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Addiction and Families: Gianna Calligy
22 Plays10 days ago
Season 4, Episode 9: Gianna Calligy is a fourth-year medical student at Cooper Medical School of Rowan University and a youth mentor for children affected by addiction. Listen to Gianna discuss the effects of substance use on families, the work of Camp Mariposa and her own reflections on addiction medicine.
Camp Mariposa is a free year-round addiction prevention and youth mentoring program for ages 9-17 who are affected by the substance use of a family member. Campers build knowledge, life skills, confidence, and connect with peers and trained adult mentors. Check it out here!
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Transcript
Introduction to The Wound Dresser Podcast
00:00:09
Speaker
You're listening to The Wound Dresser, podcast that uncovers the human side of health care. I'm your host, John Neary.
Gianna's Advocacy for Families Affected by Addiction
00:00:21
Speaker
My guest today is Gianna Callaghi. Gianna is a fourth year medical student at Cooper Medical School of Rowan University interested in pediatrics and emergency medicine. She's a passionate advocate for children and families affected by addiction.
00:00:34
Speaker
Gianna is a frequent volunteer with Camp Mariposa. program that offers free year-round addiction prevention and youth mentoring for children and adolescents affected by the substance use of a family member.
00:00:45
Speaker
Gianna Callaghi, welcome to the Wound Dresser. Hi, John, how are you? Good, good. Thanks for coming. Of course. so we often don't fully appreciate the effects of addiction on a user's family and social circle.
00:01:02
Speaker
ah How does addiction affect those close to a substance user? Yeah. So specifically um in my experience of working with kids, um the use of ah substance use disorder within the home tends to create a lot of chaos. um We see these kids, they tend to be very anxious. A lot of them are very closed off. They struggle to trust. um There's kind of a saying that kids who grew up in those environments tend to become addicted to chaos, um essentially feeling like they never really know what's coming and they they don't know how to
00:01:37
Speaker
exist in any other state than constantly wondering what's next. um In terms of outcomes, we see These kids are more likely to end up developing addiction themselves, um higher risk for suicide, higher risk for academic issues. um I've also, ah lot of the times the family disruption occurs in one way or another, either somebody goes to jail or children are placed in foster care or with a family member.
Understanding 'Opioid Orphans' and Their Challenges
00:02:05
Speaker
um Sometimes there's really serious neglect that goes on. um
00:02:10
Speaker
And so I feel like a lot of the focus on addiction as I've been in medical school, um and perhaps appropriately so, has really been on the effect on um the person with substance use disorder.
00:02:21
Speaker
And that's an extraordinarily important thing to address. um But something I felt was lacking in the medical curriculum is how do we help people um who've experienced the fallout of this um because really like that the circle surrounding somebody with substance use disorder, there's so much mistrust that occurs. We see violence in the home. um Sometimes it can lead to food insecurity, really serious neglect. And, you know, we I feel like we um as medical students are never really given any training or even thought to that in our curriculum.
00:02:54
Speaker
I know a term I've heard used opioid orphans. First off, is that a pejorative term or is that like a kind of a widely used term? I don't know that it's widely used, but I wouldn't really consider it pejorative. It is definitely true that there are children, and I've worked with some who've lost both parents to overdoses, and also children who, even if they haven't lost both parents to an overdose, um experience significant enough neglect that they were either functionally or legally removed from um the parents' care.
00:03:29
Speaker
And so there's definitely kids who are left orphans by the opioid epidemic. um And when we consider, you know, the number of kids we have in foster care, um the difficulty we have placing siblings together um and terms of finding foster homes that can accommodate multiple children.
00:03:48
Speaker
um And a lot of times what I've seen a lot too is like older siblings. And when I say older, I mean like 12 raising younger siblings. So I don't really think it's a pejorative term. I think it is pretty descriptive. um i don't really think it means to lay blame on anybody, but really just like describe this crisis of children who are left without adequate care because of addiction within their families.
00:04:14
Speaker
I know you mentioned that addiction and chaos is kind of can be a theme in some homes, but you also just mentioned about like responsibility, like 12 year olds having to be responsible for their younger siblings.
