May 2016 Member of the Month
Cathryn Christensen, MD, MPH
Dr. Christensen was born in Brunswick, Maine. She is the Clinical Programs Director at Village Health Works, an organization based in Burundi in central East Africa, whose mission is to “provide quality, compassionate health care in a dignified environment while also addressing the root causes of poverty, disease, violence, and neglect.”
She graduated from Harvard Medical School and completed residency at the UCSF-Santa Rosa Family Medicine Residency program. She also holds Masters in Public Health from the Johns Hopkins School of Public Health.
Why did you choose family medicine, and what’s your favorite aspect of it?
“Your vocation in life is where your greatest joy meets the world's greatest need.” – Frederick Buechner
Family medicine was a combination of what I gravitated to personally: longitudinal relationships with patients, their stories, the privilege of being present in their lives at some of the happiest, saddest, or most uncertain moments. And also a sense that our current moment called for more commitment to primary care, a broader perspective on what keeps patients healthy or sick, and a willingness to re-think systems.
Were you inspired by anyone to pursue family medicine?
I had minimal exposure to family medicine in medical school. However, as I became acquainted, I was struck by its culture of advocacy, both historic and current. Given the role of accompaniment family doctors often play in their patients’ lives, this makes sense. In my training at Santa Rosa, Rick Flinders made this present every day in morning rounds.
What is the most interesting/memorable experience you have had when dealing with a patient?
What I love about family medicine is that I’m not sure there is a “most” – more of a patchwork that just gets larger as you go. A recent heart-breaking case was the death of a 26-year old pregnant mother of three on our ward in Burundi. Despite having a known cardiomyopathy, she had essentially zero agency in her reproductive decisions. She passed away the day we met her. To me, it’s a reminder of how many factors are at play – and of how far we still have to come.
What one word or phrase characterizes your style of family medicine?
Hopeful. But let me cheat here and take the opportunity to quote Dr. Quentin Young, who just passed away at age 92:
In a 1994 interview with Christian Century magazine, he recalled that the young doctors with whom he trained typically viewed their poor patients in one of two ways. “About half the doctors felt that they were witnessing divine justice, a heavenly — or Darwinian — retribution for evil ways, for excesses in drugs, in booze and everything else,” he said.
“The other half,” he continued, “decided that here was the congealed oppression of our society — people whose skin color, economic position, place of birth, family size, you name it, operated to give them a very short stick,” and “you had to address issues of justice, not just medical treatment.”
“It seemed to me the first approach is judgmental and harsh and simplistic,” Dr. Young said. “Taking the alternative view gave me a shot at being a part of the human race.” (New York Times, March 17, 2016 obituary)
What is the best experience you have had during your career as a family physician so far?
Also too many to count! A patient who was able to get clean off meth during her pregnancy and years later now counsels other women. A day when I went straight from a patient’s 100th birthday party to deliver a baby – same birthday one hundred years apart.
In my current role, I most enjoy working with a team of more than 200 providers – including our Community Health Workers – getting to think about models of care and how to create the kind of clinical culture in which questions and ideas are valued.
It is important for me to be a member of CAFP and AAFP because:
Voices are stronger in collective and because we see every day what needs to be fixed. I also feel that, whereas many medical professional organizations largely seem to represent the interests of doctors, CAFP and AAFP are driven at heart by what’s in the best interests of patients.
What has been your best experience as a CAFP member? Why?
When I was in California, I found the meetings – and the obvious passion of those engaged with advocacy and policy initiatives – energizing and inspiring. Since I’ve been working abroad the last two years, I am grateful that the CAFP has made it possible for me to remain a member!
How do you make a difference in family medicine and in your community?
For now, my focus is on improving quality of care, supporting teaching and training, and developing systems – including the truly meaningful use of data – at Village Health Works and for our catchment area of 120,000 in rural Burundi.
Paul Farmer talks about the danger of “socialization for scarcity,” the notion that poorer services are acceptable for poorer people or that we have to choose between prevention OR treatment, emergency response OR development. Whether at community, state, national, or global levels, I think family doctors are well positioned to fight this battle.
Tell us about a project in which you are involved and why it is important to you:
Over the last year, coinciding with a time of instability for Burundi that, for many, has recalled the experience of past violence, we have invested heavily in our mental health program. We now have community support groups, a cadre of trained lay counselors, and a partnership to provide training and remote consultation support for psychiatric diagnosis and treatment. This is in a country of more than 10 million people that currently has a single psychiatrist in practice. As importantly, there are many ways – economic co-operatives, choirs and dance groups, volunteer days – in which community members come together on our campus and this has promoted community healing and resilience.
What are good qualities a family physician should have?
I suppose the same qualities that benefit any human: compassion, curiosity, competence, fortitude, work ethic, wonder – and a commitment to asking and seeking how to do things better.
EB White said: “I arise in the morning torn between a desire to improve (or save) the world and a desire to enjoy (or savor) the world. This makes it hard to plan the day.”
I think most days, family doctors get to hold both of these perspectives.
Do you remember your personal statement for medical school? If so, would you like to share an excerpt?
Can’t say that I do. I think I quoted Virchow: “Physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.”
What one sentence of advice would you give to medical students interested in family medicine?
We need you! Find mentors as you go and develop strategies for how you’ll keep feeling human, especially through the physically and emotionally challenging parts of training and practice – actually, that doesn’t stop.
How do you spend your free time?
If I have my druthers, on or near the water. I grew up by the ocean in Maine. In California, I would often drive to Bodega Bay or Jenner post-call. At the moment, Lake Tanganyika is my go-to spot.
If you weren’t a doctor what would you be doing with your career?
Marine biology – exploring the last unmapped parts of our planet.
Tell us briefly about your family:
I’m getting married this spring to the wonderful Deo Niyizonkiza. Check out our work together at: www.villagehealthworks.org
Each month, CAFP highlights one outstanding California family physician member who lends their voice, time, talent and resources to strengthen the specialty of family medicine and his or her community. If you would like to share your story or know a family physician colleague who deserves to be recognized for his or her impact or leadership, contact CAFP at 415-345-8667 or firstname.lastname@example.org.