Gearing up for a service-oriented semester: KIPP New Orleans Leadership Primary

Dr. McLachlan, one of the pharmacology professors, approached our program about a unique opportunity that has come up at the KIPP: New Orleans Leadership Primary charter school. His daughter is assistant principal there and mentioned that they are in dire need of volunteers to help make everyday run just a little bit more smoothly. About 15 of us from the program signed up to help out, and on Friday, Janurary 18th, 7 of us headed out to the school for a brief orientation.

Located on the edge of Marigny, KIPP Leadership Primary is a charter school that is part of a host of national KIPP schools. New Orleans itself has more than a few, and this one opened about two years ago. The school only has kindergarteners and first graders, but expands every year with one more class. Unlike many other charter schools, KIPP recruits students from all over the city; no testing or raffle is involved in the process, and they encourage anyone to sign up. The school uses metrics to determine where students are and how they are expected to perform as far in the future as the SAT and ACT. Based on the needs of the individual, teachers create a curriculum that helps each student on his/her own level so that he/she can "learn excellence" from the get-go.

After giving us a brief overview of the school and its mission, Assitant Principal McLachlan and her colleagues gave us an introduction to the types of tasks we will be doing. Teachers at the school work 10-12 hour days on average: leading classes, meeting with students individually, talking to families, planning for future classes. Each teacher is incredibly involved in the success of each student, but that leads to long days with even more work after the school-day is over. A lot of the teachers need help with administrative type work- from photocopying to helping out with general tasks, which is where we as volunteers come in.

Principal McLachlan then gave us a tour of the school allowing us to visit every classroom. It was amazing to see both how young and invested each teacher is. They each have their own, unique style, but in every classroom we saw incredibly engaged, loving, curious children. Although the building the school is in is far too large for the two grades it currently holds, and although it looks a bit run-down, each classroom and hallway that the students encounter is filled with bright colors, hands-on materials, and warmth. The teachers and students were so excited to see us, thanking us with songs and class chants and running up to give us hugs as we passed.

I'm really excited to help out at the KIPP Leadership Primary school. I'm currently applying to AmeriCorps jobs in New Orleans for next year, and I definitely want to be involved in either a public health or education position. Therefore it was really neat to see just how a charter school functions in this city that is dominated by these types of schools. Although I won't get a chance to interact consistently with the students at KIPP in terms of the type of work I'll be doing, I think it's incredibly important to come in with excitement and positive energy to help out in any way possible. I look forward to it!

Gearing up for a service-oriented semester: Common Ground Health Clinic

The office for staff and health-care providers operates out of
"The Yellow House" a few doors down from the clinic.

I started out the month of January figuring out a way that I could volunteer every week in a variety of ways that will help me explore my own interests and skills, while meeting various community members in the city. The first orientation I attended on January 7th was at the Common Ground Health Clinic (CGHC) in Algiers. I had made contact with one of the volunteer coordinators in December, and she encouraged me to stop by and fill out some documentation, take a look around the clinic, and meet other volunteers and staff. Conveniently I can hop on the bus to Algiers a block away from my apartment, and I eagerly watched as we made the brand-new trip (for me) across the river to the West Bank.

This is the front of the actual clinic, on the
of Teche and Socrates.

CGHC is a small, community-based clinic that opened up in the immediate aftermath of Katrina. It initially functioned seven days a week, helping out community members that were not receiving the necessary help from FEMA and the City of New Orleans. Healthcare providers from all over the country came to volunteer at this makeshift operation that ran out of a mosque across from the current clinic. The providers at CGHC quickly realized, however, that the majority of the patients were suffering from long-standing chronic conditions such as diabetes and hypertension. As people started recovering from Katrina, the clinic transitioned into a free primary health clinic serving mostly adults. When I asked one of the staff who the clinic mostly sees, she said that about 50% of the patients come from around Algiers, and the other 50% come from all over New Orleans and surrounding parishes. Currently the clinic operates 4 days a week on a sliding-scale system (patients pay a small fee based on their income) and is very active in the local community.

