Models and Mentors
In Conversation with Susan Anderson
Susan Anderson, MD, is an adjunct clinical assistant professor in the Division of Infectious Disease and Geographic Medicine. She is a Travel Tropical & Wilderness Medicine consultant who has been involved in a variety of educational, research, and clinical programs around the world.
How did you become interested in Travel Tropical & Wilderness medicine?
My original interest was International Health and getting involved in fieldwork projects to answer particular questions. For example, what is the molecular epidemiology of trachoma in Nepal? How can we develop a test to diagnose trachoma in the field and prevent blindness? How can we develop an outreach program to screen for and prevent cervical cancer among women in the rural Andes in Ecuador and other underserved international sites? What is the best way to teach about malaria risk in Zimbabwe?
Through these field projects, I learned a lot about the culture and health issues of particular areas, knowledge I use everyday in my work on campus and at the Palo Alto Medical Foundation (PAMF). For example, in my clinical practice at Stanford and now at the PAMF, I’ve seen and continue to see a fair number of students and patients of all ages who have returned from travel abroad with illnesses. I find that I’m able to use my international experiences to connect with them at a personal level and then to help figure out what’s wrong with them medically. I also see a fair number of people every day who have emigrated from other areas of the world.
Over the past 20 years, the field of Travel Tropical & Wilderness Medicine has been developing through a number of national and international societies, including the American Society of Tropical Medicine and Hygiene (ASTMH), the International Society of Travel Medicine (ISTM), and the Wilderness Medical Society (WMS). The ASTMH offers a certificate exam for physicians in Clinical Tropical & Travel Medicine, which I took in 1997. The ISTM has also recently started a pre-travel certificate exam for physicians and nurses.
I have always had a love of the wilderness and exploring remote places. Part of this involves understanding the culture, the language, the environment, the natural history, the economic issues and politics, etc. But it is also important to know what to do from a health perspective in remote locations with limited access. There are pre-travel, during travel, and post-travel issues. In order to be a good Travel Tropical & Wilderness Medicine physician, I have to experience all these things for myself, from high altitudes to scuba diving, from food-related illnesses to insect exposures, and living in all types of environments with minimal resources.
I have been combining my interest in International Health/Travel Tropical & Wilderness Medicine with my interest in Women's Health by writing and lecturing on gender-related issues in these areas.
You've traveled to an amazing number of places worldwide with TCS Expeditions, serving as an expedition physician and lecturer. How did you get involved with this organization?
Stanford Alumni does at least one trip with TCS expeditions each year. My background was a good fit for the experiences they needed on these trips, so they recruited me for some of their expeditions with other organizations such as National Geographic, Smithsonian, Museum of Natural History , Harvard Alumni, and so on.
Are there any particular skills that you think are critical for succeeding in International Health work?
Passion. Flexibility.
I thought a lot about what specialty to pursue in order to do International Health work. I actually had the opportunity to do Medicine, Ophthalmology, or OB/GYN at Stanford. I had a hard time choosing because I had too many passions (and continue to have too many!). First I thought Internal Medicine and Infectious Disease, then I got interested in Ophthalmology from my thesis, then I thought OB/GYN for Women’s Health, then I thought Plastic Surgery, etc. I ended up picking the most general option (Internal Medicine), which was the best choice for me, but there is a need for all specialties. Just follow your passion and everything will fall into place!
You were one of the founding board members for Child Family Health International (CFHI), a non-profit organization that assists medical students, nurses, and undergraduates in doing international work. How did this organization get started?
Evaleen Jones, MD is the president and founder. She is a Stanford medical school graduate, and a friend and colleague who now works in Family Practice at Stanford. During medical school, she worked in Ecuador with Dr. Edgar Rodas, a surgeon who had the dream of building a surgical van that could go out to rural areas to provide services. Evaleen saw this as an opportunity to help him and to start an organization that could provide ongoing International Health (IH) experiences for students.
