March 8, 2015 is International Women’s Day.  The theme is “Make It Happen.” The women I have had the pleasure to know have always made it happen.  I want to highlight my many female physician colleagues.  They are from every medical specialty.  We all went to very different medical schools but our paths were similar.  They are in leadership positions or just stepping down and entering into a new career phase.  They are finally enjoying grandchildren, caring for aged parents or just taking the time to enjoy life. It is hard to believe I have known them all for over 25 years.  Over this year, I will profile some of these remarkable female physicians,

They have been role models for a generation of women.  Dr. M, a pediatrician, who I have known since I was a resident, is now caring for the children and even grandchildren  of many of her patients in a practice that is still  in her home.  Her place in the community has allowed her to be a physician, mother, friend, and teacher.

Dr. P, I met when I was rotating at the now closed children’s hospital. It was an inner city hospital that was on the forefront in the care of children life-threatening illnesses and the pediatric AIDS epidemic.  She is an Adolescent Medicine Specialist and book author.  The Adolescent Clinic provided primary care for teens specializing in AIDS care. She was a successful grant writer and many times was juggling multiple budgets successfully and writing research papers to keep the funding stream coming.

Dr. D was the first person to make sure I was welcomed when I joined my residency. She also stood up for me. She is the smartest person I know.  She went back to medical school at age 40. Her father was the first African-American physician allowed on staff at the hospital where we were training.  He was so proud the day she joined his practice.  It was a solo –practice in the home she grew up in.  She still has a practice there.  I have such pride in her resiliency.

Another colleague, Dr. C, from our residency just sold her practice to a large group.  Her practice was the first practice owned by an African-American female acquired by this large group.  Her goal was to have a successful practice and she wanted to integrate other like practices but many doctors did not share her vision.  She has a holistic approach to patient care. She did not give up but held onto her goal when she was working long hours.  Now her practice is expanding and not dying from the inability to recruit new physicians.  She is planning to get an MBA and continue to be a force of change.

The first few days of medical school would have been overwhelming but I was fortunate enough to meet Dr. V.  She has been my friend for over 30 years.  She is a dynamic person and an excellent physician.  She has a holistic approach to care and is fearless. She is now in transition by still fearless.  I am in awe of her courage to take a new direction in medical care.

So many of the women physicians I know are caring physicians, mothers, and wives; make significant contributions to the medical field and their communities.  We run and walk miles for all causes from breast cancer to heart disease.  We lecture in the community at schools and churches and spend hours volunteering for our professional and social organizations.

One of my male colleagues once said “the best thing that happened to medicine was when we made it easier for women to join the profession.”  Woman all over the world are making a difference and many at the risk of their lives.  I am inspired by each one of them and  honor their courage, persistence and dedication.

2014 was a challenging year. The weather stressed us all out. Every meeting I had was cancelled and rescheduled due to the snow.

In March, I hosted the family Easter dinner at my home.  It was a grand event. I cooked crawfish etouffee in honor of Aunt Tommie. I made her Gumbo again this year. She died from complications of Alzheimer’s just after Easter. We had a beautiful memorial service a few weeks later.

In May, I attended The Society for Teachers of Family Medicine meeting in San Antonio Texas. I was the moderator for the closing session and it was my final year serving on the program committee. Roy and I  drove to Austin and then to Dallas. We spent a few days with his sister and her husband in Irving.

June was a spectacular month. We traveled back to Birmingham for the Second Annual Giddens Family Reunion.     .

Like many of you my  heart has been so heavy after all the events over the summer. I have been posting  updates on the police shootings and protests. All the news coverage on the NFL and domestic violence was upsetting.  The news coverage on the deaths of the  police officers failed to emphasize the fact that the shooter suffered from mental illness.   It points to some upsetting truths about views on African-American males. Mental illness is either misdiagnosed or ignored.

I went way too long without a vacation after my last trip,   I spent the entire summer working on several projects. . In December, we spent a few days in Ocean City Maryland.  The weather was beautiful. We went to Assateague Island to see the wild horses. We traveled once again for Christmas. Fortunately, we spent New Year’s Eve at home trying to stay awake.  I made it.

Here’s to 2015.  In May, it will be 40 years since I graduated from Woodlawn High School. The Class of 1975 held the first integrated Senior Prom in the Gymnasium. In June, we will celebrate our 30^th wedding anniversary. It will also mark 25 years since I graduated from Residency and passed my first Family Medicine Board. I started my practice in Cambridge MD that year.