At the orientation I was able to meet with Desiree (the outreach coordinator), as well as some of the other staff members who handle everything from billing to funding, restarting LHOP (the Latino Health Outreach Project) to hiring nurses and doctors. Desiree met with myself and three other volunteers from various backgrounds. While most of my time was spent filling out documents and going through a HIPAA powerpoint and quiz, Desiree did talk to us about the different work with which we can become involved. Because medical students from Tulane come out to volunteer in the clinic, most other volunteers are involved in the outreach side of CGHC, which is perfectly fine with me! When I apply to medical schools this summer, I definitely want to look into MD/MPH programs as well. This desire to explore public health didn't really happen for me until late into college; I would really like to volunteer with organizations that have a public and community health focus now, so that I can have a firmer grasp on what it means to be involved in real public health work.

More specifically, I looked into the CGHC because I'm really interested in the ways that they achieve this particular aspect of their mission statement: "We continue to advocate for increased access to healthcare services for all individuals. In order to do this, we must address all forms of injustice, including racism, sexism and homophobia. This includes addressing societal factors such as disproportionate numbers of people of color in the criminal justice system, and unequal access to quality housing, education, food and healthcare." As an undergraduate I definitely had the opportunity to learn about healthcare disparities that are based on different systems of privilege, but I have not yet been able to get involved in a clinic that works to address these through its services. Attending this orientation and meeting every-day people who have committed their lives to this type of work was so incredibly inspiring!

It was really interesting and exciting to hear Desiree talk about the different projects that are going on right now and that the CGHC needs help with. They often attend health fairs to hand out resource guides and meet with prospective patients. Additionally they plan events for the Algiers community, which includes free weekly women's classes, monthly events on herbalism and alternative medicine, and the development of a new community garden. They are also planning to host a teach-in at the local prison, put together a conference/forum on the changes in healthcare funding (for community members and other community clinics to attend), and host the 2nd Algiers cultural day. Overall I am so excited to spend a few hours each week helping out at the CGHC and to take on an event to plan myself.

A Spoonful of Hope

While I was back in Madison for the holiday season I thought I could use my time to shadow some physicians. I have also been hearing a lot more from my peers about exploring the option of osteopathic medicine and have started to wonder about it myself. My sister recently graduated from the Kansas City University of Medicine and Biosciences with her Doctor of Osteopathic Medicine, and I have had the benefit of hearing from her and her colleagues about their experiences. These two factors made me think it would be beneficial to see a D.O. at work. Luckily one of my mom's co-workers, and the Division Chair of Pain Management and Rehab Medicine at UW-Madison is a Doctor of Osteopathic Medicine and was happy to let me shadow him for a few days in the clinic. (I'll call him Dr. X).

Right off the bat I could tell that this would be a unique experience from the other shadowing opportunities I have had. Previously I've followed a neurologist on her inpatient service and a family practice physician who worked in a majority Latino community. Both had exposed me to a variety of patients, but for the most part they were either fairly healthy or  had end-stage disease. In contrast the patients we saw at the pain clinic were mostly elderly, with the majority having quite a few co-morbidities. From diabetes to smoking, obesity to cancer, these patients had all definitely seen a lot in terms of their health.

About half of the patients knew what their diagnosis was from previous visits and were back to have their treatment adjusted due to inadequate improvement. But the other half of patients who came in were looking for a diagnosis. As Dr. X and his resident worked through the standard questions and performed a routine neurological exam on each patient, I quickly became familiar with the signs they were looking for. Dr. X had me engage with the patients right away, and I started to learn just how each reflex is associated with a different level in the spine. In some of the patients I could feel the inflammation surrounding a herniated disc or see the subtle degenerative changes in the MRI. In terms of shadowing a Doctor of Osteopathic Medicine, I thought one of the most impressive aspects was just how hands on and personable Dr. X was with each patient. He was quick to isolate the pain on each patient, encouraging him/her to try different stretches and positions by demonstrating them himself. I was even lucky enough to see him use osteopathic manipulation on a young lady with "loose joints." Shadowing him was maybe the first time I had seen a physician be so hands-on in his practice, and I found it inspiring.

