(May 2017) Sarah
Axelrath’s one-year break between a bachelor’s degree and medical school turned
into two when she chanced into a job working with intravenous drug users.
preparing to apply to medical school, she became a case manager with [SA1] Community HealthCorps in Lakewood.
For a year, she helped homeless clientele access health care, Social Security
benefits, mental health services, food banks and crisis care.
also volunteered once a week at the Harm Reduction Action Center [SA2] in Denver, working with homeless
injection drug users, many with untreated medical issues and a distrust of the
health care system.
“I fell in
love with that, too, so I badgered a manager for a full-time job there and
deferred my acceptance at CU for a year.”
daughter and sister of psychologists, had long been interested in social
justice work, one of the reasons she attended Oberlin College in Ohio for her
undergraduate degree. In a town famous as a stop on the Underground Railroad,
the college offered Axelrath the freedom to fashion a gender studies major.
“I had the
foresight to know that this might be the last opportunity I would have to study
social studies and humanities – to try to be a more well-rounded person,” she
said. “I have not regretted it for a second. It opened my eyes to the way the
world has always been, for better or worse.”
starting medical school in 2013, Axelrath, a member of the CU-Unite urban care
track, continued to volunteer at the Harm Reduction Action Center, often
persuading classmates to join her.
In 2014, she
was invited to attend a week at the Betty Ford Center in California to study
the pathophysiology of addiction and evidence-based treatments. In her fourth year, she took part in an away
rotation at Montefiore Medical Center, working at a methadone clinic in the
South Bronx, and at Rikers Island jail to establish a Suboxone clinic for
prisoners suffering from opioid withdrawal.
as scary as I thought it might be, but it was a little scary,” says Axelrath, who
also describes the experience as “super interesting, intense and eye-opening.”
convinced that she wanted to continue working with the homeless, prisoners and patients
with substance use disorder.
think of it as a continuum of care. The homeless are in violation of the law
just by being publicly homeless. Add to that substance abuse and they are
always at risk of going to jail. That’s where they get their medical care and
mental health care … You can follow a person through the revolving door, the
street, the hospital, jail, back and forth and back and forth. It’s the same
people but different settings.”
28, witnessed firsthand the changes the Affordable Care Act made between 2011
and 2012 when she was working as a case manager. The first year, many homeless adults
with substance use disorder could not qualify for health care. But, in 2012, her
job changed dramatically because suddenly more people became eligible for
Medicaid. She realizes that many of these patients will not be able to pay for
her services when she becomes a physician if they lose access to affordable
healthcare coveragein the coming years
hang up a shingle and expect homeless folks to come see me. I’m nervous. I’ll
need help from the political side of things to make my career even possible.
Otherwise my skills are worthless. I’ve gone to medical school for nothing.”
pleased that her passion for the underserved was well received during her residency
that the only reason I got positive feedback on the interview trail was because
of my interest in the homeless and substance use disorders. That’s what set me apart from other
applicants. With opioid abuse and overdose sweeping the nation and impacting
record numbers of people and families from all socio-economic categories, my
interest is very timely. There was a lot of enthusiasm on the trail.”
her mentors at CU and elsewhere for helping her refine and retain her interest
in underserved communities. She advises incoming medical students to seek
to figure out what it is about medicine that is going to make you happy for the
next 60 years and find good mentors to take you under their wing and teach you
everything they can. Grab it and don’t let go. Don’t let anyone talk you out of
it. People love their own specialties, and they like to try to recruit you into
that specialty. They mean well, but once you set your sight on something,
double down on it. Hold on tight. It will get you through tough challenges.”
will serve her primary care residency at Massachusetts General, her first
choice because on her interview day she met residents who were working in jails
and needle exchange programs.
out all the stops and let me know that there’s room in residency to do work
that is important to me. They introduced me to people who were actually doing
it so I could imagine what it would look like.”