Rethinking Medical Education
Lash Nolen talks about the future of medical education and care.
In this episode, LaShyra “Lash” Nolen talks about the future of medical education and care. Lash is a Fulbright scholar and student at Harvard Medical School where she serves as the first Black woman class president.
As the Founder of We Got Us, Nash is helping empower Black community members with accurate science information and public health resources. She is also a vocal activist, having built a platform and social following through her speaking and writing about healthcare inequality.
Nash was born and raised in Compton, California to a single mother. She told Teen Vogue:
“Compton made me scrappy. I’m hungry for opportunity, I’m hungry for justice, I’m hungry to see my people win. So, when you put someone like me at a place like HMS, I’m going to do whatever it takes to make that vision a reality.”
Topics covered:
Why US medical students were 2-5 times more likely to have clinically significant depression than similarly aged peers
Calling out incidents in her medical education that perpetuated systemic racism in healthcare
How to diversify the physician workforce, and why it matters
How she would remake medical education
Listen
Transcript
Halle: Today on this show, I'm talking to someone who represents the future of healthcare. LaShyra Nolan, known as Lash, is a Fulbright scholar and student at Harvard Medical School where she serves as the first black woman class president. As the founder of Weka us, she is helping empower black community members with accurate science information and public health resources.
She is also a vocal activist, having built a platform and social following through her speaking and writing about healthcare in. Lash was born and raised in Compton, California to a single mother. She told Teen Vogue. Compton made me scrappy. I'm hungry for opportunity. I'm hungry for justice. I'm hungry to see my people win.
So when you put someone like me at a place like HMS, I'm gonna do whatever it takes to make that vision a reality. Lash. It's so great to speak with you today.
Lash: It's great to be here. Thank you so much for having me.
Halle: Tell us about life as a medical student. Is it what you expected?
Lash: Yeah. I mean, I think life as a medical student is a mix of a little bit of everything.
I think during medical school I've been able to maintain all the things that. Kept me driven and, and committed to my community as an undergraduate student and growing up. And I think that that's the thing that I didn't expect. I felt like in med school, I just wouldn't have time for anything. I've been very pleasantly surprised by how I've been able to, um, maintain friendships and relationships and passions, um, during my time in medical school.
So I think that that's something that, uh, really was a pleasant surprise coming into my first and second years of medical.
Halle: That's great. Yeah, I don't know. I don't know if every medical student would say that.
Lash: Oh, yeah. I mean, I, I 100% can imagine, um, most folks saying, no, it's a struggle. And yeah, it definitely, it definitely is a grind.
Um, but I think that it's one of those things where you just prepare yourself for the worst that you get here and you're like, oh, okay, if I just maneuver some things around, maybe I can make it through .
Halle: Well, on a, on a kind of somber note, you know, the Mayo Clinic and Stanford study found that US medical students are two to five times more likely to have clinically significant depression than similarly aged peers.
I'm curious what your thoughts are on that and why there's such a culture of self-sacrifice over self-care for medical students and residents.
Lash: Yeah. Well, honestly, I think it's, it's a part of the culture of medicine. It's something that I actually was just reflecting on with my partner and we were just talking about how even during the pandemic we saw so many health professionals really just be disregarded in, in how they weren't given PPE, um, but they were praised as essential workers, but really weren't getting the support that they needed at the start of the pandemic. And just generally how there's this culture where the harder you work, the less you see your family, the more you sacrifice, the more you're lauded.
And how, it's almost a badge of honor to say. I've worked over the weekends and I haven't seen my family in however many days, and that's really just a part of the culture. It sounds like Wall Street. Yeah. . Literally. Literally, right? Yeah. The Wall Street of medicine. . And I think that that very much so starts as a part of our pre-med culture as well.
Um, you have folks who are spending all nighters trying to get, as in organic chemistry and these courses that they need in order to get into medical school. Um, and it just goes on from there because I think in medicine, It's built in a way where it's very hierarchical, so you're always trying to get to the next step.
First is getting into medical school, then it's getting into residency, then it's getting into fellowship. Then it's becoming that attending, and then it's becoming, you know, that the next step in your professorship, depending if you wanna do academic medicine, of course. But I think that when you have this step-wise process, it makes you kind of, um, forget.
The fact that there's life outside of that, and I think that that's why it's been so important to me to maintain friendships and relationships outside of medicine so that I remember that the aspects of what we go through isn't necessarily normal. And to just remind me that there is life outside of that.
