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Former NICU baby graduates medical school, intends to become NICU doctor

He plans to start a pediatrics residency specializing in infant care.

Photo by Hush Naidoo Jade Photography on Unsplash

A former NICU baby is going to become a NICU doctor.

Marcus Mosley was born in 1995 at just 26 weeks gestation, meaning he spent his first few months of life in the neonatal intensive care unit (NICU). Now, 27 years later, Mosley has graduated medical school with the intention of specializing in the same kind of medicine that saved his life. He recently graduated from the CUNY School of Medicine at The City College of New York. His journey from being a patient to being a doctor in the NICU is well underway and the future is looking bright.

"It was very frightening when he was born and they told me that he was in the NICU," Mosley's mother, Pauline Mosley told "Good Morning America." "The doctors told me, they just kept giving me all these different percentages of very slim chance of him being normal, like less than 10% chance. They kept saying 90%, he might not be able to see. Eighty to 90%, he would have developmental delays. They didn't know."

While it's true that being born premature (before 37 weeks gestation) can lead to developmental delays and health problems that range from minor to severe, it's hard for doctors to predict that at the outset. The effects of being born premature and the care received aren't always known until the child gets older, but there is evidence that shows that Black babies are more likely to receive subpar NICU care.

A review of 41 studies that was released in 2019 found that Black preterm babies are the most vulnerable. Typically, hospitals with a higher amount of Black preemies had fewer nurses and lower-quality care compared to hospitals with a smaller amount of Black babies. Additionally, evidence showed that "minority-serving" NICUs had higher death rates. Lack of resources and understaffing at hospitals that serve communities of minorities is part of the problem.

Black parents have also talked about a lack of support as their babies leave the NICU. Some of the studies showed that Black parents were less likely to get referrals for follow-up care for their preemies. These parents also reported feeling less satisfied with their experiences, likely for the reasons mentioned above. If you're not feeling supported, then you're certainly not going to have a good experience.

Thankfully for the Mosley family, Marcus didn't suffer from any long-term health problems. But a return to the NICU when he was 13 set his life on its current trajectory. During the visit to the Westchester Medical Center, he met Dr. Edmund LaGamma, the chief of neonatology at Maria Fareri Children's Hospital at Westchester Medical Center. A relationship was forged between the two that would lead Mosley to make one of the most important discoveries of his life.

"He had called and said that he was a former patient of the Regional Neonatal Intensive Care Center and he was in high school and wanted to know if he could do a shadowing program over the summer," LaGamma told "Good Morning America."

LaGamma explained that in the time since Mosley had been a patient, "a lot of advances had been made," and he invited the young man to come join the team for rounds. Shadowing Dr. LaGamma and the team left quite the impression on Mosley.

"That is what really piqued my interest and then solidified my interest in wanting to go into medicine," Mosley explained.

After that summer of shadowing, LaGamma began to act as a mentor to Mosley, especially when he enrolled in the accelerated B.A/M.D. program at City College, which happens to be LaGamma's alma mater. Mosley is gearing up to begin his pediatrics residency at New York-Presbyterian Morgan Stanley Children's Hospital.

"I'm really excited and looking forward to starting residency and to be able to take care of patients now," Mosley said. "I'll be responsible for patients and involved in patient care and treating families."

And his mentor thinks that he is just the right person for such a special and important kind of job. "I think he has that personality which comes across as engaging and inviting so that he'll do well as a pediatrician," LaGamma said, adding that he's already offering Mosley a fellowship position in the future.

It's beautiful to see how a formative part of your life can lead you down a specific life path.

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Health

Global health equity champion Paul Farmer was a great doctor, but an even better human being

PBS News Hour/YouTube

The world bids a sad farewell to Dr. Paul Farmer, champion of global health equity.

You can often tell a lot about a person's life by how the world responds to their death. Over the weekend, when I started seeing a flood of social media messages from healthcare professionals that included words like "devastated" and "gutted," it was clear that someone of influence in the medical world had passed. I'm not in healthcare, but even I recognized Dr. Paul Farmer's name, largely from this quote of his:

"The idea that some lives matter less is the root of all that is wrong in the world."

After spending decades working and living in various countries around the world, making sure people in underdeveloped nations had access to quality healthcare, Dr. Farmer passed away from an acute cardiac event in his sleep in Rwanda at age 62. His death was like a seismic event in the field of global health, launching a tsunami of grief and remembrance felt around the world, from heads of state who met with him to fellow physicians who worked with him to individuals whose lives he saved.

"It is hard to find the words to express the sad news of the passing of Paul Farmer—the person, the Doctor, the philanthropist. He combined many things hard to find in one person," wrote Paul Kagame, president of Rwanda.

Farmer was physician, a professor, an anthropologist and a fierce advocate for the world's poor. In 1987, he cofounded Partners in Health, one of the world's leading global health and social justice organizations dedicated to bringing high-quality healthcare to those who need it most. Farmer's philosophy was straightforward: The fact that poor people die of illness we have effective treatments for is unacceptable. Farmer's life's work was a testament to his belief that where you live and how much money you have should not determine your right to healthcare.

