By Nancy Young
Hearing the news that she was the recipient of the 2019 Pearl Birnbaum Hurwitz Award for Humanism in Healthcare thrilled Dr. Nancy Oriol.
To the renowned anesthesiologist, innovator in mobile medicine, and educator at Harvard Medical School, this award from the Gold Foundation isn’t another honor for her – but a sign of success for a community.
“I was just so surprised and delighted because it is really an award for The Family Van,” said Dr. Oriol. “It is not about me.”
The Family Van is a mobile medical clinic that serves the neighborhoods of Boston and became a model that has spread across the country over the past 25 years. No insurance or payment is needed. Anyone can step into the van just to ask a health question or to receive services from the clinic, such as blood pressure screenings or counseling.
Dr. Oriol officially co-founded The Family Van, but she would say that she was just one of hundreds of co-founders.
“It was crowd-sourcing before crowd-sourcing existed,” Dr. Oriol said. “In 1992, we didn’t have that term.”
The Pearl Birnbaum Hurwitz Humanism in Healthcare Award was established in 2014 and is given every year by the Gold Foundation to recognize women who exemplify humanism in healthcare, particularly as it relates to caring for the underserved. It is given in honor of Pearl Birnbaum Hurwitz who – inspired by her son and her experiences caring for him – became a lifelong advocate for people with disabilities.
Dr. Oriol was nominated for the 2019 Pearl Birnbaum Hurwitz Award by two deans: Dr. Caroline Haynes, Associate Dean for Medical Education at Duke University School of Medicine, and Dr. Lisa A. Mellman, Senior Associate Dean for Student Affairs at Columbia University Vagelos College of Physicians.
In their nomination, they wrote: “Dr. Nancy Oriol started a nationwide movement 27 years ago that has contributed tremendously to access to health care for underserved populations in many major US cities.”
Dr. Oriol’s extraordinary work with The Family Van comes on top of her role as an innovator, superb clinician, and Harvard Medical School leader and educator.
The two deans pointed to Dr. Oriol’s “commitment to service learning in medical education, her work in bringing accessible medical care to her local community, and her teaching and advocacy for that model locally and beyond, that inspired” them to nominate her.
As an anesthesiologist, Dr. Oriol invented the “walking epidural” as well as a resuscitation device for newborns – exemplifying the Gold Foundation’s credo that humanism in medicine also means achieving the highest levels of technical excellence.
As a renowned educator, she has been a leader at Harvard Medical School in a variety of positions, including Dean of Students and currently Faculty Associate Dean for Community Engagement in Medical Education. The development of professionalism and humanism of medical students has been a deep concern to Dr. Oriol. The Family Van serves as an important role for medical students in expanding their understanding and exposure to patients in underserved neighborhoods.
Dr. Oriol also co-created HMS MED Science, an innovative STEM program to teach high school students science and critical thinking skills. The high school program not only provides training for future healthcare professionals, it yields real-life results today in the lives of the young people who take it, their families, and communities.
In a 2014 TEDx talk, Dr. Oriol talked about how the high school program changed the way the young students thought about their education and themselves. She cited the example of a student who one day noticed what appeared to her to be the symptoms of stroke in her grandmother. She quickly called an ambulance.
The student turned out to be right about the stroke and her quick action meant her grandmother got early care – something critical for stroke recovery.
Afterwards, the young woman said that if it weren’t for the class, she not only wouldn’t have known the signs of stroke, but even if she did, she wouldn’t have had the confidence to take quick action. She would have doubted herself too much, afraid of doing the wrong thing.
This lack of confidence surrounding seeking healthcare, this “feeling stupid” or not entitled to care, comes up a lot when Dr. Oriol talks about the barriers to healthcare.
This lack of confidence and fear almost led to a tragedy for a mother and her baby more than 25 years ago.
When Dr. Oriol first met the patient, on the way to an emergency caesarian section, all she knew about her were her vital signs. The expectant mother had been brought in by ambulance after being found unconscious on the floor of her home. The baby’s life was also in danger and so needed to be delivered immediately.
The mother and baby survived the emergency surgery and were transferred to ICU care. A few days later, after the patient had regained consciousness, Dr. Oriol went back and asked her what happened.
The patient said that she had been having headaches for a while – which can be a danger sign when you’re pregnant – but didn’t want to bother the doctor in case the headaches turned out to be nothing.
“She didn’t want to feel stupid,” Dr. Oriol said.
Add to this that the patient, while she had health insurance and received prenatal care, “had no extra time” to seek healthcare because she was a member of the working poor. She felt she needed to just power through the headaches and keep working.
This is a dynamic Dr. Oriol said she knew well, growing up in a working poor family in North Philadelphia. Her father, who worked two jobs to support them, died young.
In her work as an anesthesiologist, Dr. Oriol sees patients from all walks of life, the common denominator being they need surgery. Some patients, like this working mother, end up in need of dire care when an earlier, less intrusive and intensive intervention, could have prevented the life-threatening emergency.
Often the patients who fall into this category are poor and the answers to the “disease of poverty” were not going to be found in a hospital, Dr. Oriol said she realized.
So, in 1992, Dr. Oriol went into the community seeking answers. She teamed up with a like-minded medical student.
“We talked to everyone,” Dr. Oriol said. Midwives, barbers, and other community leaders. “They were our consultants.”
“Two years and hundreds of people later,” she said, The Family Van was born.
Dr. Oriol said that in the two years of talking and learning from people in the community a dynamic developed around the creation of The Family Van.
“There were no leaders,” Dr. Oriol said. “It was a family.”
And that original family of hundreds has grown by the tens of thousands as The Family Van’s patients continue to teach and serve the community, as well.
It all starts with feeling empowered enough to ask a question, whether it’s about your own or a loved one’s health, or about how to navigate a healthcare system that often makes you feel stupid, or about how to cure the systemic disease of poverty.
So when a new patient comes to visit The Family Van and asks that first question, whatever it is, they are congratulated, said Andrew in an audio testimonial posted on The Family Van website.
“That little bit of confidence builds in you,” Andrew said. “It makes you feel as though you did something right and you’re on the right track. You do it again, they say ‘congratulations’ again and shake your hand again. Your confidence is building again. It’s like nothing can stop me now. The Van has to try to build confidence in the community, to let the community know ‘we are here for you,’ but more so, are here for you.’”
While the community co-founders of The Family Van may not all be able to fit in the room on Nov. 20 in Boston, to celebrate at the 2019 Pearl Birnbaum Hurwitz Award Reception, Dr. Oriol will gladly accept the honor on their behalf.
“The people we serve invented The Family Van,” she said. “It’s an award for them.”