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Get Ya Life Right!
20 Plays4 years ago
In this jam-packed episode, we discuss many things to get your life right, from the importance of financial literacy to how to protect your skin from the sun’s often unforgiving rays. We also have two guest speakers, Drs. Smith and Slater, who speak on how to help our patients get their care right, from the support of palliative medicine to hospice planning, and where diversity in medicine fits into palliative care and hospice medicine. Of course there’s more, tune in to hear it all!
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Transcript
Introduction to SNMA's Pipeline Programs
00:00:00
Speaker
August is Pipeline Preview Month according to SNMA's National Service Protocols developed by the Community Service Committee. Throughout August, the Community Service will introduce you to the various pipeline programs housed under the Pipeline Mentoring Institute, or PMI, including the Health Professions Recruitment and Exposure Program, HPREP,
00:00:20
Speaker
Youth Science Enrichment Program, YSEP, and the Brotherhood Alliance for Science Education, BACE. The pre-medical minority enrichment and development PMED protocol includes activities that SNMA chapters host for MAPS members. If you are interested in learning more about the PMI and how your SNMA or MAPS chapter can start a program, we invite you to attend our webinar series where we will showcase chapters that have successfully started and maintain pipeline programs on their campuses.
00:00:48
Speaker
We have two webinars this month, August 8th and August 15th at 8 p.m. Eastern Standard Time. For more information on these webinars and for more SNMA opportunities, be sure to sign up for the SNMA Weekly Opportunities newsletter. Now, let's start the show.
Intuition and Connection in Medicine
00:01:27
Speaker
What's good, everybody? Welcome to SNMA Presents Lounge. Whether you're in the student lounge, doctor's lounge, or lounging around at home, get ready to join SNMA for meaningful conversations on topics affecting minorities in medicine and groups that often sit at the margins of health care. And it's your boy, student Dr. Aldwin.
00:01:52
Speaker
And what part of the human body would I like to be based on personality and why? Of course, the brain. I'm the resident neurologist and psychiatrist because without the brain, we can't function. And if we can't function, we can't live. The brain controls our heart. It controls our breathing. It controls our walking. It controls my ability to connect with you as an audience. So the brain is the best, baby. I don't care what nobody says.
00:02:15
Speaker
Let's get it. Hey, everyone. I'm student Dr. Isabella. And what human body part would I be based on my personality? I think I would actually be the gut. And it sounds a little bit, you know, a little bit disgusting. But you know why I'd be the gut? Because the gut is where, you know, people say you have a gut feeling about something or, you know, if something just feels wrong, you feel that like little
00:02:39
Speaker
discomfort in your gut. I follow that to the T like I like the way I follow my gut feeling and my intuition when it comes to just everything in life when it comes to whether or not I feel like I should go for this opportunity or whether or not I feel like I should remain in this space that I don't feel, you know, is safe right now. I think that the gut is almost like a second sense of how to be in tune with your environment and to be in tune with your mind, honestly. So yeah, I think I would be the gut.
00:03:07
Speaker
And you know, I like food too, so thank God I have a gut that I can break my food down and everything else that comes with that.
00:03:15
Speaker
Be careful. You want to be careful with ulcers and gastric. You're right. There you go, Professor Alderman. What's up, everybody? This is your girl student, Dr. Erica Dingle. And what part of the human body would I be based on my personality? So I would have to pick two.
00:03:37
Speaker
I'm going to step on Aldwyn's turf for a second and I'm going to go a little bit deeper into the brain. I would say I'm the amygdala because I'm very much an emotional processing center and the limbic system, you know, that's like the oldest part of the brain. Y'all know how I be feeling like onto y'all here. And then I will also pick the heart because the heart makes things flow mainly, you know, your blood, your oxygen, your nutrients, all that good stuff that helps to keep you alive.
00:04:05
Speaker
And I think I do that for people on the day to day. So those are my body parts. Love that. Yeah. Cosign. So y'all know what time it is. Drum roll, please.
00:04:22
Speaker
It's time to run the list, everyone's favorite part of the show. So for our preclinical students and for all of our loungers, running the patient list on the wards allows the team to address the pressing matters of the day. So in this segment of the show, we'll be discussing some recent events in medicine and pop culture affecting our communities and the populations we serve. And boy, do we have a list to run with y'all today.
00:04:51
Speaker
Y'all ready? Let's go. Lego.
Celebrity Privacy vs. Public Life
00:04:56
Speaker
So I'm going to just drop it real quick, just like she dropped that damn picture. Issa Rae got married. Oh my gosh.
00:05:04
Speaker
Shout out to the queen. Listen, you know, it's crazy, like Issa Rae, you know, that's my Capricorn sister, you know, I gotta, you know, I'm into astrology. So there's already, there's already some things that I already know when it comes to us Capricorn girls, you know, like, we very much listen. So Capricorns, we are very much so it's an earth sign. So we are grounded and we do, we do like to, you know,
00:05:28
Speaker
maintain some form of, I guess, privacy in regards to what we deem is necessary. And yeah, so usually with Capricorns, you won't hear them say anything unless it's absolutely necessary. I will say that for sure. We don't just divulge everything, especially we're very selective with who we choose to divulge information with. Now, I'm not saying she did this because she's a Capricorn, because maybe she doesn't even believe in astrology or anything regarding that. But I would say in regards to her getting married and people not having a clue about it,
00:05:58
Speaker
I think that people are kind of interpreting it as she was trying to hide her man, and I don't think that's what that was. I think that it was her maintaining her right to a private life outside of what we know her to be, Issa Rae, this TV director, TV writer, actor,
00:06:18
Speaker
actress, like all these big roles that we know her to be. But outside of that, she's a human being with a personal life and her own friends that we probably have no idea who her friends are and all these other things. And so I think that was just her trying to maintain a sense of normalcy outside of her job. And she has a right to do that. But some people want to say, oh, she was trying to be, you know, trying to keep him a secret or she was trying to kind of like
00:06:40
Speaker
you know, not really be open about. And I don't think that's what it is. I think that we have to like first acknowledge that she's a regular human being like you and me first. And with that comes her right to do and say whatever she chooses to do or, you know, whatever she deems is necessary. So, yeah, I think that's kind of how I see the situation.
00:06:59
Speaker
Yeah, she was actually her man. They've been together since 2012. So he actually was one of the episodes of Misadventures of a Black Girl. He had an actual cameo for four seconds. He was dating a white woman. But he's been around, and her family has fervently supported him and their relationship. And I do agree with you, Isabelle. She don't owe nobody anything at the end of the day.
00:07:20
Speaker
I didn't know she had a man but I think it was beautiful the way that she elaborately displayed her wedding and she gave you just a little bit of tidbit but not enough for you to make it seem like it's that personal because she don't know it's like she don't have to make it personal and I love that she's celebrating black love too and and shout out to her man too he's from Senegal and he's an international banker which is
00:07:39
Speaker
really dope. And he's been with her this whole time, riding with her, supporting her, and being on up and up and up. And he'd be on the red carpet with her. He's a true, genuine man, you know what I'm saying, connected to his woman. And I think oftentimes, we see our celebrities in a line like oftentimes, and we think that we're old something. We're old who they are. We're old what they eat. We're old when they go out.
00:08:03
Speaker
She has her own duty to her own personal life and she has a duty if she wants to, you know, the public life, which is us. And I think it's beautiful that she's able to separate that because oftentimes when we talk about mental health, that's something that just confines and restricts people. And that's oftentimes where people, they don't know what direction to go and how they live their life because they're trying to connect with the audience, but then also connect to their personal life. And it's hard to disconnect that.
00:08:26
Speaker
and they find themselves in a quandary. So it's beautiful. Shout out to Issa Rae. I'm so proud of you, Gourdes. She looks so beautiful. Her pictures looked amazing. Wow. They really did. I'm happy. I mean, I wish more people got the privacy that they deserve. And I think it poses a bigger question. Like you mentioned it earlier, like, is it privacy?
00:08:47
Speaker
Or was she keeping him from the world? Like, nobody owes people anything. And I think that's what social media has done. I've seen posts like, well, if you're going to post your relationship, then when this over, I want to know what happened, you know, like jokingly. But at the same time, like.
00:09:03
Speaker
Absolutely not. Like what I choose to show you is what I choose to show you. And that's my business. So shout out to everybody who's out here getting married and dropping marriage pics. And that's it. Cause I've seen it done a couple of times and I think that is.
00:09:19
Speaker
So dope. That's about to end the move. And when I do that, I don't want to hear no one say nothing because no one say not out here is rough. I hear some of us. Some of us don't want us to. Some of us don't want to drop pictures until we know it's forever and forever is when that ring comes. OK. And so listen, mind your business. I'm going to say we'll be on the honeymoon. We'll get a picture on the honeymoon. What's the model? And why be? And we better be more than getting a picture on the honeymoon. We better be at the wedding.
00:09:53
Speaker
Absolutely. Absolutely. I would. But East is not the only one dropping photos and things around
Artistic Expression and Cancel Culture
00:10:01
Speaker
here. Okay. We got other top-notch names like Kanye who just went out and just released a new album called Donda.
00:10:10
Speaker
out of the blue. So, my frustration with that though. He fake released it. Yeah, it fake release. It was like, I'ma just come sing for y'all or actually stand here. He didn't do nothing. He literally just walked around. He just had a wig cap on his head and he was bopping his head like this. That's the musical's play.
00:10:30
Speaker
But sold the place out, like he sold that joint out. Over 40,000 tickets were sold, man. And I said the Mercedes-Benz stadium could seat 70,000 people, you know what I mean? At the end of the day. So shout out to Kanye. I'm not necessarily in full support of what's going on with him because, you know, he has a very interesting past. And it's crazy when we talk about cancer culture and all that, we'll talk about that a little bit later.
00:10:54
Speaker
I think it's beautiful. Don is a commemoration to his mother who died in the mid to late 2000s from breast reconstruction surgery and things of that nature. And it also is a commemoration to his family. He's recently divorced. We talk about Issa Rae getting married and he's dealing with the mental health and anxiety issues.
