FOCUS ON: THE INTERPLAY OF POLITICS AND HEALTHCARE CENTERSPREAD| PG 6 & 7
POP CULTURE: MENTAL HEALTH STIGMA IN ENTERTAINMENT
USC’S FIRST MOBILE CLINIC
CAMPUS| PG 9
LIFESTYLE| PG 4
A RISING RENAISSANCE MAN
CAMPUS| PG 9
U N I V E R S I T Y O F S O U T H E R N C A L I FO R N I A’ S # 1 S O U R C E FO R P R E - H E A LT H N E W S
TROJAN HEALTH CONNECTION www.trojanhealthconnection.com
Volume VI | Issue II
April 26, 2016
Legalization of marijuana: A sky-high endeavor By LISA KAM Cartoonist Controversy over legalizing the use of marijuana began in the early 1930s, steadily growing root in the minds of Americans over the years. It’s no secret that the legalization of marijuana is a hot topic up for debate; marijuana rights even star a significant role in political campaigns. Additionally, the 2016 presidential candidates have already offered their own opinions concerning the matter. Regardless of their stance, however, these opinions are not easily cookie-cuttered. For example, according to previous accounts and speeches, Bernie Sanders is known to be an avid supporter of legalizing marijuana. “Someone in the United States is arrested every minute on marijuana charges,” Sanders said. “Too many Americans have seen their lives destroyed because they have criminal records as a result of marijuana use. That’s wrong. That has got to change.” However, even Sanders expresses his own doubts, particularly with concerns that focus on the difficulty of controlling marijuana trade. [See “Marijuana” pg. 6]
PHOTO COURTESY OF DUSTIN WILLIS
Zachary Steel performs for Antonio, a patient at The Norris Cancer Center. Steel, a professor in the School of Dramatic Arts, has helped pioneer the medical clowning program at USC.
Laughter is the best medicine By GABRIELLE FORTE Staff Writer
To many, the term “clowning” may not invoke more than an image of childhood birthday party entertainment. However, recent studies show that there is more to clowning than what initially meets the eye. Over the past three decades, a new form of drama therapy called “Medical Clown-
ing” has risen in hospitals around the globe. Programs like “Doutores da Alegria” in Brazil and “Dream Doctors” in Israel kickstarted the rise of “Clown Care” in 1991 and 2002, respectively. Zach Steel, professor at the USC School of Dramatic Arts and former teacher at The Clown School in Los Angeles, witnessed the healing powers of laugher firsthand when studying medical
Experiences of updated MCAT programs: pros and cons
-- Instructors that took the initiative to be accessible and informative. -- Online materials (primer questions, post-lecture questions, Princeton Review/ AAMC practice materials) encouraged students to keep up with the material.
--Practice material more difﬁcult and obscure than real MCAT, which could be helpful but also frustrating. --Beyond the Critical Analysis and Reasoning Skill lectures, there is not much strategy taught to students.
In April 2015, the Association of American Medical Colleges (AAMC) launched their redesigned MCAT (Medical College Admission Test), broadening the scope of the test by expanding current sections and adding a new section on the “Psychological, Social and Biological Foundations of Behavior.” Test preparation companies were quick to adapt their programs to these changes. Using the AAMC’s topic guidelines, these companies extensively reformatted their review books and classes. A majority of these changes involved adding psychology and sociology review classes as alterations to the curriculum. Some of the popular test prep companies among USC students
include The Princeton Review, Kaplan Test Prep and The Berkeley Review. All of these companies offer courses that target different test dates and instruction methods, with some companies having more options than others. For example, The Princeton Review offers exclusively online courses, live teaching supplemented with online material and private tutoring options. Details about specific programs can be found on each website. Test preparation companies usually aim to provide a comprehensive content review and give key test-taking strategies. To provide guidance to people who will take the MCAT in the future, we interviewed three USC juniors and seniors who have taken the newly revised exam. Their opinions are highlighted here.
THE PRINCETON REVIEW
By RACHEL DONG Staff Writer
clowning in Israel. “There’s a depth to which a clown can be effective in a hospital setting beyond an entertainment factor,” said Steel. “It’s a form of empowerment, an avenue for a patient to escape the isolation of post-trauma.” The new art form functions as a psychological healing tool through its ability to aid the feelings of unimportance often in-
-Junior, majoring in Biological Sciences – took January 2016 exam
--They provided very helpful books, strategies and practice exams. --Their practice questions are closer to the real MCAT than the other test companies’ practice questions.
--The live online course was not very helpful. --Psychology review book was not comprehensive and had to be supplemented with another test company -Senior, majoring in Environmental Science & Health - took September 2015 exam
KAPLAN TEST PREP
duced in a patient by the hospital environment. “Clowns not only provide a means of laughter for the children, but also an opportunity to experience a shift in power,” said Steel. Like a real life Patch Adams, a charismatic doctor aiming to heal the soul and the body of his patients, played by Robin Williams [See “Laughter” pg. 8]
THE BERKELEY REVIEW --The instructors are very knowledgeable and clear, with good tips and shortcuts for solving certain types of problems. --Challenging and extensive practice problems
--Psychology and sociology portions were vague --The biochemistry portion did not accurately reﬂect the MCAT, which focused on molecular biology and biochemistry experiments. -Senior, majoring in Neuroscience - took August 2015 exam
Editorial: Ethics of CRISPR/Cas9 | Comics: MediSin | News: Porter Ranch gas leak
EDITORIAL SPRING 2016 STAFF TROJAN HEALTH CONNECTION IN-CHIEF
ANA HILLEBOE BRITTNEY KUO
ABRAM ESTAFANOUS IZMA SHABBIR JEHAN BISTA OLIVIA PANCHAL
ARMAN ZADEH ASHLEY MARTIN MARIE KAAKIJIAN RAHUL MASSON
DEENA BAUM LAURIE OKAMOTO LISA KAM
NATALIE LI EMIL EKANAYAKE (ASSISTANT) MEDEEHA KHAN (ASSISTANT)
ALEXANDRA KOOPS ANDREW EZERSKY ASHLEY YI CATRINA HACKER DIANA YU CHUN CHEN EMILY LIN ESTHER KIM GABRIELLE FORTE HANNAH ZHAO MICHELLE NGAN OMAIR QURESHI RACHEL DONG SANYA KHAN SHYAM HASSAN STEFFI BOLTON
TROJAN HEALTH CONNECTION | April 26, 2016
Evaluating the cost of healthcare by OMAIR QUERESHI Staff Writer Imagine a patient at a local hospital receiving treatment for lung cancer – one of the deadliest forms of the disease. After countless surgeries, they’re confronted with their medical bills and find out that their health insurance didn’t cover the costs of any procedures. They have two choices – to continue receiving the care they need but cannot afford, or to check out of the hospital and hope that they get better. Before 2010, this is essentially what the American healthcare system was. Nearly all Americans were one illness or one layoff away from health coverage purgatory. According to the White House, before the Affordable Care Act 15.7 percent of Americans found themselves uninsured due to private insurance companies dropping clients with pre-existing conditions. In 2010, President Obama took action on his own authority through the Affordable Care Act, commonly known as Obamacare. This historic piece
of legislation attempted to level the playing field and provide more comprehensive and affordable healthcare for all Americans, regardless of whether they had a preexisting condition. Additionally, the Affordable Care Act expanded Medicaid – a social program that provides health coverage to low income citizens – and allotted money to fund research on new and more cost effective prescription drugs. It has now been six years since President Obama signed the Affordable Care Act into law. However, the debate as to whether or not Obamacare has corrected the healthcare system is still ongoing. In 2015, new federal data released by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics reported that nearly 90 percent of Americans were insured. This increase hints at a level of success for Obamacare. Opponents across the aisle, however, have argued that healthcare costs for Americans have actually gone up. According to health insurance simulation mod-
PHOTO COURTESY OF THEDOCTORWEIGHSIN.COM
els funded by the Department of Health and Human Services, the average premium cost will rise nearly 12 percent by 2017. Most of these annual insurance hikes, however, can be attributed to the misevaluation of premium costs. In 2014, insurance companies basically took blind “guesses” at what the cost of expanded coverages would be, and clearly they guessed wrong. However, the notion that high healthcare costs equate to a better healthcare system is false. The United States pays more per person in healthcare than any other industrialized country, yet has the lowest ranked healthcare system by the Commonwealth Fund, a
nonpartisan foundation that provides research on health and social issues. The most notable difference between the U.S. and other industrialized nations is the absence of universal health insurance. According to several independent studies, a federal healthcare program that diverted all the money spent on premiums today to providing comprehensive care for all Americans would no doubt cost less than what we pay now. Unfortunately, the stigma in the U.S. around government-run programs has stifled the healthcare system and in the process, has cost Americans millions of dollars.
