

• I think this is what makes people like you different from many of us. We will ALL have the power to help people later, but what if this constant schedule is what changes us throughout medical school? Most medical students come in with great ideas, motivation, and specific goals to help people they can relate to in particular ways. But how many of us come out of school with the same priorities? We keep hearing in lectures that doctors get desensitized as they go through medical education, and that maybe why some patients feel disconnected from us, but I think that is not the only reason we change. I believe what makes some of us go from being really sensitive, passionate, caring people to becoming doctors who see patients and just make money is being on constant schedule and not having enough personal time which makes us forget why we were doing it in the first place. I think maybe it is because of how a capitalistic society insists on productivity. You cannot have it both ways. You cannot constantly push people be productive all the time and at the same time demand the compassion and consciousness that patients need to see before they can trust their doctor. I recognize this because of how living here has changed me from someone who was living with their faults and flaws to an individual who is on a constant algorithm to dust off those flaws and polish myself into someone who can more easily climb the ladder.  

Going off that, there is so much we need to learn and not enough time. I do not know how to change that. Maybe the pandemic made it worse and some of us did not get the sense of community and de-stressing that we felt we needed. I think generally most people in medical school want the best for their community, but there are so many needs that we cannot address. I personally think I’m not able to make a huge difference in the world right now, but local community initiatives seem the most impactful to me. And to get involved in those, you are always going to need a team of like-minded people who can support you and help think things through. Maybe one reason people struggle and give up on their aspirations or do not invest too much into it is thinking, “I can’t do this on my own. It’s overwhelming, and I’m already too overwhelmed to add another stressor.” During residency, we are going to be working 60+ hours a week, and it is even harder then to get involved in community outreach.

Something Dr. Allen Greiner once said to me was, “If you really want to be involved in community outreach, the first thing you want to do when you go to your new city is to start looking for the right team.” A non-profit group or public health department might not be the best places to make change in every city. You need to look for the right people who care and are motivated and actually want to make change, no matter their organization. Those are your agents of change.

• Finally, is there anything you want to share that I did not ask about specifically?

I would say the main thing is just that I want people to feel comfortable being involved with different experiences in the community and beyond. School can be overwhelming, some of us do research or JayDoc on top of it, but I want people to ask themselves: what will make me stand out? What am I going to remember looking back at this? Everyone will remember studying for tests, but if you want the unique experiences that will last forever, you have got to go out there and do something different. Find what you are really passionate about and the organizations or events that match that passion. Community outreach can be as simple as playing soccer with people from all around the city with different backgrounds. You play with them and learn about who they are, and this will make you a better provider.

My whole purpose of being here is to get through medical school while learning as much as I can from the community and people around me because every experience is a learning experience, so I want people to be willing to learn from everyone. We are so uncomfortable and stressed at first, so we find what makes us comfortable and stick to it right away: “If I keep doing this, I’ll pass the test. If I do these activities, I will survive.” But maybe if we use this time to challenge ourselves more, we will learn something new that makes us better people and better providers.

• I really learned from our conversation! Thank you!

Thank you for organizing this. I enjoyed our conversation because it made me think. I know there are a lot of community conversations, but they are usually about things I cannot relate to that much, so I wish there was more opportunity for us to get together and talk casually like this.