Encapsulating Patient History for HIV/AIDS Specialists
Toronto, Canada
Overview
In the summer of 2018, I worked as an intern at Sunnybrook health sciences center in Toronto, Ontario in the Anita Rachlis HIV/AIDS clinic. During my time there, I assisted medical professionals in the clinic by doing various clerical tasks. I learned a lot about behind-the-scenes tasks of clinical work and doctor-patient interaction. During the job, I was given access to very intimate, sensitive information about patients and got to observe how to approach health work in a holistic manner. I valued being trusted with that responsibility and the privilege to learn so much about people.
Personal Importance
I have always cared for others, yet I don’t think I understood how deeply engrained that was in who I am until this position. This was my first job outside of the food service industry, and the first time I was in a professional medical environment. I had previously learned about HIV/AIDS, but had very little knowledge compared to what I know now. It was this position which drove me to learn more about the topic. The experience helped shape a health equity focus in my passions with an emphasis on and an integration of others' experiences.

(above) How to Survive a Plague is a powerful documentary which focuses on activism during the HIV/AIDS pandemic and includes real footage recorded during that time. Robert Rafsky (pictured above) is one activist I have an incredible amount of respect for. This quote from him has shaped how I view my purpose in public health: "What does a decent society do with people who hurt themselves because they're human; a decent society does not put people out to pasture and let them die because they have done a human thing"
Tasks Accomplished
After a patient of the clinic sees their medical professional, a document is sent to their general practitioner detailing the visit, their medications, and any other pertinent information. My main task in this position was to prepare this note for the doctor/nurse/nurse practitioner who was going to see a patient. In order to do so, I read through hundreds of papers in patient charts and navigated online Ontario medication databases to extract important information. I repeated this process for over 100 patients. I also updated online medical records for the clinic about new incident case of syphilis patients had reported. Lastly, I spent time organizing physical patient charts and refiling.
Leadership Competencies Gained
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Others’ Circumstances: One of the strongest competencies I developed from this experience was an understanding of others' circumstances. When reading through patient charts they sometimes read like a story of someone's life. One woman in particular stuck out to me. She had recently fled her home country in the middle east because of persecution and an abusive husband. Through reading chart notes, I learned her husband had continued stalking and abusing her from overseas, and even revealed her HIV status publicly on Facebook. Since she was not a legal citizen, the government was considering deporting her. The entire clinic staff had written a letter to the immigration office of Canada explaining her life-threatening situation if she was deported and strongly urged them to let her remain in the country. She was just one of many patients who were in tough circumstances. Others included single mothers experiencing homelessness, refugees, or young adults unable to tell their parents of their status because of the stigma. Many of these people were only able to get the care they needed because of universal healthcare in Canada. Coming back home, I struggled thinking about how in the US the same type of people would be uncared for despite such difficult circumstances because the US government still denies healthcare as a human right.
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Empathy: The same type of experiences that developed my sense of others' circumstances, also developed my understanding of empathy. Sometimes it is difficult to remember everyone has their own life outside of you, and experiences you will never know about. Being allowed to see such intimate details of people's lives broke that barrier between self and others for me. One particular patient whose story has stick with me was the same age as me at the time and had also recently entered college. He was struggling to come to terms with his HIV status and didn’t feel he could tell his parents because of cultural pressures. It pushed me to be more engaged with others' perspectives and feelings and attempt to understand the experiences they have endured.
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Self-Understanding: The emotions I felt from this work gave me yet another spark for my love of Public Health and Global Health. Within a week of starting this job I began to feel the emotional strain it put on me. In one specific instance, I had just read the chart of a patient with particularly difficult circumstances and I felt so overwhelmed with emotion I had to step outside for air and spend time processing. This moment showed me that it wasn’t just frustration and sadness I was feeling, but passion. My experiences in the clinic and the things I read ignited my genuine concern and care for others, including strangers. It inspired me to engage with the HIV/AIDS community in Seattle and drove me to learn more on the topic academically at UW. Because of that spark, I have gone on to have many other key learning experiences which are centered around HIV/AIDS. For example, I am now volunteering at a needle exchange clinic in Seattle and I've taken courses specifically on HIV at UW.
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Organization: In order for work and other operations in the clinic to run smoothly, organization was absolutely imperative. Patients deserve the best care possible, and that can only be done with efficient systems and resources. One frustration during my time at the clinic came from the online databases. In Canada, if someone picks up a medication via public healthcare, it goes into an online record. However, some people get their medications privately in Canada and that information is not entered into the government-based service database. This made it more difficult to get a complete image of a patient because of the disconnect between the two systems. It was only though using my organizational skills that I could navigate that disconnect in an effective way and maintain a high-quality level of work.
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Functioning Independently: All of the work I completed in this position was done independently. In the morning I would receive a list from the doctor of names to write reports on, then throughout the day I would pull those physical charts and create the documents. I learned how to find my own answers to questions or challenges that inadvertently popped up because I did not want to detract from the busy doctor’s time unless absolutely necessary. Initially, I asked plenty of questions to gauge the quality of my work and know what expectations there were for me. Once gaining trust around the quality of my work I was then able to function truly independently. Over time, I because became a lot more confident with my work and felt I gained skills I can use regarding online databases even outside of that specific clinic.
Going Forward...
Despite learning so much about individual patients, I never got the opportunity to interact with them. Because of this, I have felt drawn to more jobs involving direct service, such as the needle exchange I now volunteer with. It has taught me I want my future purpose to be beneficial to others. The competencies surrounding "Empathy" and "Others' Circumstances" have heavily influenced how I conduct myself with others and the position I desire to be in. Those qualities have also been useful in my personal life developing peer relationships.