And it's funny because my grandma, um, I'm, I'm a first generation medical student and my grandma's like, wait, so you're not getting paid to work right now? And I'm like, no, I'm paying them to work right now. So this is really interesting to, to, to talk to family and friends about our training. But I think, yeah, I think that's a huge part of it, you know, and in each step you're kind of taught to sacrifice your health and wellness, um, as a means to continue to progress career-wise. And I think that it's incentivized in that way.
Halle: Do you think that's changing?
Lash: I think it's changing in the fact that now if you are not talking about wellness, then your residency program isn't as attractive to folk. I think that that's a huge part of the recruitment process. Like, you know, what is your wellness process, um, for residents or in your program? How do you value that? Um, but I do fear that a lot of it is superficial and the fact that yes, you know, we have these sessions for reflection for our residents or our trainees, or even as medical students.
Yes. Like, you know, we have the club for for wellness, but we're still going to push students to answer a patient's message on a holiday. Um, in order to, because that's how you provide the best level of care is when you're always there for your patient. I think that sometimes when we, when. Have these wellness conversations or spaces.
Sometimes what people really want are like, you know, good healthy snacks in the resident room all the time. and a day off. Like if they'd rather have that hour off to just reflect and take a nap or call family or do something else. And I think that sometimes we're so focused on. feeling that wellness space with something to say we're doing something that we don't realize, that we're just adding more requirements onto people's plates.
Halle: As a patient, I'd much rather have someone looking after me who's well rested and feeling good. I don't want someone who's at the end of a 24 hour shift and just, you know, not feeling great.
Lash: Right. Exactly. Give, give them their snacks. Give them their naps. Yeah. , you know, .
Halle: Yeah. So in your, um, new England Journal Medicine article, which congrats by the way.. You shared stories about incidents in your medical education, like the CPR training or learning how to diagnose Lyme disease, where the curriculum just completely missed the mark. Can you tell us about these cases?
Lash: Yeah, absolutely. So, uh, that piece was actually the first piece that I've ever written, um, to be published anywhere.
And it really came out of this natural desire to share this, this experience that I had during my first year of medical school. And at this point I was maybe three months into school and we were in Neurobiology class, learning about Borrelia borre, the spear keat that causes Lyme disease. And we were learning about the ways that Lyme disease progresses and how in stage one of Lyme disease patients can present with a rash called erythema migrants, or, um, more traditionally known as the bullseye rash.
And the professor had an image of erythema migrants on the screen and it was on a patient with white skin. And my classmate, who is a black man, raised his hand and said, Hey, how would I recognize that rash in a patient that had skin tone similar to mine? Or a family member who had the same situation and the professor really didn't know how to give him an adequate answer.
He just said, well, you know, it, it appears a little bit more purple on darker skin. Um, but honestly it's hard to see and you can't really use this as the, your sole piece of information for diagnosis anyways. And just kind of kept on going with the conversation. So I was like, that's a really interesting point that it brings up cuz because I was also curious about the same thing.
So I just Googled, uh, bullseye rash and literally I was just looking through pages and pages on the images section of Google Images and literally could not find an image of how this presented on darker skin. And even though I knew that, not every patient presents with the bullseye rash. I was concerned because I felt that this was representative of how we're taught to recognize key clinical findings as physicians in training only on white skin, and how that in itself was a reflection of racism and white supremacy. If we're learning to only recognize disease in one group and we're completely just leaving out this other group that's been traditionally marginalized in our society. So I decided to write this piece and in, you know, telling this story that I just told you about, I learned there was a study that showed that black patients tend to receive later diagnosis of Lyme disease, and the authors believed that it was partly because the erythema migrants rash is not typically seen or recognized at its earlier stages. And that has serious implications because we know that Lyme disease can lead to, um, issues with the heart. We know it can lead. palsy and affect the neurological system, and it has this sequela that can be very disturbing. And, um, I think that the fact that we're not learning to catch that partly because of how we're being taught it shows that, that there's a systemic issue in how we're being taught medicine.
And it has serious implications for the types of physicians that were graduating. And I think the case that I bring up is how women are less likely to receive bystander intervention for CPR. And the reason why I brought that example up is because when we were learning how to do CPR something that all medical students have to learn, we were only learning on male bodied mannequins.
So that means that, you know, patients with breasts, were not as comfortable with learning to maneuver around that extra tissue that the patient has or having that conversation about consent after doing CPR or before, or what does that even look like? And I think that those are the discomforts that are leading to this disproportionate number of women who aren't receiving that care that they need.
So I think that once again, Brought up systemic issues in medical training that really needs to be addressed if we're gonna be able to graduate and provide the best level of care for all patients. .
Halle: And did you bring this up with the administration or your professors?