00:11:12
Speaker
of being divorced. Kim K was actually on hand to attend his screening for it, which is really interesting. And his four beautiful children was there, but he said he was going to release it on that day and everybody just pulled up. It was kind of like a fake, like, you know, he, he pumped fake. I'm like, oh, got him. You know what I mean? Everybody pulled up. And then I know a lot of people that pulled up to it and it was like, yeah, he wasn't even really doing nothing. He wasn't really even, he even had a mic in his hand. He was just walking around on that big white
00:11:38
Speaker
Right. Like plaster on the floor. Literally on the cloud in red. Literally. But August 5th, you know, he's releasing a he's doing another one. So they're trying to come up with creative ways to actually do this showing because there's a lot of pressure on him and on his team. Be like, you can't do the same thing. We want you to like really pull up with something different with the energy. And he's been at the stadium. He spent a million dollars a day
00:12:01
Speaker
at the scene. This is they didn't get his own mind right. So it's pretty interesting, this whole process with Kanye, you know what I mean? I don't know. What's what's your thing about this, though? This whole like issue with Kanye, like a couple of years ago, he was like, oh, I support Trump. I denounced slavery. Slavery wasn't real. We had a choice to be enslaved. And now everybody's like throwing up mad energy, mad bread, coming up and pulling up to his concerts. Like, I don't know. I don't feel I don't feel that.
00:12:28
Speaker
I think, yeah, I was thinking about that. Kanye and his career has just been through so many seasons. It's gone through so many levels. I feel like every single year, there's something controversial popping up about Kanye, whether it's about his music.
00:12:47
Speaker
whether it's about his view on a politician, whether it's about something he did, you know, so it's like, I don't even know how to feel about him, honestly, at this point, at least when it comes to like, how he connects and relates to the black community. And doing like a lot of these controversial things. However, it's like,
00:13:03
Speaker
you know, I don't know whether or not like the all the heat he gets is like can be compared to say like, what happened when Chrisette Michelle Michelle was like completely blacklisted after she performed at the 2017 inauguration, you know, it's like, like, it's like, how, how come we're not giving, I guess, like the same energy with people who also are doing other controversial things. So I do think that like,
00:13:25
Speaker
We need to think about that, too. Like, what is it that denotes or what is it that warrants somebody to be, you know, canceled versus another person being canceled? So I do think that's a question we have to sit with. I think of a couple things. So one, I've been a gay fan since forever. I also feel like
00:13:48
Speaker
And this is just me. I think we put too much, not pressure, but like we give too much credit in certain aspects of life that some of these people just don't really deserve. I'm not ever going to listen to Kanye about politics or anything politics related. Like, you know, Kanye to me is an artist and I appreciate his musical artistry. I think he's a musical genius from
00:14:14
Speaker
I mean, literally from like watching him on MTV Cribs where he described a beat as a sound. I mean, as a like he described a sound as like something visual. So I appreciate Kanye for that. I was having a conversation with a friend and we were talking about the whole Kanye getting not really getting heat versus like Chrisette Michelle.
00:14:38
Speaker
But Chrisette Michelle, she's not as and wasn't as popular. I almost want to even say valuable as hard as that is to hear. And the more you do,
00:14:55
Speaker
in a field, the less likely it is for you to be shunned. I mean, that's what we kind of see historically. So like Chris said, Michelle, it was easy to throw her away versus Kanye. And not to say that it's right. It could be very deeply rooted in patriarchy if we want to try to, you know, if we want to break it down for real, for real. It may not be rooted in patriarchy. It may be other people feel the same way, like Kanye has done more.
00:15:23
Speaker
and Chrisette Michelle just really didn't do a lot. I was a fan of Chrisette Michelle's. I don't know that I threw her away. If she came out with an album tomorrow, because I like her sound, and I really could appreciate her artistry, I would still buy it. But yeah, she wasn't as popular. So it was just like, oh, easy to toss her. Which sucks. But that's the music industry, like, call a spade a spade.
00:15:48
Speaker
Right. They didn't even do that to Lil Wayne either. He took a picture with Trump and he came out with songs. People like, oh yeah, cancel Lil Wayne. Next thing you know, he's still lit. Lil Wayne is not going to be canceled. I'm sorry. He's not going to be canceled anytime soon. Do you know the impact he's made on the rap industry? He's not going anywhere. It's a problem. I still rap the Carter 2 and the Carter 3 word. I'm saying, oh yeah, baby.
00:16:16
Speaker
He's not going anywhere for me, I'm sorry. Some of the best years of my life came from both Kanye's and Wayne's soundtracks. So they're etched, you know what I'm saying? I literally can't toss them anywhere. They could be dummies in.
00:16:32
Speaker
And that's the thing, it's like it's separating the artist from the artistry, right? Exactly. It's like, are we going to look at this person based on who they are in terms of like what they do outside of their work? Like this is their job, right? Versus like who they actually are, you know,
00:16:47
Speaker
or how they are during their job and when they make this music and they want people to consume it. How are we going to look at them? I think it's about how do you view them. If you view them on a personal basis, then you have no business listening to their music versus if you're just listening to their music and absorbing that aspect of who they are, then anything else at that point honestly is not really worth noticing or not really worth putting energy into. Right.
00:17:13
Speaker
That's a fact. Yeah, we, you know, we try to cancel Kanye. We think we can cancel Kanye, but he's uncancellable. You know what I'm saying? Uncancellable. Uncancellable. Well, you know who else is also uncancellable?
Olympics and Racial Equity in Sports
00:17:29
Speaker
Simone Biles. She's not going anywhere. You know what I'm saying? Like they try to take her down. Shout out to Black Women Magic. Shout out to all the beautiful Black women. Actually, all the Black women. Yes, yes, yes. They're all beautiful.
00:17:41
Speaker
But it's crazy how scoring rules were not in favor to prevent her from getting the scores that she knows she's deserved. And she is so excellent and so competent. I feel that she was way above stars and stars above these people. And they try to restrict her from her excellence and ability to compete and be so great. So it's just like, how do y'all feel about them doing that?
00:18:02
Speaker
In terms of Simone Biles, we see her in the media all the time. Like the other day I was listening to, I was watching her do her performance or whatever. And Homeboy was talking about, oh, Simone Biles is doing a horrible job. What's going on with her? But meanwhile, the other white chick come behind her and she messing up too. And he's not saying nothing. Like what? Like. No, they always have something to say. They always have something to say about a black woman. They can't let us rest. You know, like I want to just give a real, I want to like say a quote that
00:18:28
Speaker
Simone had said to NBC Sports, she said, am I in a league of my own? Yes. Well, that doesn't mean you can't credit me for what I'm doing. They keep asking us to do more difficulty and to give more artistry, give more harder skills. So we do. And then they don't credit it. And I don't think that's fair. Right. So it's like it's this pressure that, you know, she's under that. She has to be better. She has to excel. She has to, you know, they always tell us growing up, I get to be twice as better than your white counterparts just to even have a seat at the table. That's the fact.
00:18:55
Speaker
that's probably the model that she was most likely race under as well, that you wanted to sit there and be average. You sound crazy. It's like, I just feel like, you know, women like Simone have to just, just being a black woman and then being in a sport that has very, very little black people, let alone black women. She has to, she's done so much work to, you know, make a name for herself and to separate herself from the sport. And now she's kind of being
00:19:19
Speaker
you know devalued by doing that just because her white peers can't keep up that's unfortunate that they can't keep up but she shouldn't have to shrink herself to make them feel comfortable and the fact that she can't even get credit for it I think is crazy because the whole point of a sport is that you want to keep on you know pushing the level as to how
00:19:35
Speaker
Difficult the sport can be like what is what is like the the level that we want this word to reach eventually if a sports gonna stay the same No one's gonna be watching. It's gonna be the same thing, right? You want other people to come in to make it more competitive and to you know to up the ante a little bit so I just feel like the fact that they're kind of like Restriction from doing that is really is anti-black is racist period like I'm just gonna say it flat out because you know, I just think it's anti-black so
00:20:00
Speaker
Yeah. I mean, historically, this has been done. There was a figure skater in, I think it was 1976. If I'm mispronouncing her name, I apologize. Suriya Benali, who landed a backflip and that had been illegal since 1976 for concerns of safety during competitions, which caused her to be penalized and finished far from gold.
00:20:24
Speaker
And honestly, with regards to Simone Biles' her talent, I mean, although she can do these magical flips and turns, like you said, is, you know, up your game. And I think you're kind of crossing or teetering like a fine line between safety and athleticism. But at the same time, like,
00:20:50
Speaker
We want action. We want more action, period. We want action. And if she has the athletic talent to get that stuff done, don't take away her points. Come on. We always out here struggling. I'm trying to do better. Now you're telling me I can't do better. I won't actually receive the credit for doing better. Right. So I don't know.
00:21:15
Speaker
And you know with Surya Bonali saying like she had a similar situation in regards to just not getting the same credit as you mentioned but also she grew up she was adopted and she grew up in a family of people that were white and around her were all
00:21:31
Speaker
white people. And so she became accustomed to that culture, accustomed to interacting, engaging, but she always felt like she was never good enough. And that's why she tried to reach the pinnacle, try to overstep the hurdles each and every time. And she felt like she could not accomplish, she could not get over that throughout her career, although she was very successful and garnered some Olympics and several gold medals and things of that nature. It's just crazy to see how that's impacted her now.
00:21:55
Speaker
and how she regards her history and her career and she oftentimes states like she could have done way more if there wasn't that pressure if there wasn't you know that if she had that leeway to be who she wanted to be and express herself and now she's teaching that actually she's now ice skating coach too so shout out to she's giving back especially to you know black women are
00:22:16
Speaker
dedicated to the ice skating culture, but it's just like, this is, it's crazy. That's been, that was like in the nineties and all that. And then it's still consistently affecting our black women in these sports where we don't necessarily see them as much, right? I don't honestly know a lot of girls from my block that want to be ice skaters or that want to be, you know, in ballet or that want to, you know, do, you know, all the balancing beam things. But at the end of the day, they're setting a standard and a lot of girls are looking up to them and they're going to go out there and they want to feel like they want to accomplish that.
00:22:44
Speaker
And I think we can't restrict them. We got to still uplift them. So to all the haters that's hating on Simone Biles, I see what y'all doing. They're trying to maintain. Now, they're trying to maintain their part. They're trying to maintain their peace. But we're not going to be peaceful. We're going to support Simone all the way through. And she's going to set the standard. We're going to bring 20 more for one of hers. And we're going to dominate every, every, every field. Like, I try to dominate our countries in the past. I try to dominate what we was doing, where we was at. I try to dominate who we are as individuals. We're going to dominate. Yeah.
00:23:13
Speaker
And like, what do you guys think about the fact that she backed out from the Olympics because of these mental health concerns she had? I mean, a lot of people were giving her heat. Well, some people were under a lot of people, a lot of people were understanding and saying, you know, she has to do what's necessary. She has to do what's good for her. But then you have people saying, you know, like, was it selfish? Like, I've been hearing different things. So what do you guys think about that? Mind your business.