The ethics of CRISPR/Cas9 editing by ABRAM ESTAFANOUS Senior Editor CRISPR/Cas9 is a genome editing system that is ushering in a new era of gene therapy. The method involves the potential insertion of DNA into the cells of patients in order to prevent or treat certain disorders. CRISPR stands for “clustered regularly interspaced short palindromic repeats,” which signifies repeated regions of DNA. Cas stands for “CRISPR associated genes,” which code for nuclease proteins that cut DNA. The CRISPR/Cas9 system uses guide RNAs (gRNAs) to direct the Cas9 nuclease to specific regions of the genome for additions or deletions. Cofounded by molecular biologists Emmanuelle Charpentier and Jennifer Doudna, CRISPR/ Cas9 was originally discovered in archaea and bacteria, which use the system in adaptive immunity. While the CRISPR/Cas9 system has been shown to cure mus-
cular dystrophy and cataracts in mice, many within the scientific community are still skeptical and even warn of the use of CRISPR/ Cas9 as a form of gene therapy in humans. Critics cite the potential for off-target editing, where gRNAs would take the Cas9 nuclease to edit part of the genome away from the target gene. Mutations away from target genes are a particular concern over the use of CRISPR/Cas9 in humans. Even minimal off-target mutations are dangerous, since diseases like cystic fibrosis are caused by just a single gene mutation. Of even more concern than CRISPR/Cas9’s use as a gene therapy in humans is the technology’s implementation to edit human embryos and the human germline. There are ethical and safety concerns over its use for gene enhancement before humans are born or even conceived. The idea of using CRISPR/Cas9 in human embryos and the germ-
line has garnered extreme criticism after scientists in China used the technology to edit non-viable human embryos and obtained too many errors via off-target mutations. If the embryos had been viable, the extensive mutations could prevent the embryos from developing or introduce disease genes that would manifest when the baby is born. Critics have noted that public outcry over editing embryos and the germline could stifle current research that seeks to edit the genes of non-reproductive cells to cure diseases such as HIV/AIDS and hemophilia. Furthermore, edited germline genes would be present in a human embryo and be passed down to future generations. Currently, researchers investigating genetically modifying non-reproductive cells must obtain informed consent from the individuals whose genomes they plan to edit. It is unclear how informed consent would be obtained when editing
the genomes of embryos and thus future generations. The biotechnology startup Editas Medicine plans to use CRISPR/Cas9 on humans by 2017 to treat Leber congenital amaurosis, a rare form of blindness. Proponents claim that this is a good starting point, as scientists know the exact mutated gene that causes the condition and the eye is easy to access for genetic therapies. Nevertheless, critics still question the potential effects caused by off-target genome editing. Ultimately, development of the technology’s specificity is imperative if human clinical trials will be conducted. The system has been effectively shown to cure genetic diseases in mice. Yet, concerns prevail over its potential to induce disease if it edits a part of the human genome away from its target gene and over its possible use in human embryos. As the CRISPR/ Cas9 system continues to develop, the debate over its use in humans will continue.
Dear Readers, We hope that the past semester has served you well, and that you’re ready to ace all of your ﬁnals in a few weeks! This is our last issue of Trojan Health Connection that we’ll be heading as Editors-in-Chief, and we sincerely hope that we’ve been a valuable resource for all of you in this past year. In this issue, we wanted to once again bring focus to some of the valuable pre-health opportunities happening here at USC, as well as spotlight some truly talented students and alumni who are currently breaking barriers in the world of health care. Check out our Campus section for these stories and more. Additionally, we will be highlighting the impact that health plays in the political realm, especially in the context of the upcoming election. Though science and politics may seem worlds apart, what happens in the political spectrum does indeed have its effect on the world of healthcare — a ﬁeld that we’ll be entering very soon. Make sure to take a look at our center spread to see how politics can drive future changes in how we handle health in the U.S. We would also like to thank our wonderful staff for helping to create another great issue this semester. To all of our writers, editors, managers and creators — you all are an extremely multitalented, intelligent group of people, and we’re grateful to have had the chance to work with you this past year. We appreciate all of your hard work on this issue, from brainstorming to production, and we’re glad that we can continue to share your talents with the rest of the USC community! Lastly, thank you to all of our readers for your support! If you’re interested in working with the paper next year, please feel free to contact us by emailing firstname.lastname@example.org. Enjoy the issue, and have a great rest of the year and summer break! Sincerely, Ana Hilleboe & Brittney Kuo 2015-2016 Editors-in-Chief
April 26, 2016 | TROJAN HEALTH CONNECTION
Zika virus threatens 2016 Olympics in Brazil By PREEYAM ROY Copy Editor Due to an apparent correlation between mothers who had contracted the Zika virus in Brazil and cases of microcephaly in their babies, the World Health Organization (WHO) declared the Zika virus a public health emergency on Feb. 1, 2016. The outbreak of the Zika virus occurred in May 2015 in Brazil, where very few people are immune to the disease, and has since spread throughout several countries in Latin America. Most people who contract the virus do not show lethal symptoms. The most dire outcome of this virus’s outbreak is the increase in cases of microcephaly and other neurological diseases in babies of mothers who contracted the virus during pregnancy. Thus, the main
concern generated by the virus is for pregnant women who live in regions where the virus’s outbreak has reached or women who have become infected during pregnancy. The Center for Disease Control and Prevention suggests that women who are pregnant or planning to become pregnant avoid regions where mosquitoes of the Aedes genus, which carry and spread the virus, are common. These regions include much of South America as well as in Florida, Hawaii and along the Gulf Coast. In general, the WHO suggests preventing infection by wearing insect repellant and long sleeves. Thus far, travel-associated cases of Zika have spread beyond Latin America to most states in the U.S. as well as some countries in Asia. However, one event that
may greatly catalyze the spread of travel-associated cases is the 2016 Summer Olympics in Rio de Janeiro, Brazil, where 16,000 athletes and 600,000 visitors are expected to arrive in August. Mass gatherings for international sports events are no stranger to widespread injury or infection. For example, a measles outbreak occurred at the 2010 Winter Olympics, and a few years before norovirus had spread to several dozens of people at the 2006 FIFA World Cup. However, Zika is a new kind of threat, because little is known about the virus and no working vaccine against Zika has been developed yet. Furthermore, while the 2012 Summer Olympics in London went smoothly due to a detailed symptoms surveillance system with the capability to recognize emerging threats before
they spread, such a system would not work against Zika, which is not symptomatic in 80% of overall cases. Currently, Brazilians have launched immense efforts to reduce mosquito populations in order to quell the spread of Zika during the Olympics. However bioethicists, such as New York University’s Art Caplan, say that continuing to hold the Olympics is irresponsible in the face of public health. The U.S. Olympic committee told athletes to consider staying home this year if they feel in danger. However, officials in Rio have stated that there are currently no plans to cancel the Olympics. Other authorities, such as Mary Wilson of the Harvard T.H. Chan School of Public Health, have publically supported Brazilian’s efforts to respond to Zika and ex-
pressed confidence that they will be able to control Zika enough to greatly reduce its transmission to Olympics attendees and thus reduce travel-associated cases in general. Ultimately, the decision to continue with or cancel the Olympics depends on prioritizing public health or upholding a centuries-long tradition that unites the international community. Of course the Zika outbreak is uniting the international community in new ways, and if the Olympics were to be cancelled, this would not be the first time. From this point on, the world works to carefully monitor Zika and act in accordance with new information found in burgeoning Zika research to make sure that people remain as safe as possible - even if it means canceling the 2016 Olympic Games.