I was also excited to see just how beneficial it is to have a foundation in pharmacology; like I mentioned, many of the patients have co-morbidities and are on a whole host of medications. Part of each patient examination was devoted to figuring out if the side effects or drug interactions of certain medications were causing additional pain. One gentleman who came in was a retired professor and enjoyed social dancing, gardening and handy-work. We quickly bonded over our mutual love of ballroom dancing; unfortunately his constant arm and neck pain was preventing him from enjoying his hobbies to the full extent. I could feel his frustration at the peripheral neuropathy that had developed as a result of his recent chemotherapy. But I could also see the determination radiating from him to find some way to cope with the pain and enjoy his life.

Many of the patients were like this: distressed with their inability to meet their own goals but hopeful that the visit would elucidate some of their difficulties. Dr. X would spend around 20-30 minutes just talking to each patient, often asking about mutual acquaintances or other family members. Soon I found myself eager to hear about each patient's past medical histories, their life stories and their desires and goals for the future. Dr. X explained to me in between patients that it's important to realize what the patient really wants out of his/her treatment, and to learn how to approach him/her in a way that shows confidence and some level of control, while being completely honest. Whether he was explaining to a neurosurgery ICU nurse brimming with tears the importance of taking it slow, or he was trying to persuade a tenacious, older man (who "doesn't need doctors") that a back support would be beneficial, Dr. X was able to find a way to reach each patient in the way that was necessary.

I was truly astounded by his ability to comfort patients and asked him at the end of the first day how patients handled the news that they may be troubled by chronic pain for the rest of their lives. He looked at me carefully and stated very clearly that he doesn't ever let them give up hope. No matter what they come in with, most of his patients are willing and ready to do whatever it takes to find some relief. And therefore his primary job as a physician is to be their coach, be their guidance counselor, give them the hope that they are looking for. One of the last patients we saw demonstrated just how important this rule is: he had come in six months prior with pain from a protruding disk that was pressing on a nerve. By sticking closely to the recommended regimen of stretches, exercise and "taking it easy," he had been able to heal himself. The disk had reabsorbed the protrusion and he no longer had any pain. He may have been only one of fifteen patients we saw who was "healed," but he was an important reminder of just how hope and persistence can work.

Past Experiences

Our last block of the semester focused on the GI system as well as some Complementary and Alternative Medicines. Both of these topics are very interesting to me for two completely different reasons. The former is interesting because I have unfortunately spent a lot of time in the clinic and hospital due to my own GI problems, and the latter because I'm very interested in medical anthropology and the culture of medicine.

Growing up I would often have these painful stomach episodes, leaving me unable to move for hours at a time. It seemed to occur randomly and at its worst, I was having an attack three to four times a week. Although I saw a few doctors when I was younger, my parents chalked up my episodes to over-exaggeration and/or my unwillingness to eat a balanced meal. However in college I found myself visiting the E.R. on multiple occasions because of the unbearable pain that was lasting ten to twelve hours at a time. Although the residents and attendings conducted many tests on me, and although I visited a GI specialist, I was never diagnosed with anything specific. Instead I was told to eat less and take Omeprazole (Proton Pump Inhibitor) before my meals. In reality it just took time and a lot of trial-and-error to be able to reduce the number of attacks.

At the time of this "diagnosis" I was incredibly frustrated with medicine. I had been having these attacks since a young age, they were causing me to lose a significant amount of weight, and they were unbearable. I didn't quite understand how having a diagnosis could be any worse than not having one. However this unit has helped me see just how horrendous GI syndromes and diseases can be. I recall being tested for Crohn's Disease and ulcerative colitis. Looking at the treatment pyramid for these irritable bowel diseases, it's obvious that there is no solution. Unlike other syndromes and symptoms that can be treated, individuals with these diseases become victims of their own bodies. Even chronic Irritable Bowel Syndrome can cause a lot of pain with little hope for a solution. To some extent the GI system is still a mystery to much of medicine; it is often about "managing" rather than "curing" the dilemma.

The other aspect of this block that is fascinating to me is the use of herbal medicines and CAMs in the treatment of different diseases. It was made pretty clear during our lectures that there are often more problems associated with alternative medicines rather than benefits, and that it can become difficult to support the use of these when there is little-to-no evidence of success.

