Fiftyfaces Focus Medicine and Science

Shalom Lloyd,  after a career of over 20 years in the pharmaceutical industry, went on to found two businesses. She is founder of Naturally Tribal skincare, a beauty line based on traditional remedies including shea butter, which she developed initially to cure her son’s eczema. She is also the co-founder and Chief Strategy Officer of eMQT, described as “the Bridge between the Pharmaceutical Industry and Africa” which facilitates clinical trials for pharmaceutical companies in Africa. She has been a keynote speaker on the topic of innovation and was a fellow of the Start-Up Leadership Program in London until 2020. 

This conversation builds on our earlier conversation with Shalom, which focused on her broad entrepreneurial portfolio, and updates us on the work of eMQT in Africa. We learn about its expansion, the effect of Covid and how it lead to an awakening of awareness of healthcare disparities as well as the importance of size in terms of potential population sample.  We hear about the shift in thinking around the potential for clinical trials in Africa, and how much of the reticence around conducting trials initially stemmed from lack of knowledge and even some fear of the unknown.  eMQT aims to tackle this lack of knowledge through education and outreach, and we hear about the programs are currently underway. 

The company's "why" include the following:

There is more information on eMQT on the website: https://emqt.org.uk/

Dr. Alan Carver is a neurologist at Memorial Sloan Kettering Cancer Center where he treats patients with neurological complications of cancer.  Interviewed by Maeve McQuillan, the conversation starts with his journey into medicine and what attracted him to neurology.

He describes his fascination with the brain, and how when the brain changes people change and how it gets to the essence of personality and function. 

The conversation then turns to palliative care and how active a role that doctors play in ensuring that the care is effective and meaningful. It touches on the human aspect of dealing with patients and reflects on the profession of medicine and whether he would recommend it to the next generation.

Dr. Patrick Devitt is my father and co-host of the first series of Inspiring People in the Law.  He is a consultant psychiatrist in  in Dublin, Ireland, and formerly spent time as Mental Health Inspector. His area of specialty is community psychiatry and Medico-legal psychiatry. He also has degrees in law and science.

Our conversation starts with his upbringing in Dublin in the 1950s, why he initially pursued a degree in science and some of the twists and turns that led him to go back to pursue an undergraduate degree in medicine.  We discuss his brief detour into a career in acting as an extra in TV advertisements – which, despite his promising good looks, was purely to pay the bills during medical school – and learn about his skillset in purposefully carrying a six pack of beer or preparing a cheese sandwich – all for the camera.

We spend some time discussing what it was like to return to study medicine while at a later stage in life than some of his peers, and how the “embarrassment” method of teaching was such a bonding experience that age was no barrier.  We move then to his time in general practice and how that started to involve community mental health issues from the very beginning. This galvanized his interest in psychiatry, and we hear about his early years pursuing this profession.

We indulge then in a reasonably detailed dissection of the state of modern psychiatry, trace its development from the era of widespread institutionalization and transition to a community based treatment scheme.  Dr. Devitt talks about the introduction of “game changing” anti-psychotic drugs which enabled better management and treatment and some of the failings of the transition to a community based treatment regime.  We discuss the use of drugs in modern psychiatry and the massive growth in awareness of mental health issues among the general population.

Dr. Devitt then explains why he believes that mainstream psychiatry should focus on what he describes as the Big Five: Schizophrenia, Bipolar Disorder, Severe Depression, Severe Anxiety, and Severe Personality Disorders.  We talk about the more holistic approach being taken overall, and why communication to family members, management of expectations and treatment is so key to successful outcomes.

Finally we examine diversity in medicine today, particularly in the field of psychiatry, and why medicine, as essentially a “problem solving” pursuit is so intellectually challenging and has such universal appeal.  We then examine the role that running has played in this psychiatrist’s life, how it is key to managing anxiety and promoting wellbeing.

Dr. Devitt refers to the following article in the New York Times: https://www.nytimes.com/2022/10/04/opinion/us-mental-health-community-centers.html and the following book about the experience of young Medical Interns: https://www.goodreads.com/en/book/show/60858767-the-night-interns.