Porter Ranch gas leak unsettles residents By CATRINA HACKER Staff Writer Over a month after the permanent sealing of the Porter Ranch gas leak on Feb. 18, residents remain in fear and uncertainty, as air quality tests cannot provides answers as to why they continue to experience health issues. The Southern California Gas Company initially discovered the gas leak in the San Fernando Valley Community of Porter Ranch on Oct. 23, 2015. Residents reported symptoms of nausea, headache, dizziness and nosebleeds, which persisted even after the leak was sealed. SoCalGas consequently conducted a number of air sample tests beginning Jan. 11, 2016, at nine locations within the town. Tests will continue to be run every twenty-four hours. However, no tests have indicated anything that poses a health risk to residents. Despite the results of tests run
by SoCalGas, residents who have recently moved back into their homes are complaining about returning symptoms. In a recent survey of 210 homes in the area, 60 percent of people reported symptoms. The Environmental Protection Agency, UCLA and other local public health groups began indoor testing of air quality and dust samples on March 25 in the hopes of finding the source of these symptoms. Some officials believe that there are still tiny particles circulating in residents’ homes, causing the symptoms. There is, however, one toxin that officials are already willing to rule out. “We do not believe benzene would cause these short term symptoms,” said Angelo Bellomo, Deputy Director for Health Protection for the Los Angeles County Department of Public Health. Meanwhile, frustrated residents are calling for federal action from President Obama as the Porter
Ranch gas leak has been declared the largest methane gas leak in American history. However, the residents of the area do have the support of California Senator Barbara Boxer. “This gas company in the face of this better step up and keep people out of their homes until it is absolutely 100 percent clear that it is safe,” said Boxer. For residents who have not returned, however, this offers little comfort as they are forced to weigh potential health risks with the inconvenience of remaining relocated. While SoCalGas was initially only responsible for housing displaced residents until March 25, on March 22 a court ruled in favor of the victims, mandating that both parties file appellate court pleadings by March 29 to decide how much longer residents can remain in temporary housing. Despite the obvious symptoms of returned residents, SoCalGas
lawyers still insist that it is safe for residents to return due to the passing air quality tests they conducted. “The Los Angeles County Board of Supervisors and Department of Public Health have been
unable or unwilling to provide clarity or to demonstrate any evidence-based need for relocated residents to stay away from their homes,” the company said. Residents, however, continue to complain about their symptoms.
PHOTO COURTESY OF CBS NEWS
Infrared video frame still of Porter Ranch gas leak
Pause for Paws: therapy dogs alleviate stress By JEHAN BISTA Senior Editor
ADRIANA SHEN / TROJAN HEALTH CONNECTION
A student enjoys the company of a therapy dog as part of the Pause for Paws program. These dogs can be found on campus every week.
While USC students certainly have their share of fun, it is no secret that college can be stressful sometimes. Students find themselves inundated with papers, assignments, exams and various extracurricular activities on a seemingly weekly basis. USC is an institution of higher education, where the coursework can often be rigorous and overwhelming for students. Thus, the school has implemented programs that help ensure that students have outlets to regulate their stress levels. The Office for Wellness and Health Promotion (OWHP) and Be Well USC have recognized this dilemma and have sponsored an initiative known as Pause for Paws. Every Thursday, therapy dogs are taken to various locations on the University Park cam-
pus so that students can play with them. This popular program has already garnered widespread support from the student body. But regardless of their appeal, can these dogs actually help students cope with their high stress levels? It turns out that they can. “Pets offer an unconditional love that can be very helpful to people with depression,” said Ian Cook, a psychiatrist and director of the Depression Research Clinic at UCLA. So what makes dogs so capable of alleviating stress and depression in humans? First, dogs love their owners simply and unconditionally. “You don’t have to worry about hurting your pet’s feelings or getting advice you don’t want,” said psychologist Teri Wright. Dogs offer their owners a sense of responsibility and give them a newfound sense of purpose in
caring for another life. Dog owners also find themselves sticking to a routine and engaging in more physical activity, exemplified by the act of walking their dogs regularly. Lastly, dogs offer their owners a sense of companionship. Overall, these factors contribute to an higher quality of life, as well as a greater life expectancy in dog owners by lowering blood pressure, decreasing levels of stress-inducing hormones such as cortisol and stimulating the production of endorphins. Any students interested in the Pause for Paws program can find more information on the USC OWHP Facebook page, where they give weekly announcements on where the dogs will be located every Thursday. College can be stressful, but having a puppy (or three) around may do wonders in more ways than one.
TROJAN HEALTH CONNECTION | April 26, 2016
PHOTO COURTESY OF NEWS EVERYDAY
Figure 1: Instagram for doctors By ALEXANDRA KOOPS Staff Writer The iOS and Android application Figure 1 allows medical students and professionals to share information and collaborate on cases. Co-founded in 2013 by critical care medicine specialist Josh Landy, the app is now used by over 1 million healthcare professionals around the globe. Using Figure 1, healthcare professionals and students can now “favorite” posts and comment on them, follow others’ medical cases, or post photos of their own. Users can now pose questions about treatments, seek advice from medical professionals and teach others about specific cases. Figure 1 makes the wealth of the collective knowledge of the world’s brightest minds readily available and accessible. Professionals benefit from the input, patients benefit from the speed of the flow of information and students benefit from learning about unique medical cases. The app offers a unique ap-
proach to the globalization and circulation of medical knowledge and is available in over 100 countries, allowing doctors from around the globe to collaborate with each other and offer unique cultural and social perspectives on medical cases. Additionally, doctors who are familiar with rare diseases or difficult treatments can assist other medical professionals in order to save lives and provide the best possible healthcare. Figure 1 makes patient confidentiality a priority by requiring all users to remove any personal information about a particular patient from photos or posts. The app itself also has many tools to assist users in ensuring patient anonymity. Automatic face blocking, for example, recognizes facial features and removes them in photos. In addition, the manual block feature allows the user to remove specific patient identifiers such as tattoos or body marks. As an added security measure, a team of moderators sifts through all photos before they are
posted to ensure that there is no leak of personal information. To comply with HIPAA, Figure 1 requires that patients sign an in-app consent form or an institutional consent form, depending on the hospital or institution. As well as offering a social media platform to encourage the flow of information, Figure 1 provides email updates on cases users follow, weekly images highlighting specific medical scenarios and a featured case of the week. Figure 1 not only promotes collaboration amongst healthcare professionals but also educates students wishing to learn more about different healthcare fields. The app also offers short quizzes via email to allow students to learn about the treatment of specific diseases in a casual, interesting way. With a simple download from the app store, Figure 1 provides a new and unique way for prehealth students to acquire knowledge about healthcare that is both practical and applicable to their future professions.
SAMANTHA TSAI / TROJAN HEALTH CONNECTION
PHOTO COURESY OF AMERICA PINK
The current relevance of mental health: going beyond the stigma By MICHELLE NGAN Staff Writer When R&B singer Kehlani was reported to have been admitted to a hospital following a suicide attempt, many people showed their support on Twitter and other social media outlets. Reports of her hospitalization came after rapper and ex-boyfriend PartyNextDoor posted a photo of them together. Consequently, she was accused of cheating on Cleveland cavaliers guard, Kyrie Irving, her boyfriend at the time. And although it soon became clear that the picture was not recent, it didn’t stop certain people from criticizing her. One of these people was Chris Brown, who went so far as to accuse her of using her suicide attempt as a publicity stunt after she posted a picture on Instagram (now deleted) of an IV in her arm. “There is no attempting suicide,” Brown tweeted. “Stop flexing for the gram. Doing shit for sympathy so them comments under your pics don't look so bad [sic].” While his comments elicited immense criticism from social media, the event has since reopened discussion of mental health and the stigma surrounding it. In recent years, as the public became more open towards understanding mental health issues, the topic of mental health has come to the forefront. The idea of mental health has nearly always been accompanied by certain stigmas, for it is often discussed in the aftermath of tragic events such as shootings and suicides, when the mental states
of those involved come into question. In popular culture, movies featuring characters with mental health issues had often been dark and bleak. Now more movies and T.V. shows portray these characters in a more positive light, incorporating comedy and giving viewers a more realistic view of living with a mental health disorder. Some of the most prominent shows have included “Orange is the New Black,” “My Mad Fat Diary” and “Skins.” In particular, certain characters within the shows have sparked discussion about mental health. In “Orange is the New Black,” for example, Suzanne “Crazy Eyes” Warren is an inmate at Litchfield Penitentiary with numerous mental issues (though the show never actually specifies which conditions she has). Played by Uzo Aduba, who has won multiple awards for her performance, Warren is known primarily for her emotional attachment to other people and her devotion to those who show her acceptance and love. This changing perspective on mental health has been facilitated by celebrities, who have come forward and shared their own experiences in treating mental health disorders. One such person is Prince Harry of Wales. In a recent interview with “Good Morning America,” he addressed the stigma surrounding mental health and war veterans. "We’ve got to keep the issue at the forefront of people’s minds,” he said. “The simplest of things. Just talking about it makes all the difference."
