Five Questions for Joseph
1. Who or what inspired you to enter the field of public health?
As an ER doc in New Orleans I care regularly for individuals experiencing homelessness, suffering with addiction, victimized by violence, and burdened by social needs and unhealthy environments that prevent them from living healthy lives. My interest in public health began by realizing the limits of our reach in the acute-care setting, and the need for upstream interventions. Instead of merely tending to wounds, we realized a desire to work across sectors to fix the cracks. In the ensuing years, our team has built programs addressing chronic homelessness, addiction, domestic violence, and homicide–all which span multiple sectors and capitalize on an interdisciplinary team capable of providing supportive service across a wide continuum of settings.
2. What is one of the most interesting projects you’ve worked on?
We’ve had the opportunity in New Orleans to learn from the experience of Hurricane Katrina and build public health systems to protect vulnerable populations in times of emergency. We now have a system that identifies vulnerable individuals with special medical needs ahead of time, and directs resources to ensure their protection should we encounter an evacuation, protracted power outage, or other emergency. It is wonderful to be able to learn from disasters of the past and use those lessons to help develop programs to protect the community, particularly vulnerable individuals, in the future.
3. What are the greatest challenges you face in your work?
Much has been said of public health’s “invisibility crisis” and I think it is well-founded. When we do our jobs well, few people notice. We work in the background, behind the scenes, and rarely take curtain calls. Few people understand how the hard work of public health practitioners affects their own lives. We should change this, both to be in a better position when advocating for resources and as a way to continue attracting qualified, motivated, altruistic young professionals into the discipline.
4. What’s a story or experience that keeps you going, even when you’re feeling challenged?
I think about my patients and what they’ve overcome. I am fortunate to have the ability to continue to practice emergency medicine in our community’s safety net hospital. This affords me the opportunity to engage in a substantive way with many of the issues we focus public health resources and attention on, like substance use and addiction, interpersonal violence, food and housing insecurity, and sexually transmitted infections. More notably, though, the clinical work often provides me an opportunity to connect personally with patients whose lives are touched by public health initiatives or programs operated by our health department.
I think of a single mother skillfully occupying the attention of three young children while the fourth, the oldest, has his broken ankle tended to. I remember a young man who, despite being deep in the throes of opioid addiction himself, saved another man’s life by administering naloxone on the street and then accompanying him to the hospital. And of a Honduran father working through four days of excruciating abdominal pain (it turned out to be appendicitis) because he wanted to continue supporting his family. I think of what patients like these have overcome, and how whatever hurdle may be facing in the moment is comparably minuscule, and easily surmountable.
5. What did you want to be when you grew up?
A teacher! But there is still time, and I hope to return to this goal later in life.