“Where we stand is land that was stolen from the Quinnipiac people,” said Lee Cruz to an audience of 30 medical residents who gathered at the corner of James and Chapel Streets in Criscuolo Park.
The group was introduced to their three-mile walking tour of the Fair Haven neighborhood with Cruz, outreach director at The Community Foundation for Greater New Haven and Fair Haven resident, who has been leading these excursions for 22 years.
Originally, Cruz’s tours were centered around the environment and environmental justice. But in subsequent years, the program branched out, leading groups of fellows from the National Clinicians Scholars Program at Yale, and students from the Yale Schools of Public Health, Law, Architecture, and the Environment.
“Yale School of Medicine was looking for opportunities to have their physicians better understand the community they serve, so working with their leadership we developed a tour that respects and honors the history of our neighborhood while giving context to our current health, social and economic reality,” explained Cruz.
“We stand on the shoulders of people who came before us,” he said. The tour would help the trainees understand “how history connects us to current reality, our health, and your ability to keep us healthy.”
As the group walked counterclockwise around Criscuolo Park, Cruz educated them on the background of the Fair Haven Walking Trails project, the demographic makeup of the community, and the history of the area, going back to the Revolutionary War. He detailed the recognition of the 29th Colored Regiment and its monument in the park, which was dedicated in September of 2008. The black stone obelisk and its eight stone markers lists the names of the members of the 29th Colored Regiment who died during the Civil War. The location of the monument marks where soldiers trained for battle.
Cruz explained the visible pollutants in the area, such as the salt pile, which was visible as the group paused for a photo on the jungle gym. He also detailed the invisible environmental pollutants in the area. “70 percent of the soil in New Haven is contaminated with lead,” Cruz said. Cruz educated the group on the history of the area going back to the American Revolutionary War to document how long lead has been in area soil and to connect current health problems to this issue.
Shown on the tour was one of the 50 community gardens of Gather New Haven, an organization who “promotes health, equity, and justice for people and the environment.” To learn more about Gather New Haven, visit their website.
Another tour highlight was a new section of the Mill River Trail.
In previous years, first-year residents attended the tour, but because of the COVID-19 pandemic, the events were on hiatus for two years. Between June and August, Cruz gave four tours this year to medical residents, ranging from PGY-1s to PGY-3s.
Soumya Banna, MD, a PGY-2 in the Internal Medicine Traditional Residency Program, left the Fair Haven walk inspired. “What I took away from the tour was just trying to put yourself in the patient's perspective when offering care. Hearing about the background of the local communities and the possible barriers to care was really valuable and changed the way I approach patients. And then also there were a lot of historical pearls that he was giving, which I thought was cool, because it does put into perspective how institutionalized the inequities are. So not only on an individual level when you're caring for patients, but there also needs to be more outreach and initiatives on a community level and a policy level too. I think having that framework and understanding is really helpful, because sometimes you can feel a little bit helpless with some of the scenarios we see in clinic,” said Banna.
For Sarah Korones, MD, a PGY-3 in the Internal Medicine Traditional Residency Program, the tour was a full circle moment. Her grandparents grew up in Fair Haven on Lombard Street. When she moved to New Haven, her grandfather was really excited because he still remembers the neighborhood streets and drove her by their old house.
She didn’t know about the history of the area. “I didn't expect Lee to go as far back as he did all the way back to the Revolutionary War, so it was nice to get that perspective and that history. Korones cares for patients at the New Haven Primary Care Consortium, an innovative collaboration between Yale New Haven Hospital, the Cornell Scott-Hill Health Center, and Fair Haven Community Health Care. Many of her patients live in the Fair Haven community.
“The tour was a good reminder that we don't practice medicine in a vacuum. There's so much more to health besides your medical problems, and so I think remembering that we're just meeting patients at one small portion of their life and they exist within the community, and there's so many different factors that contribute to their health,” said Korones.
Paul Bernstein, MD, associate professor of medicine (general medicine) and associate program director of Yale’s Traditional Residency Training Program, enjoys Cruz’s teaching style.
"The tours have pre-dated me, but the essence has persisted which is, ‘Let's better understand the people that we're taking care of.’ So Mr. Cruz has us walk the pavement there and not just learn about the patients didactically. The lunch at the end has such gravity to it in terms of trying to understand, ‘This is who we are and who lives here.’ We are better doctors by understanding the structural challenges, such as pollution, that affects this community,” said Bernstein.
“I think it is really important that physicians understand the context in which they are serving and the idea behind these tours is so that they better understand the context in which their patients and their families live,” said Cruz.
“I thought it was one of the most valuable didactics that we've ever had,” Banna said.
Learn more about the community of Fair Haven on the Chatham Square Association website. For more information on the Department of Internal Medicine’s Residency Programs, visit their website.
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