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M2 Gabriel Martinez Alvarez: when disaster strikes, rebuild

Born and raised in Arecibo, Puerto Rico, the Class of 2020’s Gabriel Martinez Alvarez returned home in December 2017 with an interdisciplinary VCU team to provide care to the storm-ravaged island. He wrote about his experience for the Association of American Medical Colleges. In his own words:

It can be easy to become distracted from school if you let yourself. There are holidays, family gatherings, stocks, sports, social media; but nothing distracted me more from my studies than Sept. 20, 2017.

I come from a small town in Puerto Rico called Arecibo, where the sun shines bright, the ocean breeze is never far, the beat of the salsa music infuses the ground, the people are loud, and the food is always fried. It’s a combination of the flavors of Spanish culture mixed with the sounds of African culture. It’s vibrant, it’s friendly, and it’s home.

Much of my family still lives there and I always look forward to spending time at home. I was planning my trip for Christmas when I saw reports of Hurricane Maria headed toward Puerto Rico. I began to worry, and my thoughts went back to just two weeks prior when Hurricane Irma had just missed the island. Maybe Maria would do the same.

Helpless to a helper

An interdisciplinary team including medical school faculty and students travels to Puerto Rico with donated supplies.

An interdisciplinary team including medical school faculty and students travels to Puerto Rico with donated supplies, ready to manage acute and chronic care needs for the island’s residents.

On Sept. 20, 2017, Hurricane Maria raged, plowing through my childhood memories, my culture, my people, and my island. It was the worst recorded natural disaster in Puerto Rico’s history. I could not turn off the news. I scrolled through Facebook, watching every video and reading every post I could find. Days after the hurricane and I still had no word from any of my family or friends; nothing from my siblings, my grandparents, aunts and uncles, cousins, or friends. I just wanted something that would calm my fears. My phone was silent, and my worries were loud.

I couldn’t concentrate when I studied, and I got my worst test grade ever that week. I donated money, but felt helpless. It was a week before I heard anything from family members and at least a week and a half before I heard from any friends. They were all unharmed, but had no power, no water, no fuel, and little food.

When an opportunity came to go to Puerto Rico with a team from VCU and work with the Iniciativa Comunitaria Organization, I quickly changed my holiday plans. I leapt onto the airplane with 17 suitcases filled with supplies we collectively gathered. As we flew in at night, I could only see patches of dark, lightless, towns.

Resilience of a community
One of the most memorable experiences was a trip to a town called Ciales, about 45 minutes away from where I grew up. Even though it had been three months since the hurricane, I could clearly see the devastation of Maria as we drove. Electrical poles are still laying on the side of the highway and even on the sides of houses. Blue tarps covered many of the roofs. The roads were valleys between mountains of debris on either side. To this day, the people of Ciales are still filling containers with water from PVC pipes that jut out of the mountain side because they still don’t have access to running water.

The day before we arrived, a local church had gone door-to-door to announce that our group was coming to provide medical care. We set up a makeshift clinic on a basketball court and saw about 60 people that day. You could tell that they were hardworking people when only the deepest setting for the lancet was able to draw blood from their callous fingers. We took histories and vitals and made sure patients with chronic diseases had enough medication. But more than anything, they needed someone to listen to their stories. Old ladies with arthritic hands were still hand-washing their clothes. A woman with sleep apnea couldn’t use her CPAP machine because she couldn’t afford a battery pack. One family spent well over $1,000 in gasoline for their generator.

The stories of the people were striking, but what was even more impressive was the optimism and positive attitudes of people who have every reason to complain. One family ornamented piles of debris with Christmas decorations. A farmer who had lost all of his crop was proud to share that it was already growing again. Puerto Ricans are very proud of our little island and as a sign of solidarity and hope, almost every house we drove by had a Puerto Rican flag displayed.

M2 Gabriel Martinez Alvarez walks the streets in Toa Baja during a weeklong trip to storm-ravaged Puerto Rico.

M2 Gabriel Martinez Alvarez walks the streets in Toa Baja during the weeklong trip to storm-ravaged Puerto Rico.

On another day, we went door to door providing medical services in Barrio Ingenio, a neighborhood in Toa Baja. Walking through the neighborhood, you would have thought the hurricane had happened just the day before. Severe flooding and mud left almost half of the neighborhood abandoned. Names of residents were spray painted on the sides of houses, a result of the rescue efforts. We saw cars in garages completely covered in mud.

The people we talked to were mainly elderly living alone. Many had uncontrolled chronic diseases, chronic pain and had trouble sleeping. Aside from counseling them to comply with their medication regimen, there was little we could do. Counseling them to eat a balanced diet and limit their salt intake was of no use, as many of them eat what they can find or whatever they are given. Even now, the neighborhood still has no power, so they rely on processed and canned foods.

As we walked through the neighborhood we saw a tent with a big gathering of people. It was a block party set up by their community leader. She told us that many in her community are suffering from depression and she is doing her best to organize events to lift people’s spirits. Again, I walked away saddened by the devastation from the hurricane but encouraged by the resilience of the community.

Rebuilding together
When we weren’t traveling to different towns, we worked at a clinic in Toa Baja where I was able to practice my interview and physical exam skills. Most of the patients we saw still had no access to their primary care physician or their children’s pediatrician, either because the offices still had no power or because their doctor had left the island indefinitely. In between patient visits, we helped the clinic organize the many donations they received. It was encouraging to see how many individuals and organizations were coming together to make this volunteer clinic run.