April 26, 2016 | TROJAN HEALTH CONNECTION
Silent crisis: the commonplace Summer medical reading list abandonment of the elderly By RAHUL MASSON Associate Editor Every time I spend a couple hours in the Leavey basement, my heart yearns for that enriching and fulfilling human touch. However, it’s hard to imagine how life would be to live in isolation for a seemingly unquantifiable amount of time. Such is the case in the thousands of nursing homes in the U.S. Day after day, month after month and year after year, hundreds of thousands of aged and disabled people spend their time in an enclosed room surrounded by nurses, IVs, prescription drugs and solitude. Interactions with nurses and doctors who have to take care of many others are often short and shallow. The typical, fast-paced American lifestyles stop children and other relatives
from visiting their loved ones in these facilities. A short Sunday evening visit does little to soothe the yearning of these individuals. The societal rejection of the elderly largely stems from the American emphasis on productivity and the most efficient output possible. As individuals, we are largely valued for the objective, measurable benefit that we provide and fail to realize that often times, the subjective life lessons that the elderly have are equally important. The number of elderly in these nursing homes is projected to hit about 72 million by the year 2030, according to the Huffington Post, signifying the need for an immediate intervention. In a Polish study, 30.4 percent of seniors showed “high levels of emotional solitude” and 52.0 percent were socially isolated within
PHOTO COURTESY OF HUFFINGTONPOST.COM
A Polish study found that 30.4 percent of seniors show “high levels of emotional solitude.”
the nursing home. According to various studies, feelings of loneliness can lead to “suicidal ideation,” Alzheimer’s disease, a weakened immune system and many other harmful emotional effects that eventually translate into harmful physical illnesses. Thus, instead of fulfilling their intended purpose of providing a safe atmosphere for the elderly, nursing homes may, ironically, be causing even more health problems amongst those in these institutions. Without a defined social network to lean back on, many residents start to lose a sense of purpose for their lives and consequently, the healing process is significantly hampered. The accompanying mental disorders also cost our nation billions of dollars per year. The first step to finding a solution to any problem is realizing the extent of the damage and working on targeted techniques that yield results. Loneliness is not something that can be cured through a pill or an injection; it requires, as Mother Teresa stated, love. Shifting away from the biomedical focus of our society, it is critical that we realize the importance of subjective treatments and therapies to redefine the experience for these seniors. As a society, we must learn to shift our priorities and hone in on the silent crisis that nursing homes are facing. If we fail to do so, it may not be long before we lose the exact essence that makes us human.
Sorokdo island: leprosy and its social lesions By ESTHER KIM Staff Writer Isolated from the other rapidly modernizing provinces of South Korea, Sorokdo Island isolates over 500 patients affected by Hansen’s disease from society. Hansen’s Disease, widely known as leprosy, is a rare, chronic bacterial disease that results in damage to the skin, nerves, limbs and eyes. Contrary to popular belief, leprosy is not very contagious and is curable in its early stages through a multidrug therapy treatment. Nevertheless, due to persistent social stigmas and rumors, the disease has exiled its patients in secluded communities like Sorokdo since ancient times.
Sorokdo Island’s history is full of misfortune, and began with the community’s establishment during Japan’s occupation of Korea. During that time, the enforcement of the 1907 Leprosy Prevention Law forced Korean lepers to be exiled on Sorokdo Island. Segregated from the rest of society, many patients were forcibly sterilized to prevent reproduction. Furthermore, pregnant women were required to abort their babies in an effort to curb population growth in Sorokdo. Even after their deaths, the leper patients were forcibly autopsied for the advancement of modern science before cremation. At its height in the 1940’s, Sorokdo confined over 6,000 Han-
PHOTO COURTESY OF DAILYMAIL.COM
A staff member assists patients at Sorokdo Island.
sen’s disease patients. In 1934, Sorokdo was declared a national hospital. The hospital presently works with volunteers, doctors and nurses to provide comfort and treatment to its patients. Volunteers from around the world support the mission of Sorokdo Island: to help the Hansen’s disease patients with their daily activities and provide a place of comfort and acceptance. In 2009, a bridge was finally built to physically connect South Korea’s mainland to Sorokdo Island. Prior to this, the only access to the island was through a ferry ride from the main peninsula. While the island is now partially open to visitors, Sorokdo holds the unfortunate memories of injustices that lepers had to endure on this island. Nonetheless, the new bridge to Sorokdo symbolizes the Korean community’s aim towards unification. What does the future hold for the people of Sorokdo Island? Sorokdo currently exists to provide comfortable and enriching lives for many elderly patients who were outcast from society. By increasing accessibility to this historically isolated island, the hope is that the increased awareness of Hansen’s disease will one day seamlessly integrate the people of Sorokdo into the global community.
By DIANA YU CHUN CHEN Staff Writer WHEN BREATH BECOMES AIR - Paul Kalanithi At the young age of 36, soon-tobe neurosurgeon Paul Kalanithi was suddenly diagnosed with inoperable stage IV lung cancer. This heartbreaking turn of events spurred Kalanithi to look back upon his life, especially back to his college days when he was debating becoming a writer or going to medical school. Faced with the very real possibility that he might in fact not be able to achieve the things he had “put off till later” in life, Kalanithi decided to write this book, chronicling his constant struggle to understand “what, given that all organisms die, makes a virtuous and meaningful life”. A book that is both profoundly moving and exquisitely written, Kalanithi’s journey from doctor to patient will resonate with anyone who has ever wondered what gives life meaning. BRAIN ON FIRE: My Month of Madness - Susannah Cahalan Part medical mystery and part memoir, this book is currently being made into a movie starring Chloë Grace Moretz as the author and main character. 24-year-old journalist Susannah Cahalan wakes up one day in the hospital room in restraints, unable to speak or move, alone and unable to comprehend what is happening or how she got there. Plagued with hallucinations and paranoia, she is seen as both a flight risk and possible psychotic, but the doctors are continuously incapable of giving her a diagnosis. What follows is Cahalan’s attempt with her family to uncover what is wrong with her and how – if possible – to begin her fight back to health and sanity. THE HEALING OF AMERICA: A Global Quest for Better, Cheaper, and Fairer Health Care - T.R. Reid With the presidential election and its various promised reforms just around the corner, there is no better time than now to take a look at the American healthcare system through this fascinating and eye-opening book. Ironically, the U.S. healthcare system is more expensive compared to that of any other developed country. Nevertheless, this system still leaves millions uninsured and unable to access life-saving medical treatment. Journalist T.R. Reid embarks on a journey for several years and travels to countries all over the world, such as U.K., France and even Japan in order to understand what other countries are doing better than America with regards to healthcare. Ultimately, this book asks readers to ponder a fundamentally important question: should all Americans be able to access healthcare regardless of social and economic class?
PHOTO COURTESY THEGUARDIAN.COM
PHOTO COURTESY SARAHSBOOKSHELVES.COM
PHOTO COURTESY BANGORDAILYNEWS.COM
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TROJAN HEALTH CONNECTION | April 26, 2016
Health care & the election By SHYAM HASSAN Staff Writer The 2016 election cycle has proved to be not only unpredictable and polarizing, but also to be of pivotal importance for the future of the country. Healthcare, in particular the Affordable Care Act, has been debated by candidates from both sides of the political spectrum and continues to add to the polarization of American political discourse. The Affordable Care Act, otherwise known as Obamacare, has a favorability rating of 40 percent while 45 percent oppose the legislation. Such figures make Obamacare a key battleground issue for the November election. President Obama himself has a favorability rating of 47 percent and an unfavorable rating of 48 percent. This divide is shown through the gap between healthcare policies proposed by the Republican and Democratic candidates. The Democratic frontrunner, Hillary Clinton, has been a fierce proponent of Obamacare, arguing that the law has potential to be a long-term healthcare solution. At a recent debate hosted by Univision on March 9, Clinton pointed out that 90 percent of the U.S. populace
has some form of healthcare due to the Affordable Care Act. She believes that continuing the current policy and expanding the program can help reach the 10 percent who are still uninsured. Clinton, who was part of the Obama administration, believes the strength in Obamacare is derived from the subsidies it provides to drive down costs for lower income families
Healthcare is not a singular issue, but has
ripple effects on many other areas, such as taxes, budgeting, public health, and regulations. and individuals. On the other side of the political spectrum, Republican frontrunner Donald Trump has starkly contrasting views on healthcare. He is strongly opposed to the Affordable Care Act and has stated repeatedly that he plans to repeal it if he were elected president. He claims Obamacare does not sufficiently encourage insurance companies to
lower their prices. Trump has advocated a free market approach to the healthcare issue. He wants to abolish boundaries that prevent insurance companies from competing across state lines. Trump has claimed this would increase competition and lower prices overall. He has also spoken about the need for better negotiation with pharmaceutical companies. Currently, insurance companies charge market price for drugs and the government has not taken action. Trump claims that with better negotiating, insurance and drug prices would lower overall and make Obamacare unnecessary. Healthcare is proving to be an issue definitive of party alignment. According to Vanderbilt University, 27 percent of Democrats consider healthcare a top priority compared to 11.1 percent of Republicans. The same study found Democrats far more willing than Republicans to support tax increases to fund healthcare-related government programs. Healthcare is not a singular issue, but has ripple effects on many other areas, such as taxes, budgeting, public health and regulations. It is currently shaping to be a deciding factor in Novemberâ€™s elec-
tion, which will likely decide if the nation will continue support for a subsidy-based Obamacare, or look to the free market. Conversations with several students currently studying health studies and political science only confirmed the polarizing nature of this topic. One student pointed out that though Obamacare has appeared sustainable for its growth, as the program continues to expand it will become more unsustainable and may begin to fail under its own weight. He added that in this initial stage, premiums already have risen 7.5 percent and there is no mechanism to prevent further increase. However, there are also voices to give credence to the other side of the issue. An active member of the USC College Democrats pointed out that the healthcare industry has thrived under Obamacare. He also pointed out that Medicaid programs have since then expanded to cover more individuals, reducing the stress on Obamacare funding. In summary, only time will tell the viability of Obamacare. However, the fact that it has become such a divisive issue will weigh on the minds of voters this coming November.