Lash: I did, I did. Um, especially with, uh, the Lyme disease, um, piece. I mean, something about me is like, I'm, I'm someone who's gonna call out the system, but I'm always gonna tell you that I'm gonna call you out. Right. So I'm not, I'm not gonna, you know, publish like a tell all. And you're not gonna know that I'm telling it all. I'm gonna give you the chance to, to do better.
And then, Together we're gonna work to, to address the issue. So I actually approached that professor and I said, Hey, I gotta say, you know, the way that we handled this situation in class yesterday didn't really feel completely resolved. And I had a conversation with that professor and he said, you know, I completely agree and I support you in writing this up because I do think that it's a systemic issue.
And the next day he came to class and we really had like a five minute conversation about disparities and, and how he felt like the way that the situation was handled, um, wasn't adequate and it was really fruitful. But I think the issue is that it was only a five minute conversation that was had because a student of the marginalized group raised his hand and said, Hey, How would I support my community with the information and the education I'm being given here?
And I think that that's it. It brings up a lot of issues. Number one, these conversations can't just be a five minute add-on, and two, it can't be the marginalized group that is advocating for themselves in these spaces. Yeah. It needs to be a we that's saying, Hey, why aren't we learning how to recognize this in all patients?
Halle: And on on that note, research does show that diversifying the physician workforce can help reduce health disparities. Yet the percentage of students from these groups in medicine is increasing at a really paltry rate. And I actually read that it has decreased for black men since 1978. Yeah. So what needs to happen to to reach parity for black and Hispanic doctors in the us?
Lash: Oh my goodness. I mean, I think, big question, but Yeah. Yeah. No, it's a big question. Um, but I'm so glad you asked it. I mean, I think the, the first thing that needs to happen is we need to look way down the pipeline.
Um, and I'm talking, just looking at our education system and reflecting on the way it's set up and thinking about who has access to quality. education in stem and for example, there are students who don't even have the resources that they need for their chemistry classes, who clearly don't have the same, um, advanced placement, um, accessibility within their courses.
Um, and all of those things are reflection of systemic racism and the way that redlining impacts. The way that taxes are paid and which schools get a certain amount of support. And when we think about the public school system versus the private school system and the charter schools, I mean, it's all really wrapped up in all of those things.
Um, but I think that just being a medical student and getting to this day age as a first generation student from Compton, California, um, I was raised in one of those communities where we didn't have a lot of resources, but I was blessed to go to a Magnet and gifted public school programs where a lot of resources were poured into me.
But when we consider the, the path that it takes to get to medical school, this profession is really one of the wealthy. It's, I mean, when you look at. Who is largely represented in, in medical school classes. Um, there's been studies by the A A M C and reports by them that have shown that a lot of these folks are among the, the most wealthy of our society.
And in order to, for example, if you think about just applying. to medical school. First you have to, um, become a pre-medical student at a university. So if you're first gen, um, you're not coming into the situation with much, um, generational wealth. You have to go, um, and, and spend this money, you know, if you don't get that scholarship, um, to get your undergraduate education.
Um, and a lot of these students are also doing work study. A lot of them are working while they're in school. Yeah. So it's this added pressure because you have to do. The, the volunteering, doing the clubs and also excelling your courses while also funding your education. And then after that, it's time to take the MCAT and you then have to fork out this money for an MCAT prep course and you're talking in the thousands.
Wow. Wow. Right. You know? So you're thinking, okay, like it's a really be competitive. You then have to think about applying for these courses, or if you don't do that, then buying the books and then thinking about the time that it takes to study for the mcat. So you're coming out, you know, and this is if you decide to take a gap year or whatever the case is.
You know, I took two gap years. So you have folks who are taking time to study for the mcm. But they also have to work. They also have to find to, in order to study for the mcat, there's a level of privilege that you have to have to put that time aside to really put into studying. Yeah. Um, and then you have to pay for the mcat, right.
Which can, you know, cost you another three, $400. And then after you take the mcat, then you have to apply to medical school. Which for each school can run you, um, over $100. And then once you get into those schools, you have to go and you have to interview, you have to buy a suit, you have to buy shoes, and, and this is all to make sure that you maintain this level of quote unquote professionalism when you go.
for these experiences. And then once you get into medical school, I thought the costs were done once I finally got into medical school. Right. But , you're wrong. . I was totally wrong. I was like, this is just the beginning, right? Yeah. Um, you know, you get to medical school and even at Harvard, you know, there's all, we're all using the same resources, right?
Like we're all using, you know, sketchy micro to help us with microbiology. We're all using UWorld for question banks to help us study for our shelf. And then we're also using ambos. I mean, there's all of these hidden costs, Pathoma, you know, these are all words that I didn't know anything about, but there are these extra resources that's kind of expected for students to buy as a way to help them succeed on these standardized tests that we take.