00:04:25
Speaker
um I would imagine that, you know, ah kind of age inappropriate sense of responsibility is something that that kids often get, ah you know, put on their shoulders when they have the addiction in their their homes.
00:04:40
Speaker
Can you talk more about like how you've kind of seen some of that play out for some kids?
Camp Mariposa: A Sanctuary for Children
00:04:47
Speaker
Yeah. um Like you said, like the over over so overstated sense of responsibility. um There's this one kid that we worked with who's an absolute sweetheart and she's responsible she was responsible for her younger siblings at home.
00:05:01
Speaker
um And it was really hard for her to step out of that when she would come to us at camp and like realize like, no, we're here to take care of you. um You don't need to be taking care of anybody else right now. Yeah.
00:05:13
Speaker
You know, these kids, um and when I look at kind of the spectrum of the way that addiction tends to affect these kids, these kids do tend to be the higher achievers of the bunch, but they're so extraordinarily anxious. um And it's really difficult on the younger siblings too, because imagine being parented by a 12 year old. um You know, it's it's not, it's certainly not an ideal circumstance for them either. um And it just really creates like this profound sense of loneliness in those kids, you know, feeling like they have to be responsible for cooking for their siblings, feeding them, getting them to school, um
00:05:51
Speaker
A lot of times they also feel responsible for like keeping the peace within the home, which is of course not the responsibility of a kid that age. um And so it does really lead to, you know, an over-exaggerated sense of blame and guilt in these kids. And then for their younger siblings, they're just dealing with effectively the the effects of having teenage parent, somebody who's really unprepared for that level of responsibility. um And it ends up being really tragic for everyone involved.
00:06:21
Speaker
So the camp you mentioned is Camp Mariposa. And as I understand that provides a lot of support resources to kids who are affected by addiction. Can you talk more about ah the mission of Camp Mariposa and ah you know, what they bring to the table for for kids ah touched by addiction?
00:06:38
Speaker
Yeah. Camp Mariposa is probably one of the favorite my favorite experiences I've had in my whole life. um What we do, i think what we do is ever we do a couple of week weekend camping trips per year. so we do them about every other month. um We take these kids to a campground. And we do all the fun camp activities with them. So there's boating, there's hiking. Sometimes we do the ropes course, we play sports, we have dance parties, um you know, hang out in bunk beds, braid each other's hair, all kinds of fun camp activities. But we also um have structured support groups that teach these kids coping skills. And it's led by... um a couple of social workers in addition to volunteers.
00:07:22
Speaker
um And we teach them coping skills and we teach them about the disease model of addictions. And we um also teach them about the seven C's, which is kind of our fun little acronym for how we, the the way that we teach kids to conceptualize addiction and their what is and is not their role in, you know, taking care of themselves and others. So the seven C's are I didn't cause it. I can't cure it. I can't control it, but I can take care of myself by communicating my feelings, making good choices and celebrating myself. um And I think that's really like a good model of what we try to teach them at camp. We see them really develop confidence from trying new things and
00:08:02
Speaker
and learning to do something like, for example, get in a canoe, which is something a lot of inner city kids have never done before. Also a c Canoe can be the eighth Yes. um So, you know, it's like they've never gotten to do these things before and they get to build confidence through doing that. um And then The highlight, in my opinion, every single time is they do letter to addiction where they write a letter to addiction and then they burn in the campfire, then we all roast s'mores.
00:08:36
Speaker
It's really fun, but what it overall gives them, like I think it's for a lot of them a space to be kids, which for the ones who've had way too much responsibility placed on them very young is extraordinarily powerful.
00:08:49
Speaker
um And it gives them a place where they can connect with others. You know, a lot of these kids, um they there There may be other kids in their class at school that have ah family members with substance use disorder. In fact, it's statistically likely, but there's so much stigma and shame. And a lot of them don't know anybody else who's been in foster care or doesn't live with their parents. um And for them to have a place where they get to talk about those experiences and know that they aren't the only one is really, really powerful.
Framing Addiction for Children
00:09:22
Speaker
Yeah, I like those. i like those seven C's. I think we could definitely use those in more context than just care of Mariposa. But how do you frame the you said you also discussed the disease model of addiction? How do you frame it for a lot of the kids so that they can, you know, so it's an age appropriate description of what's kind of going on with with their loved one?
