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Medical students visit Durham to learn how history and culture affect health

Monday, October 15, 2018
By Will Alexander
Downtown Durham

The intersections of tradition and change that define Durham in 2018 are easy to see in a trip downtown. After being vacant for nearly 20 years, the old brick Chesterfield cigarette building reopened this year thanks to a $128 million renovation. The family-owned Gurley’s pharmacy, with its old-fashioned entrance and red awning, sits in the shadow of glass-and-steel high-rise condominiums that are selling for more than $500,000 each.

Empty railroads, which once carried out the tobacco that built and sustained Durham for generations, run adjacent to the Durham Performing Arts Center, where the hit play Hamilton is coming this fall. For the people who have been living in the Bull City for years, each piece of new development and lingering tradition has an effect on their health.

This semester, the Duke School of Medicine’s class of 2022 spent an afternoon in downtown Durham to learn about how this blend of history, setbacks, and growth affects the health of people living in Durham.

The visit was part of the School’s Cultural Determinants of Health and Health Disparities course, taught by Kenyon Railey, MD, assistant professor of community and family medicine and of neurology, and Victoria Parente, MD, assistant professor of pediatrics. The semester-long course teaches students the profound and complex ways that non-medical factors, such as socio economics, geography, race, and culture influence health and well-being. This visit focused on the Bull City itself.

“As a medical provider, we are often tasked with integrating ourselves within intimate moments of people’s lives,” Railey said. “I think we have a responsibility to learn the stories of the communities we practice in, which provides context for our care. I wanted medical students to hear that message early and hopefully it will influence how they practice.”

Even the trip’s form of transportation illustrated Durham’s dual role as a new city in the old South. The class left in a pair of biofuel-powered buses from Greenway Transit, the Southeast’s first 100% green transport company, which was founded by a Duke alumnus.

From the School of Medicine, the class traveled to Duke Regional Hospital, where a panel of providers and administrators discussed the complicated, interdependent relationships that have grown between Durham and Duke.

A panel at Durham Regional Hospital discusses Durham and Duke's intertwined histories.

Next, the class visited the Hayti Heritage Center, a historic preservation site housed in one of Durham’s oldest AME church buildings. The Center’s Reverend Casimir K. Brown and Eddie Davis hosted a Q&A session where they discussed the patterns of growth, setback, and rebirth that the Durham’s African American community has experienced, and continues to experience, since settling here after the Civil War: the Hayti neighborhood which grew and expanded in the early 20th century before being gutted by the Durham freeway; NC Central, the country’s first state-supported liberal arts college for African American students; and the people who live here today.

The last leg of the visit took the class on a walk throughout the center of Durham, where the city’s past, present, and future often appear on the same block. Trendy new restaurants bring money and jobs into Durham but have also accelerated gentrification. They sit near the site of the 1957 Royal Ice Cream sit-in, one of the first organized nonviolent protests against segregation. Even as chain pharmacies have taken over the country, Gurley’s and a few other family-owned pharmacies still play a vital role in compounding and delivering medications to families living nearby.

Attendee Monica Alvarez said the trip, and the Cultural Determinants of Health Class, helped put a human face on the patients she hopes to treat since coming to Durham six years ago. “This event in combination with the rest of the course are a constant reminder that as doctors we are called to help and treat people,” Alvarez said. “These people come from very diverse backgrounds and all have unique stories to tell, and we should not lose sight of that important detail.”

Shauntell Luke, who has been living in Durham for the past two years, said the visit “opened my eyes to the fact that history plays a bigger role in healthcare than I thought. As I practice medicine it will be important for me to learn about the history of the community. I know now how much it can impact my patients and their healthcare and it is my duty to address all aspects of my patients’ care.”

Walking through downtown Durham, Duke medical students passed trendy new restaurants, empty railroad
tracks, family-owned businesses, and new luxury condominiums.

For Evan Murray, who grew up in Durham before entering the Duke School of Medicine this fall, the trip was a reminder of the rapid change Durham is experiencing. “Every time I go downtown, I’m surprised by all the change that has occurred over the past several years,” he said. “There seem to be new buildings on every street corner, and the landscape has changed dramatically since my childhood here.”