And then you have to pay for the test. So, yeah, it's, it's extremely expensive. And I think that even if you think about clinical rotations, um, a lot of folks will say, yeah, like, my, my site was, you know, 45 minutes or an hour away from school. So you're thinking about Ubers, you're thinking about cars, who has access to those things.
And there's just a lot of hidden fees and costs associated with a career in medicine. and it's a forever thing. It's something that goes on and there's this assumption that, oh, well you're gonna be fine because you're gonna be a doctor. Yeah. But you have to think about who's coming in with intergenerational wealth.
And if you think about the history of slavery, The, the genocide of indigenous peoples. Um, you think about the struggles that our Latinx community has in our country, there are going to be marginalized people who are fixing the, the wrongdoings of our society by making sure that their family stays afloat, where they're not gonna be able to have access to extra income after they become a position to just simply pay off their loans as other communities.
Halle: Yeah. And how many years does it take you to pay off that debt? A decade at least. Right. . So you're putting off. Yeah, I mean in, in choosing careers, uh, you know, if you're gonna be putting off income for 10 years versus graduating college and you know, doing another profession that you can earn income immediately.
If you're supporting family members, it that trade off. I can't, I can't imagine being faced with that. Yeah. 100%. So you wrote, uh, another article. I love reading, uh, what you write cuz it's so insightful. So your article for the Boston Globe was titled, why Doesn't Medical School Prioritize Social Justice?
Yeah. So on, on this note. So not just ensuring that students have, uh, equitable chance of getting in. An equitable chance of succeeding in medical school. Um, tell, tell us all about how medical schools don't prioritize social justice and why.
Lash: Yeah, so, so that piece, um, was one that I wrote after having a conversation with a mentor and as amazing mentors, do they help you get your CV together?
And we were going through the process of getting your CV prepared for. In, in the format of someone who's interested in academic medicine, right? So there's like a specific format for cvs for different careers, and I was like, okay. I was learning the, the ropes for, for academic medicine and we were going through the various sections.
You know, you have your publications, you have your, um, speeches and things that you give and, and lectures and. , we kind of just brushed through the community service section, you know, they were just like, okay, well you know, this section really isn't as important unfortunately, so let's like keep on moving down to the publication section.
So here, and we kind of went into this deep conversation about the various sections that mattered and how you really need to beef up those sections. And I was like, it's just so interesting to me that. We're brushing over this community service piece because I believe that's the reason why I even got into medicine in the first place.
And I started to reflect on the process of getting tenure in academic medicine, and I started to reflect on the types of research projects that are funded by the N I H. The answer to those reflections was overwhelmingly that our system does not incentivize people who are dedicated to social justice.
And I think the examples that I thought of when it came to getting tenure is that really what is valued is your output. How much are you producing? in regards to your research, but it doesn't, that, that type of system doesn't really give much to the community because, for example, if I'm a disparities researcher and I realize that having conversations about hypertension or doing hypertension screening and, and black barbershops is what leads to improved outcomes, I'm not incentivized in this system to then apply for a grant to apply.
Findings that I found in my research to the community and to spend that time really in community building out this blood pressure, um, and prevention program in black barbershops because I already have to be thinking about, okay, what's the next thing that I'm gonna write about? What's the next disparity that I'm gonna elucidate?
And I think that it really puts a lot of pressure on, on community-based researchers, because in this system it's really. Like quantity over quality, and in a system that just incentivizes output, this, this published perish mentality who really benefits and who really suffers. Right? Because you know, I, I wrote this piece in, in the New England Journal of Medicine, which I hope will have some level of impact on medicine by who will read it.
But my community members, my family, my grandma, they don't have access to Nija. So when we publish these pieces, it's like, who is reading? and who are they for? Is it really for us to serve ourselves and moving forward in our careers? Or is it so that we can create that research, which is important and imperative, but how do we translate it to community work?
Without it negatively impacting our ability to move forward as professors, as scholars in a way that is meaningful for ourselves and our students. And I think the, the second example that I brought up is how you have a lot of black professors at academic medicine institutions who are really. doing a lot to mentor marginalized folks at these institutions.
So for example, when I think about Harvard Medical School, we have, you know, that, that we, we tout, we have so many faculty, like over 10,000 faculty, right? But of those 10,000 faculty, how many of them are black women? And that's gonna be a mentor that I'm really gonna need in my circle because they're gonna help me navigate this space, especially as a first gen medical student.