00:09:45
Speaker
Yeah, I'm actually really impressed with the depth in which they get into. um We do end up using words like neurotransmitters. um And at one point we were teaching them about different areas of the brain in like words, such words that I hadn't heard until I was in college. um Like they were talking about like the temporal lobe and everything like that, which i I think it's incredible that they're able to break it down and make it accessible for them to understand these things.
00:10:10
Speaker
concepts that can be like that, that we study for our medical school exams. um But we we do talk about how ah they talk about like dopamine and serotonin and how when, you know, we we get this, these neuro-professional neurotransmitters from normal things in our lives, but the disease of addiction throws that all out of whack. um and how it rearranges your priorities as such like that the addiction becomes more important than everything else in your life. And there was one book that did a really good job of breaking it down. It was called the the icky, sticky, tricky addiction monster. um And the the book, it kind of, it it it used like the monster as addiction and like the monster was like taking over the kid's mother. um
00:10:54
Speaker
And they just do a really good job of, you know, i think finding that middle ground of where like we know addiction is a disease, but there are choices we can make to prevent ourselves from developing the disease of addiction. Just like there are choices we can make to prevent um ourselves from developing like um heart disease. um And they do a really good job teaching the kids that, you know, like,
00:11:21
Speaker
it's not that this person is a bad person because they've struggled with addiction, um but also they don't say it in such a way that makes them feel completely helpless about their own risk of addiction. Yeah, it's kind of like, I could see that being tough when you're kind of counseling kids, right? You don't want to frame addiction as a character flaw because it's not.
00:11:41
Speaker
But at the same time, if you just frame it as sort of a genetic thing or like like ah like an inheritable disease, then it's like your sort of free will is gone from kind of directing the course of your life.
00:11:54
Speaker
So do do you find that's difficult at times to kind of strike that balance? Yeah. I mean, I had a kid once directly asked me if she was going to become an addict like her mom.
00:12:05
Speaker
um And that was a really tricky conversation to navigate because um i didn't like, i mean, I, I never, you never have a crystal ball about these things. And when I ended up telling her it was like, well, just because, you know, we have this predisposition in our genes, it doesn't mean that it's going to happen. And I told her, you know, we learn all these coping skills at camp. um And that she's really just such a ah bright, well-rounded, talented kid, um that she's got so many things in her life that she can look to um in moments of distress rather than drugs. And I told her that by continuing to choose those things, um that's how she prevents herself from developing
Gianna's Personal Narrative: Coping Through Childhood
00:12:52
Speaker
addiction. But it was really, it was a really tough conversation to navigate um because seeing that fear is there and that risk is also there. And yeah,
00:13:02
Speaker
we have to do our best for these kids and give them the resources that they need. um And just really, really hope it sticks. So I know your your role in this is that you're a volunteer. I know you said it was that the program is more run by social workers, but I i guess there's a lot of volunteers there. And i imagine your role is to sort of mentor these young folks, but do you find it hard?
00:13:27
Speaker
Do you feel like you have to set boundaries and it's it's kind of hard to like frame your relationship with them in a healthy way? Um, not necessarily. I think there have been moments where my boundaries have been challenged, but I think that comes with working, not just with kids, but like working with anybody. Um, somebody is going to find a way to push buttons in a personal way. ah and i think, um,
00:13:56
Speaker
You know, the kids, they have a pretty good idea of like what our job is at camp. It's really rewarding to kind of be an adult that they trust um and build those relationships over time.
00:14:09
Speaker
ah One moment where I did feel like my boundaries were challenged was actually not really by a kid, but by one of the social workers. um We were doing like a group therapy exercise with the kids. And sometimes we'll ask the adults to participate too, just to like kind of model how to do it.
00:14:23
Speaker
so I didn't really think that was a big deal, but the the... specific exercise they were doing was we had to like cut out paper hearts then we had to like write mean things that people had said to us and then like read them out and as we read them out we had to like crumple the heart and I was like it it was a weirdly um emotional moment because i'm I'm used to like kids asking me sort of personal questions and I have my sort of uh kind of flow diagram of how I deal with each time a kid asks me like a personal question. But I remember that um that group therapy exercise cut kind of deep and I was not really expecting to have those feelings come up while I was just like supervising group therapy.
