Tell us a little bit about your background.
I was born in Boston, Massachusetts and grew up in Concord, New Hampshire. I spent 10 years at the University of Vermont, where I went to undergraduate and medical school. In 2006, I moved to Rhode Island for an internal medicine residency and an infectious diseases fellowship. I fell in love with Rhode Island and have been here ever since! I am currently an Associate Professor in the Department of Medicine and School of Public Health at Brown University and infectious diseases physician. I am Chief Medical Officer at Open Door Health, the state’s only community-based LGBTQ+ clinic. In addition, I am a Consultant Medical Director for the Rhode Island Department of Health and helped lead statewide efforts to address COVID-19 during the pandemic with a group of amazing and dedicated individuals in public health!
Why did you decide to go into medicine?
I find it incredibly fulfilling to make such a profound difference in the lives of my patients and the people I take care of. To me, being a physician requires a lot of compassion and kindness. I believe that the doctor-patient relationship is really special and love being able to make a difference. What has also really been fulfilling about working in public health is that I am a “doctor to the public” and hopefully making a difference for the better!
What was the best advice anyone ever gave you, and who gave it?
One of the best pieces of advice I have heard and one that I mention often to students is to “kill people with kindness.” This piece of advice was given to me by one of my mentors at Brown University (Dr. Timothy Flanigan). I have taken this to heart, and I think it’s been important especially during the COVID-19 pandemic when everyone has been on edge and people can become easily frustrated and upset. I think we can never show enough kindness!
You’ve been involved in the COVID-19 pandemic since the beginning. What are the major lessons learned?
There have been so many lessons learned during the pandemic. From a public health perspective, we’ve learned so much about COVID-19 and how the infection spreads. The mRNA vaccines were game changing, as well as the medications used to treat COVID-19. Hopefully, some of these scientific advances will translate to other areas as well! On another level, I think all of us in public health have learned to think a little more broadly and from a different perspective. For example, early in the pandemic, we had very strict “stay at home” measures. While approaches like this may have prevented COVID-19 transmission, they had significant consequences on the economy, education, and mental health. There have been so many difficult situations where our state leaders have had to make impossible decisions. Overall, I have been proud of how our state leaders have responded during the pandemic, and also proud of how our state has come together. It has been amazing to see such cooperation across all levels of state government and different sectors!
What was the most challenging situation(s) for you during the COVID-19 pandemic?
I think there have been many challenging situations during the COVID-19 pandemic. Some of the more difficult ones that we dealt with in public health included nursing homes, where deaths during outbreaks occurred in up to 30% of all residents. At the moment, the most challenging situation is addressing the significant amount of misinformation about COVID-19. It is deeply troubling that some people are basing their health decisions on such misinformation. We must place a greater emphasis on the science. People also need to realize that science evolves over time and that sometimes our understanding of an issue may change. However, you can be sure that the last place you should be getting information about your health is Facebook or TikTok.
What can the state – and the nation – do to best prepare for the next pandemic, which experts say is all but a certainty, although the timing and origins are yet to be revealed?
There is no doubt that we will eventually see another pandemic. We’ve already seen two in the last few years (i.e., COVID-19 and monkeypox). The interconnectedness of the world ensures that what happens in one part of the world will probably happen here in the United States and in Rhode Island. There are several things we need to do based on lessons learned from the COVID-19 pandemic. We need a robust “surveillance system” to be able detect these threats as soon as possible, as well as develop tests in a timely manner. Early in the COVID-19 pandemic, it was impossible to find a test. We also need to consider responding in a more timely manner. We were too late to shut our borders when COVID-19 was first spreading. Importantly, we have to invest in both our public health and clinical infrastructure. Healthcare and public health are both short-staffed and overwhelmed. It is critical to invest in this infrastructure so we can effectively respond when another pandemic happens.
Many of us know you from the COVID-19 pandemic. What did you do before COVID-19? What are you doing now?
As a public health physician, one of my main areas of focus has been addressing HIV and other sexually transmitted infections (STIs), as well as Hepatitis C. These infections are affecting a lot people in Rhode Island. In 2020, I partnered with my colleague Dr. Amy Nunn at Rhode Island Public Health Institute (RIPHI) to start Open Door Health, the state’s first LGBTQ+ community clinic. I currently see patients there with an exceptional group of staff including our clinic manager Michaela Maynard. We provide primary care, gender care, HIV treatment, pre-exposure prophylaxis (PrEP) to prevent HIV, Hepatitis C treatment, and STI testing. Check us out at odhpvd.org.
What do you see as the top public health issues in the state of Rhode Island?
Both public health and healthcare in general were stressed before the COVID-19 pandemic, and have been overwhelmed since then. I want to acknowledge all the hard work of my public health and healthcare colleagues. I think a major priority for the state should be to work to stabilize and build up our healthcare and public health infrastructure. There are also several other public health issues that deserve significant attention. Mental health and substance use have both been exacerbated by the COVID-19 pandemic. Hepatitis C (spread by blood contact) and sexually transmitted infections (STIs) continue to increase. There are ongoing initiatives and partnerships across Rhode Island to address these issues, which will require timely attention and resources to reverse increasing trends.
What should Rhode Islanders know about these issues?
Many of these topics can be sensitive. Rhode Islanders should check in with their primary care provider with any questions. Some resources and information include:
Hepatitis C: People should be tested at least once in their lifetime for the hepatitis C virus. Hepatitis C is generally transmitted through blood and people may not always be aware of their infection due to exposure through routine medical care before the blood supply was screened. People who’ve injected drugs or done intranasal cocaine are also at risk.
HIV and other STIs: People should also be tested at least once for HIV in their lifetime. Younger people may be at higher risk for STIs and should be tested if sexually active. For those who may be at higher risk of HIV, pre-exposure prophylaxis (PrEP) is a pill a day that people can take which prevents infection.
Substance use: Addiction is a powerful disease. We are seeing very high rates of substance use, overdoses, and deaths due to opioids. People seeking treatment can find assistance here:
health.ri.gov/addiction.
Mental Health: Mental health illness was a problem before COVID-19 and has been significantly worsened by the pandemic. People seeking assistance can find some resources here:
bhddh.ri.gov/mental-health/individual-and-family-information/where-get-help
What general advice do you have for Rhode Islanders?
I want to thank Rhode Islanders for their patience and resilience during the COVID-19 pandemic. I think it is critical for all of us to work together in a productive way to address issues of public health concern. We should continue to base our decisions on science and evidence, and continue to perform research to answer unknown questions and address evolving questions. Above all, we should continue to show respect and kindness to those around us, even when we disagree!
Finally- what do you like to do aside from public health and medicine?
I enjoy exercising (i.e., running and biking) and being outside. I love to downhill ski and even took up “uphill” skiing last year! I also love to read and collect books including older medical textbooks. I have also traveled the world, which has included providing medical care in many resource-limited settings. I am reminded that despite all the challenges in our country, we generally have it pretty good!
