Continuum

The idea behind UROP, he says, is that contrary to Thomas Wolfe’s famous dictum, you actually can go home again. While big city residents might turn their noses up at small-town practice, a fifth-generation Blandingite like Lyman knows the beauty of rural life and the benefits of working in such locations: good money, a wide variety of procedures, and a broader scope of practice.

Indeed, Lyman is a poster child for UROP. He, his registered nurse wife, and their two small children currently live in Los Angeles, where he is a third-year resident at a Level 1 trauma center. He plans to return to Blanding as an orthopedic surgeon. “I want my children to grow up in the same close-knit and supportive community I did,” he says.

From a small basement office housed in the U’s Department of Family and Preventive Medicine building, longtime UROP advisor Bob Quinn BS’86 keeps a watchful eye on the 17-year-old program, which runs on an $8,000 annual budget. In 2017, first-and second-year medical students visited 40 high schools in 15 different counties, accumulating more than 70 hours of classroom presentations for a total of 1,566 students. Medical students sign up for all sorts of reasons, ranging from wanting to go home for the holidays to seeing a national park.

In late 2018, 40 students signed up to spend much of their winter break visiting as many high schools as they could in the state’s rural and frontier counties. That included two first-year students, Jen Christiansen and Kassie Amann. They picked visiting some of the state’s most isolated schools during a four-day road trip from Salt Lake City to the epic splendor of Monument Valley.

Christiansen and Amann’s journey in the latter’s silver SUV, with a cooler full of cow hearts and pig lungs in the trunk, revealed the challenges distance imposes on rural communities and the importance of UROP in terms of encouraging students to pursue medicine. Christiansen summed up the trip’s meaning for her and Amann over a late-evening burger in a family-run diner. “I just want them to look at Kassie and me and know that, ‘No matter what I want to do in life, regardless of if that is medicine, it’s worth the work.’ ”

L to R: Kade Shumway (by Kim Montella); San Juan High; and Jen Christiansen and Kassie Amann (by Shara Lyman).

At 5 a.m. on Monday, Dec. 15, Amann had stopped to pick up Christiansen in Salt Lake. They needed to make Moab’s Grand County High before the 9:53 a.m. bell to meet their first class, anatomy students. There are two key elements to UROP’s pitch: one is a presentation, the other dissections.

Their presentation began by asking, “Why medicine?” Then they detailed the wide variety of health careers, comparing the average debt to become a doctor ($161,000) against average salaries ($189,000 for a family doctor, $450,000 for a surgeon). When Christiansen and Amann pulled out the organs for dissection, excited students pulled out their phones to take pictures.

Afterwards, Christiansen and Amann drove to their lodgings at Bullfrog, Utah, near Lake Powell. Daylight revealed few houses but many dry-docked house boats. At Lake Powell, their class was seven male students from the seventh and eighth grade, half of whom were Navajo.

Next on the itinerary was San Juan High School in Blanding. And while it turned out to be larger than they expected, Blanding still amounted to a small town with one blinking red light swaying over the main intersection.

“How did you want to handle this?” Christiansen asked Amann as 130 students filed into San Juan High’s auditorium, a quarter from Tracy Johnson’s anatomy class. After the seven students of Lake Powell, it took the visitors a moment to adjust to the shift in scale.

“The point we’re trying to get across is, there’s a shortage of medical practices across the state,” Christiansen told the hall. “We’re trying to inspire you guys to fill this need.”

It turned out that some had already heard the call. When Christiansen asked how many wanted to be medical students, a dozen students raised their hands, citing career interests ranging from becoming a family practice doctor to an anesthesiologist.

Such ambitions reflected how many of them had relatives working for the 19-year-old Utah Navajo Health System (UNHS), which currently has multiple clinics and hospitals in the region.

“It has totally changed the landscape,” says Monument Valley High principal Spencer Singer, whose mother, Donna, founded the nonprofit. “The majority of boys [on the reservation] aspire to be welders, or in the construction trade. Why? That’s what dad does, what their uncle did. Now their aunts and uncles work for UNHS, and it’s created a different avenue for jobs. ‘I can do that,’ the students say. ‘I can be a nurse or a doctor that works in the clinic.’ ”

Despite the burgeoning local medical industry, the value of UROP remains the same: letting high schoolers know medicine is within their reach.

L to R: San Juan High School; a stop outside of Blanding; and Monument Valley High School (by Shara Lyman).

When Christiansen and Amann put out cow hearts, 50 students lined up for the dissection. Amann struggled with the scalpel as she cut open the muscle. “They gave us the world’s smallest scalpel to do this with,” she laughed.

As teenagers pulled on purple plastic gloves, the quips came hot and fast. “They’ve stolen my heart,” said a native student. “This is the definition of playing with someone’s heart,” joked another. One student was more concerned about his impending lunch. “This has ruined my appetite,” he muttered.

Roughly half of those considering medicine thought they’d return to practice in Blanding. “I think there are deep family ties that make you want to come back,” Johnson says.

Christiansen and Amann left for Whitehorse High in Montezuma Creek, 45 minutes away, to find 40 tired students who’d just finished their state exams. Once the organs came out of the cooler, eyes widened in interest, especially among the female students.

Amann enjoyed the buzz students got from the dissections. She had one question she wanted the students to take away from their visit: “Do you want to do this more than just today?”

Kassie Amann and Jen Christiansen celebrate the success of their road trip  (by Shara Lyman).

The U students stayed at a motel in Mexican Hat perched on the red-rock banks of the San Juan River. As they dined on beef stew and Navajo fry bread, they reflected on how the trip was “about giving these kids an intro to things,” Amann said. “This is a slice of how cool medicine can be.” Both valued modeling health care careers for young women. “You can’t be what you can’t see,” Amann says.

The next morning’s drive out to Monument Valley High took them over the river and through a bleak landscape of black rock towering over tiny, one-story houses with concrete floors and wood stoves, standing unprotected against the weather. Very few of these homes have electricity or running water.

Despite the challenges of getting and keeping teachers in what is a deeply isolated, poorly resourced location, Monument Valley High has seen a dramatic turnaround under Principal Singer, going from a long-standing F to a C in the 2017-18 academic year. That’s with a 220-strong student body of whom 70 percent are classified by the state as homeless and 60 percent with English as their second language. Many of them live in situations where trauma from abuse, alcoholism, drugs, and neglect is ongoing.

In the school auditorium, Amann and Christiansen made their last presentation to 12 Navajo students. None of the students had questions, but when they moved to the cafeteria for the dissections, their standoffishness dissolved into enthusiasm and inquisitiveness. Not that handling animal organs was necessarily novel to them. Recently, a live sheep had been brought to the school, its throat slit in front of the hogan and the students taught butchering so that every piece of the animal was used.