00:15:00
Speaker
From what I've heard you say though, for for the kids though, the the biggest thing as a volunteer that you can offer them is ah as ah a listening ear, right? Just to kind of ah be there for them and and and hear their stories.
00:15:13
Speaker
Yeah, absolutely. um You know, sometimes they haven't really had anybody to talk to about it. And more importantly, they haven't really had anybody listen to them.
00:15:24
Speaker
um A lot of times what happens to these kids is they sort of end up getting told either explicitly or implicitly that they're not really important because addiction sort of like takes up the whole family. And so these kids having somebody who does want to listen to them, whether it's about, you you know, their recent soccer match or about like losing a parent to an overdose, um having somebody who's just willing to like sit with them and listen to them talk about whatever it is they need to talk about um is really special. And you can see that the kids kind of open up when they realize that like, this is a place where they can trust us.
00:16:06
Speaker
I imagine, you know, ah you're a ah super volunteer because as you've described to me, you've had experiences of addiction in your own family. ah you expressed a willingness to kind of talk about them today a little bit.
00:16:20
Speaker
Um, so if you wouldn't mind sharing, like how has addiction touched, uh, your own life? Yeah. Um, My mom struggled on and off with alcohol um and she would go to meetings and she would stop going to meetings. And it was kind of confusing when I was a kid. And then my older brother got into heroin and opioids and all sorts of bad things. um I guess I shouldn't say bad things, but I guess we could define the drug itself as a bad thing. um And that really threw my family into chaos. And it was kind of like the two of them made each other worse. um
00:16:57
Speaker
And I was pretty young at the time this was happening. I think when things got really bad, I was about eight. um And just growing up in that chaos was very challenging. um i remember was this really shameful like secret. I was always told not to talk about it. um The implication was that like, I would get in trouble at school if I were to tell anybody. um And that like, you know, there was sort of this combination of like,
00:17:26
Speaker
both implicit and explicit blame, um which, you know, I understand come came from like a place of like their own illness. um But it was something I very much internalized, feeling like I was the one who had to keep them from using and I had to keep the peace in the home. And if somebody...
00:17:47
Speaker
if some If there was any drinking or drugs, it was my fault. I remember the police um coming to the house and rating it and being called out of gym class to talk to DC PNP at one point.
00:17:59
Speaker
And it was just a really, really profoundly lonely experience um because I felt like I couldn't talk to anybody at all about it. um And I assumed that because it was this big thing we couldn't talk about, it must not be happening to other people.
00:18:14
Speaker
um And of course, I came to the realization that that wasn't true. And what really helped me and I think I tried to model um my own relationships with these kids off of was I had a wonderful aunt and uncle. um And they had a they had a daughter who was a couple years younger than me. And but they i They obviously knew about it and I realize that now. um But even then, like i wouldn't I wouldn't talk to them about it, but it was just, they were just there for me in such a way. You know, they would like take me to museums and they spent so much quality time with me and just kind of feeling like they gave me the family I felt I didn't have. Yeah.
00:18:54
Speaker
was really wonderful um and something I try to emulate when I'm with these kids. um And so when i reached out to Camp Mariposa, I was, you know, obviously inspired by my own experience um because I didn't want the other kids to feel as lonely as I had. And I wanted them to know that like things would be okay. um And it's been so, I didn't really expect it to have the impact that it had on me.
00:19:28
Speaker
um But it was just like, even hearing like it said to those kids, like, it's not your fault. And I was hearing those words and I was like, whoa, it wasn't my fault. um And that was a really wonderful, like they really powerful experience to have. How did you ah feel like you coped with all that as a youngster? Um, did you sort of feel like you tried to tune it out or, or kind of bury yourself into other things? How do you, how do you feel like you could cope with that chaos in your home?
00:20:01
Speaker
Um, I wrote a lot and I still write. Um, the funny thing was the way I would write about it was like, I would write about it as if it were happening to somebody else. Um, i remember at one point,
00:20:15
Speaker
i wrote like a short play about the overdose I had witnessed. um And I, but it was like, it this had to be about like somebody who wasn't me.