00:23:38
Speaker
Yeah, I personally she backed out not just because of mental health but also it was something physical with her so right and it's funny because you know There I'll read this quote real quick about just pretty much the athletics involved There's an added risk in
00:23:56
Speaker
landing specific type of mounts with or without twists, including a potential landing on the neck. So if you have NBC Sports quoting stuff like this and you have one of your top athletes that's stepping out for something physical, why are you giving her backlash? So essentially it's like, pick a side. Do you want people to take care of their health, whether it's mental health or physical health? Or do you want to let them compete as is?
00:24:25
Speaker
I don't know. There's a lot that we have to face as Black people. It gets on my nerves so bad to see it happen. And to Alderman's point earlier, and your point, Isabella, the white man, they just get away with a bunch, like a whole lot. Pierce Morgan wouldn't be coming after whoever else if they weren't a person of color like he did after Simone Biles with regards to her withdrawing, in my opinion.
00:24:52
Speaker
Yeah, he could kick rocks. But like, at the end of the day, like you like honestly, and like you mentioned, Erica, they call it the twisty. So the twisties is basically a phenomenon with the brain, what happens that there's a disconnect between the neurons and nerve cells in the brain and actually what the person is able to physically do. So Simone was noticing that things that she normally could accomplish, she could not accomplish while being in competition.
00:25:19
Speaker
So what happens is that with neuroplasticity in the brain over time, these people develop their nerve cells to do certain moves and coordinated, land appropriately, know their positional awareness and know where they are when they're competing. And what happened was that with Simone Biles, she was
00:25:34
Speaker
and able to register that connect between where she was at and what she was trying to do. And so that's why she got out initially out of competing because she knew that she wasn't at her standard. And people got to respect that physiological and physical process. They're not aware that if you're not at the highest level that you can, it's a limit for God's sake. So
00:25:53
Speaker
She, she knows that she's, you know, she's doing worse off. Yeah. Her, her do justice for our country. You know what I'm saying? In terms of representing, but if she can't get to where she needs to, then why is she going to like lower our ability to accomplish in that? And in those fields, you feel me? So it's a respectful and moral thing for her to do that. And she has grace and integrity say, Hey, I'm not where I need to be. I need to take time
00:26:15
Speaker
And we talked about this on a lot of past episodes over training syndrome, this happens to where you train so much, you get burned out. And that burned out, burned out leads to cycle where you're physically dis enabled and is dismantling your connection between your mental state and your physical state. And I think this is one of those cases and people did not wear that. Why can't athletes feel like they can accomplish at that particular time? Why we can't respect that we talked about Naomi Osaka, we talked about Kyrie Irving, he had to take a
00:26:42
Speaker
a mental health break. We talk about these great athletes that doing every day, they putting hours and hours on their bodies and physically were not meant to do that. They're on a journey. They only hide like 24 hours of the day. Most people, they couldn't even do that, like 30, 25 minutes of the things that they doing, like working out wise. You feel me? Right. This is 9 to 5. Right. You know what I'm saying?
00:27:03
Speaker
Like, for real, like, so to the people that's trying to shun her, like, really kick rocks. And I always see it like this. Look at the person's environmental factors. Look at the pressures. Look at their mental health circumstances. Like, learn who they are as an individual before you say, one individual said, oh, she's so selfish. She's immoral. She doesn't want to represent our country. What a waste of time. She should never compete in Olympics. Like, who are you? Have you ever even stepped stage on an Olympic stage? Have you ever even trained at the level that she's trained?
00:27:30
Speaker
Like, shout out to Simone, man. Like, keep doing your thing, Shoudy. Like, we proud of you, and I'm always going to support you. Shout out to Simone, all right? That's it. That's one girl. Period. But on a less positive note, we do have to acknowledge the recent assassination of the Haitian president.
Haiti's Political Crisis
00:27:51
Speaker
Who wants to pronounce his name? Aldrin, I need you to pronounce his name so that way I don't mess it up.
00:27:55
Speaker
Yo, Skender, don't be mad at me, okay? But his name is, I think, Jovanel Moyse, I think. I would purge you. I would purge mine with that. Jovanel Moyse. It sounds right to me, because we're not allowed to mess up a man's name who had such an important role for Haiti. But on July 7, 2020, the president of Haiti was assassinated by a group of gunmen in his home. And is it parallel in five, a district of Petit Shonville,
00:28:25
Speaker
I think I said that right. I took a little bit of French here and there, chill out. You know, I took a little bit. But Moist was shot with 12 bullets in his chest, arms, right leg, and left hip, and he had a shattered left eye. So first lady Martine Moist was also shot multiple times in the attack.
00:28:52
Speaker
suffering gunshot wounds in her arms and thighs and addition to severe injuries to her hands and her abdomen. So that is just a really tragic thing to have happened to a president representing one of the best black countries that exists in this entire world. And it's unfortunate that
00:29:08
Speaker
I don't know. I feel like they talked about it a little, but I feel like there was representation from Haitian Americans about what happened. But I don't feel like the news really advertised it to that extent, which I think is really messed up, especially because we know that Haiti has been a country that's gone through a lot in regards to the earthquake and everything that went on with that.
00:29:28
Speaker
It's a country that America is definitely very much familiar with and has taken heed to when things have happened. But I don't really remember the media giving it its fair justice. I don't know what you guys think about it. I feel like what we do know is just about the suspects. We always get the stuff that, yeah, it matters, but it doesn't. Like in the grand scheme of things.
00:29:52
Speaker
So 18 Colombians and several Haitians and Haitian Americans are connected to the murder and the Haitian police are still seeking others. The suspects included retired Colombian commandos, a former judge, security equipment salesman, a mortgage and insurance broker in Florida, y'all.
00:30:12
Speaker
Two commanders of the president's security team. And according to the Haitian police, the elaborate plot revolves around a 63-year-old doctor and pastor, y'all. And this person, Christian Emmanuel Sanon, who officials say conspired to hire the Colombian mercenaries to kill the president and seize political power. I think the biggest question, though, like, what does this mean for Haiti's future?
00:30:39
Speaker
There's so much that is deeply rooted in Haiti's history. How does Haiti come back from this? I don't know that we can do anything to really help here, but what does that look like moving forward for Haiti?
00:30:57
Speaker
Yeah, it's just this whole situation is just unfortunate and very alarming. Again, like Isabel, like you mentioned, in terms of the media outcry and coverage, there's just not been enough. And when we talk about Haiti, 59% of people in Haiti live below the poverty line, which is one of the highest rates in the world. And then 24% live in a situation of extreme poverty.
00:31:20
Speaker
And it's crazy. Only 36 percent of the population had access to electricity in 2012. And that's increased significantly since then. But I'm saying these stats to say, like, we live in a world where we good. Right. I'm here. I'm on incident. I'm talking to you. Like, I got food downstairs. My mom is here. She's chefing up. You know, she got everything. But most people out there, they live in day to day. Most people live on less than two dollars a day. And so for their president to be assassinated and create such destabilization already in a in a state where they're at is
00:31:48
Speaker
already creating an influx of challenging situations and barriers, right? We know that the political aspect influences things on the lower level in terms of finances, economics, the access to jobs, access to education. Many other many other children in Haiti don't even have a reading level that is to the level that we see in America, you know, saying less than 30% of the kids there could read, you know, adequately at their at their age. So I think
00:32:15
Speaker
We got to really put our paws on this and really recognize what's going on there. And American, I don't necessarily say we need to directly intervene in terms of, all right, we got to help them institute a president. But I feel like we got to put our money where we put money into Israel, right? Like we bring bread over there, right? Israel's in a whole nother continent, bro.
00:32:35
Speaker
But we can't at home in the Caribbean help Haiti, who's a country we've taken advantage of. France has taken advantage of. And the crazy thing about France is that they demand the reparations, which has indebted the nation. And France, like, how do you? France, you don't want that enslaved that like took advantage of the economy.
00:32:52
Speaker
Yeah, two, 300 years. So y'all talking about y'all want reparations for that. And it's crazy how this system affects black people, right? Internationally, locally, the communities all around the world, and we don't talk about it. We got to strategize and connect with the people in Haiti. I know they're distant, but I feel like we got to understand their plight because it helps us understand what we got going on here, although it's
00:33:16
Speaker
is separate. It's quite unique, but I feel like we, we, there's a lot to say for the Haitian people. I mean, I was reading an article the other day and because of the gang violence from the assassination of the president, there's people that have been displaced from their homes. You know what I'm saying? Like people are literally trying, they're at homeless shelters. You have little children.
00:33:34
Speaker
And you know what I'm saying? Their mothers and fathers, they like, we don't know what's going on. We don't even know when we could get back home. So that stability, instability influences how people live on a day-to-day basis. And because we don't see it, if we're not aware of it, then we can't institute the changes that are needed to implement the necessary upgrowth and mobility of the people there. So shout out to the Haitian people and what they're dealing with. I think we just got to continue to support them in any way we can.
00:34:03
Speaker
Right. I agree. You know, and it's, you know, you mentioned Alden, you know, how there's, you know, kids who are being taken away and like, you know, being in these, you know, very unstable conditions, these scary conditions. And that's the same thing, you know, that kids who are currently under DACA are experiencing as well. You know, people who have come to this country, you know, at a really young age who were not even like aware of the culture
00:34:33
Speaker
of the country that they technically were born in and then they're not even sure whether or not they have safety or if they're able to be secure in America because they're undocumented, right? And so DACA has served as this documentation. Basically, like under the program, children of undocumented immigrants have been allowed to remain here if they were under 16 when their parents had brought them to the US and if they had arrived by 2007.
00:34:57
Speaker
And so government figures also show that over 90% of DACA participants also have a job, nearly half of them are in school, and many don't even speak the language or even, like I said, know the culture of their home countries. So this document has really allowed undocumented immigrants to be able to feel more stable, and now there's risk that they may not be able to qualify for DACA anymore. And so I don't know what you guys' thoughts are on that situation.
