Episode 16 of AuntMinnie's Keeping Up with the Radiologists podcast takes you into the life of the Everest region Sherpa community's first doctor, Mingmar Sherpa, MD. From the village of Solokumbu in Nepal, a young Sherpa weighed the strong push and pull of the local climbing culture against the choice of practicing medicine to buck the trend.
Sherpa became a doctor in the small district hospital serving the village Phaplu at the foothills of Everest. While the hospital was small at 15 beds, Sherpa was responsible for a population of about 100,000 people.
As such, he was responsible for everything, Sherpa explained in a conversation with host Saurabh (Harry) Jha, MD, and guest co-host Gyan Moorthy, MD, a rising interventional radiologist just out of the Perelman School of Medicine at the University of Pennsylvania, who is headed into residency at Mallinckrodt Institute of Radiology.
"I knew that I would be sent to some village, and I would have to do everything myself on my own," Sherpa explained. "Because of that, I focused my attention on the practical education during medical school. That was quite helpful ... I was alone in the village."
Health services in Nepal have been inadequate, and Sherpa tells of life at that time, for example, treating people blinded by cataracts who were carried for miles. Back in the 80s, people would walk for seven or eight days, some trekking as long as two weeks to receive medical care. People sacrificed their livelihoods in numbers, according to Sherpa.
"I was quite happy being able to help my own people in the village," he said, adding that once doctors became doctors, they tended to leave Nepal for the U.S., the U.K., or Australia. Today, keeping doctors at home in Nepal is easier, and a road to medical care in Kathmandu has shortened the trip for many to about eight or 10 hours, he noted.
Throughout his career, Sherpa has often practiced at the edge of and beyond his comfort zone, he recalled. A promotion eventually drew him to Kathmandu, where he would begin working less in medicine and more on administrative matters. "I started telemedicine," he said.
Sherpa would go on to become actively involved in reducing maternal mortality. Ultrasound played a key role in birthing centers away from the district hospital. For Moorthy and Jha, Sherpa explained the path to protocols with the help of the University of Washington and, furthermore, the decision to teach a network of nurses obstetric ultrasound with the help of Sonosite.
Moorthy added insights from his own experience in Botswana in South Africa.
"Health posts" have been integral to identifying pregnancy complications and reducing maternal mortality, according to Sherpa. Establishing birthing centers wasn't easy and difficulties exist today ... in preventing infanticide by not teaching sex determination and culture and structure-specific compromises.
However, "this is the most direct example of imaging saving lives," Sherpa continued. For radiologists in the U.S. who may feel somewhat removed from patient care, or interested in global radiology, this episode is a must-listen.
More impressions:
{01:42:00} Early years
{06:11:00} Access to healthcare
{08:25:00} Areas of study and telemedicine
{11:51:00} Challenges of practicing medicine
{15:49:00} Difficult patient journeys
{18:54:00} Maternal mortality program
{22:51:00} Birthing centers
{25:23:00} Ultrasound training
{29:53:00} Nurses' roles
{39:04:00} Opposition to maternity program
{45:47:00} Outcomes of program
{48:53:00} Next steps
{52:19:00} Advice for those considering global radiology
Featured
Mingmar Sherpa, MD, Everest region Sherpa community's first doctor.
Guest host
Gyan Moorthy, MD, is a future interventional radiology resident at Mallinckrodt Institute of Radiology. His interests include bioethics, global radiology, and cross-cultural communications. He graduated from the Perelman School of Medicine.
Host
Saurabh (Harry) Jha, MD, is an associate professor of radiology at the Hospital of the University of Pennsylvania. Jha obtained a master’s degree in health policy research from the Leonard Davis Institute at the University of Pennsylvania. He earned his medical degree from the United Medical and Dental Schools of Guy’s, King’s, and St. Thomas’ Hospitals. Jha developed Value of Imaging, a set of radiology educational resources.
This episode of Keeping Up with the Radiologists is brought to you by AuntMinnie.com in collaboration with Penn Radiology. The series is also available on Spotify, YouTube Music, and Apple Podcasts. Check back for new episodes!