Professor Brian Devitt is a Consultant Orthopaedic Surgeon, Professor of Orthopaedics and Surgical Biomechanics at Dublin City University.  He studied medicine at University College Dublin and has a particular focus on the knee. He is also my brother and given that he has spent that last 8 years in Melbourne, Australia and we have only seen eachother a handful of times in this period, I am excited to sit down with him and touch base on his medical career and outlook.

We start with what motivated Brian to study medicine, which was a continuation of a family tradition, and how he came to orthopaedics as a speciality. We spend some time on what excites him most about this area today – the massive advances in surgical techniques, the integration of surgical interventions with other lifestyle changes and advances that are making a massive change to the quality of lives of a population that is living longer.

We examine then the fusion of medicine and sport, given that sport, and rugby in particular, is another one of Brian’s passions and we ask what techniques in sports rehabilitation can be applied to the general population.  We move then to the issue of medical training and assess the four different jurisdictions in which Brian has practiced medicine – Canada, the USA, Australia and Ireland.  We look at how the approaches to training and practice compare and ask what is best practice in each place.

Finally we turn to reflections – on the surprising fulfillment of blending academic work with surgery, on the importance of patient communication and on the need for restraint when intervening in a surgical way. We cite influential figures as well as words of wisdom and overall the importance of emotional intelligence as a way to “get on” and succeed in medicine.

Chidiebere Ibe is a medical student and Forbes-Featured medical illustrator whose illustration of a black fetus in utero went viral in December 2021.  Many commentators said that this was the first time that they had seen a depiction of a dark-skinned fetus or pregnant woman and provoked a discussion about the lack of representation of such images in textbooks and journals. Chidiebere has a bachelors degree in chemistry from the University of Uyo in Nigeria, and is the Chief Medical Illustrator at the Journal of Global Neurosurgery.  He holds numerous roles on various committees relating to medical education.

Our conversation starts with Chidiebere’s upbringing in Nigeria and some of the difficulties he encountered in getting even basic services – such as internet access.  He describes how he used to travel one hour each way to his church to get access to an internet connection. He then discusses his first attempt at medical illustrations and how he was essentially self-taught in this domain.

We move then to talk about “that” iconic image of a black fetus in utero that caused such a profound reaction across medical circles, medical schools and the media at large.  We talked about how empowering representation of diversity can be and how important it is to demonstrate belonging, a right to be counted and to be recognized and how it can enable better access to healthcare and better equity.

We finish with Chidiebere’s personal reflections as he embarks upon another quest to attend medical school.  About the importance for him of understanding where he has come from, where he is now and where he is going.

See these links for more information on Chidiebere’s work: www.chidiebereibe.com and https://www.championingchange.africa/

Yele Aluko is Chief Medical Officer at EY, a role he has held for close to 4 years. He is Co-Chair, Health Equity Advisory, at the international Well Building Institute, an Advisory Board Member at the Children’s National Hospital and a Board Member at the Wake Forest University School of Business. He has worked as a Cardiologist in hospital settings for over 30 years.

Yele was born in Nigeria and we start with when he first realized his calling to be a doctor. We trace his journey to the US and how at the beginning he went through a difficult integration into life there – with little social capital locally and few relationships. We move to his journey to cardiology and his experience in hospital settings, and ultimately to what led him to move away from bedside medicine into matters of medical policy.

True to the mission of this podcast series we examine the issue of diversity in medicine, and Yele discusses the concepts of “missing persons” in medicine – the gap in representation of people of color at every level of medicine and the trickle down effects that this causes in terms of access to health care, trust in medical professionals and healthcare equity. We discuss initiatives to eliminate bias, and whether they work, and why they often lack sufficient “buy in”.

This rich discussion is part of our Fiftyfaces Nigerian Voices series which will be released later in July. We are releasing it now as a counter narrative to that espoused by the podcast by the JAMA of February 2021 that questioned whether systemic racism in medicine existed

Kate Baur recently started her surgical residency in Ann Arbor, Michigan. She has a particular interest in colo-rectal surgery, in particular as anal cancer is a cancer that has a higher incidence in populations such as the LGBTQ+ population.  Since recording her podcast she has not only started her surgical residency but has got married.