In a medical anthropology class I took my junior year, I remember learning how we as a society look at alternative medicine as a cultural thing. Take for example Traditional Chinese Medicine or even Voodoo. While it is easy as an American to hold some skepticism in terms of the efficacy of these medical practices  we often fail to realize that Western medicine- biomedical medicine- is a culture in itself. And just like any culture, it is hard to force down everyone's throats. From what we learn as Pharmacology students, and more so as medical students, it is hard to imagine believing that bio-medical medicine is not the right answer to many diseases. There is scientific evidence to support all of it! But at the end of the day, doesn't it matter what the patient also wants? Won't that affect the outcomes too?

When I was shadowing a family practice physician a year ago, I remember meeting an elderly, Cambodian woman who had just been diagnosed as having diabetes. As we are learning in this current unit (Endocrine), diabetes is an incredible dangerous and chronic disease, but if it is handled carefully, patients can live fairly healthy lives. As the physician emphatically explained that treatment was necessary and that the patient should see a diabetes counselor  the patient listened quietly and patiently. When the physician had finished however, the patient explained as best as she could that treatment- management- was not going to be okay. In her community and culture, people had previously been diagnosed with diabetes, but they had sought out traditional Cambodian remedies. The patient was convinced that she could be cured by this alternative medicine just as her friends and family had been.

Unlike many other physicians, the one I was shadowing had had a lot of previous experience working with different cultures and addressing the use of CAMs. She was incredibly respectful of the patient's wishes, and came to an agreement: the patient should test her blood sugar everyday and let the physician know if it got above a certain threshold. She also encouraged the patient to visit a diabetes counselor in addition to trying out her traditional medicines.

In the end, it's not always easy to say what is the right treatment for a patient. From the culture of western medicine, it may be clear cut. But not every patient holds the same values or wants the same outcomes as this culture. As I aspire to go to an allopathic medical school in the United States, I obviously stand by the tenant that physicians should use evidence-based medicine. But I also aspire to work in under-served communities and to provide health-care globally. Even though these are MY goals, I strongly believe that every physician and health-care provider will encounter at least one patient who holds another medical culture above western medicine. Therefore all physicians need to be culturally competent and prepared to help their future patients as best as they can.

To the Prospective Student, From a Current One

Every once-in-awhile my sleeping pattern gets thrown out of whack, and I find myself awake at the ungodly hour of 5 AM. And every once-in-awhile, I like to read other peoples' blogs. However it occurred to me this morning that perhaps prospective applicants to Special Masters Programs- SMP for short- (including this one in Pharmacology at Tulane) may happen upon our list of student blogs and seek out student feedback and advice on applying. While I recognize that picking my name out of 28 is unlikely, I still feel obligated (and I really just want to) to offer my two cents to all those future applicants and ye who is considering medical school "one day."

I know that for myself, who applied to medical schools as a senior in college, it came as a somewhat disappointing surprise that I would need to restart an application process in March of my last semester. After speaking to an advisor about my own, individual circumstances, and getting feedback from some alumni friends, I realized that I didn't have many options that would help me ultimately achieve my goal of getting into medical school. One very viable -and almost necessary route- however, was to apply to one of a number of post-baccalaureate programs across the nation. Coming to this decision did not reduce my stress whatsoever. Unlike college or even medical school applications, post-baccalaureate programs come in a variety of flavors, have no obligations to an overhead, regulatory organization, and can be a right-bother to deal with. Few people know much about them which only adds to the hesitancy so many graduates have about applying to them.