But then they're not paid for that, are they? They're not paid for that. Exactly. Right. And there's only so many of them. So they have this, this publish or parish mentality that they have to learn to conquer, right? Yeah. But then they also have to mentor me. And oh, they're also gonna serve on your anti-racism task force that you've requested for them to be on with no extra pay, with no extra way to, to compensate them for the time that they're spending.
It's like, okay, if you're gonna ask your your U R M faculty to mentor all your U R M students to serve on your committees, and you're not gonna incentivize their research, but then when it comes to promotion, you're gonna say, oh, I'm sorry. Your output isn't enough. It's really just a system of gaslighting.
We'll
Halle: be right back after the break.
So, kind of changing gears in terms of you being in medical school and GE kind of getting to know your peers, do you think that your generation of doctors are going to approach medicine differently and change the
Lash: system? I have so much hope for this next generation of physicians. Like, awesome. That's great to hear.
Yes. I, I really do. I really do. Um, I think that what's exciting is that it's not just in medicine. Like when I think about. Friends and colleagues that I have, um, in divinity school, in public health school, um, in law school and business school, there are folks who are really thinking about how do we make a more equitable system?
And I think that the, the generation of like millennials or I think they're gen i, i, I get confused with, you know, all of these different names that they give the groups. But I think that the generation. Younger than me, they're even more social justice minded, and I feel like
Halle: Gen Z, gen Z. Right. You're Are you Gen Z?
There we go. You're, I'm I, I'm an old millennial. You're probably a young millennial and then they're a Gen Z .
Lash: Yeah. Yep. I love it. Yeah. I always, I feel like there's so many different parameters. I'm like, this, someone could write a dissertation on this, you know, . But yeah, I, I, I, I really am inspired and I think that the reason why I think.
I'm feeling hopeful is that I see. My peers educating the old guard. Yeah. So when they're, when they're on their rotations, they're like, look, every patient that I speak to, I'm gonna introduce myself with my pronouns. And I don't know if that's what you do, but that's, that's what I'm gonna do. I don't care what age the patient is, how they look.
Yeah. That's what I'm gonna do. And I think that by being, Unforgivably dedicated to social justice. Yeah. That is the way that that, that this generation of future physicians is, is really gonna change the game. But I think that that change can go only as far as the system is willing to be malleable. Yeah.
So if we are gonna continue to train physicians in a system that is systemically racist, a system that is systemically making. , our students and trainees depressed, then you can come into this career, into this system with all the hope and desire to make a change in the world. But if you don't give folks the space to really thrive and be joyous because of this system, then you're gonna sap it out of them.
And by the time they become that attending, they're gonna be so jaded and they're gonna be in this system of, let me publish or perish and. That's why we need systemic change. Yeah. So it can't just be an individual imperative. It has to be a collective one.
Halle: So on that note, if you could wave a magic wand and completely remake medical education in the us what would that look like?
Lash: Oh my goodness. Um, well, I think, you know, one, one thing that I would hope to do is off the bat, I don't think that any student should be doing the work of, of medicine and healing without knowing their community. So I think that the first step of of training would need to be meeting with community leaders, um, learning.
Where people go to eat, where they go to fellowship, where they go to feel safe, where they go to play. Really learning about what the lives are of the folks that they're gonna be serving, because that's going to directly influence how your patient is gonna be able to take their insulin, how they're gonna be able to manage their hypertension or their diabetes.
If you're saying, Hey, you know, I need you to take this Metformin, but at the same time you don't even. The access to healthy food or the access to safe spaces to exercise, then you're gonna be unable to fully be the healer that you need to be for that patient. And I think that that's where a lot of us are failing in that, you know, we come to these communities and we work.
but then we leave. We're not eating lunch in the community. We're not, um, you know, going to the gym in the community. We're doing all of that elsewhere and then we're coming in. Yeah. So I think that really learning about the systemic struggles of community members and, and learning that they really are the folks that we have so much to learn from, um, as a way to become better healers.
I think that that would be the first thing that I wanna do. And I think that some schools have versions of it. I know we do that for like a date here. At Harvard Medical School. But I think that that needs to be a longer immersion and I think it needs to be a continuous immersion. Yeah. And I think that more and more really, community leaders and activists and advocates should be our professors.
And I think, um, if we can move in that kind of, uh, direction, that'd be awesome. And I think the second thing I do is, is making sure that conversations about disparities aren't these slides at the end of a. You know, a 45 minute lecture and you spend two minutes on this slide saying, Hey. Yeah. So today we talked about diabetes, and as you can see, you have, uh, black, Latinx, and indigenous peoples who have disproportionate rates of diabetes.
