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Cultivating cultural, medical understanding

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Strolling through his rambling backyard,
nestled on a bluff above Sioux City, IA,
Thomas Benzoni stops to pick up a little
head of seeds. “This is gaillardia, also called
Indian blanket,” he says, showing his guests
the seed head’s anatomy, as enthusiastic as
if he’d found a rare gem.

Later, in the emergency department of the
city’s Mercy Medical Center, he gives his
guests tips on using their stethoscopes more
effectively. During a break, he explains the
financial structure of his five-member emergency
medical practice. He poses questions they
should consider to help determine whether
one patient’s eye injury was the result
of physical abuse.

Benzoni, D.O.’83, is as comfortable
teaching as he is practicing
emergency medicine. That’s why he and his wife, Noreen O’Shea, D.O.’84, offered to host visiting DMU students Gilbert Sangadi and Juliet Babirye for a week in their home in May. Sangadi and Babirye are fifth-year medical students who participated this spring in DMU’s eight-week rotation for students from Makerere University in Uganda, East Africa.

During their visit, Benzoni also taught the students key lessons of emergency medicine: Be flexible; don’t expect for a second you’ll have control over what comes into the ER; and learn how ER doctors sleep.

“Dr. Tom gave me the book on that,” says Sangadi: Crystal Zevon’s biography about her ex-husband, rock’n’roll wild man Warren Zevon. “It’s called I’ll Sleep When I’m Dead.”

Immersion in medicine

DMU and Makerere University launched their partnership last year to give students from both schools medical experiences in their respective countries. Sangadi and Babirye worked four weeks in the DMU Clinic and three weeks at Mercy Medical Center in Des Moines before their week in Sioux City.

“I wondered whether in such a short time, will it take me two days to
adjust?” says Babirye, relaxing in the living room of the Benzoni-
O’Shea home. “But the ER got me excited. I knew it would be
fast-paced and we would see everything.”

Sangadi says one of the week’s highlights was the man who came to
the ER late one Saturday night after “being run over by a Mustang
sports car.” During the exam of his pelvic injury, x-ray, intubation
and treatment, the students observed the interactions among the
paramedics, nurses, physicians and other staff.

“The different teams worked so well together,” Sangadi notes.

“They’re motivated to do what they’re supposed to do, and they
help each other,” Babirye adds. “They’re centered around the
needs of the patient.”

Three hours into one early-morning shift, the students
saw patients with gall bladder problems, alcohol withdrawal
and an eye injury – “pretty slow,” Benzoni says, obviously
disappointed. “When the students get here at
oh-dark-hundred” – his shorthand for the shift’s 4 a.m. start
– “we don’t want them to be bored.”

During an 8 a.m. break, Benzoni talks with the students
about his practice, which – unlike the vast majority of ER
doctors – is an independent group employed by the hospital.
That has its downsides; for example, the practice will have
to cover the cost of caring for one patient who came in with
no job and no insurance. But even that’s okay.

“ER docs are very proud of the patients we treat,” he says. “They’re the ones whom the fancy doctors with the fancy offices won’t see.” At that moment, one of the four paging devices Benzoni carries goes off. Break is over. He grabs a cellophane-wrapped bagel to top off the doughnut and juice he’s consumed. “Some mornings I’ll go through 6,000 calories,” he says.

Lifestyles of service

Benzoni and O’Shea met as undergraduates at Creighton University. After graduating from DMU, they practiced for four years in eastern Kentucky, working for the National Health Service Corps in Appalachia. They continue to incorporate service to others in their careers. Benzoni is an at-large member of the Iowa Medical Society Board; also the leader of an Iowa Disaster Medical Assistance Team, he provided medical care in the aftermath of Hurricane Katrina in Louisiana and floods in eastern Iowa in 2008.

O’Shea is medical director of Elk Point Community Health Center, over the
border in Elk Point, SD; its clients include the elderly and those with low
and no incomes. She has led the center in adding
evening and weekend hours and mental
health services.

“I like the challenge,” she says. “You
have to use your brain a little more.
You can’t just order tests, because
the patients can’t afford them.”

Benzoni feels the same way about
emergency medicine and all its
unpredictability, often erractic hours
and sheer physical demands.
Growing up, he says he was a
“mother’s worst nightmare” who
“spent more time in the ER” than any of his peers.
The specialty fascinated him.

“When you’re a kid and you see someone in a wheelchair, you ask your mom, ‘Why is that person in a wheelchair?’ And your mom shushes you because grownups consider that rude,” he explains. “But as an ER doc, I get to ask, ‘How did that happen?’ It’s just fun.”

Not all work, no play

Speaking of fun, the Ugandan students’ hosts showed them a good time during their visit. In Sioux City, they went jogging with Benzoni, toured the area and attended a performance of “Cats.” They also accompanied Benzoni one evening to the studios of KCAU-TV, which since 2003 has featured him in a weekly “Ask the Doctor” news segment.

Sangadi and Babirye spent their seven weeks in Des Moines with Barb and Fred Hofferber, who took them shopping in Kansas City and Minneapolis’ Mall of America; fishing in Minnesota; and visiting youth at a local juvenile detention center. They went to the horse races at Prairie Meadows near Des Moines and marveled at one uniquely American phenomenon, garage sales.

“Thank God for host families,” Babirye says. “When you’re adjusting to a new place and culture, they make you comfortable and let you experience the life of Americans.”

That experience also dispelled some misconceptions, the students agree. “Most of what we know about Americans is from movies,” Babirye notes. Many of those images didn’t jive with their host families. For example, the Hofferbers have been married for 40 years; Benzoni and O’Shea, 31. The two students described meeting fun, friendly, hard-working Americans as well as those with problems.

Their eight weeks in Iowa also exposed Sangadi and Babirye to an important skill set: osteopathic manual medicine.

“We don’t have that in Uganda,” Sangadi says. “What I’ve learned here will give me an additional way of doing things and caring for patients.”

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