Transformational Times

Words of Hope, Character & Resilience from our Virtual Community

Friday, June 24, 2022

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Thank you to Rahmouna Farez, MD, assistant professor OB/GYN and clerkship co-director, for curating this week's issue...

In This Special Reproductive Health Issue:

Director's Corner


Perspective/Opinion


Take 3


Poetry Corner

  • Rick Wison: Longing for Summer

Your Turn


Upcoming Events/Announcements

Director's Corner


Things are Likely to Get More Complex: Once Again, We Need to Navigate Difficult Terrain




By Adina Kalet, MD, MPH and Libby Ellinas, MD, MS

 


This issue of the Transformational Times is dedicated to the medical education and key clinical implications of anticipated changes to federal access to abortion law. As director of an institute dedicated to the transformation of medical education with character, caring, and competence and the leader of our institution’s Center for Advancing Women in Science and Medicine, we believe that discussion, dialogue, and debate surrounding this complex issue which impacts many members of our community is essential. As a start, we invited a small number of authors to contribute to this issue of the newsletter. We plan to continue these conversations, over the next few months to provide opportunities for our community to engage with this critical issue in the education of health professionals who must serve the needs of the public with wisdom and courage ...   

 

 

 

If the Supreme Court of the United States decides Dobbs v. Jackson Women’s Health Organization as anticipated, it will create a more complex reproductive healthcare landscape that will impact millions of Americans. The immediate and long-term implications of this change are yet unknown. But one thing is certain, if access to abortion is no longer a federally protected right, then the work of health professionals who spend their lives providing reproductive healthcare will be impacted directly in a myriad of predictable and unpredictable ways. There will be unprecedented regional shifts in both medical practice and opportunities for health professions education. And of course, all people of reproductive age may be affected. It behooves us as medical educators to engage with this complex, often contentious, issue and work to remain evidence-based, open-minded, and respectful. This will not be simple or easy, but we believe it is important to begin.  

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Perspective/Opinion


What do the Safeguards under Roe v. Wade Mean to a Chair of OB/GYN and an Oncologist?

 


 By Janet S. Rader, MD

 

All healthcare providers have benefited from protections offered by the Roe v. Wade 1973 Supreme Court decision. Abortion is not just about unintended pregnancy—it assures evidence-based health care for all patients …




Last month, I logged onto our weekly tumor conference to participate in the treatment planning of women with gynecologic cancers. These conferences are multi-disciplinary, including experts in surgery, chemotherapy, diagnostic imaging, radiation oncology, pathology, and genetics. In the conference, we discussed two pregnant women with cancer. One woman with a twin pregnancy—one sac containing a fetus and one sac containing a molar pregnancy, an abnormal growth of cells that normally would be the placenta. The second pregnant woman had cervical cancer requiring chemotherapy and radiation. Discussing these patients, I also realized how our tumor board was free of external influence and open to discussions of science, clinical trials, and the overall best treatment options for our patients.

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Perspective/Opinion


Beyond the Slogans and the Shouting: Choice as Seen Through the Eyes of a Practicing Obstetrician/Gynecologist




By Amy Domeyer-Klenske, MD

 

An obstetrician/gynecologist shares her journey as her views changed over the course of her training, and looks to the medical community to unite in defense of compassionate abortion care...

 

 

 

I began my medical education desperately trying to avoid the topic of abortion. I knew early on that I wanted to become a gynecologist. I dressed up as a uterus for Halloween my M1 year. I was also raised Catholic and attended Catholic elementary and high school. Prior to my training and work as a physician, I only saw one perspective that framed my views on abortion care, one that is commonly referred to as “pro-life.” Yet this perspective failed to prepare me for the faces and stories of individual patients I would meet in my career who chose termination of pregnancy.

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Perspective/Opinion


Mickey Mouse and the Murky Middle




By Michael Lund, MD

 

Dr. Lund, a practicing OBGYN faculty member, shares stories that can show readers that things are never as right and wrong as we might be led to believe …

 

 

I was a privileged kid.  My father, the OG Dr. Lund in my family, had a meeting in Orlando every other year for most of my pre-teen existence. We never stayed at the fancy Disney hotels (there weren’t more than three or four of them in those days, anyway) - no, we drove from Illinois to Florida in our Ford LTD pulling a Prowler trailer behind, and we would set up camp at Fort Wilderness. Even before the age of ten, I had a foolproof system for navigating the parks (well, there were two parks) and could tell you about each and every ride. We were privileged to have another family who traveled with us on every trip - my father was a work colleague of their father. We did everything together: three kids in my family, two kids in theirs. We didn’t see them a whole lot the rest of the year, but we all looked forward to those trips … until we never saw them again. 

