Yesterday was the first day of my practicum at the Orange County Health Department in Orlando, FL. Among my list of “first days,” it ranks pretty high. Although not much was planned for me, my conversation with one of the public health nurses in the epidemiology department, Karen, helped bring a little perspective into what life is like for a public health worker post-graduate school. Prior to working for the county health department, she had worked as an ER nurse at a hospital in New York City. Quite a large leap. When I asked her which environment she thought to be more stimulating, thought-provoking, and interesting, she surprisingly chose her current job within the epidemiology department. I was pretty flabbergasted, expecting her answer, in her subtle Jamaican inflection, to be “ER, hands down!” As I entered the department, all I saw was a precinct with a standard fare of workplace knicknacks–an unrelenting murmur of copiers, fax machines, and shredders, cluttered desks brimming with beige manila folders to give people a false appearance of preoccupation when really it’s just intense disorganization, and of course, an exuberant amount of anti-bacterial wipes to mop anything and everything under the sun, something I would expect of a department preoccupied with infectious disease. I silently thought to myself she thinks this is more exciting than the hustle and bustle of an ER within the largest metropolitan city in the country? Spilled coffee had to be the extent of “commotion” within this office.
How glad I was to be proven wrong. Within two hours she explained to me how working within an epidemiology department is comparable to placing all the medical maladies resulting from infectious diseases that happen within a population and then winnowing out the common, humdrum infections that more often than not stifle hospital waiting rooms. What’s left? The rare, exotic cases that fall outside the perimeter of everyday, pedestrian illnesses and fester even further to the point where others besides the patient, become at risk. Epidemiologists are like kids at a birthday party eagerly awaiting the burst of the piñata. When it finally tears open, epidemiologists are the first ones to get their pick of the candy, ensuring that their cases are the among the most “succulent” of the fare. So immediately I ask her what are some of these “juicy” cases?
Imagine sitting in a restaurant, admiring a water fountain that adds to the general ambiance of the evening. Now imagine the bacterial outbreak of Legionellosis, a fatal bacterial organism that loves aquatic environments and can be transferred via air by water vapor, sitting in that fountain. Not only are you inhaling it in, the air is also in contact with your food, your drink, your clothes, and the others surrounding you. Now imagine being in a water park. Naked to the human eye, infective cycles of the intestinal parasite Giardia are being ingested and proliferating rapidly within the pool, the very same water which kids are immersed in head to toe, splashing everywhere. Now imagine being a 7-year old, anticipating escaping the humidity of the heavy Florida weather by jumping into one of the tons of lakes in Florida. 4 days later, you’re brain-dead due to the entry of a brain-eating amoeba, Naegleria fowleri, through the nasal cavity. All of these are actual cases that at one point in time plagued the department, where seemingly non-eventful actions turned into full-fledged events, often times becoming fatal.
Orange county also, not surprisingly, ranks as among one of the hottest destination spots among the world what with Disney World, Universal Studios and Sea World, to name a few of their popular destinations. Thus, with an influx of global tourists comes with them an inundation of disease and vulnerability making for a diverse spread of what the department will encounter. Needless to say, Karen amped up the hype factor for me. If you thought I was completely invested in public health before, you have no idea how excited I am now…