Our conversation starts with Kate’s upbringing which saw her live around the world in communities in Korea, India and China and what this taught her about different cultures as well as some of the grave inequities in services, particularly medicine.  We trace her path to medical school and her interest in surgery, and reflect on the presence of role models within medicine among women and gay women in particular and find that there are very few.  We speak then about the importance of medicine embracing the different needs of the LGBTQ+ community and how little of the curriculum addresses this.

Kate is passionate about advocating for the relatively “invisible” LGBTQ+ community when it comes to medicine and this is what drew her to colorectal surgery in particular. We compare the approach to screening for anal cancer to screening for cervical cancer and find that the principles are the same but, again, the advocacy is lacking.  There is more information about the “Anchor Study” which is investigating screening and treatment for anal cancer in patients who are HIV+ on the following link.  https://anchorstudy.org/

Kate mentions GLMA which is an organization of health professionals advancing LGBTQ equality (https://www.glma.org/) as a prominent affinity group that is raising awareness.

Miss (Dr.) Samantha Tross is a consultant orthopaedic hip and knee surgeon, and she was the first black female orthopaedic surgeon in the UK. She is Associate Professor of Orthopaedics at the American University of the Caribbean, a role she has held since 2010, and is Associate Editor of the Journal of Medical Case Reports. She's a member of the Board of Trustees of the British Association of Black surgeons, and the Secretary of the International Othopaedic Diversity Alliance, which was set up to increase diversity within orthopaedics. She's been a member of the Black Power List 100 since 2010.

Our sweeping conversation starts in the Caribbean, and her upbringing in Guyana, and the early seeds that were sown for her to become a surgeon. We follow her educational path through boarding school and medical school in the UK and discuss the diversity within her medical school class, which was very minimal. We trace then her path to become a surgeon and why she enjoys the field of orthopedics. We discuss how patients in this area are generally well other than the reason for the operation, the ready availability of feedback on the operation and the ability for these interventions to have massive impacts on the patients' quality of life. 

We move then to issues of diversity and first Miss Tross's own experience throughout her training.  We discuss how the issue of race is perhaps one of the last issues to be addressed within medicine in terms of taking steps towards better inclusion, and also address team dynamics and how to handle bullying within workplace settings.

Finally we look at the importance of self-belief, having a plan and remaining true to oneself and one's ambitions.  This is an empowering discussion that hopefully will pave the way for many more such discussions. 

There is more information about BABS, the British Association of Black Surgeons here: https://babs-uk.org
The British Hip Society website is here: https://britishhipsociety.com
There is more information about the International Orthopaedic Diversity Alliance here: https://www.orthopaedicdiversity.org

Dr Brian Dooreck is a Board Certified Gastroenterologist with a particular focus on private healthcare advocacy, life balance, and gut health. We met on Linked In when I became aware of his frequent health tips and his work within the private wealth community to promote ways to optimally navigate healthcare. He lives in Florida.

Our conversation starts with what led Dr. Dooreck to pursue a career in medicine and how gastroenterology appealed to him because he found it intuitive and understandable. He also found it relatable and noted how all of us relate to it.

We move to talking about advance in that area, and what excites him most - in particular the screening tools that enable him to detect pre-cancerous growth in the colon, as well as the importance of taking a holistic approach to gut health.  We talk about fads in this area, what really works, and the importance of balance in one's daily diet.

We turn then to another one of Dr. Dooreck's passions, which is helping people to navigate the healthcare system, and he noted how "broken" the healthcare system is and how people underestimate the importance of navigating it properly.  He also observed that patients themselves can greatly improve their access and experience of the healthcare system by learning how to properly advocate for themselves, by capturing their own health history, being responsible for logging it and communicating it and how important this can be in terms of getting the right care when it matters.

Finally we look back at what have been the most significant highs and lows in Dr. Dooreck's career so far.

In this inaugural Fiftyfaces Focus Medicine and Science podcast series we dive into disciplines that are rich and multi-layered, hold the power to transform lives and outcomes but also suffer from underrepresentation, neglect and bias. 

We first ask our diverse range of guests what it was that drew them to medicine or science, and find out what role "problem solving" plays.  We examine what sacrifices were made in the determination to follow a dream and what it takes to succeed as a practitioner as well as a patient.  The role of EQ, curiosity, self-advocacy and drive is noted. 