00:20:27
Speaker
um And I would just, I would just write about it from a perspective that wasn't mine. and I think it kind of separated me from it a little bit. I was really into theater too. I think it was like this element of like,
00:20:44
Speaker
getting to be somebody else. um But yeah, I think think writing came through for me. um Reading, just getting lost in ah getting lost in the book and again, somebody else's life.
00:20:57
Speaker
um Yeah, that i guess I guess in a way that sort of sounds like what what you were saying with the writing to be sort of dissociative to kind of just like separate yourself out of it, which I guess can be, sometimes we think of it as like a negative coping mechanism, but I guess and if if it's kind of done through the lens of like writing or the humanities, like might be more of like a positive coping mechanism.
00:21:19
Speaker
Um, So was this was was all this stuff going on at home? It it sounds like pretty you pretty have have explicitly stated that you couldn't talk to about it with adults at your school. Was it something you would even like tune your friends into? Or was that still even off limits for for like having a line of communication with somebody?
00:21:40
Speaker
No, um I was told not to tell anybody and I kept that. I took it pretty seriously because, again, kind of the implication that like I was the one who stood to get in trouble um if, you know, everybody found out about what was going on. Yeah.
00:22:00
Speaker
So I, I remember like the very first friend I told was when I was like 15. ah um and it had been like a really, like, it had been a really long standing friend that I had known for a long time. And like, I finally told him about this. Um, and after the first, I told a couple people like shortly after that, but it wasn't really until, um, I think medical school that, uh,
00:22:28
Speaker
I kind of felt like it was something I was like able to talk about without feeling like deeply ashamed. and And one of the things that I think is interesting too, about like facing challenges in adulthood versus childhood is that as a child, you sort of can't, you don't have all the context, right?
Complex Family Dynamics and Empathy
00:22:50
Speaker
You don't, you don't really understand all the details or like nuances of what's going on. it just, Everything's probably just feels more in like broader strokes, like chaos versus not chaos. And like, it kind of like, um not binary, but it's just like very, I don't know. So did did did that, how was that experience as a kid feeling like you didn't really know what was going on, but you knew there was chaos?
00:23:18
Speaker
Yeah, um I have this kind of it like specific memory of um trying to make and like a an anti-drugs pamphlet.
00:23:29
Speaker
like Like one of the ones that I guess they show us in D.A.R.E. class. Like I got the the bright idea that like, oh, if I just like make like the right like anti-drug pamphlet, it will it will um fix everything. I guess it goes back to like the heightened sense of responsibility. Yeah.
00:23:47
Speaker
And just not fully understanding what was really going on. I remember at one point being at a ah meeting with an AA meeting with my mom. And I didn't know it was an AA meeting.
00:23:58
Speaker
And they were like shouting out like how many years different people had been sober and you're supposed to cheer after the number of years. um And somebody said like five years. And I started cheering because so I thought it was like, oh, like who's like five years old. um And everyone thought it was really funny, ah which is it kind of it's kind of like an example of not fully grasping it.
00:24:15
Speaker
um But yeah, it was just, I didn't really understand what was going on. i Remember at one point, i think it was because like, I don't know, like either a probation officer or police were coming over and somehow we knew about it in advance. And then like, like my mom put a bunch of like paraphernalia in my closet because like she didn't think they would look in my closet because I was a kid.
00:24:44
Speaker
And thinking about that now, like i I didn't understand what was going on or like what even it was, but just like, That memory kind of disturbs me now because I'm like, you know, i was kind of being told to, like, keep secrets from the police, essentially. um And yeah, it was just like chaos. You know, i I don't know when I became aware of the word addiction, um but...
00:25:17
Speaker
Yeah, just like seeing like i know people act kind of crazy and I know they get mad and then I know that there's a crash. And then it was just sort of not fully understanding what was going on, not really like knowing who i would be going home to.
00:25:37
Speaker
you feel like your relationships with your with your your mom and brother have... have evolved over time? And if so, like how, you know, what was, what was helpful in healing those relationships?