Um, and we're doing everything we can to, to really address this, and it's really sad. And that's the end of the lecture, right? . Yeah. And I feel like that's, that's the reality right now. And it's like, no, let's have an entire conversation about this. Let's discuss it in small groups. And it's okay. I think we always end on this question of like, you know, what do we have to be hopeful about?
And it's okay to not be hopeful about it, but to really do the work to make sure that we address the issue. Um, because right. We, we aren't hopeful. And I think that that's okay. I think that there's always this like, you know, nice bow that we wanna put on difficult conversations, but no. Yeah. What do we need to do to get there?
And I think that that's something that I like to change. And I think lastly it would be the conversation that, that we just had where we think about incentivizing social justice. So how do we build a system where our medical students and our residents and um, even our attendings are really. Push to do the work of social justice in a genuine way.
Um, and, and they really are able to become that researcher professor, um, and leader that they wanna be without feeling like they have to sacrifice or lose something in, in their journey to, to get there. Yeah. Um, so we can, we can go on for days, but I think there's really centering community and love, um, and, and allowing us to be whole people in our training is really what I would hope to, to.
It
Halle: actually sounds a lot like the public health curriculum, so I just, at age 37, finished my MPH in about a third of my colleagues were practicing physicians well into their careers. Who, yeah, a lot of them told me that's really why they wanted to get their MPH to be able to look more holistically at cases with their patients and understand the social determinants of health.
And so it feels like perhaps there's some more public health curriculum that could be embedded into the medical school cu.
Lash: Yeah, absolutely. I mean, I think that public health schools have always been on it. I think that you know that that view, that upstream understanding of medical problems is the way to go.
And I think specifically with an anti-racist lens, I think that all these things we really have to consider. Okay. What are the underpinnings of our country and what are ways that sociopolitical decisions, policies, and intentional things have led to these outcomes? And I think that that's where even public health schools can do better, right?
Because a lot of times we talk about. , these are social determinants of health and these are kind of, you know, disparities, but really thinking about how these things aren't natural. And they weren't just kind of created and just appeared magically, but really they were purposeful systems that have led to the things that we're seeing.
Yeah,
Halle: throughout someone's entire life. I mean, the life course perspective is really interesting. So when did you know you were gonna be a doctor? Is this something that very early on you knew or high school?
Lash: Yeah, I mean for me it was actually like third grade. I, that's like the, the first time I remember like speaking the words like, yes, I'm gonna become a doctor.
And I remember like, my love for science really came through after I won the third grade science fair at Ambler Elementary School, um, in la. And I like told my mom the day before that I had this science experiment to do for the, for this. This's Fair. She was like, what? So we went and we like googled some projects and we ended up like looking at the behavior of Phish and how they respond to darkness or something like that.
And, um, it ended up winning and it was just, it was, yeah, it was really fun. It was cool. I was like, oh, this is neurology. I was like, I'm gonna become a neurosurgeon. And that's what I would tell people. I was like, yeah, I'm gonna become a neurosurgeon. That was like my thing. Um, and I'm still fascinated by the brain, but no longer wanna be a surgeon.
Uh, but I think that that moment was very much so emblematic. How my mom has always just supported me and guided me without question, you know, she was like, okay, we're gonna do it. Um, and she really is, you know, the, the engine behind me and everything that I've been able to accomplish. And, um, I say that I'm so proud of her all the time because she's the reason why I'm even here, you know?
Yeah. So I'm like, if you're proud of me, then you gotta be proud of my mama because I, I wouldn't be here. .
Halle: Yeah. I wanna, um, your, your white coat speech had me tearing up when you called her out. Oh, love. Yeah. It's, it's really beautiful. So, uh, you know, have you ever had moments where you really were close to giving up and, uh, other than your mother or maybe only your mother, what really kept you going?
Lash: Yeah, I mean, I think for me, the most challenging moments of my journey to becoming a physician was really an, an undergraduate. And the undergraduate portion when I was in college, because being pre-med is a grind, you know? I feel like at every step, like there's someone who's trying to weed you out, there's always someone who's telling you, oh, well I don't know if this is right for you.
You know, I have so many different, uh, professors and people kind of tell me. Are you sure this is the track for you? And I was a health and human sciences major at my school, and that's like where, um, you learn a lot about public health and you learn a lot about like human anatomy, physiology, but it wasn't considered like a hard science major, like a biology or a biochemistry.
So in that sense, you know, I feel like there was a lot of, you know, um, unspoken. Discouragement of folks from where I was coming from to, to go into to medicine. And I think also just adjusting to the fact that, you know, where I went to school, I didn't necessarily, you know, take like AP physics and I think that there were, there were people who kind of came into college from.