We look at a variety of specialties from psychiatry, to gastroenterology, to orthopedic surgery, cardiology and colo-rectal surgery and ask what advances excite the experts most.  We look at gut health, mental health, the increased holistic nature of medicine and where it is broken, and compare geographic areas.

We hear about pioneering drug trials from Shalom Lloyd, whose firm eMQT addresses the massive disparity in drug trials on populations in Africa, and why this presents an opportunity for data gathering and learning.

We hear about underrepresentation in medicine - from black medical students and practitioners, to LGBT professionals to women, and ask what can be done to resolve this.  There is a bias in how medical images are presented and Chidiebere Ibe, a renowned medical illustrator from Nigeria, shares how he bucked the trend here and produced an image of a black fetus in utero which subsequently went viral.

 
Our Guests in Series 1 are:

Dr. Yele Aluko, who is Chief Medical Officer at EY, a role he has held for close to 4 years.  He is Co-Chair, Health Equity Advisory, at the international Well Building Institute, an Advisory Board Member at the Children’s National Hospital and a Board Member at the Wake Forest University School of Business.  He has worked as a Cardiologist in hospital settings for over 30 years.

Dr. Kate Baur, who is a surgical resident in Ann Arbor, Michigan.  She has a particular interest in colo-rectal surgery, in particular as anal cancer is a cancer that has a higher incidence in populations such as the LGBTQ+ population.

Dr. Alan Carver (interviewed by Maeve McQuillan), who is a neurologist at Memorial Sloan Kettering in New York City.  He has a particular interest in neurological complications of cancer and Its treatment; headache and pain medicine, end-of-life care and general neurology.

Professor Brian Devitt, who is a Consultant Orthopaedic Surgeon, Professor of Orthopaedics and Surgical Biomechanics at Dublin City University.  He studied medicine at University College Dublin and is a specialist in orthopedic sports medicine. He is also my brother and given that he has spent that last 8 years in Melbourne, Australia and we have only seen eachother a handful of times in this period, I was excited to sit down with him and touch base on his medical career and outlook. 

Dr. Patrick Devitt, my father and co-host of the first series of Inspiring People in the Law.  He is a consultant psychiatrist in in Dublin, Ireland, and formerly spent time as Mental Health Inspector.  His area of specialty is Community psychiatry and Medico-legal psychiatry. He also has degrees in law and science.

Dr. Brian Dooreck, who is a Board Certified Gastroenterologist with a particular focus on private healthcare advocacy, life balance, and gut health. We met on Linked In when I became aware of his frequent health tips and his work within the private wealth community to promote ways to optimally navigate healthcare.

Chidiebere Ibe, who is a medical student and Forbes-Featured medical illustrator whose illustration of a black fetus in utero went viral in December 2021.  Many commentators said that this was the first time that they had seen a depiction of a dark-skinned fetus or pregnant woman and provoked a discussion about the lack of representation of such images in textbooks and journals. Chidiebere has a bachelors degree in chemistry from the University of Uyo in Nigeria, and is the Chief Medical Illustrator at the Journal of Global Neurosurgery.  He holds numerous roles on various committees relating to medical education.

Shalom Lloyd, who after a career of over 20 years in the pharmaceutical industry has gone on to found two businesses - she is the founder of Naturally Tribal skincare, a beauty line based on traditional remedies including shea butter, which she developed initially to cure her son’s eczema. She is also the co-founder and Chief Strategy Officer of eMQT, described as “the Bridge between the Pharmaceutical Industry and Africa” which facilitates clinical trials for pharmaceutical companies in Africa. She has been a keynote speaker on the topic of innovation and was a fellow of the Start-Up Leadership Program in London until 2020.

Miss (Dr.) Samantha Tross who is a consultant orthopaedic hip and knee surgeon, and she was the first Black female orthopaedic surgeon in the UK.  She is associate professor of orthopaedics at the American University of the Caribbean, a role she has held since 2010, and is Associate Editor of the Journal of Medical Case Reports. She is a Member of the Board of Trustees of the British Association of Black Surgeons, and the Secretary of the International Orthopaedic Diversity Alliance, which was set up to increase diversity within Orthopaedics. She has been a member of the Black Powerlist 100 since 2010.