My IH experiences as a medical student in Nepal and as a medical resident in Africa, Asia , and South America were all self-designed projects. I liked the idea of helping Evaleen to develop an organization that would provide IH opportunities to students at all levels of experience. I actually did a Faculty Fulbright Fellowship in Ecuador one summer, during which time I studied Quechua and learned about the culture. I also worked at the Jambi Huasi Clinic, which combines western and traditional medicine. This experience enabled me to be a better board member, and to help CFHI develop their curriculum.
For a number of years I was the Stanford clinical faculty sponsor, along with an Ecuadorian woman physician (who is incredible), for female medical students doing a traveling scholars project in Ecuador on cervical cancer screening. I loved this project because it combined my interests in International Health and Women's Health, and it was fun to mentor students and to provide a service to the women in indigenous areas.
You are also site director for a project called GeoSentinel at the Palo Alto Medical Foundation. What is this project about?
GeoSentinel is a surveillance project for emerging infectious disease. It was initiated in 1995 by the International Society of Travel Medicine (ISTM) and the Centers for Disease Control (CDC) as a network of ISTM member travel/tropical medicine clinics. GeoSentinel is based on the concept that these clinics are ideally situated to effectively detect geographic and temporal trends in morbidity among travelers, immigrants, and refugees.
Right now, we’re building a pilot site, and as the pilot project evolves I may be looking for interested students to help with data collection.
You've spent quite a lot of time teaching, advising, and working on course development here at Stanford, both in the medical school and with other Stanford departments. What do you think makes a good teacher or advisor? Is there anything you've learned in this process that has enabled you to be a better teacher now than when you started out?
Experiences and passion about what one does build upon ones ability to be an outstanding teacher, advisor, and mentor. I believe the opportunity to teach makes me a better physician, and being a physician/clinician makes me a better teacher.
What is it like working in an Urgent Care center? What do you enjoy most about this part of your job?
I get to practice all the specialties in medicine, which is good background for any international work and for the expeditions I do. I have my niche areas in infectious disease and women’s health, but in Urgent Care I get to practice everything from cardiology to sports medicine, dermatology to ophthalmology, etc.
In Urgent Care the work is always interesting and challenging. I work with great people. And the patients are really appreciative, as when they come to us it’s because they can't get in to see their regular physician, don’t want to go to the Stanford ER, are visiting from another country, from another area, etc. Urgent Care is open to the entire Bay Area community, so we see anyone who walks through the door (in fact, 50% of the patients I see are not PAMF patients). It’s the place people go when they get off the plane from Africa with a fever, or they’re a visiting scholar or businessperson from India with diarrhea, or they’re a student just back from doing research in Belize with botfly larva
I also have a flexible schedule. It’s "shift work", so I work really hard when I’m there, including a lot of weekends and holidays, but I can schedule time off to teach a class on campus, to teach at a CME course or national or international meeting, to write a chapter for a textbook, etc. I can also schedule a block of time off to do an expedition or field project.
Who are your role models & influences?
I have had a number of incredible role models at Yale and Stanford, too numerous to mention. Other role models have been women explorers and adventurers such as Alexandra David Neal.
Do you have any advice for students who are interested in international work or travel/tropical medicine?
Go to the conferences sponsored by organizations like the International Health Medical Education Consortium, the American Society of Tropical Medicine & Hygiene, the International Society of Travel Medicine, or the Wilderness Medical Society. We also have a Bay Area International Health Group consisting of those of us at Stanford, UCSF, and UC Berkeley who are interested in International Health and Community Health issues.
Pick a project in an area of interest and just do it! It may or may not work out. If it doesn't work, try again! Talk to other people who have done IH work. Go to national and international meetings. Keep trying to get an organized International Health program going at Stanford to facilitate the process!!!!!! And I am happy to help in any way I can.
-Interview by Lauren Cochran
Posted 5/11/05