00:35:28
Speaker
Um, so United States, I sure you want to do that because we just had a runner. Because I don't know if they know that's real. Who qualified to run for his native Guatemala. He ran for the United States and actually won, um, the gold medal. He finished, um, actually finished a line second in the 5,000 meter race, um, and the NCAA track and field, but he did win a gold medal. Um,
00:35:57
Speaker
And so if y'all want to actually execute that, we know that we're putting so many individuals advantage that are part of our culture, are part of our community. And DACA is a great way for us to connect with people who didn't choose to be here, right? Their parents brought them here. And we could talk about the parents on a side note, but these people are accomplishing, they're doing great things. And they're highlighting what the American values are, which are sacrifice, which are investment in your future, which is
00:36:23
Speaker
right committing to who you are and being passionate and working hard for the American dream. And I think that they represent something that many people don't even have that when they come from so so little and they have to work so hard to get to where they need to, they teach us a lesson about ourselves. So those who are already privileged that are here. And so I really respect them and integrity and the moralities that they have for themselves because they come here, they don't complain. There's people that don't
00:36:49
Speaker
And I'm not saying everyone that's from this background is working certain jobs, but there's people, some of them, they work, you know what I'm saying? They clean bathrooms, they sanitation workers, they do the jobs oftentimes that we don't necessarily equate to being successful, but they enjoy it. They come work hard, they support their families, and they do what they gotta do. And a lot of people, they living on unemployment checks and thinking that they got disability.
00:37:16
Speaker
These people, they don't know about that, you know what I mean? And they're not even from this country. They're taking advantage of us in this country. A lot of the DACA people, they're not doing that. They out here actually promoting the economy and helping it build. So it's crazy to me how we're not seeing the statistics and how this is supporting who we are as American and the values where, you know what I'm saying, as Americans. These values, right?
00:37:38
Speaker
Yeah, I think it's wild because I think, as you said it, these children, they didn't ask to be here. And I just feel like it's our responsibility as Americans. This is what we claim to do. We claim to be the land of the free, the home of the brave. All these are the lies. Yep, I know. All these are the lies and deceit, girl. But at least look out for the children.
00:38:08
Speaker
That's a fact. I just, I have a soft spot for certain populations of people and children aren't.
Protection of DACA Recipients
00:38:14
Speaker
That's definitely one of my soft spots. Um, beets. Cough, cough, but, um,
00:38:24
Speaker
Yeah, you know, they deserve, if they're here to get the same education, they should be able to experience the same, how do I say it, the same novelties, if you will, the same luxuries. I mean, I know we don't all experience that, but
00:38:41
Speaker
Why, why negate them? They did not ask to be here. And I mean, if you feel like changing stuff, then go back to the constitution and get things right. Then that's not going to happen. We don't have a travel time travel to go back and fix anything. So let's just exist how we exist and look out for those that come here. That's it. That's it. That's all.
00:39:09
Speaker
Aldwyn, anything else to add? I really loved listening to you on that. You really got passionate. Oh, not me. Because honestly, I know from living in the South Bronx, I know a lot of
00:39:25
Speaker
people who have benefited from DACA, and I see their growth, I see what they've accomplished, and obviously I'm not gonna shout out who they are, I wish I could, but at the end of the day, it's just when you're personalizing that whole experience and how they're committed to what they're doing and how that inspires you as a person, it's just beautiful to witness and behold, despite their challenges, despite, like we mentioned, many of them, this is not their native language, but they persisted, they prevailed. There's people on the other hand on my block that they've been here
00:39:52
Speaker
five, six generations and they didn't do nothing. You know what I mean? I'm just being honest. Even our peers, right? Our peers in medical school, like thinking how many of them are actually benefiting and like these are talented individuals. Very much so. Very much so.
00:40:17
Speaker
But onto something else that now this is a sweet spot for me, y'all. I love this stuff right here. I know, resident dermatologist. One day, hopefully, praise the Lord.
UV Awareness and Skincare
00:40:30
Speaker
So, July, although we are now in August, July was UV Awareness Month. And listen, Black people, people of color, y'all got to protect your skin.
00:40:41
Speaker
You need a skincare regimen and you need to use sunscreen at all times. So with regards to the importance of protecting yourself from UV rays. So as we know, UV radiation is a significant risk factor for a number of things from melanoma. UV induced melanomas and squamous cell carcinomas have actually been found in people of color with a wide variety and range of complexions.
00:41:04
Speaker
So like, everybody, y'all need to be out here protecting your skin. And also, I don't know about you, is I'm trying to stay youthful. Period. What about me? Excuse me. Do y'all want me to drop the skincare regimen? Because I can, OK? Drop it in the group chat.
00:41:22
Speaker
I'm gonna give a shout out to this one brand that I have literally like, at this point, I've thrown away everything else I've used and I've just stuck to them and my skin has been doing wonders. This is someone, this is coming from somebody who's literally dealt with eczema since I was a baby. So my skin is like, I don't play with my skin, right? Because once it hits winter time, there's a big chance I get my flare ups and stuff like that. So I always try to prevent that. But Sarah Medex,
00:41:48
Speaker
sit like Sarah, C, E, R, a med X, E X, right? Not just X. They, I have everything they're, uh, facial, uh, uh, what's it called? Facial cleanser, their facial lotion, their body lotion, their body, everything. My skin has never been happier. I love them. I love it.
00:42:06
Speaker
Yeah, so I would definitely say and of course sunscreen. Don't forget sunscreen. I'm a big fan of black girl sunscreen. They've done wonders for me as well. I would say that your skin is very much a reflection of like actually what goes on inside of your body, right? So you do have to be very much like cognizant of like, you know, monitoring like what is going on with your skin, right? Usually, if there's something wrong with it, there might be something wrong internally. So you definitely want to
00:42:32
Speaker
be people kind of downplay your skin to say, Oh, I'm black. I got melon. I'm good. I'm not going to burn. Like, I don't deal with these things. But you have to realize that like, because we're darker, actually, it's harder for us to notice what when there is something wrong with our skin. So we actually need to be more, you know, like safe and like playing it more safe with what we choose to use, because it's not that easy for where we don't just we don't turn red and green and blue when something happens to us. We stay black. So we got to, you know,
00:42:58
Speaker
be cognizant of what's going on. Yeah, so I would definitely say I'm a big proponent of skincare all the way. Yeah, and skin cancers in people, persons of color, it doesn't show up the same. We're less diagnosed than white people are. So we also end up with a worse prognosis because a lot of times you just don't know. So that's why I think there's such a big push from a lot of black derms right now.
00:43:27
Speaker
And just different organizations, for example, the Skin Cancer Foundation cited two studies. So one that found an average five-year melanoma survival rate of 67% in black patients as opposed to 92% in white patients. That's
00:43:44
Speaker
that's way less. Like imagine if we actually were in these offices and taking care of our skin. And then another showed the late stage melanoma diagnosis to be more common in Hispanic and black patients versus white patients. So I do want to shout out and this is not an endorsement at all. None of what we've been discussing in terms of product lines are an endorsement, but
00:44:08
Speaker
a personal shout out for a skincare line that I love that has an amazing sunscreen, Malay skincare, which was actually co-created with dermatologists of color. And I would love to shout out one of my mentors, Dr. Diane Davis, who is one of the co-founders. She's a cosmetic dermatologist.
00:44:27
Speaker
Listen, we out here and we are taking care of our skin. You see a glow in the area and there's other ones that we mentioned in 11 by Venus Williams, you know, or black girl tennis queen. We got a, you know, shout her out to another one called bio sense mineral sunscreen. So like Erica mentioned, these are not sponsored. Um, but we just want to make sure that we shout out these, uh, sunscreen brands that are definitely made with us in mind. Right. Cause we know a lot of these sunscreens are not made with us in mind. You put it on, you got a white cast that makes white cast.
00:44:57
Speaker
I like them. Look at like Casper out here when you're trying to protect your skin and you're not going for Casper. We're going for translucent. We're going for glow. Okay. So like it. TMs make them translucent. What's your skincare? All when, since we go on the topic, we might as well, you got a skincare regimen. I don't want to hear no three and one all did.
00:45:22
Speaker
I used to be man basic man like nah I really gotta I ain't gonna lie to you like I really need to get on the skincare wave so I really appreciate that I know a lot of people in the SNMA family they probably not too aware and as pertains to black men I feel like actually I'm interested in starting a black men skincare line and things that nature but anyway I think it's important that we discuss this and we
00:45:46
Speaker
I it's just it's unfortunate that there's not enough telling the truth and realities of this. When you see melanoma, obviously, we talked about this in the past. You see it on white skin, but you never see it on black skin. Like last week was the last first time I seen Lyme disease, the actual, you know, I'm saying like pinpoint with the central clearing on a black woman, you know. So it's just interesting. Like when we talk about these issues are the black community got to stand up and really recognize that it won't just affect white people as black people, too. If you understand enough, you will get melanoma. You can get skin cancer.
00:46:16
Speaker
our melanin does protect us, but it also, you know what I'm saying? It ain't absolute. Our skin is love. Our skin is love. We love it. It's beautiful. It's beautiful. Yeah. Y'all putting me onto the skincare, so I'm going to let y'all know how to go. You know what I mean? I'll be looking forward to it, for sure. We glowing, baby. We glowing.
00:46:39
Speaker
And I mean, it's August, so we still got a whole month of summer left, y'all. It's not nowhere near cuffing season yet, so get that sunscreen going so you get your skin care going for the fall months to come. And that is Run the List to share your opinions on any of the topics we discussed. Email podcasts at snma.org, and we may read them on the next episode.
Palliative Care: Expertise and Impact
00:47:02
Speaker
Now we will be discussing palliative care with our dear Aldwin and our guests, Dr. Cardenale Smith and Dr. Grace Slater.
00:47:15
Speaker
What's good, everybody? Hello, everyone, and thanks again for tuning in to the SNMA Presents the Lounge. I am student Dr. Aldwin, and I am glad to have the opportunity to interview two amazing individuals today. Woo, they are the live-est. I'm excited to know about palliative care. But before we start, I would like to introduce our guest. First off is Dr. Cardenale Smith.
00:47:42
Speaker
M.D. PhD. She is an Associate Professor in the Department of Medicine, Hematology and Medical Oncology and Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. She holds many administrative positions, including Chief Quality Officer for Oncology, Director of the Supportive Oncology Program, and Associate Director for Community Outreach and Engagement at the Tisch Cancer Institute.
00:48:11
Speaker
Dr. Smith is an active clinician in both oncology and palliative medicine. In addition, she's an active health services researcher at the intersection of oncology and palliative care, emphasizing minority populations.
00:48:27
Speaker
Second guest is Dr. Grace Slater, who received her medical training at the University of Illinois College of Medicine in Peoria, Illinois, and completed her pediatric residency at the Medical College of Wisconsin. She began her pediatric hospital medicine fellowship at UPMC Children's Hospital of Pittsburgh in the summer of 2019. Dr. Slater is an upcoming UPMC Pittsburgh hospice and palliative medicine fellow. So I want to say thank you guys for pulling up
00:48:57
Speaker
Thank you so much for taking the time to speak with us today. We are excited to learn about palliative medicine. We are excited to be engaged in this conversation that is oftentimes missed in our communities, in minority groups. And let's get to it. Let's learn about this. Let's create dialogue and discussion. So without further ado, I want to say Dr. Slater and Dr. Smith, we give you a round of applause. Let's go. Yeah.