00:25:50
Speaker
Um, you know, I still really struggle with those relationships, particularly with my brother. Um, at some point, Like, I remember just, like, shutting down and deciding not to talk to him at all.
00:26:04
Speaker
um And that was for years and years. And honestly, we don't really... When I see him on holidays, I talk to him, but I i don't talk to him very much now um outside of, you know, like, Thanksgiving and Christmas.
00:26:18
Speaker
um I have slowly been working through the anger I felt towards him. i think it's partially being in medicine and seeing, you know, the...
00:26:32
Speaker
the vulnerability within people that leads them to this and like understanding, like understanding that, you know, the things in my brother's life that led him down that path. um And now he is um at least as far as I'm told in the process of recovery.
00:26:52
Speaker
um And so I do kind of have, empathy for him in the situation of like, I've seen how this happens. And also watching my little brother um begin struggling with alcohol at a very young age and like With him, like, it's not that I wasn't mad at him, but it's just, like, I could clearly see how this happened to him, you know? Like, it was just so obvious, like, from witnessing what had been modeled in his childhood. Like, it was not at all surprise. And then sort of realizing i have to apply that logic to my older brother as well. um
00:27:24
Speaker
It's not like, you know, it's it's not like he woke up and chose addiction one day. um and yeah, i do... Yeah, i still very much struggle with our relationship um because I always was like jealous of people who are close with their siblings, but it just felt like something I could never achieve.
00:27:46
Speaker
um And with my mom, our relationship is very complicated. ah But there's um an element of trying to understand that she she was trying to protect us in her own way. And that, you know, she um once again, like,
00:28:05
Speaker
Her struggles were not in a vacuum. um It's not like what she had envisioned either. and i hope one day that i am able to have like better relationships with them.
00:28:27
Speaker
But it's just, I think, um I think the element of trust was not something that was so this was was not really present when I was growing up.
00:28:40
Speaker
And that's a very challenging thing to rebuild when I feel like I got very, I was very successful at um at distancing myself from and from them, kind of out of self-protection. So it's it's hard to build back that trust as an adult, but it is something i would like.
Impact on Gianna's Medical Practice
00:29:06
Speaker
I know you you said the humanities have helped you cope between writing and musical theater. And I know you're big into acapella But another thing knowing you ah is that your your faith's really important to you. And I would imagine with healing some of those relationships, like you've been talking about, like like faith and forgiveness ah could be very powerful. powerful So I guess if just ah to hear more about how like maybe your faith has helped you coped with all these circumstances in your life?
00:29:39
Speaker
Yeah, absolutely. My faith is probably the only reason I've achieved any forgiveness at all. And it's something that i I kind of stare down when I look at, you know, this, this forgiveness being the center of my faith, the fact that I'm forgiven and therefore I have to extend that grace to other people. um And I feel like every single Sunday, ah i hear something that kind of like strikes me in the heart about that.
00:30:08
Speaker
And my faith was not really something, I think um I didn't find it till I was at the very end of high school. But it just, it gave me this, you know, sense of purpose, this sense of, you know,
00:30:26
Speaker
kind of understanding that on this side of heaven, you know, there's going to be damage. Um, and you know, I'm responsible for some of the damage that's, that's on this side of heaven, but that one day, like all will be made right. Um, and my hope is that eventually, like eventually, um,
00:30:53
Speaker
I will be able to see my family the way that God sees them, um, that I'll be able to, you know, truly love them for who they are and not harbor any sense of anger or resentment towards them.
00:31:06
Speaker
Um, and what gave me is like at that time where like at the end of high school where I was just feeling like I was very self-reliant, um,
00:31:20
Speaker
just feeling like I existed in my own vacuum and where it was like, you know, I have to rely on myself. I'm the only person I can trust. um And understanding that I, am loved that I was created for a purpose.
00:31:39
Speaker
And therefore, you know, my, my family also is equally as important to God um that every single person that I've ever interacted with, um, is just this divine creation. And Mother Teresa, um, she says in her book, No Greater Love, that each person, each time we talk to somebody, like, we're talking to Jesus. And she, she said that, like, we're talking to Jesus in disguise. Um, and she specifically mentioned, you know, it's hard to see, like, Jesus in that person who's angry and drunk.