But Farmer's advocacy work was also much more personal than that. He didn't preach about global equity from atop an ivory tower; he worked on the ground, at the grassroots level, doing hands-on medical care in some of the poorest parts of the world.

Much of Farmer's work involved getting effective AIDS treatments to patients in Haiti and Rwanda in the face of pushback from those who felt it was too expensive or that cultural differences would get in the way. Farmer refused to accept inequity and did everything he could to alleviate it.

“Human rights violations are not accidents; they are not random in distribution or effect," he wrote in "Pathologies of Power: Health, Human Rights and the New War on the Poor." "Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm.”

He was uncompromising in his belief that every human being, regardless of circumstances, should have access to the best healthcare humanity has to offer. Being born into or living in poverty does not give anyone less of a right to health, and if we have effective treatments for illness and disease, everyone should have access to them.

He touched countless lives—those he treated and those he accompanied in the field of service. Often it was people in the medical field he trained with, but he even inspired people outside of healthcare to use their privilege and know-how to better the lives of others.

When you pass away and everyone who met you has only the most glowing things to say about you, you know you've lived a good life. The world has lost not only a great doctor, but a champion of global health equity who serves as an example to us all.

"His vision for the world will live on through Partners in Health," Sheila Davis, Partners in Health CEO, wrote in a statement. "Paul taught all those around him the power of accompaniment, love for one another, and solidarity. Our deepest sympathies are with his family.”

Watch PBS News Hour's remembrance of Dr. Farmer below, and for more details of his extraordinary work, I highly recommend Tracy Kidder's profile of him in The New Yorker. The man was truly a legend of a human being in all the best ways possible.

Rest in peace, Dr. Farmer. Thanks for showing us how it's done.

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Wellness

ER doctor in Canada writes 'climate change' on patient's chart in an unprecedented diagnosis

Photo by kerry rawlinson on Unsplash

Climate change is causing record-breaking heat and intense wildfire seasons, worsening health issues.

As record-breaking heat and out-of-control wildfires raged in the beautiful Canadian province of British Columbia this past summer, people started arriving to the emergency room of Kootenay Lake Hospital with symptoms of heat illness.

Dr. Kyle Merritt, the head of the emergency department, told the Times Colonist that most of the doctors at the hospital had only seen such heat illness in medical school. Now they found themselves with a flood of it as the temperatures rose.

"We were having to figure out how do we cool someone in the emergency department," said Merritt. "People are running out to the Dollar Store to buy spray bottles."

A patient arrived who was struggling to breathe. The smoke from the wildfires in the area hadn't lifted for days, and the patient's asthma was being aggravated by it.

Merritt took the patient's chart and wrote two words he'd never written on a chart before: "climate change."

When asked why he did it, Merritt said, "If we're not looking at the underlying cause, and we're just treating the symptoms, we're just gonna keep falling further and further behind."

"It's me trying to just...process what I'm seeing," he said. "We're in the emergency department, we look after everybody, from the most privileged to the most vulnerable, from cradle to grave, we see everybody. And it's hard to see people, especially the most vulnerable people in our society, being affected. It's frustrating."

Merritt said a woman in her 70s who lived in a trailer with no air-conditioning had come into the ER. She was struggling to stay hydrated, and the heat was exacerbating her other health conditions, including diabetes and some heart failure. Patients like her, with multiple health problems and little money, will be the most affected by the climate crisis.

However, we're all seeing that there's no escaping its impact. Hundreds died during this summer's heat dome in western Canada and the northwestern United States. An entire Canadian village was wiped out by wildfire as temperatures reached a record 121 degrees this summer. We've been told for years that climate change would result in more extreme weather events, and here we are.

Merritt said he hoped seeing "climate change" on the patient's chart would prompt other doctors who see it one day to make the connection between their patients' health and climate change.

Extreme weather affects more than people's physical health. Merritt says he saw a number of patients already suffering from depression or anxiety have their symptoms worsen during the wildfire season. Wildfire smoke even triggered flashbacks in a patient who was coping with post-traumatic stress disorder from his time as a soldier.

The World Health Organization calls climate change "the single biggest health threat facing humanity" and health professionals worldwide are responding. Doctors and nurses in western Canada held a climate rally at the B.C. Legislature organized by Doctors for Planetary Health—West Coast on November 4. The healthcare workers are calling on lawmakers to act in the face of the growing ecological threat to health and demanding that the provincial government declare a climate and ecological emergency.

Writing "climate change" on a patient's chart may be unprecedented, but so are the times in which we live. If we are going to keep breaking records each year and keep seeing health-affecting extremes in temperature and weather events, we're going to have to do unprecedented things. Doctors and nurses are on the front lines, seeing those health impacts firsthand.

Perhaps we should listen to them.

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