00:49:26
Speaker
To begin, many individuals confuse hospice with palliative care. So we want to make sure our audience is aware of the differences. Could you perhaps define it first for us and provide a brief explanation as to why you chose your chosen subspecialty? Dr. Slater, you can go first.
00:49:44
Speaker
Sure, I'd love to. Thanks so much for having me. I'm really excited about this area of medicine. So the difference for me between hospice and palliative care is palliative care is really about making the best of your life, even if it is shortened from what we would expect. And hospice is making the path towards death comfortable and
00:50:12
Speaker
being prepared to meet that when it comes into our lives. As it does for everybody, my area of specialty is obviously pediatrics, which means I deal a lot with kids. And the reason that I became interested in hospice and palliative care in the pediatric world is because of my deep love of hospital medicine. So there is a growing population of
00:50:43
Speaker
pediatric patients that have these very complex medical histories. And the more that medicine grows and its ability to prolong life and to do amazing things, we also see that there is a creation of this new category of patients that is really growing.
00:51:09
Speaker
with complex medical needs and multiple comorbidities and shortened life expectancies. And so it's amazing that medicine can keep these kids alive and well for as long as it has, but there is also this
00:51:31
Speaker
end that we know is coming earlier than what we would expect. And it's a population that doesn't have a lot of expertise until just recently. And being a hospitalist and having this interest in complex care and kids with complex medical needs and helping families along the journey of figuring out how to make the most of these kids' lives is really
00:52:01
Speaker
where I found a purpose and I found a lot of joy in coming and walking alongside these families for however short or long their children's lives may be and providing support and increasing those kids quality of life. And that is what led me to pursue a fellowship in hospice and palliative care.
00:52:26
Speaker
So, I mean, I would say I look at palliative care as sort of the larger umbrella in that it is specialized medical care that aims to treat symptoms and relieve suffering for patients who are living with serious illness and to help support their families or caregivers.
00:52:51
Speaker
It's given by an interdisciplinary team of clinicians that include physicians, nurses, advanced practice providers, spiritual care, social work, and other integrative team members as well.
00:53:08
Speaker
You know, I chose palliative care as a subspecialty. I sort of came to it, I don't know, sort of a circuitous route, I guess. I was a medicine intern and I knew I was going to go into oncology. And I had a patient experience where it was a gentleman with metastatic prostate cancer.
00:53:32
Speaker
And he had been in the hospital for a really significant pain related to bone metastasis, so cancer that had spread to his bones. And he, every day I would go in the room and he would say, you know, why are you doing this to me? Why are you doing this to me? And there was just this incredible amount of suffering and I didn't know how to respond other than to say, you know, we'll get you through this, you know, we will get you on a pain regimen that will help you.
00:53:57
Speaker
And we called in the palliative care consult team to help manage his pain symptoms. And I happened to be in the room when the physician came in and the physician simply said, wow, it sounds like you're really suffering. Tell me, tell me what's really, what's worrying you the most when you think about
00:54:13
Speaker
your cancer and your future. And that was an aha moment for me. I had never really experienced anyone speaking to a patient in that way in my own medical career. And so I knew if I was going to be an oncologist, I had to be an oncologist who had those skills and could communicate and care for patients in that way.
00:54:34
Speaker
Yeah, I think it's amazing both of you work with underserved populations, one with pediatric patients, and of course, understand the fact that medicine requires us to communicate and connect with a diverse array of individuals. But specifically speaking about when we talk about hospice medicine and hospice patient care, according to the National Hospice and Palliative Care Organization, in 2018, about 82% of hospice patients were white.
00:55:04
Speaker
compared to 8.2% for African Americans and 6.7% for Hispanics. What are some of the factors that contribute to the racial disparities in palliative care among minority patients? And second, how do you think the SDOH plays a part in the fact that black Americans use less advanced care planning than white Americans? Dr. Smith, you can go first. Sure.
00:55:32
Speaker
So hospice is sort of one component of palliative care that is care that's given at the end of life. And we happen to have a definition for hospice care, which is regulated by Medicare. So it essentially says that if a patient with a serious illness like cancer, for example, has an estimated prognosis of six months or less,
00:55:59
Speaker
they're eligible to go on hospice and they sort of forgo any illness, any, in the case of cancer, any cancer directed treatment, for example. So really the focus is on supportive care.
00:56:14
Speaker
And I think that there are a multitude of factors that contribute to this. The hospice benefit, which came about through policy, was created by a certain set of individuals who believed that there is a certain norm around how people want to approach the end of their life.
00:56:36
Speaker
And we know that that's not the way everyone approaches the end of life. Not everybody wants to die in their home. Not everyone has resources to be able to be maintained and to remain comfortable in their home outside of the services the hospice can provide. And even more, not everybody has a caregiver who's able to be present with someone and really help them with whatever symptoms they may need or whatever other support that they may need.
00:57:04
Speaker
And so I think when hospice was created, hospice wasn't created with those, you know, structurally marginalized groups in mind to think about how they would want to accept care or what care they would need, what sort of culturally competent and relevant care should be given to them. Yeah, I agree. I think that there are so many different cultures when you talk about race within
00:57:34
Speaker
one particular color of skin. There's so many different ways that people function as a family unit and that looks different even when it comes to death for different populations and different minorities. I think that
00:57:57
Speaker
In my family, the approach to where somebody should die or would be comfortable dying is very different from the common
00:58:15
Speaker
maybe perceived notions of how society feels like people should or want to have the environment be around them when they die. And so I think that it really comes down to people are so diverse and so different, even within the same color of skin or culture. And that has to be taken into account when we
00:58:44
Speaker
even when we look at the time period surrounding death. And it really should be an ask of every patient of what they picture and what their desire is for that time and that setting. And I think that currently
00:59:04
Speaker
Our population has a very fixed picture of what that should look like, and we need to be a little bit more open about just providing the space for people to have different opinions of how they want the end of their life, or their life leading up to the end of their life to look like.
00:59:24
Speaker
Yes, I think you both hit the mark and Dr. Slater is certainly important to cultivate that dialogue between your patients and allow them to have that autonomy to make the decisions that they think are best appropriate for themselves and their family at the end of the day.
00:59:42
Speaker
Now we talked about pallets of care and racial disparities from an overall overarching theme, but we know that the pandemic has cultivated and actually accentuated a lot of racial disparities and it's done a tremendous
01:00:01
Speaker
impact and create a tremendous burden, particularly on the Black and Latino population. What influences has the pandemic had on palliative care for the minority community and individuals with terminal illnesses from your perspectives?
Pandemic's Impact on Palliative Care
01:00:17
Speaker
Dr. Smith, you can go first. Yeah, so I mean, I think the pandemic was hard on all of us.
01:00:26
Speaker
and particularly those groups who are already on the fringes. You know, I think, so I'm going to start with the silver lining of COVID because I like to think that there have been some. You know, if anything, I think the importance and the role that palliative care played, particularly among admitted patients with COVID-19,
01:00:53
Speaker
was really tremendous and I am in New York where we were one of the initial epicenters and our palliative care services were definitely required and in need. In fact, we happen to have hotlines on the weekends to be able to get to expert palliative care.
01:01:14
Speaker
And I like to think that that sort of brought the importance of specialty palliative care to the forefront and has also, I see this shift. So we have this terminology where we talk about specialty palliative care and those are those clinicians whom have done expert training in the palliative medicine palliative care fellowship. And then there's primary palliative care. And those are sort of, you know, frontline clinicians like an oncologist, for example,
01:01:44
Speaker
who has palliative care skills to be able to take care of the daily needs of their cancer patients, pain, anxiety, basic communications, et cetera. And I think what this has taught the healthcare system in general
01:01:58
Speaker
is that these primary palliative care skills are really important for all clinicians, not just specialty palliative care clinicians. And I think by being able to both educate the primary clinicians with whom patients have the most interactions with, we will hopefully be improving the care for the minority community and for minority folks who happen to have serious illness.
01:02:27
Speaker
I also think that it has brought to the forefront a conversation around advanced care planning and why it's important to talk about your wishes or at least share your wishes with your loved ones so that if you ever have a serious illness or you land in the hospital, someone knows what the care is that you would like to have received. So I think that
01:02:55
Speaker
Some of the most, so obviously I didn't get to experience the palliative care side as deeply. Seeing as while COVID was happening and up until now I have been a pediatric hospital medicine fellow, but we do have some overlap in
01:03:14
Speaker
There are some families that choose to not have their loved ones, including their children, at home during the end of life care. And I have gotten to take care of a few patients who have
01:03:33
Speaker
been in long-term care facilities during this COVID-19 pandemic. And I think that one of the things that has struck me the most is that during the COVID-19 pandemic, families have not been able to see their loved ones in these long-term care facilities. And the increased amount of stress and grief that has
01:04:01
Speaker
built on an already stressful and grieving time for the general population, but this past year in particularly has been hard on minority populations, especially the African American and Black population, just given cultural events that have been going on. I think that for me,
01:04:22
Speaker
to see the increased amount of stress and grief on those families, to have not been able to see their loved ones for a year, and then to be seeing them when we were withdrawing care or providing end-of-life care only for a couple of hours or days, it was heartbreaking. It was really devastating to see the effects that
01:04:51
Speaker
no one could have foretold or foreknown at the beginning of the COVID-19 pandemic.
01:04:58
Speaker
Yeah, I can't even imagine, from a pediatric perspective, just seeing families, like you mentioned, not being able to be around their children or other family members, how that can cause a disastrous effect as we talk about mental health issues. And we talk about creating a connectiveness with the pandemic. Social isolation was certainly a huge factor, even for me personally, I've known.
01:05:26
Speaker
several individuals whose family members ended up dying in the hospital all alone and the amount of pain and such a negative impact on turmoil that caused, I mean, I can't even imagine, but seeing how for you, this question goes to both of you, but Dr. Slater, you're going into palliative medicine after doing a pediatric hospital list.
01:05:54
Speaker
One of the main things we schools that we don't hav as it pertains to our r me personally, you know, I didn't even get to exp radiology. You know, we do medicine, O. V. G. Y. exposure to palliative med I don't think I know of in my class that did pers
01:06:20
Speaker
But what can we do to diversify the palliative medicine workforce? We see that it became a medical subspecialty in 2008. And the field has grown to include 7,618 board-certified palliative care medicine physicians. And I might be one of them one day. I don't know. Y'all talking real right. I might join the crew.