I started my hunt on the AAMC website; they have a database devoted to post-baccalaureate programs and are really helpful in allowing one to narrow down the many options. But after that, it really is up to the applicant to find out what's best. My own personal checklist included the following:

1. What kind of post-baccalaureate program is it? Now this can be a tricky one. I know that when I first considered programs, I steered clear of anything with a "Masters" attached to the title. Why? Because I assumed it meant a greater than one year commitment and a thesis. However I was pleasantly surprised to find that this is not the case for MOST SMP's. Sure, there are the occasional ones that require the thesis (Boston for example). But most SMP's have a one year curriculum that is tailored to students who are looking to gain admission into professional school in the near future. Additionally, many Masters programs will focus on a certain concentration (Pharmacology, for example). While I do know that medical schools often look upon SMPs more favorably, there are definitely non-masters programs that are considered good as well. (Personally I love being at an SMP that is focused on Pharmacology; not only is there more structure and connectedness to the material I learn, but I also have the added advantage of understanding a subject that is so important in medical school BEFORE I get there.)

2. What affiliations does the program have with medical schools? This is actually also a doozy, because in my own research, I found that fewer and fewer programs have formal agreements with their affiliated medical schools. Do take what I now say with a grain of salt- it's often like a game of telephone with even greater levels of speculation. Back to programs: A few still guarantee a seat into the next year's class (and if you have the criteria to get into one of these - like Tulane's Anatomy Masters- than do it!), but most applicants to SMPs fall just short of such programs. Others guarantee an interview, while others yet will put their own masters students in a "separate pool" when they do apply. I think what really matters, however, is that the program is both affiliated with a school that has it's OWN medical school, and that it grants you access to faculty members who are involved in teaching medical school classes, in medical school admission, or both. (The Tulane Pharmacology SMP has no formal guarantees, but there is definitely a lot of support from the faculty and staff.)

2. What are classes like? Are they with medical students? How will you be graded? This is definitely one of the most important things to consider in applying. The advantage of sharing classes with medical students is that you are basically proving you can do it too! The material will be relevant to you one day, and you are often being taught by physicians. A downside is that you may be graded directly against these same students. That's definitely a worry. However some programs will grade you against (but separate from) the medical school curve. Other SMPs will only have a few classes with medical students. Others won't have any. (I really like the way that the Tulane Pharmacology program is set up in that we have Medical Pharmacology with the 2nd year medical students both semesters. All of our other classes are just us. This results in a really nice balance of being exposed to what medical school is really like, while getting the background, pharmacology-specific details in our individual classes. I also like that we started almost a month before the medical school; this allowed all of us to get to know each other in a classroom setting, as well as to become familiar with the Pharmacology faculty.We're also compared to the medical student performance on our MedPharm exams, but are not graded with them.)

3. How big is the program? As an alumni of UW-Madison, I can safely say that bigger is not always better. Don't get me wrong- a huge campus brimming with some 40,000 students makes for an amazing, intellectual environment. But if you're considering applying to one of these SMPs, it's important that you consider what you yourself need to succeed. I KNEW coming out of college that I valued the smaller class size above almost everything. Even if you succeeded at a large university, consider this: in a smaller environment (like at Tulane), you get to know every faculty and staff member, you create lasting relationships with the majority of your class, and you lose some of the cut-throat competitiveness that comes with a large program. (Being here at Tulane, I am confident that my decision to go with a smaller program has led to my current success as a graduate student. Additionally, there are so many other students and people around you! You won't ever feel the need for company because there are many ways to meet students in different programs and ways to get out into this vibrant community. I myself am the class representative, and I'm having a blast getting to know the other representatives from the other Biomedical Sciences graduate programs).

4. How old are they? Is there a tradition of success? This is huge. With more and more undergraduates defining themselves as "pre-meds," and with an increasingly older entering medical school class, post-baccalaureate programs are popping up left and right to fill the demand. And that is where you need to look at numbers critically. Older programs are often the successful ones. And even then, look at the specific success rates. Are 70% of students getting into their desired professional school? Over how many years (1? 2? 10?)? What is "desired professional school"? If you know you want to go into medical school, and say more specifically: allopathic medical school, is that what the statistics are saying? (Tulane by the way, is one of the older programs and has a great success rate for getting students into allopathic and osteopathic medical schools. I think it's something like 80% in a few years.)