RE: ELECTION 2016
April 26, 2016 | TROJAN HEALTH CONNECTION
Examining California’s physician-assisted suicide law By ADRIANA SHEN Photographer
ILLUSTRATION BY LAURIE OKAMOTO
After much controversy, Governor Jerry Brown legalized assisted suicide in California in October 2015 as part of the End of Life Option Act. On March 10, the legislative “ordinary session” called by Brown closed and the act will go into effect June 9. Modeled after the “Death with Dignity” Act passed in Oregon in 1997 and subsequent acts in Washington, Montana, Vermont and New Mexico, Brown’s bill will allow physicians to prescribe lethal medication to terminally ill adults who are still competent and capable of making decisions. Specifically, this law would be applicable only to patients with a confirmed prognosis of six months or fewer to live. A patient would then be able to self-administer the lethal dosage after requesting a prescription two separate times, at least fifteen days apart. Even in California, there have been various previously failed efforts to pass similar bills in 1992, 2005, 2006 and 2007. For centu-
ries, assisted suicide has been a controversial issue with conflicting viewpoints from physicians, religious groups and the Democratic party. Disability advocates from the Disability Rights Education and Defense Fund and National Council on Independent Living, among others, strongly opposed passage of assisted suicide laws due to the possibility of doctors abusing weaker patients. Groups are concerned that the doctors hold authority when making these types of decisions — as doctors are the ones who confirm a patient’s prognosis, who determine that patients are mentally competent enough and who affirm that the whole process was wholly voluntary. There is often a discrepancy in people’s definition of disabled and terminally ill. As seen in Oregon, it is possible that society and physicians could easily assist suicides of insecure patients who feel like “burdens on others” or have felt a loss of autonomy or dignity due to their illness. Further, there is still the resurfacing of moral conflicts over the physicians’ Hippocratic Oath. While the oath assures that
doctors do their patients no harm, the End of Life Option Act allows physicians to administer lethal doses of medication to kill patients. The bill has divided religious groups in several ways, as well. Reverend Vernon Holmes from the California Church Impact supports quality of life over quantity, stating that life may get to a point that is worse than death, and assisted suicide would allow for patients to end their pain and suffering to find closure. Christians, on the other hand, believe it wrong to tamper with life or death situations and would rath-
er leave these matters to the hands of God. Despite the groups that oppose such an act, the End of Life Option Act will come into effect within a couple months. California sets an example for states to follow, as the passing of this law means offering the chance to end life with dignity to one in ten Americans. Until June 9, it is unknown how this law will really affect healthcare in California and how it will influence future legislations in other states, but it will definitely provide more options for the terminally ill.
Brittany Maynard was a Californian patient who moved to Oregon to end her life after discovering she had a fatal brain tumor.
[“Marijuana” from Front Page] Unsurprisingly, aside from the lack of serious regulation, the use of marijuana has raised many questions pertaining to its serious impact on health. In a recent study by Colorado Department of Public Health in February 2015, marijuana is responsible for stimulating a variety of reactions. Primarily, marijuana consists of similar carcinogenic substances discovered in tobacco smoke. Other symptoms include
inducing temporary memory loss, developing psychological disorders (such as schizophrenia) and even impairing behavioral performance of toddlers during pregnancy. Further research conducted at the University of Queensland suggests that marijuana, while not as toxic as its illegal relatives (like ecstasy, etc.), can cause additional heart problems, which have led to the rising number of deaths by marijuana abuse. However, most proponents of
legalization counter the claim with fresh evidence of their own, pulling out the “health” card to argue about marijuana’s beneficial effects. Despite its well-known stigma, marijuana behaves similarly to another family of chemicals called endocannabinoids, which have been known to boost the immune system against diseases and also prevent premature deaths of growing cells. The most famous political manifestation that acted upon these claims is Proposition 215 from the state
PHOTO COURTESY OF NPR.COM
INFOGRAPHIC BY SAMANTHA TSAI AND ANDREW EZERSKY
of California. While California has yet to legalize marijuana for recreational purposes, Proposition 215 states that limited usage of marijuana is allowed only via prescription under licensed doctors. According to Matthew Abel, executive director of NORML (National Organization for the Reform of Marijuana Laws), American legalization of marijuana would not only be a health-friendly maneuver, but would also be an economically beneficial one. “It could be huge and the people are very interested and very supportive,” Abel said. He also explains that a future influx of job opportunities would become available for Michigan farms. This positive insurgence has not gone unnoticed by other states: in mid-March, Louisiana considered legalizing marijuana to pay off their $850 million state debt via tax money, and Massachusetts has openly voiced its interest in allowing marijuana for recreational purposes. So far, Vermont has outstripped its peers, coming closest to achieving legalization after proposing a bill which recently passed Senate scrutiny. However, supporters of prohibition are quick to counteract the legalization of marijuana, reasonably pointing out its lack of serious regulation – a major loophole previously brought up by Candidate Sanders. Shortly after passing the bill in Vermont, State Senate President Campbell expressed similar concerns over the management of marijuana trade. “Shouldn’t we be trying to solve that problem first, before we introduce another drug that we all have to admit has mind-altering characteristics?” Campbell said. Yet despite heated debate, much about the medical effects of marijuana remain unknown. Sufficient marijuana research has yet to be conducted that would allow individuals to reach a definitive conclusion in the years to come.
