Models and Mentors
In Conversation with Nicole Marsico, Stanford Medical Student Class of 2005
You've been working on domestic violence issues in the Latino population for several years now. How did you get into that work?
My interest in community health began as an undergraduate, where I learned about the lay health advisor model while studying health care systems in developing countries. I was very interested in the idea of training community members in health promotion as a way of reaching under-served populations and fostering community leaders. When I came to Stanford, I became involved in PriSMS and was vocal about my interest in the lay health advisor model. An advisor mentioned that a local organization by the name of Sor Juana Ines (SJI) was interested in pursuing a promotore program. In fact, by the time I contacted SJI, they had already written a grant to start a promotore program and were looking for a volunteer research assistant to help run it. This was all in Fall 2001, when SJI was a small agency located in a tiny house in San Mateo. Since then, the staff of SJI shrunk and then the agency eventually merged with Center for Domestic Violence Prevention in San Mateo, which now is called Communities Overcoming Relationship Abuse, or CORA. CORA offers legal services, support groups, counseling, a shelter, a teen program and services in several languages including Spanish and Tagalog.
What has been the most important aspect of your work with Sor Juana Ines?
I think the most important aspect has been the ability of the agency to stay true to the voice of the community in the development and maintenance of its promotore program.
How did you learn Spanish?
I acquired my Spanish skills here and there through community evening classes and classes on the undergrad campus and at the med school. I also participated in a two-month language program in Peru through the Amauta Language School in Cusco, Urubamba and the Manu National Rainforest. I’ve been able to practice while traveling and working with patients, and through my involvement with SJI.
What was the most interesting finding in the study you conducted for SJI?
For me, the most interesting finding was in the qualitative data, which suggested that survivors made gains in their well-being and in their own healing processes by sharing their stories of abuse and helping others understand the realities of domestic violence. (Note: study abstract and results are available online.)
How does this fit with your plans to become an MD?
I think some of the lessons I have learned through this project, such as the importance of really listening to a community's voice and the need for change to come from within the community (or person), will be important to remember in my future work with patients. I also realized it's impossible to grasp the reality of a patient's life and the health implications of that reality in a single, brief office visit. Community outreach programs help us to improve the well-being of patients in a way that is culturally appropriate and acceptable.
As you think ahead to the kind of MD you want to be, who are you some of
your role models?
Mmmm. I suppose Paul Farmer for his long-term commitment to community-based medicine and his creative use of community resources to improve health. I also admire Lisa Chamberlain’s commitment to fostering advocacy in the physician world.
Paul Farmer, Harvard Department of Social Medicine
Lisa Chamberlain, Stanford Department of Pediatrics
What other organizations have you linked with in doing this work?
El Concilio of San Mateo: a non-profit coalition of organizations committed to improving the quality of life for Latinos in San Mateo County. We have used their offices for meetings, and met with them to help understand the workings of successful lay health advisor programs
The Riley Center: a domestic violence organization in San Francisco where I did my 44 hour DV training
Would you be willing to be contacted by students or others interested in your work?
Of course! Drop me a note at .