5. Can you reach the program via phone call or email? Will they answer your questions? Additionally- their website?
Unfortunately without a uniting organization to hold all post-bac programs to the same standards, it can become hard to get the answers to all those important (and listed above) questions. The best thing to do is to call the program yourself. If they are willing to talk to you and answer your questions honestly, that's a huge plus. If they seem unavailable or disorganized: bad sign. Another good place to check is the program's website. The same rules apply- do they answer your questions? are the organized? (Tulane is AWESOME in this respect. As I've already mentioned, I love the Pharmacology department. They are helpful, supportive, kind, brilliant and fun! It really feels like they are all here to see each of us succeed in our goals, but they often remind us to enjoy the journey along the way.)

6. Are there additional opportunities/requirements?
Going to an SMP does indeed mean changing your previous studying habits and time-management techniques, but it doesn't mean you should drop everything. Once you feel settled, you may be interested in pursuing additional activities to balance out all the studying. It's good to know if the program you're interested in allows students to get involved in research, and maybe even pursue a thesis. You may also want to join a program that places a special emphasis on a unique feature. (For example, I was drawn to Tulane in part because of the commitment students and staff have to volunteering. It's even worked into our curriculum!) Other programs offer different ways to get involved, as well as optional electives.

7. Other important stuff that I don't have much to say about:

• What is the cost? This is often the biggest limiting factor for many. And don't forget the cost of moving, travel and living when you calculate this.
• What city is it in? Let's be real: you don't want to live in Podunk, Nowhere for a year. Important side note in my shameless plug for Tulane: hurricanes really aren't a big deal. According to our program director Dr. Clarkson: "It's either time for a mini vacation or a Hurricane party."
• Do they encourage students to apply to medical school while they are in the program or after? Some programs say one thing, others say the opposite. Part of this is dependent on how much YOU need to prove yourself in the program. If you do: don't apply that same year
• Will the program provide letters of recommendations? They better.
• Are there opportunities at the school or in the city for any additional time you take off? Personally I think Tulane University and the city of New Orleans provide ample opportunity for me this next year. And to be honest: I'm super pumped!

While this is a lot of information, it's definitely something that I wish someone had told me while they were in an SMP. I am incredibly happy about the choice I made to apply to a variety of programs, and more so in my decision to come to Tulane University. I've already learned so much, on everything from pharmacology to how to study better, on serving the community to building relationships. Yes, I was worried about my "next step" when I realized I wasn't going to medical school right out of college, but at the ripe old age of 23, I'm learning that life really is about the journey you take to reach your goals. Even while keeping an eye on the end-goal is necessary, don't be afraid to take the less-traveled path.

"Breath In and Breath Out..."

This past month has been all about the pulmonary system. I had never studied it extensively, but I found myself enjoying it quite a lot! Growing up, I knew a lot of children with asthma, and I recognized the limitations some of them faced on a day to day basis. But learning about asthma from a pharmacology standpoint was truly fascinating. There is no cure for asthma, but there are definitely drug regimens that can help patients manage their symptoms and episodes. In addition to asthma, we learned about drugs used for tuberculosis and pneumonia. These are all definitely diseases that come up in our everyday lives, and so it was interesting to see how physicians approach different cases based on different factors. More so, it was curious to understand and see first hand the differences in outcomes for patients with either disease. When I shadowed a neurologist at UW-Madison, I was able to follow her around on her consults. One of the patients she visited I will never forget; he was a prisoner with disseminated tuberculous and was found to be brain dead. At that point, I didn't understand why there was no treatment for him- surely medicine could find a way to treat something like tuberculosis. But after understanding how drug regimens are picked and administered for different stages of tuberculosis, I can now see how serious his case was. He had HIV. His tuberculosis was beyond any traditional drug regimen. He was at a point where medicine could do little. Although reflecting on my experiences with these different diseases may have been more challenging than in other units, I definitely value the knowledge I now have.

On a more positive note, in my last post about the curriculum I mentioned that I am trying out a new studying technique. I've found it to be quite effective as my exam scores from this past block have demonstrated. In addition to my new approach, I have also found a few people that I can comfortably study with in a group. It seemed at the beginning of the semester that finding a consistent group would be a challenge, and indeed it was. I tried to study with various people in a multitude of ways, but everything sort of fell into place these last two block exams. This method was especially effective for the material from our Molecular and Cellular Pharmacology class. Thankfully my experience in a laboratory setting has put many of our lectures into perspective for myself, but I find that explaining it to others helps both me (in reviewing), and helps others get a more tangible grasp on the material. Onto GI then!