00:32:15
Speaker
Um, And ah in our um my profession, i'm I'm called to do that. I'm called to to interact with people who are really struggling with addiction. um But it's also been a very powerful way for me to look at my own family and, you know, recognize that like underneath all of their struggles and everything that's happened, um you know, I'm still talking to Jesus in disguise. um
00:32:48
Speaker
And I very much hope that I'm able to live that out so that that's evident to them.
00:32:59
Speaker
Um, and that within my own heart, I'm able to see that. Yeah. I think you kind of led into my next question, which is framing how all your experiences will shape your medical practice. I, I sense that, um,
00:33:15
Speaker
you're goingnna you're going to have an overwhelming sense of empathy and compassion for for folks who otherwise might be sort of, you know, look the other way by by either medical professionals or just, you know, regular people on the street. And I don't know, how do you how do you think this is all going to empower you as a doctor?
00:33:35
Speaker
Yeah, um i think i i think I see my patients kind of from a different perspective. Like when I... see, you know, my homeless patients, I'm always kind of struck by like the fact that my own brother was homeless.
00:33:52
Speaker
Um, and that, that thought's always like really hard for me to sit with, but then I'm like, okay, well, how would I want somebody to treat my brother? You know, um, like definitely the fact I've seen these patients like more dismissed and treated more poorly than other patients, unfortunately, because our system's not perfect. Um,
00:34:13
Speaker
And I also think I sort of have a tendency, I do struggle, I think, with bias, as we all do. um But I just, I remember on my like addiction medicine rotation, i was just having like the hardest time having empathy for these people because like my bias is like, yeah, well, why can't you quit for your kid?
00:34:30
Speaker
um And I know that that's not that's not really the way I should be thinking about these people. Yeah. But I did struggle with that. But then also when I hear the stories that go with it, and particularly when I talk to people who are in recovery, um and when I sort of hear them like reflecting and kind of taking account of their experiences and what has shaped them to be the way that they are and
00:35:06
Speaker
you know, often like the really horrific things that kind of led them down this path. um I think that's in the back of my mind and I try to have a positive view of the human person.
00:35:19
Speaker
um But I'm also I feel like I'm the most drawn to helping the kids. When I hear about these situations, I'm my mind's always like, okay, well, like how are the kids doing? um And that tends to be the area in, into which I focus and where I end up diverting a lot of my energy. It's like, what can I do to make this like family situation better?
00:35:45
Speaker
um and I think that especially shaped the way I interacted with my pediatrics patients when discussing their home lives with them just and just being able to recognize that environment matters um and identifying and then identifying the really difficult things that that can be that can be addressed, even though they seem scary and taboo, but just the fact that these things, you know, there there are resources, there there is hope. um
00:36:24
Speaker
And so I think I've been a lot more a lot more at tuned to the overall family situations um that occur. But it's been really, I think the biggest thing for me with like medicine is just understanding that nothing is unique. I think there was like a weird sense of comfort that was brought to me. Maybe it's a twisted sense of comfort, but I feel like on a practically like daily or weekly basis, like I see a family that kind of resembles mine. um And I hear a story that kind of sounds like mine.
00:36:58
Speaker
um Or maybe a story that could have been told by somebody else in my family. And just sort of that understanding that nothing is unique helps me have kind of this global sense of empathy for my patients um and just an ability to hear them without you know, reacting like I'm shocked or anything, just kind of being able to hear them and listen to them and not make them feel like it's the first time I've heard it because
Complexities in Addiction Medicine
00:37:32
Speaker
it's not. And I think that's really like the beautiful thing about medicine is we we hear people's stories. um
00:37:37
Speaker
And i think it's also very powerful when you hear your own and somebody else's. Yeah, it can reduce that sense of isolation, right? That, you know, I'm the only one who has these problems. I'm the only one who suffers in this way. And, you know, whether you've had ah addiction in close to you in your life or or not, we all kind of work through the human condition. And I think that's what physicians extract so well from their practice of medicine, right, is ah you can you can lose this sense of isolation and dive into a sense of community. and And we're all kind of going through this together.
