CHARLESTON, W.Va. — On a recent international medical mission to rural Honduras, one patient stood out to several students from the Marshall University School of Medicine.
“A young woman who had come in with an infant, probably less than a year old or so, came in for routine care. It was the first time she had ever seen a doctor,” said John Davitt, 26, a fourth-year medical student at Marshall.
“She had walked something like six hours, started in the middle of the night the night before and walked the whole way just carrying her baby. It kind of blows you away to see that kind of dedication and appreciation for the service, that they’re willing to walk so far and wait so long, whereas people here start getting flustered if they have to wait for more than 20 minutes,” he added.
“I saw my first live seizure,” remembered Aaron Dom, 26, another fourth-year student who worked with Davitt to organize the trip.
The patient, he said, “had run out of his epilepsy medicine, so we were able to refill his medication for long enough that hopefully he gets it under control.”
In all, nearly 1,060 patients were seen in four days earlier this month.
It was the eighth such trip for dozens of students, faculty and health-care workers from the tristate community, an annual mission that sprang from the depths of unspeakable tragedy.
Nearly 13 years after a Marshall medical school graduate was killed in the 9/11 terrorist attacks, his legacy makes it possible for students from his alma mater to treat poor and ailing patients in rural Honduras each summer.
Paul Ambrose “was the guy that embodied all the good aspects of what health care in America should be: preventing, caring, looking at people within the context of their lives,” said MU faculty physician Dr. Chuck Clements.
“He was destined for great things when his plane flew into the Pentagon,” Clements added.
An endowed fund in his honor, supported by his parents and the university, significantly underwrites the annual international mission trip.
“This is the reason I went into medicine in the first place — to help people, to make any kind of difference we can,” Dom said.
The conditions in the most remote regions of Honduras, where most people have very limited access to health care, could generously be described as basic, he said.
“We set up in an empty school, and had to use whatever resources we had, so our dental chair was a lawn chair. And even for lighting we had to use our iPhone flashlights to see into patients’ mouths or get a better view of a rash,” he added.
“You’re out in the middle of nowhere, so it’s very rural,” Davitt said. “The infrastructure isn’t there. It’s bumpy roads to get out to the site, very little running water, if any, and what you find when you interact with patients, you get to see some different pathologies that you don’t see in the United States because a lot of things are eliminated before they become an issue.
“We have clean water, so people don’t generally have parasites; we don’t have dirt floors, so people aren’t getting a lot of infections from bug bites.”
Patients with diabetes or high blood pressure are often told to diet and exercise, but in Honduras, most of them already do a lot of walking and other physical exercise, and they have a low-fat diet to begin with, Clements said.
“So we don’t have the option of prescribing a lifestyle change — we have to go ahead and treat them.”
The trip is organized through Global Medical Brigades, an international student-led global health and sustainable development organization. For patients who need further treatment, they provide free round-trip transportation to the nearest medical center, as well as medications to treat chronic illnesses and follow-up.
For most students, who spend their first few years of medical school buried under massive piles of homework and sitting through endless lectures, the trip represents a rare chance to interact with patients.
“This is the first opportunity for the fourth-year medical students to interview someone, make a diagnosis, come up with a treatment. It puts them in the hot seat, so to speak,” Clements said, “and they really blossom. By the end of day four, they have a really good handle on the kinds of things they are doing.”
It is the kind of thing Paul Ambrose was all about.
“He was really passionate about improving the health of individuals and groups. He was interested in alleviating disparity,” said his mother, Sharon Ambrose, a retired nurse who has gone on three of the mission trips, including the one this year.
By Sept. 11, 2001, Paul Ambrose had graduated from medical school at Marshall and had gone on to study at Dartmouth and Harvard.
He’d been engaged for all of two weeks. He’d also secured a prestigious fellowship in the Office of the Surgeon General, and was en route to a California conference on childhood obesity when terrorists took over American Airlines Flight 77 and eventually flew it into the Pentagon, killing everyone on board — 64 people — and 125 more on the ground.
“The question each student in medical school has to answer is not what do you want to do when you grow up, but who do you want to be? And going on trips like this is one of the ways you can discover that,” Clements said.
“The students go down there thinking they’re going to give so much, and afterwards they end up deciding they probably got more from the experience than the patients.”
It is, he said, a logical extension of what Paul would have wanted the students to learn.
“Paul is gone, but his legacy continues at Marshall by shaping future doctors.”