The Little Things

This month I volunteered with Habitat for Humanity twice. Our pulmonary block had a bit of flexibility, so there were quite a few days in the month that we had free to volunteer and study. On November 6th, ten of us went to volunteer at Annette Street. We were split into two groups and sent to separate houses on the same street. My group of five ended up at the same house I had volunteered at previously; I was excited to be able to work on something that I was somewhat familiar with from before! We were quickly set up with moving the excess dirt from the front of the house and dispersing it evenly underneath the house. This took most of the morning and by the time lunch came around, we were all exhausted. It was necessary work, but it was also a lot more tiring than any of us had expected.

After refueling, we returned to find we would be measuring, cutting and fitting rebar into the future sidewalk in front of the house. However, by the time we finished with this task, we were informed that the front stairwell into the house had been built wrongly. We needed to raise the platform by about a foot, but we had almost no tools or resources to do so because the site had been cleaned up already. Because one of the group members -Justin- has previous experience in construction, he was quickly able to figure out a way to accomplish our necessary task. As he disassembled and recreated a new stairwell, the rest of us brought back some of the dirt from underneath the house. By doing this, we could use some of the resources around the house to raise the necessary platform. After we had accomplished this, we went around the house cleaning up any left over scraps of lumber, bricks, nails and garbage.

I returned to another house on Annette Street on November 27th to volunteer with Alex and Luke. It was a cold, rainy day, and so we were stationed inside with a small team. The three of us were the only student volunteers and were part of a team made up of three adult volunteers and five or six AmeriCorps volunteers. We were all quickly assigned different tasks that still needed to be completed inside the house. Luke, Alex and I were given instructions to make shelves and install them in all of the closets. Because there weren't many electrical connections, it was a balancing act of using what tools were available at any given time. Many of us ended up needing to use the wood saw or the nail gun at the same time as others, but through patience and humor, we created some sort of agreement.Overall it was a pleasant experience working and sharing resources with others to achieve our individual goals.

After lunch, Alex and I were set to spackling in all of the holes around the house to prepare the house for another coat of pain. As we slowly moved from room to room, filling in every nail or staple hole we could find, we encountered the other volunteers putting in floor boards, installing door frames, and sanding down edges. For me, spackling was a completely different task than I had previously done at a Habitat build day, but it was equally rewarding in its own way.

During both of these build days in November, what struck me most was the importance of accomplishing the "little things" in order to create a home for someone. When I initially signed up to volunteer with Habitat, I thought I would be cutting wood, painting walls, putting in shingles, etc. I was only thinking about the big things that really stand out in a home, the things that I always look at in a house. But lately all of my jobs have involved the little things. From leveling out the landscape, to putting in rebar, to making sure shelves are put in correctly, to filling in the little grooves along the walls, I have been helping create a home for someone. These may not be the first things I notice in a house, but I now recognize that they are the things that demonstrate the care and love that goes into building a home.

One other invaluable experience I've gained from volunteering with Habitat is meeting all the wonderful people who come to volunteer with this organization. On the 27th, the three of us Pharmacology students were volunteering primarily with adults, people who have committed themselves to serving the community throughout their lives. We met one gentleman on Tuesday who works in Washington D.C. as an architect. He was in New Orleans for a vacation, and made a point to volunteer with Habitat on one of the days of his trip. After talking to him some more, I learned that he volunteers with Habitat on almost all of his trips. Another couple that was volunteering committed to two days to help accomplish some of the major tasks that needed to be finished.

Much of my volunteering experience in the past has involved other students, but rarely do I get the opportunity to volunteer with adults. For me, it was an honour to work with those who see community service as a duty of all citizens, and those who engage in it so often. By getting out into the community through opportunities both here at Tulane and in my hometown, I feel confident that volunteering is something that I will continue to do as I get older. Maybe it will be through Habitat or maybe it will be through another opportunity, but I look forward to committing some of my time to my community.