00:38:18
Speaker
um You know, you've worked in It sounds like you've you you know had a lot of exposure to addiction medicine, both in your education and in your personal life. In your eyes, kind of what are some of the things that are working and and or not working within addiction medicine?
00:38:38
Speaker
Yeah, um it's ah bit difficult to say exactly what is and isn't working. um i struggle kind of with What I heard on my addiction medicine rotation, they were like a little bit anti-AA.
00:38:54
Speaker
And, you know, i i thought that was interesting because I feel like the times I've seen it stick, it's usually involved some type of group support such as that.
00:39:05
Speaker
um I also feel like the the model in which we talk about it in medicine, very it's very much focuses on the disease model of addiction, which is a good thing, but I feel like sometimes almost to the extent that it sort of reduces the amount of personal choice that is involved. um And there's personal choice involved with every single disease process. you know like We choose to take our medicines or not. um We like choose to exercise or not. And These things don't determine our fate necessarily, but they, you know, stack the deck in our favor. um
00:39:40
Speaker
And sometimes I feel like there's almost... a bit of a sense of hopelessness that occurs. um We have a huge issue with, um unfortunately, adherence to medications um and just the broken situations that people are in. you know i think when we meet people in the hospital, they're very motivated to change. um Everybody wants to recover in the hospital.
00:40:04
Speaker
And it's wonderful to be in that moment and kind of be a person who gets to encourage them. But then we also have to face the reality like, okay, like they don't have a home to go to. um there's not necessarily a guarantee that they can get to the pharmacy to pick up their naltrexone.
00:40:22
Speaker
And the social dynamic too. um I think something that's kind of having lived on both like sides of this is like, I needed to isolate myself from my brother. And yet,
00:40:41
Speaker
you know, social support is important, but when people struggle with addiction, their social support tends to be other people with substance use disorders. um And that causes just this really like vicious cycle of, you know, when all your friends behave one way, it's just very hard to um break that cycle.
00:41:04
Speaker
And it's also very hard. It can be hard to reestablish those positive relationships. um Like my brother and I have not successfully reestablished a positive relationship. um And it's just, you know, that environment matters. um I think prevention also really matters. You know, we see like the DARE program, which was kind of very fear and shame based, um didn't do a whole lot to prevent substance use. Yeah.
00:41:39
Speaker
What i do think seems to be working is, you know, the way Camp Mariposa does it, um which it's kind of talking about it from us like the scientific basis of addiction. um And also just the education about, you know, over-the-counter drugs, ah refraining from using prescription drugs that aren't prescribed to you. um They really do a very...
00:42:05
Speaker
good job of kind of breaking down that it's not just stuff you buy on the street. And I think that prevention piece is really important. We have to get to people before they start turning to substances and we have to be their bridge to healthy coping mechanisms.
Concluding Insights with Gianna
00:42:25
Speaker
With that, it's time for a lightning round, a series of rapid fire questions that tell us more about you. Okay. I know you're a big runner. um So what's your favorite brand of running shoes?
00:42:38
Speaker
Asics. Who is your celebrity crush? Jesse Williams.
00:42:48
Speaker
Oh, funny enough, you were you were just hanging out with him not too long ago, right? yeah Yeah, it was a good day. i know you're a big cook. What's your secret weapon when it comes to vegan cooking?
00:43:02
Speaker
Nutritional yeast. And what do you use that for mainly? Everything. It's like tofu scramble, mac and cheese, putting it on pasta, pesto sauce, um tofu. It's great on everything.
00:43:17
Speaker
we We said you're a big singer in acapella. What's your favorite song to sing and with a group? um For the Longest Time by Billy Joel.
00:43:30
Speaker
Nice. I think I ordered that for somebody for a Valentine's Day gram. yeah
00:43:39
Speaker
And lastly, what's one myth about addiction you would like to dispel? Oh boy.
00:43:47
Speaker
That anyone is responsible for anybody else's recovery. Gianna Callagy, thanks so much for joining the Wound Dresser. Great. And you just pronounced it wrong.
00:43:59
Speaker
Gianna Callagy. Thanks for joining the Wound Dresser. Thanks for having me, John.
00:44:13
Speaker
Thanks for listening to the Wound Dresser. Until next time, I'm your host, John Neary. Be well.