01:06:43
Speaker
But what do you think are some things that we can do to increase the amount of particularly minorities in palliative medicine? Yeah, I think you're right. I actually didn't get exposure to palliative medicine until I was in my pediatric residency. And so it was something that I had no idea about when I was a medical student. I think that
01:07:07
Speaker
like for so many things, representation is really important. And in order to diversify a workforce, you really have to start with the pipeline. And so I think early exposure to palliative medicine is a really effective way to kind of
01:07:30
Speaker
help people see how the skills of palliative care can not only apply in the great communication techniques that you learn in palliative care, they apply across a wide board of specialties. And I feel like some of the most powerful palliative care doctors I've seen are doctors who are not just
01:07:55
Speaker
focused on solely palliative care, but have some sort of other training. So you often see our hemonic doctors in palliative care with an added palliative care fellowship. One of the palliative care doctors that I worked with in my pediatric residency was actually trained just as a pediatrician, did a bunch of outpatient pediatrician work, and then became involved in palliative care after he had
01:08:25
Speaker
retired from being a pediatrician for most of his career. And so I think that it's a specialty that really draws on compassion and great communication. And early exposure to those skills are going to help physicians in any area that they choose to go into, but also it will help to
01:08:48
Speaker
create a greater exposure and to kind of increase the awareness of palliative care as a specialty. And so I love that SMNA is doing so many initiative things to look at exposing minority students to a larger breadth of
01:09:10
Speaker
of specialties than the more common specialties. There's also great work being done by a lot of palliative care doctors, including the University of Pittsburgh here. There's a grant and an internship that medical students can come and
01:09:28
Speaker
be a part of the palliative care rotation here. And so I think that there is groundwork being laid to kind of make an avenue for a diverse amount of minorities to come into the specialty. But I do really think it starts with the pipeline. Yeah, I completely agree with that. And I
01:09:51
Speaker
And I would expand on that to say that I agree with both of you. I'm clearly not probably clearly older than both of you. I graduated medical school in 2003 and I certainly didn't have any exposure or experience with palliative medicine when I was a student. And I'm encouraged that we are going to be recruiting you on this call and hopefully others who are listening to this podcast because
01:10:20
Speaker
I would argue that palliative medicine as a field is certainly one of the most rewarding. In fact, I most recently had a student say to me, wow, this is what I always thought medicine was supposed to be. I'm not knocking any fields, right? I'm also an oncologist. And I think that there's something really rewarding about being in this field.
01:10:44
Speaker
I do think that there are several really intentional things that we can do to help build that pipeline. I think one is that we should have our medical students have mandatory rotations within palliative care. So here at the ICAM School of Medicine at Mount Sinai, all of our third year medical students during their geriatrics rotation,
01:11:11
Speaker
they have a week of palliative care, a week of palliative care rotation. And certainly one week is not enough, but it is an exposure to a field that you otherwise would not have exposure to. And so I think when we think about the accreditation of medical schools, making that be mandatory is something that we should be considering.
01:11:34
Speaker
I also, you know, there is this bill that is sort of being stalled within Congress. It's called the Palliative Care and Hospice Education and Training Act, or PACHIDA. And it really includes a lot of money for not just research, but to be able to pay medical schools and institutions to hire speciality palliative care clinicians to be able to do the education we're talking about.
01:12:02
Speaker
It also includes money for loan forgiveness, which is something that, at least for me, I know when I graduated from medical school, would have been really nice to know that that is out there somewhere waiting for me instead of looking at the $200,000 that I have had to pay back.
01:12:23
Speaker
And I think when we think about pipeline programs, you know, our academy, the American Academy of Hospice and Palliative Medicine has mentorship opportunities for those who are interested in going into the field and being connected to a mentor. You know, you may not have, we don't have enough specialty palliative care folks in the workforce, and so
01:12:43
Speaker
if someone happens to be at an institution or a medical school where maybe they don't have the mentorship that they would need, that's a connection to get you connected to someone and to give you the ability to come to the national meeting so that that can be on your CV and can help you as you look into getting into residency programs. So I think focusing on all of those things are really what we need to diversify this workforce.
01:13:11
Speaker
That said, you heard it here first. Parrots of Medicine is the way to go. And we have our two wonderful guests. We'll get their contact information, but as an MA fan, definitely check out Parrots of Care. It's definitely a wonderful field, as we have talked about, discussed, and learned about during this podcast episode. Now,
01:13:31
Speaker
In late February, the House and Senate introduced a telehealth modernization act. This act was introduced in the House and Senate in late February, and the bill extends certain flexibilities that were initially authorized during the public health emergency related to COVID-19. It calls for action to expand telehealth services, use for hospice permanently, and seeks the permanent expansion of the Center for Medicare and Medicaid Services.
01:14:00
Speaker
temporary waivers on geographic and site-related restrictions. Two, the Leveraging Integrated Network and Communities to Address Social Needs Act of 2021 was also introduced to Senate on March 1, 2021. This act would give states funding to facilitate better coordination of care regarding social determinants of health. SDOH for short.
01:14:24
Speaker
In addition, this legislation aims to create a program to help states build or improve community integration network infrastructures for health and social services. So I just wanted to give a background as an MA fan before we get into this question. So you guys do know what we're talking about.
01:14:42
Speaker
But in regards to both of these acts, how do you believe these bills will help to reduce the telehealth disparities that minorities confront as they walk through the palliative or hospice care practice? Dr. Slater? Yeah, I think that telemedicine is actually a really nice resource that was really underutilized before the pandemic. One of the
01:15:10
Speaker
ways that hospice and palliative medicine could benefit from continued support of telehealth services is that it makes televisits and visits where you can actually see a provider and a provider can see you without actually leaving the home. So you can imagine that
01:15:31
Speaker
Some people, especially people with complex care needs and a lot of need for medical support items, it can be very hard for them to get up and travel to a clinic appointment or to a hospital. And so having the ability to be able to, as a physician,
01:15:53
Speaker
have a broader list of patients that you can see because home visits are wonderful but you have a lot of time lost that's driving from home to home and home visits are still going to be necessary to some extent but imagine
01:16:07
Speaker
that you can expand the patients that you can interact with and visit with and care for by twice as many because you are eliminating the time it takes to drive to do home visits. It's an amazing opportunity to
01:16:26
Speaker
increase the amount of interactions that hospice and palliative care patients can have with their physicians. And a very easy way to make something that might feel impersonal, like a phone call, to be much more personal when you can see the provider that you're actually talking to. And so I think that expanding and continuing to expand telehealth services is going to be an excellent thing for the hospice and palliative care community.
01:16:58
Speaker
Yeah, I mean, I definitely agree with all of that and that telehealth is certainly an added benefit, especially when we think about certain rural communities or patients with serious illness and mobility is an issue. I think how much
01:17:15
Speaker
what these acts will help with, I think remains to be seen. The devil, as they say, is always in the details. You know, it is one thing to expand telehealth services and allow us to be able to see patients across state lines or to expand the reimbursement for telehealth services.
01:17:37
Speaker
but it's a completely different thing to make sure patients have both the access to broadband-enabled devices as well as access to broadband data, which even in a place like New York City, which is an urban environment, and you wouldn't think that we don't have the same sort of broadband deserts as might exist in more rural communities, but there still is a dearth of broadband access.
01:18:03
Speaker
particularly in minority communities. And so I say that it has to be both. It has to be expanding that access so that we can reach more people. And it has to be addressing those social determinants of health so that one, we know and we're documenting who has what. And then we're able to connect those folks to the kinds of services that they need to really breach that digital divide.
01:18:35
Speaker
So we talked about with these acts an increase in accessibility and awareness, as you both mentioned, telehealth has definitely been a benefit to so many patients in so many fields and in particular palliative care in increasing the opportunities to increase the scope of practice that you all can engage in. With that being said, what are ways in which we can eliminate the discrepancies
01:19:03
Speaker
in hospice and palliative care for minorities? And what are some of the initiatives that we can engage in to do such things? So I would say first is awareness, right? I mean, I think most people would know if they feel like they're having chest pain or a heart attack that they would call a cardiologist. I don't know that most people with serious illness would know to call a palliative medicine physician.
01:19:29
Speaker
So, and I think that there there still is a sort of a misconception about what palliative care is and what hospice is so that, you know, with palliative care, you continue to get all of your serious illness care and with hospice.
01:19:45
Speaker
you are focusing on supportive care only and not getting concurrent serious illness care like for cancer. And so, you know, I think that there has to be some work in getting this message out to those communities. I think partnering with faith-based organizations
01:20:03
Speaker
partnering with other community-based organizations who have both inroads and relationships with those communities to let them know that this is okay, that this is acceptable, to encourage dialogue around palliative care principles like advanced care planning. I also think when we talk about sort of eliminating some of these challenges that exist
01:20:30
Speaker
You know, there's also a system issue here so that for patients who are living with pain, for example, we know that pharmacies and predominantly minority communities are less likely to stock adequate opioids, pain medications for patients. And so, you know, you can't expect people to be able to treat their serious illness if they can't access the medications that they need.
01:20:57
Speaker
And so I think there has to be a critical look at what are these policies that we have put in place from a sort of systems lens that has helped contribute to some of these differences. Yeah, I definitely agree that we really need to
01:21:19
Speaker
focus on better understanding of what palliative care and hospice is as a specialty. I think that the most common question that I get when people ask what I do and I explain that I'm going into a hospice and palliative care fellowship, they're like, oh,
01:21:37
Speaker
What's that? Are you going to work at a nursing home? And so it really is, there's like really this misconceived notion and total lack of understanding about what the specialty is as a whole. And I think that we have a lot as people have a lot of fear when it comes to thinking or talking about end of life care or
01:22:05
Speaker
that admits that there is going to be an end at some point, right? And so I think that really opening up the conversation and bringing this conversation to the forefront and making it a lot more commonplace is going to be important to raise awareness. And I also think that representation matters, right? We can't be scared to be part of
01:22:33
Speaker
a small population of minority doctors in the field, right? Somebody has to go first. And I am so honored to follow amazing doctors like Dr. Smith, who obviously has been a forerunner for minorities in this field. And so I admit that there's still disparities in the population of palliative care
01:23:01
Speaker
doctors that there's not as many brown-skinned African-American or Black or Latino or other types of diversity that we would love to see in hospice and palliative care, but I think we're moving in that direction, but we can't be scared to be the people who lay the groundwork and be the people who step into this kind of land of the unknown and support that growing diversity.