Different prep schools and they kind of had access to resources where it was easy for them to kind of just jump into it. But I think that I had a lot to kind of learn and get used to. And you know, I definitely had moments where I was like, yo, is this the path for me? Is this, is this really what I wanna do?
I really thought like, should I just do public health? Because I felt like, you know, as I was learning in school, like that was more where my passions lie. But I was like, no, I really need to become. A physician because I felt that that mindset that I had, that public health mindset needed to infiltrate medicine because those are the folks who are having the direct day-to-day relationships and conversations with patients.
So absolutely, I, I mean, I say it all the time. I mean, I was, the studying for the MCAT was brutal. I feel like that was the most sad I ever was. I just wake up and just, just study and just look at this book all day. And I was like, Goodness. So that was rough. Um, you know, I got a F on like my first chemistry exam.
Um, but I'm still here. Y'all, you know, I got a B on my, you know, I got a B on my, on my report card at one point. Uh, but still made to Harvard Medical School. So I, this is all to say like, you know, when. , you have this idea of like, you know what you have to do as a pre-medical student. You're like, I have to do these 1000 hours of community service or, you know, direct clinical care.
That's another point I, I felt to bring up is that, you know, there's these requirements that you have of getting exposure to, um, to medicine, right? And thinking about who has access to like that position in their family, who can give them those hours that they need. But it was really hard. Yeah. At first to.
Like find people that would let me shadow them. Like I would have to just like cold email people, like, Hey, would you let me join you in your office? And I didn't always get a response. And I think a lot of folks don't get a response. And now being a medical student is seeing how busy my preceptors are, I'm like, I see why I wasn't getting a response.
Right? Like yeah. You know, I think that, and, and it goes back to the extra burden put on U R N faculty and, and health providers because, feel this natural desire to wanna serve and to help their community by allowing that student to shadow them. But it's like, it's hard to, to do that. Yeah. Um, for so many students.
So all this to, to to say like, you know, it's, it's a journey and it's a tough one, but I think that during the entire process, I always kept in mind the person. I was becoming and the person that I wanted to be, and I never let the challenges get me down because number one, I knew why I was doing it. And I knew that I was raised by the strongest woman I've ever met in my life.
And I knew how hard she was grinding how hard she worked for me to be here. So how can I give up when my mom raised me as a single parent in Compton, California? and managed to get both her bachelor's and master's degree and continues to push herself every single day to be better. Wow. And to strive greater for her family.
Yeah. So I think, I think really, you know, she's my, my engine. But I think also my journey to get here wasn't smooth. It wasn't, you know, just a straight shot. Mm-hmm. . Yeah. So when I encounter challenges in medical school, whatever it may be, you know, a hard day, you know. Feeling like I'm incompetent because of whatever.
You know, just, just being a med student, you just push through and you get up and you just do it again cuz you know you're doing it for your community. .
Halle: Yeah. That's beautiful. I hope that we have some future med students that are listening. Um, yeah, it's, it's very cool to hear the, the truth about it, that it isn't always an easy path, but here you are and you're making a difference beyond just the work that you're doing at school.
You also have a nonprofit that you started, that you're running. I can't imagine how you have time for that on top of all the articles and using your platform for social justice. That's awesome. Can you tell us about, we got us your nonprofit?
Lash: Absolutely. So we got us was, was started because in December when the vaccines were first approved, uh, I was getting a lot of messages from family members and friends asking about the vaccines.
They were just like, look, What's up with this? And I think, you know, naturally being the first in your family to do this Yeah. You really become like the doctor
Halle: and wait space. They were, they were skeptical about should they get the vaccine or not. Yeah, okay.
Lash: Yeah, exactly. Yeah. They, they were just, they were just wondering about it, you know?
I feel like ev like everybody was, they were just like, okay. We were, it's, it's like we were all waiting for the vaccine to come, but then when finally came, we were like, but wait, it's huge. Do I want really wanna be one of the early ones? Yeah. Right, right, right. Exactly. So, So naturally a lot of my family and friends were coming to me asking me about it and if I felt like it was safe.
And um, I was doing a lot of explaining about the science behind it. And you know, as I was doing my own research and at the same time that I was doing that work, there was a lot of reports coming out in the media about this idea of skepticism within the black community about the vaccine. And they were really citing these historical instances.
Medical racism as a reason for that. So they were talking about, um, the untreated syphilis experiments. They were talking about Henrietta Lacks. Uh, they were talking about, um, you know, Betsy and Nacha and, and the enslaved women that Marian Sims operated on and that experience, but they weren't really focusing on.
the day-to-day experiences of medical racism that my community faces. And they also weren't talking about access. They weren't talking about how once we got these vaccines, how are we gonna make sure that communities have access to it, access to the education that they need to understand why this vaccine is safe.
