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SOCIAL DETERMINANTS SAN ANTONIO
OF HEALTH MEDICINE

COVID-19 & Education journey, on which we have embarked together, it was not one big thing rather the collection
I believe that it is quite common on this
of little ones. The little moments and the little
The GAP Year By Leah H. Jacobson, MD, FAAP to experience similar feelings and make like- interactions. The little girl who as a refugee
minded connections. How we interpret these
ended up in my care, who looked up at me and
may differ for us individually and how we saw a scarf that she could relate to, who told
On draw meaning from each encounter to relay it me she wanted to be me when she grew up. The
No one could have imagined what would happen to our education get this pandemic under control, to our path again may be more personalized little breaths of air, taken by a dying man sur-
system at the start of the pandemic in March 2020. What initially was and start fresh next year. It does and sacred for each. I am unsure of the senti- rounded by his family; one who knew life as a
thought to be a “blip” in the education of our children and young peo- not mean we should not continue Becoming ments of the majority when it comes to deep daredevil, who was used to breathing fire, now
ple has turned in to an arduous ongoing journey with no end in our to educate and provide for our reflection on past events but I personally find engulfed by it in a fever because the cancer cells
foreseeable future. Students, educators, administrators, staff and par- children and young people during a Physician myself skipping this necessary step at the end had nested too long. The little steps taken by
ents have all been affected. this time, but we should take the of my days. I don’t know that I fully allow my- the aunt down what seemed to be a never-end-
As a general pediatrician and a parent in our community, I quickly pressure off of them, the parents, self to ponder the nature of what it is that I am ing hospital corridor, who went from holding
learned about the good and the not-so-good aspects of virtual/dis- the educators, and the school sys- By Abeer Chohan doing. I think that it is easier to go through up her family to being propped up by a friendly
tance learning. I chose to get involved at both the local and State level tems during this very difficult pe- the motions of care than the emotions of care. OT in recovery from her stroke. The little tri-
to help educate myself, as well as other health care providers and the riod in our lives, and not expect Of course, every patient has a story to tell, be- umphs and the little sorrows encompassing the
community about the ever changing aspects of the Sars-CoV2/ perfect attendance, great test yond the story of their chief complaint and vast experience of what it means to become.
COVID-19 virus. More importantly, I wanted to know how it was scores, or large academic achieve- their past medical history, beyond anything I think it dawned on me a little too late per-
affecting us. ments. Basic needs and health are that physical scars and aches and sores can haps that being a doctor is not treating a dis-
With regards to the current education situation, there are no win- the important keys at this time. comprehend. It is not until you reach into the ease, it is healing a person. A person with a
ners. Everyone is struggling in their own way. That could be the student crevices and tap into the rich mines of the story and a life and a soul and memories to
who chooses to stay home to keep her elderly grandparents safe, but suf- Leah H. Jacobson, MD FAAP is a general pediatrician in wounds that you will truly understand an- share. I do recall when I first was let out onto
fers due to social isolation, or it could be the kindergartner who is losing private practice. She is Chair of the BCMS COVID-19 Task other's suffering, truly empathize with an- the wards, an eager kid excited to see all the
out on basic education because his family does not have the economic Force Subcommittee on Pediatrics and Schools, a member of the other’s pain. pictures I've spent so long staring at; jealous
means to afford high speed internet. Then there are the educators who Metro Health PreK-12 Consultation Group, a member of the TMA In “becoming” what it is we set to be, I think when a classmate recollected a stirring tale of
are putting themselves and their families’ health at risk to teach our chil- School Reopening Work group, a member of the TMA Committee on many of us will have noticed how “unbecom- what rare diseases and conditions they bore
dren. We are literally having to weigh health versus education. Child and Adolescent Health, and was the 2017 BCMS President ing” of our former selves we are. It is a dynamic witness to; always forgetting that there is a life
Recent statistics point to community positivity rates being high change to be molded into one who is ready to who now embodies that disorder, whose life
again, and the patience of students, teachers and parents are wearing References and Information serve. Each tribulation fragments you and has been molded and twisted and plunged,
thin. The Texas Education Agency (TEA) is applying pressure to 1 . CDC guidance as of September 2020. sometimes even delivers a blow so strong it will maybe by that same warrior tsunami that came
schools to bring more students back for in-person education, which 2 . State level data: https://dshs.texas.gov/coronavirus/schools/ wring and shake the very core of your being, for us, into becoming a patient.
adds more stress to the situation. texas-education-agency/ causing the soft and malleable parts of you to We are becoming together and in that be-
Fortunately, we know more about SARS-CoV-2. Global, national 3 . TEA/State level data: https://tea.texas.gov/sites/default/files/ shift and reform you once again. Not so much coming we find connection, meaning, unity
and local data provide some reassurance about in-school transmission covid/SY-20-21-Public-Health-Guidance.pdf like a diligent sculptor who continuously chips and from that we heal, prosper, and become
(see additional information below for links). 4 . Local data: https://covid19.sanantonio.gov/What-YOU-Can- away at the right corners and constructs the whole.
Bexar County has particular disparities associated with the issues Do/Reopening-Safely/Information-for-Residents#RemoteLearn- perfect image, but rather like a warrior tsunami
brought about by the COVID-19 virus. A higher rate of infection ing. Almost all cases represent out-of-school transmission (i.e. that knows only destruction in its path, its Abeer Chohan is a 4th year medical
has been found in certain areas/zip codes of the county. And it has household, social circles). (But there are several studies that show winds and water forcing the pliable sand to student at UIWSOM, pursuing a res-
been repeatedly stated that certain school districts’ students/families that children do transmit to household members—and certainly shift and violently reassemble itself from idency in pediatrics. She is a proud
lack the means to provide essential technical infrastructure, such as adult staff do.) amongst the remnants. member of the inaugural class at UIWSOM and
high-speed internet, or provide basic necessities, such as food. There 5 . Additional local data (epidemiological reports): I think many see the journey as a factory as- a member of the Bexar County Medical Society.
are reports of increased domestic abuse related to loss of job/income, https://covid19.sanantonio.gov/About-COVID-19/Dash- sembly line, and maybe that is what it seems
added stress, etc., as well as mental health conditions (for all boards-Data/Epidemiological-Reports. Cases in children on p. 6 from the outside. A naive bright eyed pre-med
ages). Many students with special needs are suffering without school- of November report, and hospitalizations on p.11. goes in and a hardened and wise physician
provided services and therapies. These students are the ones that need comes out. But what it takes to get from point
to be present in school, but contrarily also need to be at home (as to In a Previous Health Directive, Junda Woo of the San Antonio A to point B only few truly know. It is hard for
not be potentially exposed to the virus). Metro Health defines Red/Yellow /Green (https://covid19.sananto- me to imagine one single instance, one event
So, what is the answer? I do not think there is just one, but my per- nio.gov/files/assets/public/files/about/health-directives/healthdirec- that I can look back on and say “yes, that is
sonal thought is that this is a “Gap Year!” Everyone take the year off, tive-schools-amended-20200903.pdf ). when I knew I had become a doctor.” I think

30 SAN ANTONIO MEDICINE • January 2021 Visit us at www.bcms.org 31