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Perspective/Opinion



Abortion is Healthcare

 


By Talia Coney, MD

 

 



Dr. Coney, a practicing academic OBGYN physician, shares her thoughts on why safe, equitable, and compassionate care for women includes the availably of abortions. The US has the highest maternal mortality among developed nations and Wisconsin’s Black people have some of the worst health care systems outcomes in the nation. Making abortions illegal again will disproportionately put the lives of women—particularly women of color—at increased risk …



I trained at the Medical College of Wisconsin as an OBGYN resident from 2016-2020. I was trained at a residency program that was strong surgically and in obstetrics. My residency program also had an un-wavering commitment to full spectrum OBGYN care. You cannot claim to perform full spectrum OBGYN Care if you do not offer abortion care. Abortion care is essential to the health and well-being of individuals capable of getting pregnant. Access to abortion is a crucial component of reproductive health care. It is an individual’s right to have the ability to choose if, when, and how to give birth.

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Perspective/Opinion



The Toll of Abortion Restriction on Learners and Patients

 



By Laura Grogan, BA. - MD Candidate Class of 2024

 

 

Story shared with permission



Nearly one in four women will seek abortion care before they turn 45. As Ms. Grogan anticipates the overturning of Roe v. Wade, she fears for the future of providers, as training becomes more difficult, and for patients like her friend, whose abortion delays impacted well-being far more than the procedure itself…

 

 

My Wisconsin friend became pregnant in her twenties after her birth control failed. This all happened during a traumatic time in her life following the unexpected loss of her brother. Her case reflects the experience of most unwanted pregnancies: a woman in her twenties not ready for motherhood.

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Perspective/Opinion



What I Have Learned from Families Forced to Make Difficult Prenatal and Pediatric Choices

 


By Steven R. Leuthner, MD, MA

 

 

Dr. Leuthner, who is part of Children’s Wisconsin’s Fetal Concerns and Palliative Care Programs, has spent much of his career helping families through very difficult decisions, some of which involve deciding whether to terminate a pregnancy. He shares some of his experiences in this essay …

 

 

As the medical community awaits the SCOTUS decision on Roe vs. Wade, I am only beginning to think about how this may affect the patients and providers I work with in our Fetal Concerns Program and Palliative Care Program at Children’s Wisconsin. In my many years of experience counseling women and families who come to us with significant, sometimes lethal, prenatal diagnoses, I have met families who struggle with profound personal decisions. Many women come with ideological ideas on what they thought they would do, with some sticking to their beliefs and others changing their minds, toward either side of the political spectrum, regarding this topic. I have met with women who were thinking about termination until they heard more about the neonatal outcomes, at which point they continued the pregnancy. Then there are the families who come to us with hope for their baby, and we have to share how we cannot cure everything. This naturally and historically leads to choices to be made.

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Take 3



Take 3 with an Abortion Provider

 



By Kathy A. King, MD

 

 



I am a Generalist OBGYN and Associate Professor in the Department of Obstetrics and Gynecology and have worked at MCW since 2001. I have always incorporated the provision of abortion into my practice because I know access to safe legal abortion is integral to the provision of reproductive healthcare. I understand and respect that people have different views on abortion. For 25 years, I have cared for patients referred to Froedtert for abortion services because their own physicians would not or could not terminate their pregnancy. None of these individuals ever planned to have an abortion until medical complications occurred, a devastating fetal diagnosis was made, or life circumstances changed. Being able to provide people with access to high-quality compassionate abortion care has been one of the most rewarding aspects of my career.  

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Take 3




The Difficult Decision

 


Name withheld by request

 

  



During a routine twenty-week ultrasound, a local woman found that her fetus had a significant, very high-risk heart condition that, for any hope of a brief survival, would require multiple surgeries and, possibly, a heart transplant. After many difficult discussions, she and her husband decided that they would proceed with termination of pregnancy. She shares the experience …



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Past Issues

Longing for summer

By Rick Wilson


Longing for the days so long and so bright

Longing for the days of warm, loving nights.


Longing for the grass so fresh and so green

Longing for the sky so cloudless and serene.


Longing for the warmth and the scent of many flowers

Longing for the long shadows that seem to tower


Longing for the morning so hot and so free

Longing for the sight of the bumble bee


Longing for the brightness of each given day

Longing for the smell of freshly cut hay.


Longing for the nights, so full of laughter and voice

Longing for the evening entertainments and lots of choice


Longing for the beach and the golden sunset

Longing for the waves, so forceful and wet


Longing for a cool drink, watching over a clear night

Longing for a warm shower, and a thunderstorm at its full might.


Longing for summer days, full of memories gone

When the sun was full of warmth and just shone.


Longing for summer, it soon will be here

Sweeping away the cold of winter and all its fear.


Submit a Poem for Next Week

For this week's reflection prompt, please answer the following question:


What is a talent you recently discovered you have?



Share Your Reflection


Let Me Ask You Something Podcast


Listen to Dr. Adina Kalet as an interviewer as the group discusses "Because We Care: A Philosophical Investigation into the Spirit of Medical Education" by Camillo Coccia and Mario Veen. You can download it here.


This is the 8th installment of the series on philosophy in medical education of Mario Veen and Anna Cianciolo, which appears in Teaching and Learning in Medicine: An International Journal -- it will also appear as a book chapter in our upcoming book Helping a Field See Itself: Envisioning a Philosophy of Medical Education (Springer, forthcoming 2022).


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Read the June 16 Issue Here
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