I have been to Puerto Rico many times. It’s where I grew up. But this time spent in Puerto Rico was different. In exchange for my small contribution to a long and hard rebuild of the island, the trip contributed greatly to my understanding of what matters most. As a medical student I learned many things. My experience reinforced the importance of listening and taking into account situations and environments when treating a patient’s conditions. Perhaps more significant than that was a life lesson my people taught me: when disaster strikes, rebuild. Absolutely everyone on the island was affected by the hurricane. Though it tore infrastructure apart, Hurricane Maria brought the people of Puerto Rico together. Everyone is suffering together, but they are also all rebuilding together. There is a lot of work to do, but with the positive attitudes of the people, time, and patience, the island will breathe life again.

Gabriel Martinez Alvarez’s story was first published by the AAMC; read more first-person accounts on the Aspiring Docs Diaries blog.


Neuroscience alumnus John Campbell receives American Diabetes Association research grant

John Campbell, PhD’12 (NEUS), who received a $1.625 million grant from the American Diabetes Association

Neuroscience alumnus John Campbell, PhD’12 (NEUS), who received a $1.625 million grant from the American Diabetes Association to support innovative diabetes research.

Alumnus John N. Campbell, PhD’12 (NEUS), is one of six recipients of the 2018 Pathway to Stop Diabetes grants awarded by the American Diabetes Association. Campbell received a $1.625 million Pathway Initiator Award for his basic research project titled, “Molecular and Functional Taxonomy of Vagal Motor Neurons,” which seeks to identify the precise brain cells governing hunger, digestion and glucose metabolism.

“I am incredibly honored and excited to be part of the next generation of ADA Pathway scientists,” says Campbell, who now serves as an instructor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center. “With the support of this ADA Pathway award, we’ll be able to greatly advance our understanding of how the brain controls digestion and glucose metabolism, areas of keen interest to diabetes medicine. I cannot imagine a better start to this research program, or to my career as a neuroscientist.”

Campbell works in the lab of Bradford B. Lowell, M.D., Ph.D., professor of medicine in the Division of Endocrinology at Beth Israel Deaconess Medical Center. “It’s a huge honor,” Lowell says. “These grants are incredibly competitive and hard to get.”

As part of his project, Campbell and his colleagues are working to generate what they call a “parts list for the brain.” They seek to catalog the different cell types and neuron subtypes that make up the brain, study how these parts differ from one another and how they connect to control behavior and physiology.

Campbell’s project focuses on region of the brain called the dorsal motor nucleus of the vagus, a region that connects the brain to visceral organs including the stomach and pancreas via the vagus nerve and controls digestion and glucose metabolism.

“Previous studies suggest that neurons in the DMV are organized into functional units which innervate different organs and play distinct roles in organ physiology,” Campbell says. “And yet, there’s been no way to identify and specifically access these functional units in order to learn more about them. With the support of the ADA Pathway to Stop Diabetes award, our study aims to shed light on how this important brain-body interface works and potentially reveal new molecular targets for treating diabetes and diabetic gastroparesis.”

Now in its fifth year, the Pathway to Stop Diabetes research grants awards a total of $9.75 million to six scientists over a five- to seven-year grant term to spur breakthroughs in fundamental diabetes science, technology, diabetes care and potential cures. Since its launch in 2013, Pathway has awarded more than $47 million to 29 leading scientists selected from a highly competitive applicant pool of only one nominee per institution.

“We are thrilled to welcome the six newest recipients of Pathway awards into this elite group of researchers who continue to make extraordinary contributions to diabetes care,” says Silvia Corvera, M.D., chair of the ADA’s Mentor Advisory Group and professor at the University of Massachusetts Medical School in Worcester, Massachusetts. “This unique funding model creates unmatched opportunities for scientists to impact the lives of millions of people living with or at risk for diabetes.”


John T. Povlishock honored at Brain Injury Association’s 35th anniversary benefit

John T. Povlishock, Ph.D.

John T. Povlishock, Ph.D.

The Brain Injury Association of Virginia, Virginia’s leading voice on brain injury, honored John T. Povlishock, Ph.D., as the 2018 BIAV Legacy Award winner. The Legacy Award recognizes significant, long-term contributions of lasting impact to the field of brain injury.

Povlishock is professor and chair of the Department of Anatomy and Neurobiology and director of the Commonwealth Center for the Study of Brain Injury in the VCU School of Medicine. He also serves as the editor-in-chief of the Journal of Neurotrauma.

Povlishock was recognized on March 2 during BIAV’s 35th anniversary celebration and awards event. The event was attended by Gov. Ralph Northam, legislators, policymakers, caregivers and members of the brain injury community from across the state.

“We are so proud to see Dr. Povlishock honored in this way,” says Peter F. Buckley, M.D., dean of the School of Medicine. “He has a national and international reputation.”

BIAV’s 2018 honorees were selected for their innovative and outstanding contributions to the brain injury field.

“We are absolutely delighted to recognize these individuals for their exceptional and inspiring work on behalf of individuals with brain injuries and their families and caregivers and for their extraordinary contributions to the brain injury community,” Brain Injury Association of Virginia Executive Director Anne McDonnell says. “Researchers such as Dr. Povlishock are often the unrecognized heroes of trauma care. His groundbreaking research has changed the field of brain injury as we know it and it is our great honor to present Dr. Povlishock with BIAV’s inaugural Legacy Award.”

The celebration’s other honorees are Legislator of the Year, Senator John Edwards, 21st District, and the Weinstock Awardee Greg O’Shanick, M.D., president and medical director of the Center for Neurorehabilitation Services.

The mission of BIAV is to advance education, awareness, support, treatment and research to improve the quality of life for all people affected by brain injury.

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Updated: 04/29/2016