TROJAN HEALTH CONNECTION | April 26, 2016
How to study abroad as a pre-health student By STEFFI BOLTON Staff Writer As a pre-health student, it’s easy to believe that studying abroad is not an option in order to graduate on time or apply to medical school. However, USC offers some semester-long abroad programs as well as ones that can fit into the summer. Pre-health students have many options when it comes to choosing where to go abroad. In Africa, students can apply to study in Botswana or South Africa. In Australia, they can study in Brisbane, Canberra, Melbourne or go right next door to New Zealand and study in Auckland or Dunedin. Many students wish to spend their time abroad in Europe, and they have the opportunity to go to London or Brighton in England, Ireland, the Netherlands, Scotland or Istanbul, Turkey. These programs all require at least a 3.0 GPA. Over the course of a semester, students take courses as well as participate in research, clinical rotations and volunteering. If students want to stay on campus for the fall and spring semesters, there are two very popular Problems Without Passports (PWP) summer programs geared toward pre-health in England and Guatemala. The first, based in England, is BISC-428: “The Biology of Health from a Global Perspective,” a 4-unit upper division biology class directed by Erin Quinn or Michael Cousineau, who rotate each summer. This class has no prerequisites so students can take it any summer. However, they are required to have [“Laughter” from Front Page] in the 1999 film, medical clowns often dress in white doctor’s coats and red noses to mock physicians. Their outrageous gestures and expressions allow the patients to feel a sense of control. “[They] break the tension between patients and doctors/patients and parents...that prevents healing,” said Steel. In light of the practice’s newfound popularity, Steel and David Bridel, Dean of the USC School of Dramatic Arts, set out on a quest to bring medical clowning to the USC community by co-creating an undergraduate program in the School of Dramatic Arts designed to train individuals in therapeutic medical clowning. The upcoming SDA program will be segmented into three classes. The first class, “Intro to Medical Clowning,” will officially be available to all USC undergraduates in the Fall of 2016. “[The course teaches] principles of listening, audience engagement and improvisation, in addition to tapping into what makes you funny,” said Steel. This studio-based class will focus on the basics of clowning techniques. After completing the fall introductory level course, students may choose to continue into “Advanced Medical Clowning” and learn more about the intricacies of clown care in terms of the patient-clown interaction. In this class, students will focus on lessons in vulnerability, higher-level improvisation, perception and pa-
a 3.0 GPA and be enrolled at USC in the following fall. Judy Haw, the director of Supplemental Instruction at USC, coordinates the entire trip and accompanies the students going each summer. The three and a half week course spans almost the entire month of July, where 25-27 students first meet in London. After the weekend in London, everyone travels to Oxford University, where they receive two daily lectures from physicians associated with Oxford during the rest of their time there. “These physicians do research on a number of global health issues in the sub-Saharan and tropical areas, so they are not just in Oxford,” said Haw. The lectures are given on a variety of relevant topics like malaria, Ebola, traditional medicine, tuberculosis, vaccines, pharmacies in developing countries and snakebites. In addition to work such as daily lectures, a research paper and a presentation based on their research, students tour Oxford and visit famous English landmarks like Blenheim Palace, one of the filming locations of Downton Abbey, Stratford-upon-Avon, the former home of William Shakespeare, Christ Church and various palaces in Oxford. Students also see a play in Shakespeare’s Globe Theater and have a free weekend where they can choose to stay in England and explore, or go elsewhere. “Students [have flown] to Paris, Dublin… they can do whatever they want to do,” said Haw. “Some have gone to see cousins in Germany or friends abroad.” tient interaction. Lastly, after the completion of the upper level elective, students interested in interning at select hospitals in Los Angeles may be offered a summer position to implement the tools learned from the program in a hospital setting. In the future, Steel hopes to expand the newly released program into an emphasis for SDA undergraduates and ultimately a progressive degree track. As medical clowning begins to make its mark on children around the world, USC takes its first step in joining the movement and harnessing the unthinkable positive outcomes of a good laugh. After all, as the old adage says, “laughter is the best medicine.”
GABRIELLE FORTE / TROJAN HEALTH CONNECTION
Professor Steel (left) stands with Dean Bridel (right).
PHOTO COURTESY OF ERIN QUINN
USC students from last summer’s Problems Without Passports trip to Guatemala. The second trip, MDA-499: “Health, Disease, Language and Culture in Guatemala,” is directed by Quinn and takes place from the end of May to mid-June. This trip has a language component, where each student is given a Spanish tutor based on their level of Spanish. The Guatemala trip mirrors the Oxford trip, with Guatemalan physicians giving daily lectures, but instead of staying in dorms, students stay at home stays. Students visit clinics, learn about the pros and cons of the Guatemalan healthcare system and experience Guatemalan culture. The Guatemala trip is the more affordable option of the two, as BISC-428 costs add up to approximately $11,000 compared to MD499’s $7,000 cost. This difference is due to one less unit of tuition money
and the lower cost of living, but anyone can apply to receive the Summer Undergraduate Research Fund (SURF), which requires a 3.0 GPA. The Pre-Health Office advises students to take their lower science courses on campus ahead of time. Additionally, if they’re planning on taking the MCAT, they should try to fit in time abroad before taking the test and begin the medical school application process. When students go abroad, they are not required to only take science courses, but it is recommended. Students can also take general education courses abroad that can be counted as credit towards their degree. While it may be too late to apply for this summer, consider taking advantage of these opportunities while at USC. The application process
is competitive, and the only edge is given to rising seniors. Students need to have an interest in health in some capacity, but are not required to want to become a physician by any means. “Yes, I want the academics. Typically at USC that’s not hard to find… but I want individuals that will come together and travel well as a group,” Haw said. Often, these trips are best described as “eye-opening.” “Very often students go into them thinking that medicine is about biology, or chemistry, or just science,” said Haw. “But they realize that it’s about culture, it’s about economics, it’s about weather and politics. You’ve gotten rid of your blinders, and find out that it’s more than biology and anatomy.”
Exploring alternative health care careers By SANYA KHAN Staff Writer There are many tracks that students can take in order to be successful and make an impact on numerous lives. Physical therapy and physician’s assistant programs are growing rapidly, as is the need for these medical professionals. As a P.A., one has direct contact with patients and essentially performs the same tasks that an M.D. does. The biggest difference is the level of autonomy. Physician assistants, as the name implies, work under a physician who is required to sign off on all of their charts, and double check what they do before sending a patient home. Aimeeanna Pina, a junior, is following the P.A. path for many reasons. “PA school is only 2-3 years, which allows me to get my career started earlier than if I went the traditional medical route,” Pina said. “[I was] motivated by the idea that someday hopefully I will get to work as a health care professional and be able to help others, which is something I’ve dreamt of doing as a child.” Additionally, there is the option of deciding to go to medical school after a few years of hands-on experience as a P.A. The USC Nurse Practitioner and Physician’s Assistant Club provides resources to those interested in learning more about those respective fields of work, such as having physician’s assistants and nurse prac-
titioners visit and speak about their careers. Attending USC allows undergraduates to have direct access to students and faculty at the best physical therapy school in the country. According to U.S. News and World Report, USC has been ranked as the #1 physical therapy school in the nation, tied with the University of Delaware, University of Pittsburgh and Washington University in St. Louis. The faculty at the USC Physical Therapy Associates Clinic gave insight about the importance of physical therapy. Noriko Yamaguchi, a board certified geriatric physical therapist, specializes in oncology rehabilitation at the USC clinic. She
“I have noticed how close the P.T.s become with their patients and that is something I look forward to” emphasized that the field of physical therapy is filled with diversity and that a physical therapist has many options in terms of their future career direction. She cited that working with patients and building a relationship with them as one of the many perks of the job. However, Yamaguchi also shared common struggles experienced by physical therapists. “The time it takes to manage the whole patient, from documentation, making follow-up calls with other health care providers and advocacy,
are not budgeted into our clinic day, which means this all has to happen off-hours,” said Yamaguchi. Leanna Blair, an aspiring P.T. student at USC, highlights the D.P.T. program, which allows students to earn their doctorate in physical therapy after 3 years of graduate school. “In 1992, USC became the first school to create a transitional Doctorate of Physical Therapy program,” said Blair. “I think the transition to these programs is great for the field and really expands the role of a PT within the health care system. In addition to this, some states are adopting the Direct Access to Physical Therapy Law, which allows patients to see a P.T. without a doctor’s referral.” Like Yamaguchi, Leanna loves the patient interaction and the connections she gets to build with the people she is working with. “From my experiences in the Athletic Medicine Department and shadowing at other clinics, I have noticed how close the P.T.s become with their patients and that is something I look forward to experiencing in the profession,” said Blair. Similar to the P.A. club, there is a pre-P.T. club on campus that is a way for USC students to get involved and learn more about the program. “Just about three years ago I was still unsure about what health profession I wanted to pursue,” said Blair. “Being part of the club convinced me that Physical Therapy is the right profession for me.”
April 26, 2016 | TROJAN HEALTH CONNECTION
You CAN do it all: a profile on pre-med Sam Dhillon By OLIVIA PANCHAL Senior Editor
Junior Sam Dhillon.
PHOTO BY FRANK ZHANG
Being a pre-health student requires a lot of time. Not only are the required courses intensive, but there is also volunteer work, research, shadowing, leadership positions and acing the MCAT to worry about. Just the thought of adding another commitment might make a student sick to their stomach. However, taking on an activity unrelated to getting into a health professional school might be more beneficial. Students might think that they won’t have time to study and their grades will suffer, but that’s not necessarily true. Just ask pre-med junior, Sam Dhillon. On top of working towards his goal of becoming a neurosurgeon, Dhillon is also on the USC men’s basketball team, CEO of his own investment firm and founder of the Deep Roots Foundation.
