Christiana Shoushtari’s first job after completing her MPH put her in the thick of the debate over health care reform, as a health legislative correspondent for U.S. Senate Majority Leader Harry Reid (D-Nev.). In October, Shoushtari, MPH ’08, talked to Findings about life on Capitol Hill, the struggle for reform, and why she loves being an SPH alumna. (Note: At the end of October, Shoushtari left the Senate to begin work in the Office of the Administrator at the U.S. Department of Health and Human Services.)
Findings: What does a health legislative correspondent do?
Shoushtari: I meet with constituents and also respond to their concerns and questions over the phone and in writing. My key issues are areas like health care, Medicare, abortion, public health—even food safety. My work directly builds on what I learned at Michigan—understanding different stakeholders and their perspectives and what’s important to them.
Findings: What are you hearing on the health care reform front?
Shoushtari: In general, what you’re hearing—everything from extreme support to extreme opposition. Both over the summer and during the fall, people have been concerned about how reform is going to impact them, their families and their businesses. Being in the majority leader’s office, I get a lot of questions about which specific provisions—like the public option—will stay in the final merged bill that will be considered by the full Senate.
Findings: Has anything surprised you?
Shoushtari: I’m surprised by how many people are engaged. Everyone’s going to be affected by health-insurance reform, so the debate seems to have engaged even those who’ve never participated in politics before. I’ve also been surprised by some people’s overall lack of understanding of the legislative process. Still, this moment seems to have increased civic engagement and shown how much legislation can impact individuals and their communities.
Findings: Is public health getting the attention it deserves?
Shoushtari: People are realizing that an investment in prevention is key to curtailing the escalating cost of health care, so there’s an appreciation of prevention and wellness programs. I even overheard one senator say, “We have a ‘sick’ system, not a ‘health’ system.” But the message that public health investments are important still doesn’t get the attention it deserves from either the media or the public.
Findings: What’s the best part about living in Washington?
Shoushtari: I’m surrounded by talented and ambitious people and at the epicenter of federal health policy, so I’m learning some-thing new every single day. I’ve also been able to reach out to the SPH alumni network. There are a lot of them here, and they’ve all been so helpful in getting me oriented to D.C. I love U of M. People tell me it’s challenging to get students to go to Ann Arbor, but I’m definitely feeling the benefit of having moved to Ann Arbor for three years. <
Photo by Chris Lewis.
Patient Care at 30, 000 Feet
Air Force Colonel Richard Bachmann Jr. has realized many dreams in his life, among them two from boyhood: becoming a doctor and flying airplanes. By doing both—as a flight surgeon, former dean and commander of the United States Air Force School of Aerospace Medicine, and current vice director of the Air Force Research Laboratory’s Human Performance Wing—he has been a leader in changing the way the U.S. military takes care of sick and injured soldiers. Today the odds of an American soldier in Afghanistan or Iraq surviving a disease or battle wound are higher than at any previous time in history. Ordinary Americans have also benefited. Bachmann, a 3-time UM alumnus (BS ’82, MD ’85, MPH ’95), explains:
"In the Air Force Medical Service, we have developed a system where we can provide high-tech medical care while moving critically ill or injured people rapidly and over very long distances. We can stabilize someone wounded in Iraq or Afghanistan, perform initial surgery in a field hospital, and have them back in a state-of-the-art hospital in the U.S. within 36 hours. This is a huge change. As recently as 1990, patients had to be very stable before we could move them by air.
"Until after the First Gulf War, the concept of operations for all branches of the U.S. military was that we had large, tent-based hospitals with thousands of beds, which we moved laboriously by air or ship or land to wherever we thought they might be needed. Because our ability to provide care while flying was limited, we had to keep wounded or sick persons hospitalized in the theater of action until they were stable enough to be moved with minimal care en route. Today we can take a C-17 wide-bodied cargo aircraft that just delivered a load of cargo, and in a matter of an hour we can turn it into a flying hospital with multiple Intensive Care Unit beds. Using highly trained critical-care air transport teams and portable equipment, we can move patients who would challenge the University of Michigan Medical Center’s ICU. The patients do remarkably well, even though the stresses of air evacuation on the body—turbulence, cold, vibration, and hypoxia—are significant. This means we don’t have to put 500 ICU beds and 10,000 ward beds near the front lines. And we achieve better patient outcomes.
"In addition, our preventive medicine specialists have made huge strides in providing troops with immunizations and other disease counter-measures and in employing sanitation, water quality, pest control, and other public health measures. During the conflicts in Iraq and Afghanistan we have supported thousands of soldiers in very austere conditions while achieving the lowest rates of non-battle disease and injury ever recorded.
"We use the same skills in peacetime in response to natural disasters. I was honored to lead the Air Force medical response to Hurricane Katrina. Over the course of four days we evacuated more than 2,400 sick patients out of New Orleans while working with civil authorities to re-establish clinical and public health services throughout the Gulf Coast region. Today I’m helping to lead a 2,000-person organization that teaches medical professionals how to do these missions, and that researches ways to do them more effectively. My UM education certainly prepared me well." <
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