I hope that this year will bring enlightenment and a more intelligent discussion on race in America. I am looking forward to seeing “Selma” and Kevin Costner and Octavia Spencer in “Black or White.” These two movies highlight some important facts about race, civil rights and how much we all have in common. Also important is the fact they highlight what we can lose if we refuse to understand and support each other. We can lose our right to vote, die at the hands of someone who only sees the color of your skin and fears you.

“Domestic Violence Awareness Month evolved from the first Day of Unity observed in October, 1981 by the National Coalition Against Domestic Violence. October has been targeted to educate the public about the Domestic violence.” Domestic violence or intimate partner violence (IPV) is the leading cause of injury in women.  Intimate partner violence is a criminal offense.  It is defined as “actual or threatened physical or sexual violence or psychological/emotional abuse.”  Intimate partners include “current or former spouses, boyfriends, and girlfriends (including heterosexual or same-sex partners).”

Unfortunately, even with all the NFL scandal, our major TV News outlets missed an opportunity to highlight this issue during Domestic Violence Awareness Month. They opted to cover and raise money for Breast Cancer. The good news is that the overall rate of is declining but not fast enough

Each year more than 10 million men and women are victims of physical violence by an intimate partner. Intimate partner violence is seen as a criminal offense but it is also a medical problem.  Both the victim and the perpetrator would benefit from early detection and appropriate intervention.  Early detection and treatment requires a team approach involving health care providers, law enforcement agencies, mental health providers, and local agencies that assist the victims.

Acute medical conditions associated with intimate partner violence include: concussions, bruises, cuts, fractures, trauma due to rape, exposure to sexually transmitted diseases, unwanted pregnancy, injuries during pregnancy leading to complications such as miscarriage and premature births. Chronic illnesses that result from intimate partner violence include: depression, post-traumatic stress disorder, chronic pain syndrome that include headaches, gastrointestinal and pelvic complaints.  Chronic hepatitis and HIV infections may occur.

Unfortunately, I have seen it all. One patient kept returning to the office with a positive chlamydia test. Her partner was not getting treated and kept forcing her to have sex. His rationale was that if she had an STI no one else would want her.  Another patient would have repeated admissions for seizures because her husband threw away her seizure medication.  One memorable patient would always leave before being seen for her appointment to prevent her partner from knowing she left the house.  Being late would expose her to physical harm. With the help of our local agency, we were able to get her to a shelter.

Intimate partner violence affects women more often than men and has become the leading cause of injury to adolescent women.

http://www.futureswithoutviolence.org/userfiles/file/Children_and_Families/DomesticViolence.pdf

http://www.futureswithoutviolence.org/userfiles/file/Children_and_Families/Reproductive.pdf

Over the years I have witnessed that despite the physical and emotional pain, many women stay in dangerous situations for fear of retaliation from their abusers. Unfortunately when women try to leave these situations, they may be at risk for severe or life-threatening injuries.  One patient was locked in her in bedroom during the day until her partner returned from work. Another was forced to travel with her husband when he made cross country hauls in his truck for years.  Many women are faced with the cultural and financial constraints of leaving these relationships.  Many states do not offer adequate and safe shelter systems, medical and psychological care, or assistance with legal matters.  Many women get frustrated and feel abused by the system.

Each year as many as 10 million children in the United States witness intimate partner violence in their families. For children, witnessing violence can lead to long-term problems, which include alcohol and substance abuse, mental health problems and perpetrating or being a victim of intimate partner violence.  Violent partners usually abuse the children.  Abused adolescent females are more likely to drop out of school, have unwanted pregnancies and suffer physical abuse during pregnancy.

Statistics from 1998 show that only 59% of women reported intimate partner violence to the police. Despite all the information being provide, that number is now about 55%. Intimate partner violence accounts for 36% of all injury-related emergency room visits in women.  Women fail to report the cause of these injuries because of shame, prior insensitive responses from friends, family and health care providers, and a sense of hopelessness. IPV accounts for about 8.3 billion dollars/year in health care expenses.

Thankfully Congress did pass the Violence Against Women Act. The President signed the Proclamation to keep the month of October as Domestic Violence Awareness Month.

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