“[I see] it as 24 hours in a day and [plan] the whole day out to incorporate both finance and medicine,” said Dhillon. It may seem like too much to handle to some. Dhillon agrees it is challenging, but that’s what he loves about it. As a pre-health student, it can be very easy to only focus on goals that pertain to the mission of getting into a professional school. However, it is recommended that students do not forget about their other passions, whether it’s sports, art or politics. In fact, health professional schools will see the applicant as a more well-rounded candidate if they have life experiences outside of medicine. “Find what you are passionate about and pursue it,” said Dhillon. “You’ll thank yourself later, you will be doing something you truly enjoy and you will make a more profound difference that way.” Furthermore, though students might not even realize it, their
experiences outside of medicine might actually help them with their professional goals too. For example, Dhillon’s interest in finance has allowed him to adopt different viewpoints toward a number of situations. “[It let me] think outside of the box and look at problems in real life scenarios from different perspectives,” said Dhillon. Don’t let being pre-health be an excuse for turning down an opportunity. Give it a chance! If the activity is too much to deal with on top of school work, a student doesn’t have to continue doing it. However, at least an attempt was made and there are no regrets for giving the opportunity a chance in the first place. More often than not, a student can find something that they love and with a little extra discipline, balance it with school. It’s all about finding a balance between happiness and pursuing one’s professional goals.
The rise of USC’s new mobile clinic program By NATALIE LI Layout Manager With the plethora of student-run organizations and clubs on campus, it may seem that USC has a wide enough variety of volunteer opportunities for undergraduates. However, for the first time at USC, a mobile clinic has officially been founded this past semester. Partnered with the John Wesley Community Health (JWCH) and Keck Student Run (SRC) clinics, the new USC mobile clinic aims to serve the local Los Angeles population. Co-founder Monica Liu was inspired to start USC’s own mobile clinic her freshman year. According to the current junior, she started working on Skid Row and from being in that area, she believed that USC could do so much more for the local population. “I realized that with USC being where it is – its prime location as well as its many resources – we can utilize these [resources] to help the homeless population in the area,” said Liu. “I looked to join a mobile clinic because I knew that there was a dental clinic at USC, but couldn’t find a mobile clinic.” Instead, Liu contacted the UCLA mobile clinic, which has been running for more than a decade, and talked to them about how they started the clinic. She then worked with additional co-founders Jason Hsieh, Sam Dhillon and Rubi Montejano to bring both the SRC and JWCH on board to form USC’s own mobile clinic. “It took almost three years to get the clinic running, but once we had legal backing from both JWCH and SRC, this partnership really allowed the mobile clinic to start,” said Liu. Currently, the club contains a limited amount of undergraduate spots. This is due to the limited availability of undergrads work-
ing on clinic days, of which their duties include patient intake, discharge and advocacy. Students also participate in “shelter days,” in which they help out at the shelter outside of the clinic in order to form connections with the shelter residents. “This helps bridge the gap and eventually we want to know the people more,” said Hsieh. “Sometimes it’s easier to talk to undergrads because they’re more friends than authority figures, and they can be a middle step.” Considering that most of the schools in the University of California have had established mobile clinics for more than a decade, USC’s new mobile clinic was founded much later in comparison. Liu believes that this may have been due to the UCLA medical school having the initial people to start their respective mobile clinic. “They had a lot of support from the physicians, and if someone from the medical school hadn’t had the idea, it probably wouldn’t have happened,” said Liu. Additional barriers include consistent coordination and goal-setting among the many different types of individuals needed in order to implement the clinic in the first place. “The biggest thing is that people are always trying to set a mobile clinic up [at USC], but since it is so interdisciplinary with all the professors and professionals needed, coordination always fails if people aren’t very willing to see it through,” said Hsieh. Another factor he cited was that USC already contains a wide variety of community service organizations that may have branched out student interest in serving different aspects of the community. In terms of future directions, the club has a number of plans. Several short term goals include solidifying the undergraduate clinic role and implementing a 2-unit class in order to teach stu-
PHOTO COURTESY OF USC MOBILE CLINIC
Members of USC’s mobile clinic work to provide aid to the local population dents about the stigma of homelessness and both the challenges and approaches to helping this population. Long term goals include increasing the number of clinic days and expanding to more shelters. “Hopefully we can […] branch out and bring our own medical
team and serve other places that people normally can’t get to,” said Liu. While the club is still fairly new, its members have shown dedication toward the organization and its mission, and call upon future members to drive the further growth and development of the
clinic. “Everyone so far seems pretty passionate about this club and have the initiative to do little things we need,” said Hsieh. “Whoever wants to join in the future has a lot of power to change and shape [the clinic] into what they want.”
USC alum tackles new approach to cancer research By ARMAN ZADEH Associate Editor Cancer is not one disease. Despite the fact that similar tools are used to fight the many forms of cancer, each cancer is uniquely complicated. In the present era, cancer research has been devoted toward treating each cancer individually as the healthcare industry moves toward a vision of accurate, specific and customizable medicine. Precision medicine, as it has been come to known, will treat illnesses related to both cancer and noncancer, but oncology is arguably at its focus. Working toward a “big hairy audacious goal”, or BHAG for short, in the developing field of precision oncology is Ignyta, a biotechnology company based in
San Diego. Their BHAG is “not just to shrink tumors but to eradicate residual disease - the source of cancer relapse and recurrence” in specific patient populations by 2030. USC alum Jacob Chacko, from the Class of ‘00, is on the frontlines and helping to advance their BHAG. With experience in healthcare, finance and management, Chacko assumes the role of Chief Financial Officer at Ignyta and is helping establish Ignyta’s place in the rapidly growing biotechnology industry. “We’re a precision oncology company that is bringing together the diagnostic and the therapeutic to essentially match up the right drug to the right patient,” Chacko said. “And that requires understanding the underlying driver of the cancer, in other words, under-
standing why do [patients] have the kind of cancer they have and getting them a drug that is targeting that underlying cause as opposed to a shotgun approach of chemotherapy, for example.” The “shotgun approach” to treating cancer, wherein each patient receives treatments from surgery to chemotherapy to drugs that attack the body beyond the cancer, has been the primary approach to treating the disease. Oncologist David Chan describes the inefficiencies and failures of this system and advances in a new era of cancer treatment in a Slate magazine article. “Cancer [is] a general term for many diseases that have some things in common and many things that vary from one type of [See “USC alum” pg. 10]
TROJAN HEALTH CONNECTION | April 26, 2016
Students compete to win big at the International Global Health Case Competition By IZMA SHABBIR Senior Editor This year marks the fifth annual Global Health Case Competition held at USC. The competition involves groups of students engaging in consulting-inspired problem solving of an assigned contemporary global health issue. This year, students were asked to develop five-year realistic solutions to implement cancer prevention strategies through preventative tactics. The students were treated as mock consultants for the American Cancer Society. “Everyone presented on cancer prevention, but our group took a special look at breast and cervical cancer prevention,” Claire Justin, a sophomore double majoring in NGO’s and Social Change and Global Health, said. “We focused on lack of access to screening in [India]. We proposed a system of specialized free clinics in grocery stores that would perform breast exams and pap smears. This solution addresses the problem of lack of access to and knowledge about breast and cervical cancer screen-
ing in India.” Students receive the case with the global health issue and are expected to present five days later. Three teams advance to the final round, and the winning group moves forward to compete at Emory University’s International Global Health Case Competition. Emory opened up its competition to other universities in 2010, and some universities specifically pick groups to compete. USC, however, has created its own competition to allow more students to compete for the spot at Emory University. The winning group this year included MPH candidates Danielle Pappas, Evan Pye and Jessica Frankeberger; psychology undergraduate Jennifer Bailey and dual-degree pharmacy and PharmD/ MPH student Amy Nham. The competition is a dynamic way to bridge the gap between undergraduates and graduate students, as well as University Park Campus students and Health Sciences Campus Students. The American Cancer Society-sponsored competition took
place on Feb. 11 and students presented to a panel of faculty from the USC Institute of Global Health and Keck School of Medicine, as well as representatives from the American Cancer Society. The multidisciplinary group of students had one week to pre-
PHOTO COURTESY OF IGNYTA
Jacob Chacko, C.F.O. of Ignyta [“USC alum” from pg. 9] “cancer to another,” said Chan. “Even within a cancer, like breast cancer, we are finding that there are different subtypes that have different molecular signatures that should be attacked in different ways.” For problems like these, members of the biotechnology industry are investing their resources in developing new, unique treatments to specific cancers. For example, Ignyta’s lead compound, entrectinib, targets specific protein kinases (Trk1/2/3) in its attack on tumors in patients with specific genetic mutations. Attacking cancer with this level of precision is a phenomenon only achieved recently with advances in technology, exemplified by Genentech’s launch of Herceptin, a breast cancer drug that targets the protein HER2, in the 1990’s. By utilizing his background in medicine in developing relationships with patients, investors and analysts alike, Chacko is eagerly bringing the company closer to its
PHOTO COURTESY OF USC INSTITUTE OF GLOBAL HEALTH
During the course of the competition, students work in teams to come up with solutions to address a modern day global health issue.