Physical access to the vaccine, um, access to physicians who look like them, um, who can explain information about it. And the other piece of it was related to that last point. There were studies that were also coming out showing that racial ethnic concordance between. Provider and patient led to increased seeking of information about the vaccine.
So that mean if if you put a black provider in front of a black patient, that black patient was more likely to want to get more information about the vaccine and to feel more comfortable in doing so. Because that physician looked like them. Yeah. And because of the posity of physicians that we have in our country who are black people because of systemic racism and the challenges of entering the career and the Flexner report and so many other things.
This is the situation that we were in. So I knew that there was a need for an organization that would, number one, have an understanding of medical racism in a historical sense, not just focusing on these events that happened years and and decades ago, but really the way it presents today. And then also making sure that we connect.
providers who look like the patients and communities that they're trying to impact and give information to. And also increasing access to the vaccine by doing the door knocking and the canvassing that was necessary to get that information out there. So I literally, um, it was Christmas break. Um, I'm like, lash, you have no time to do this.
Like you're literally in your clinical year. You are a full medical student right now. Um, But the more I thought about it, I, I literally sat on the idea for about a week or two and I was like, if I don't do this, who's gonna do it? And I was like, okay. So I just wrote this little proposal, um, started sending emails to folks and, um, stumbled upon a, a great.
support within the American Board of Internal Medicine. And he was like, okay, lash, I'm gonna give you $10,000 to start this. And I was like, okay. So I just went, you know, I sent out a call for applications to different black medical students and pre-medical students across the Massachusetts area. Did an informational session, um, started interviewing folks for positions and.
Now, you know, six months later, we're a coalition of over 100 students. Um, have an executive team of eight folks. Um, and each of them are committed to various aspects of our organization. And, and what we do, um, is we empower through education, we do these things called empowerment sessions, uh, where we really spend about an hour with different community groups virtually talking about the history of medical racism, the way the vaccines work.
and really answer any questions they have about the vaccines, and we tailor it to the needs of each group. So if you're interested in the vaccines in relation to, you know, being a pregnant person, if you're worried about the vaccine and how it relates to youth. Uh, we also do youth empowerment sessions and have a team of high school students that works with us.
And in addition to that, we're in the community. Um, and we're, we do, uh, canvassing and we do various. Community events, uh, where, you know, if you're out having a festival, we're gonna be out there talking to folks about the vaccine and getting them vaccine appointments. And recently we started to do our own community events where we've had comedy shows and also have kind of combined the arts with, with also public health in that way.
And it's been a phenomenal opportunity. It's, it's really been. Really everything that I wanna do. I mean, I imagine myself being a 100% community-based physician and really, you know, bridging this gap between the information and access to tools that we have. So it's been a, a, a major blessing and I'm just really proud of how the organization is growing and, um, excited to see where we go in the future.
You've already
Halle: impacted the lives of so many, and no doubt you'll continue to do so as you carry on your journey to become a doctor. My last question for you is how we can support your work.
Lash: I would say, uh, if you're interested in learning more about, we got us, uh, you should check us out at We Got Us Project.
Um, and that's on Facebook, that's on Twitter, and that's on Instagram. And we're regularly posting, uh, different videos. We have this awesome animated video that recently was released that really breaks down, um, the vaccine and the disparities that we've seen. So if you're looking for something that is tangible that you can share, Um, community groups and leaders, please check us out there, um, on, on all our socials.
And if you just wanna donate or learn more about the organization and our origins, check us out at, we got us project.org or our website. We have all that information there. If you're interested in volunteering, collaborating, we would love that. Just please hit us up there. Um, and if you wanna follow my work personally, um, you can.
any and all of my articles@lashnolan.com. Um, I also rap as well, so you can check out some of the raps that I do there. Um, and, and all the other panels and things like that that I participate in. I'm on, um, Instagram at Lash Nolan official and on on Twitter at Lash Nolan. So, Uh, please follow me. I love to engage in conversation around all these topics of social justice and, um, I just wanna thank you so much.
Thank you. Thank you. I really hope that this conversation can, can impact some hearts and lives. Absolutely. Thank you so much, lash. Thank you.
Thank you for listening to the Heart of Healthcare podcast. If you like today's show, be sure to subscribe. Leave a review on Apple Podcasts. Follow us on social, and tell all your friends to listen. The Heart of Healthcare with Halle Tecco is a product of off-script media.