01:23:33
Speaker
Yes, diversity and representation certainly matter. For that pre-med student or that medical student that's listening in right now and is saying, man, palliative care is a bomb.com. I'm all with it.
Benefits of Palliative Care
01:23:47
Speaker
And I want to learn more. Or for that individual that just wants to engage with it and wants to learn more about it in regards to their family members or if they're put into that position to make such decisions.
01:23:58
Speaker
What are your final thoughts you would like to impart upon the audience and our SNMA fam in regards to what we discussed today? And second, how can our listeners connect with you? Dr. Slater, I'll let you go first. Sure.
01:24:13
Speaker
I think that for me, the biggest thing that I would say is to explore doing a rotation in palliative medicine. There are so many benefits to just exposing yourself to different fields of medicine and what they offer to patients, but also what they can offer to you
01:24:34
Speaker
as a well-rounded doctor and individual. And I am so excited to increase my communication skills and be a part of this community and family that really focuses on making people's lives better. And I cannot say enough for how much fulfillment and how much joy
01:25:04
Speaker
I find in
01:25:06
Speaker
being with these doctors who care for such serious patients with such serious illnesses and how much that has made me grow as a person and also as a physician. And I cannot wait for all of the folks who are going to join us in the amazing work that's being done in hospice and palliative care.
01:25:36
Speaker
And on quite a few social media accounts, you can find me on Twitter at Dr. Grace Slater. And then if people want to get in contact with me to hear a little bit more about my experiences and how I got into palliative care, they're also welcome to email me at my UPMC email, which is M-U-G-A-N-D-A-G-N at UPMC.
01:26:08
Speaker
Yeah, and I want to thank Dr. Slater for her lovely comment to me. Thank you.
01:26:15
Speaker
I look forward to meeting you in person one day. I think that if folks want to get any information about palliative care for their own family or loved ones, there's a website called getpalliativecare.org, which has a list of palliative medicine physicians throughout the country.
01:26:38
Speaker
You can also go to the Center to Advance Palliative Care or capc, C-A-P-C dot org, if you want to get some more information about palliative care itself. And then if you want to reach me at all, I also have the Twitter handle. I'm at Cardi Smith. That's C-A-R-D-I Smith. It's pretty easy.
01:27:02
Speaker
And if you want to reach out and email, I am cardinal.smith. So that is C-A-R-D-I-N-A-L-E.smith at mssm.edu. And I would be more than happy to talk to anyone about mentorship, about other information around getting into the field, research, quality opportunities, you name it, Opendoor.
01:27:30
Speaker
Well, there you have it, Dr. Slater and Dr. Smith. I just wanna say thank you again for taking your time out to chat with us and to discuss palliative care and as well as diversity in palliative care and medicine. This has been a wonderful and terrific experience. And I know that the SNMA fam is gonna be thrilled to learn more about
01:27:49
Speaker
this very innovative and very important field of medicine, which we need to increase our awareness, we need to increase acceptability, and we need to increase advocacy, particularly for minorities in our Black community. So shout out to y'all, continue being legends, continue representing. We'll see y'all at the top, SNMA fam. Have a good day. Much love. One love, baby.
01:28:13
Speaker
Thank you to our guest speakers, Drs. Cardinal Smith and Grace Slater, for sharing their journeys into palliative care and the importance of diversity in palliative care medicine to better serve individuals, particularly individuals of color, on difficult conversations surrounding end-of-life care.
Impact of the Flexner Report on Black Medical Education
01:28:30
Speaker
Now, we'll be moving into a discussion about the Flexner Report, financial literacy within the Black community, and how white supremacy has negatively impacted the progress of Black individuals within the United States in these two spheres.
01:28:44
Speaker
So starting with the Flexner Report, this report was submitted in 1910 by Abraham Flexner with the backing of the Carnegie Mellon Foundation and was intended to serve as a guideline to what medical education in North America should look like. Prior to this report, medical education was unregulated in the US, largely in the form of proprietary trade schools that were unaffiliated with a college or university, and there was no standardized curriculum.
01:29:15
Speaker
Using John Hopkins as the ideal model for what a medical school should look like, claiming that it was the one bright spot of medical education in the US, Flexner made the following recommendations. To reduce number of medical schools from 155 to 31, increase the prerequisites necessary to enter medical training, train physicians to practice in a scientific manner and engage medical faculty in research,
01:29:44
Speaker
Give medical schools control of the clinical instruction in hospitals and strengthen state regulations of medical licensure. Proprietary schools were encouraged to close or be incorporated into existing universities.
01:29:58
Speaker
As a result of these recommendations, medical education was quickly streamlined and curricula standardized. The quality of the average physician increased significantly as well. In 1904, prior to the report, there were 160 MD granting institutions. By 1935, more than half of all schools merged or closed with a total of 66 medical schools remaining.
01:30:20
Speaker
Of the historically black medical schools, only Howard and Meharry were left open, while five other schools included the report closed. In the meantime, the remaining medical schools would not admit women or black physicians for years after the report, and the effects of this are still felt today.
Addressing Black Physician Shortage
01:30:37
Speaker
Yeah, I mean, I think that this report, like, and it speaks to the reason why we have such a stark shortage of, you know, black people pursuing medicine. I mean, what, how do you have seven and it goes, what is it, six or seven black medical schools? And it goes down to just two that are left Howard and Meharry. You know, I think that that's really, um,
01:31:04
Speaker
That's really concerning and I think it really explains why we've had such a shortage of black people pursuing medicine. And I also think we have to talk about the American Medical Association in terms of what have they done to actually redress this harm that's been done through the Flexner Report. JAMA did release an article that's entitled, Projected Estimates of African American Graduates of Closed Historically Black Medical Schools. And they go into
01:31:34
Speaker
you know, how the shortage of black men in medicine has continued to remain slow since these closings of the HBCU medical schools, you know, and they kind of go in and discuss it. You know, with JAMA, I still have my, you know, my little pick with JAMA, but.
01:31:50
Speaker
You know, I think that it was important and I think it was useful that they, you know, they brought up a topic concerning this because that is super important. I think that we'd like to say, oh, there's not enough black people medicine because they just don't want to do it or they, you know, or they just, you know, think that it's too hard or whatever. And we don't talk about all of these historic, like, just imagine if we had all those same HBCU medical schools open to today, like, listen, how many more black medical, you know, how many more black physicians would we have, you know,
01:32:21
Speaker
It's crazy. I'm over here looking at this list. So I'm being educated in this very moment. And I don't know that many even were aware of the schools that existed. You had Flint Medical College, Knoxville Medical College, Leonard Medical School, Louisville National Medical College, and University of West Tennessee. So if you consider these areas,
01:32:49
Speaker
the populations obviously were black, right? And to your point, how many more doctors? I mean, as a HBCU graduate,
01:33:02
Speaker
I would have loved to have more options of applying to schools here. I'm a Caribbean medical student and a number of us, listen, everybody doesn't go to a U S med school. It's just, it is what it is. But seeing this man, like, can we get these schools back up and running? Like, what does that take? Like that's where my mind is at right now. Um, but it's unfortunate and
01:33:27
Speaker
I mean, underrepresented minorities in medicine, imagine what that could do for academic medicine, for example. Because I think all of us went to HBCUs at one point in time, right? Yes, we all did. So just think back to, and I know a number of our listeners may not have attended, but there's just something about going to a black college.
01:33:50
Speaker
That's a fact. And being educated by your own. I tell people this all the time. It gives you something like this. It's like this fire that literally does not stop burning. It might go down a little bit. You might have to throw a little gasoline on it something. That's where homecoming comes in or that's where your network comes in. But you always feel like I can do this. Imagine
01:34:16
Speaker
if we had more opportunities to be educated in institutions that were our own again. Yeah, you know, it's craziness. And also in the article, they estimated and projected that between 10 and 30,000 additional black physicians would have been, would have graduated and be in place. There's your primary care shortage.
01:34:41
Speaker
Yeah, if those schools were to continue to persist. And Abraham Flexner, yeah, I hope you rolling y'all hope you like kicking rocks in your ball head trash ass. Let me just chill.
01:34:56
Speaker
He was born in Louisville, so it's crazy. He closed the HBCU Louisville Medical College, the HBCU Medical School in the same place that he was born at. But I think it's just unfortunate when we know this is the stats, right?
Significance of Black Medical Schools
01:35:08
Speaker
It's 14% of population, 5% of physicians are of color. And it would have been just so dope to like,
01:35:14
Speaker
Like Erica, you said, have an opportunity to apply to more HBCU medical schools and be connected to that, be in that spirit. Like so many of the students that are in medical school that I know, it's like they've never had that pride, that feeling. Like when you go in class and it's like, you know, you're going to see a black PhD, you know, you're going to see a black doc. It's guaranteed every day that you step on campus.
01:35:34
Speaker
at least at HBCU Medical School, from what I experienced, that you'll see a black doctor come across, connect, be like, bro, what's up, sis, or doc. You just got that natural energy and that natural flowing vibe. And I think that's just a miss. And nowadays, it's like we go to places oftentimes where we feel segmented and we feel like we don't belong. And that imposter syndrome just reigns so strong. But if we had the opportunity to be around us, because they wanted to segregate us, so why not keep us segregated? You feel me? Why not keep us segregated?
01:36:04
Speaker
in that same position. And now, you know what I'm saying?
Historical Policies and Black Wealth
01:36:07
Speaker
Y'all trying to bring things and mold it together? Like, nah, I bought that. Like, let us control our destiny. Let us control how we interact with the world and what we're trying to accomplish. And they took that away from us. And I think that we are disillusioned to think that we truly have power right now when we're not working together. We're not in the same spaces where entrepreneurs, black entrepreneurs, black doctors, black lawyers are not in the same room, right? We working for the man instead of working for ourselves.
01:36:33
Speaker
which is a community. You know what I mean? So you're going on to a great point. You're going on to a great point because we also have to talk about the financial literacy, right? And that gap of knowledge that we as black people and just the setbacks we've had when it comes to financial literacy. So historical policies have
01:36:48
Speaker
continued and still continue to prevent black individuals and families from accumulating wealth at the same rate of white individuals and families, you know, and majority of wealth in the United States is tied to homeownership. And I know my buddy, Alvin knows exactly what that's about because he just bought a home and he served in. Oh, snap, thank you.