vision of being “ the world’s leading precision medicine company, with an integrated approach to ‘Rx/Dx’ in oncology.” “What gets me excited about [Ignyta] is that if you have these small patient populations within each different kind of cancer, so within lung cancer, within colon cancer… by finding those patient populations and identifying those that respond best to a drug, we can give them that drug and have a phenomenal response rate,” Chacko said. However, before he was Dr. Chacko, C.F.O. of Ignyta, he was Jacob Chacko, the Marshall Scholar, Trustee Scholar, member of USA Today’s All-USA Academic Team and USC class valedictorian. When USC last heard from him, he was preparing to study abroad at Oxford for two years while simultaneously deciding whether he would attend USC, UCLA or UCSF for medical school when he returned. That was in May of 2000. In the 16 years since, Chacko
has been persistent in his desire to make macro-scale changes to healthcare. After deferring his acceptance UCLA for medical school to study economics and social history at Oxford, Chacko spent time at McKinsey, a consulting firm, serving clients in health care. “I didn’t think I was actually going to go to McKinsey, but I heard what they were saying about people who like to have impacts on health care on a more macro basis by changing the ways that companies do business and the way they deliver care,” Chacko said. “It was incredibly intellectually stimulating and I wanted to go back full time after I finished my time at Oxford. ” A summer at McKinsey turned into exactly that, a full time job at McKinsey, requiring Chacko to defer his admission to UCLA once more. Chacko would return to UCLA in 2003 with a new understanding of how he wanted to spend his career. “It was in 2006 that I decided
pare for the competition. “[The competition] was a great reminder of how people can pull from different areas of knowledge to create the best plan possible,” Justin said. “Even though they’re becoming more common now, [global health] case competitions
are still pretty rare in the undergraduate world. That’s a shame. After doing this competition, I feel like there’s no better way to apply your knowledge than to propose solutions to real-world problems and defend those solutions.”
that even though I still wanted to practice medicine, that I was eventually going to go back to the business side of healthcare,” said Chacko. “As part of that, I decided I also wanted to get an MBA and that’s when I went out to Harvard in 2006.” In 2008, Chacko completed both his MBA requirements at Harvard and final year of medical school at UCLA after having thoroughly explored his interests in medicine and business, an opportunity he credits to his two role models and the generosity of both UCLA and Harvard. “I was very fortunate to have phenomenal role models, my parents. I saw the two of them both working in incredibly demanding professional jobs. They were both incredibly supportive of both my brother and me exploring all the areas we found interesting,“ Chacko said. “They always told us we should spend our twenties figuring out what it was we wanted to do with the rest of our lives and getting the skills in place to do that. They really encouraged exploration.” Finally at a fork in the road between his first interest, orthopaedic surgery, and his newfound interest, business in healthcare, Chacko had to decide between residency or continuing to build the business skills he learned at McKinsey. “I made the decision that if I wanted to do orthopaedic surgery, that’s a really long period of training if I know definitively that I’m just planning to leave afterwards,” Chacko said. “That’s when I made the decision to go to the business side of healthcare and go to TPG capital to focus on healthcare investing because it gave me more insight on how to evaluate health care businesses: what makes a good business and how do you
make those businesses more successful.” At TPG, Chacko successfully lead teams responsible for acquisitions worth over 10 billion dollars and served as a Vice President focused on healthcare and digital media. However, after six years, Chacko decided it was time to move on. “After [TPG] is when I got the bug to try something more entrepreneurial,” Chacko said. “The kind of things I was working on at TPG were multibillion dollar acquisitions and that was a lot of fun, but I was craving something more entrepreneurial.” After a conversation with a mentor of his and C.E.O. of Ignyta, Jonathan Lim, Chacko joined the team in 2014, about three years after its founding. As for what the future holds, Chacko sees himself continuing his work with Ignyta. “If you talk with patients and you see how they’re doing and the tremendous benefits of being on the drug, it’s really fulfilling to see that. And then it gets you excited to want to get the drug into the rest of the clinical studies and get it approved and hopefully one day bring that benefit to a much larger patient population,” Chacko said. “We have a 20 year vision for what we want to do with cancer and we’re in the early days of that. So it’s going to take a while to do it, and I’m excited to be a part of that for the long term vision.” Looking back, Chacko credits the support of his parents and brother, David, for helping him reach where he is today. “It’s been a fortune of having two amazing parents who were so supportive and a younger brother who’s now become a peer to me and more successful in all the things that he’s doing,” Chacko said. “And it all started at ‘SC.”
by Lisa Kam
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April 26, 2016 | TROJAN HEALTH CONNECTION
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MEDICAL SCHOOL SPOTLIGHT
TROJAN HEALTH CONNECTION | April 26, 2016
Perelman School of Medicine aims to train next generation of future leaders By HANNAH ZHAO Staff Writer The Perelman School of Medicine, nestled across the Schuylkill River in West Philadelphia, is one of the top five medical and research facilities in the United States. Although the university boasts its success in educating prospective physicians in patient care, biomedical research and medical education, Perelman is famous for its prestigious eightyear MD/PhD program. The Perelman School of Medicine’s curriculum is centered around six modules: core principles; integrative systems and disease; technology and practice of medicine; required clinical clerkships; electives, selectives and scholarly pursuits; and lastly professionalism and humanism. The first two modules are intended to integrate basic science and clinical medicine into the practice of medicine. Following the fundamental establishment of knowledge in the medical field, module three immerses medical students into hands-on clinical decision-making and diagnosis. Students are then required to participate in a clinical clerkship during module four that prepare the future physicians for module five and six, the stages of the curriculum that require internships and shadowing in the five hospitals within walking distance of the school. Dual Degree Programs Perelman School of Medicine is known for its successful yet rigorous MD/PhD program intended
PHOTO COURTESY OF U. PENN PERELMAN HEALTH SYSTEM
for students who have interests in being a physician scientist. In this program, medical school requirements are weaved into clinical connections in order to provide students with a balanced physician-investigator experience. Within eight years, the students are able to complete coursework while completing clinical work in their respective dissertations. Perelman also offers a degree and physician scholar program, the MD/Master of Public Health program (MPH). This program is geared towards students who not
Class of 2019 proﬁle #3 Best Research #11 Best Primary Care Faculty-student ratio 4.7:1
Deadline: October 15 Application Fee: $80 Acceptances: 3/1-3/30
Top Specialties Chosen by Students
Drug/Alcohol Abuse Internal Medicine
Geriatrics Pediatrics Women’s Health
Median Overall GPA: 3.85 Percent Science Majors: 68% Percent Other Majors: 32% Entering Class Size: 156 Mean MCAT: 37 Verbal: 11 Physical Sciences: 13 Biological Sciences: 13
Gender Distribution (Men/Women): 53%/47% Percent Pennsylvania Residents: 15% Percent MD/PhD Students: 15%
Tuition: $52,210/ year
5,830 Verified Applications 882 Interviewed 156 Matriculated 2.9% Acceptance Rate
only are interested in medicine, but are also interested in public health. Unlike other programs, this one is designed to introduce medical students to disease prevention, health education, policy making and other interdisciplinary training. With careful planning, the MD/MPH degree can be completed in five years. Dual degree programs also include nine MD/Masters Programs. For example, Perelman offers a MD/Master of Business Administration (MBA) program intended for students who want to
combine medicine with the business aspect of the health care system. The curriculum successfully provides medical students with a strong background in healthcare management. This program is one of the many programs on the rise at Perelman, as the role of physicians with MBAs and other combined degrees are becoming more prominent in modern society. Residency Matches In 2015, 161 of the Perelman School of Medicine graduates matched with specialty programs. While the most common special-
ty program was internal medicine, numerous students matched with some of the top 10 most competitive residency programs in the nation. These included dermatology, neurological surgery, otolaryngology, ophthalmology and plastic surgery. Hospital Affiliations Perelman is associated with five main hospitals: Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, Chester County Hospital and Lancaster General Hospital.