01:37:06
Speaker
Shout out to Aldi for that, because that's not an easy feat. And that is the first step to establishing generational wealth. But we have all of these historical, like mentioned, policies such as redlining, the GI Bill, the Homeowners Association Act, monitoring practices, loan sharks, you know, that have been such a big influential aspect of people being able to accumulate wealth in this country that black people have not had access to.
01:37:30
Speaker
So just to give a little bit of context, you know, the GI Bill was created in 1944 for World War II veterans and established low-interest mortgage loans, which largely benefited white veterans, something that not all black veterans were able to speak to or even have. Redlining, Homeowners Loan Corporation created residential security maps of major cities in the United States to show areas that were good financial versus poor financial risks.
01:37:54
Speaker
Predominantly white areas were green, while areas that were predominantly of color, specifically black neighborhoods, were redlined. As a result, many individuals in those areas could not get loans and turn to loan sharks, which mortgaged at extremely high interest rates with negative financial consequences.
01:38:10
Speaker
And this practice also perpetuated segregation as it tied real financial consequences to integration in the form of a neighborhood's rating decreasing. While this is now illegal, there are still social, environmental, and financial consequences of redlining that can still be felt today. So when we go to a neighborhood and we see, oh, this neighborhood is filled with black people and no one's ever moved from this neighborhood. And we see the white neighborhoods and we're thinking, oh, that's just because they just decided that going to this neighborhood would maybe be a better financial
01:38:39
Speaker
or an easier financial opportunity for them or maybe that they just don't want to move out like they just they want to stay where they're at and they're not concerned about elevating or you know going through the social mobility or financial mobility when in reality these things have happened from
01:38:53
Speaker
Like since back then when they just said let's let's put this dividing line as to who can come and who can leave and I think that that's made a lot of black people stuck or Feeling you know that it's harder for them to even get out because these are like literal generational curses that have been placed on them and
01:39:09
Speaker
Since god knows when and i think that we have to talk about that and before we just want to jump to why somebody's still in the same neighborhood still in the project still wherever we have to talk about you know what is even the history where's the origin of this coming from where where did this all start from and i think that's just so necessary to unpack.
01:39:28
Speaker
racism, point blank period, but got it all the way. I mean, it's perfectly facts. And then Isabella, you talking about that, like we talk about redlining nowadays, when you talk about projects living the hood, your property taxes dictate your education, the values in terms of the valuables that you get in terms of your resources. So
01:39:46
Speaker
If you in an area where it's not necessary, you don't look right, quote unquote, it doesn't look nice, your property value is going to go down, then your property tax is going to be low. And then so when your kids are going into the education system, they are not going to have access to good teachers, good resources for books. They're not going to have access to, you know, after after school activities. And that's where you find a lot of the issues that we get plagued in in a lot of black communities. And when you go into white communities, they have all of these resources. And so
01:40:12
Speaker
If that racism already starts then, when you're five, six years old, and it's like, we don't have any after school programs at the city or the actual place that you at, whatever municipality is supporting, they don't got it for you over there. So what you do, you're going to be in the streets, you're going to be running around, do odd, and you got the OGs, whatever, teaching you this and that, running the street, and then you learn it from that, and then you just build on and build on, and it's generational. You know what I'm saying?
Financial Literacy and Wealth Building
01:40:36
Speaker
versus other areas where it's like, oh yeah, we have basketball camp or we could go into ballet or school supporting us to go to a trip to overseas or whatever the case may be. They have that opportunity and many people oftentimes in our communities don't. And so we got to realize that's where a lot of those issues come from and some from. And if we don't acknowledge our past and we can't move forward with our future and we are ignorant, it's as ignorance and bliss to say that
01:41:01
Speaker
It's all in due part to our fault. It's systematically engaging each and every day. I go back to the Bronx and I know there's a lot of my brothers in my homies. They're doing the same thing because naive and they fall. I know they got the opportunity to do so if they have the right people in place to tell them, yo, this is how you move. But if you don't get exposed to it, then you are what you see. If you see people moving around, wait, if you see people doing this and that in the streets and you're going to accomade to doing that, you know what I mean? So you've got to change the game in regards to that. And that's why.
01:41:30
Speaker
I love being on this podcast and I love this financial literacy game. This showing tips a lot of things is so important, you know
01:41:36
Speaker
I have a question and I might get some pushback for this. And I'm not saying that I don't believe homeownership is tied to wealth, but do you consider the idea that you could become wealthy without being a homeowner? And I asked, I saw a post recently on Instagram, some people don't want to own homes. And I think bigger than
01:42:01
Speaker
I mean, financial literacy encompasses a lot. It's not just home ownership, but, um, in terms of how to accumulate wealth and within our community, if you could, I don't know, give three things, what would be like the three things that you would say, here's where you could start, whether it's as a medical student, whether this is a 42 year old who just wants to try to better themselves. If it's somebody that's 18 and their freshman year of college.
01:42:31
Speaker
What would be three key performance indicators, if you will, for generating wealth? Like three directives. Is that directed toward me or everybody? I'm going to say, what's throw it to Aldwin? Mr. Homeowner, we're going to throw it over to you.
01:42:52
Speaker
I would say I'd always tell people this, like pay yourself first, whether it's $10 a week or $100 a week or $10 a day. The fact of the matter is we as a culture, we overspend, right? We are so glamor. There's so much glamorization. We're getting that newest car, that newest with billionaires, millionaires. They don't think like that. They look the same basic way they do. They got the same basic cars because they know frugality
01:43:15
Speaker
is key to creating generational wealth. The more you save, the more that you can invest, you know what I'm saying? The more that you spend, the more that you lose, you know what I'm saying? And lose out on opportunity. So I say pay yourself first and create dividends at the end of the day. And then from there, then you could build other opportunities, for instance, to invest in vending machines or invest in, you know, for instance, buying a car and then using that to rent out tutorial, which is a car rental app that you could use or
01:43:40
Speaker
get yourself a house and Airbnb out certain spaces and living there. You know what I mean? So I think that's one of the main issues that we find in our community. Like we live day-to-day paycheck to paycheck. As soon as you get that first paycheck, you spending most of the bread on your family or whatever the case may be. And then it's like, oh yeah, let me get some new J's and then let me get the new Prada. And you see it all the times on IG. It's like, yo, they always glamorizing like the newest thing, Dolce Cabana or true religion, whatever the case may be. And that is instantly and
01:44:09
Speaker
Intentionally creating that thought process and so many black people in our community instead of saying let's save and how about we create our own brand? How about I save in it? My other man's he saves and then we come together We come with a line and then we promote that at the end of the day. I mean, so That's okay. So you gave one. Yeah is is you give one and I'll give one I like that 13. Okay. So mine is
01:44:32
Speaker
Would be to teach literacy from when students are in elementary school. Yes, when they can like when you know how to count money when they start, you know, I don't know if y'all had these back in the day. There were these little sheets and they showed you like what a penny look like what a quarter look like what five cents look like all the way up to 50 cents.
01:44:52
Speaker
Like from that moment where children are able to recognize what currency looks like, that's when they should start being taught these skills. Because kids are like sponges and there's certain advanced things that they don't get, but I feel like you can start there. That would be mine. Start teaching it at that level. Like I remember
01:45:14
Speaker
Um, I think I was in third grade and we actually had to open up like a banking account and like have like a checkbook. I don't know how it was done. I'm sure it was through my parents. Maybe it was like a savings account or like a savings bond, something, but I remember I had to take like a little passport to school. It was like an assignment. So that, that would be mine starting school. I think.
01:45:40
Speaker
that my tip would be we need to stop having a fear of money and a fear of what happens if I lose this money, right? I think that
01:45:54
Speaker
especially in the black community, a lot of us are afraid to take financial risks out of fear of losing money versus thinking about how we could gain more money, right? So a lot of people don't want to take out that stock. A lot of people don't want to, you know, like Alden did, buy that home. A lot of people don't want to do something that they feel like they could financially lose from rather than thinking about
01:46:19
Speaker
you could actually gain and maybe gain a lot more than you even thought you could. So I think it's about trying to have a more healthy relationship with money as a community is our first step, or at least one of the important steps to gaining financial freedom, knowing that if you do it the right way and if you do it with good intentions, that there's no way you could really lose
01:46:43
Speaker
so much that you would be in the red, you know?
SNMA's Financial Literacy Initiative
01:46:47
Speaker
And so I think, yeah, just trying to redefine what is our relationship with money as a Black community. The relationship with money. I love that. Yeah. This was a good talk. I'm excited for this part with our co-host heading this up pretty much, right, Aldwyn?
01:47:07
Speaker
I mean, it's a team. It's team, baby. You know, we is three heads together. You know, we did three headed monster. You know what I mean? So since we here at SNMA believe that financial literacy is so important, we are starting up as you guys just witnessed the greatness of the financial literacy. You feel me? What we're going to discuss things regarding our community regarding how could you become financially independent?
01:47:32
Speaker
liberation is key, right? We have to emerge from the trenches in order for us to own, build power. You feel me? We have to learn how to negotiate contracts. We got to learn how to acknowledge that we got a lot of high student debt ratio. How do we kind of emerge with that knowledge base and learn how to promote ourselves and the culture in the world despite all the financial obligations we have? And oftentimes in medical school, they don't teach us none of this stuff.
01:47:57
Speaker
often times in residency they tell you be an employee work your butt off 80 hours a week and then you come out of there and then you don't even know how to balance your checkbook or you don't even know how to you know invest this and that or you don't know how to work the stock market or you don't even know how to connect with the entrepreneur and then start a business plan.
01:48:14
Speaker
So this is some of the things that we're gonna talk about. So I hope y'all gonna really take heed to this because black wealth and knowledge is gonna create something great for each and every one of us as individuals and also as a community. You know what I mean? So SNA members, you're gonna be put on a game and y'all could get a headstart into securing this bag and maintaining stable financial literacy. Yeah.
01:48:37
Speaker
Let's get it. So y'all gotta tune in to our upcoming episodes. Y'all gonna learn a lot more of my co-hosts, Erica and Isabella. We got so much more. We gotta exploit this field. It's not enough that we doing. Pay yourself first. You are the most important creature in your life in an afterward invest. That's it. That's our show. Thank you so much for joining us for this episode of The Lounge.
01:49:05
Speaker
And let us know your thoughts about the discussion we had today by emailing us at podcast at SNMA.
01:49:19
Speaker
And be sure to follow the SNMA on all our social media platforms to stay up to date on upcoming events. And if you like what you're on the show and want to be involved, reach out to podcast at snma.org to join our team. Thank you guys so much for listening. And that is all we have for you.
01:49:51
Speaker
Bye!