Rahul Nanduri (left) and Alekyha Gurram (right) show off
pickleball-themed earrings made by HARC participants
Summers and Terrell.
What drew you to the Albert Schweitzer Fellowship (ASF)?
Rahul: The main thing that drew us to ASF at first was this community of mentorship and service. Both Alekhya and I studied public health at college, so that was an interest for both of us right off the bat. I think it was just such a great opportunity for us to join a community where people were excited to come and learn about things like the systemic barriers to healthcare from people with so much knowledge and wisdom in the field. That's one thing, but then it's a totally other thing to actually learn that and be able to put it into practice and get mentorship from people who have public health backgrounds and who have backgrounds in community service. It makes such a huge difference in our project to be surrounded by people who are so motivated to make a difference in the community, especially when we're dealing with groups that are traditionally underserved. It's a beautiful thing to be able to talk to people who are doing the same thing, but doing it with different groups, doing it in different ways and different locations. It just brings so much versatility of thought. We're constantly learning new things and finding new ways we can implement our project better, and at the end of the day, it makes us better doctors as well. As medical students, our job is to learn how to serve our community and how to serve the people in our community and unfortunately, a lot of the groups in our community are traditionally underserved. So everything that we learn through ASF also makes us better medical students and hopefully better doctors in the future as well.
Alekhya: ASF was a really good way for us to feel like we were properly implementing a project and had the support to do so. We could make it more well established and have the resources to be able to stay consistent with improving our project each month and also have an end goal towards it. I think the structure and the leadership of ASF are really helpful for us in that process and really helped guide us through our public health perspective of how to make our project have a more widespread impact on the participants at HARC.
Why did you choose The Houston Aphasia Recovery Center (HARC) as your project site?
Alekhya: During my time in undergrad, I originally was looking for opportunities to volunteer in the community, but it was the pandemic, and everything was virtual, so HARC came across my way. I found out that I would be able to help the participants with speech therapy, and I thought that was a super cool way, even during the pandemic, to stay connected with a traditionally underserved population. I would shadow and see how the speech therapists there would work with participants. I then talked to the executive director, Eleni Christou, and she knew about my dance background, and she was like, “since you love dance, I was thinking, what if you start a dance-related program? A lot of the participants love dancing and singing but don't really have the option to do so at HARC so far, so that might be something interesting, especially during the pandemic when a lot of people feel more isolated and don't have the opportunity to mingle in that way.” That’s how I started being involved in HARC, and I did it for a couple of years until my last year at Rice. Then, while I was transitioning to medical school, I stepped aside from HARC. Coming back into medical school, I knew that I really wanted to incorporate art and humanities into my medical career and the way I approach medicine. So, I reached out to Eleni and asked if I could participate in HARC again, especially because I knew that the pandemic was over and I'd be able to participate in person. I'd never been to HARC in person, and I thought that would be a really meaningful way to get to know the participants again. Because Rahul has a very musical background as well, we thought it would be a great idea to work together to expand it beyond just dancing and singing to have more musical instruments involved and then also various types of arts and crafts. We knew HARC would be a great place because they already have such a good structure, and I knew all the staff there and also was familiar with the participants, so it was just a very easy transition for us to be able to implement this broader project.
Rahul: When Alekhya first approached me about this, I thought it was a wonderful idea. Alekhya was on a collegiate dance team and I was on a collegiate acapella team. It just felt like too good not to happen, right? We were talking about a dance and singing curriculum, and both of us actually have half and half of that experience, so we just thought it was honestly a wonderful opportunity. I myself have always also had an interest in how music can be used in medicine. Starting from high school, when I was in orchestra, my orchestra used to go around the Texas Medical Center and play pieces in various hospitals for patients because there was so much research and literature coming out on the impacts of music and creative therapies on mental and physical health. I just thought it was a wonderful way for us to implement a program of our own and explore this side a little bit more.
What is the goal of your project?
Rahul: Our overall goal is generally just to provide participants with creative spaces to express themselves. We've already learned so much about so many of the participants there, from just the most basic things, like what they choose to paint, what songs they like to sing, and what sort of conversation topics come up when we're doing this or that. It allows us to make connections beyond what we would be able to make if we were just having conversations with them. It really provides them an outlet to express themselves how they want to express themselves, which is a huge thing for people living with aphasia. You don't really have a traditional relationship with language at that point, so a lot of people with aphasia feel more comfortable expressing themselves through these outside-of-the-box outlets. Giving them the space to do that and giving them people who are willing to be perceptive is our goal. Obviously we hope that this improves their quality of life and mood, so we hope our project will be sustainable and integrated into HARC for the years to come as well. There's kind of this intersection of creative therapies in aphasia. There is research on it, but it's definitely a newer thing, so we also want our model to be an example for programs like this to be instituted in other rehab centers. HARC is the only rehab center for people with aphasia in Houston, but there are others around the state and country as well, so we hope that our model will show that this sort of thing is useful.
How did you approach the project and getting to know the community better?
Alekhya: I think during each of the sessions, we really try to make an active effort to not just do the activity with the participants but also talk to them about the activity and parts of their lives that they want to communicate about. Slowly, by attending every week, we were able to pick up on the different communication styles of each participant as well. In the beginning, it was obviously a learning curve because we are not trained speech therapists, but we received the HARC training. It took a while for us to understand what each participant needed, but once we were slowly able to cater to each of their needs, it was really awesome because I felt like they were more comfortable sharing their stories with us as well. We have people talking about their backgrounds, where they come from, and then what football teams they're fans of, showing us music videos of their past as well as talking about their children. It's so amazing to hear about that because the end goal is to get the participants at HARC to be more comfortable with expressing themselves, even if that means we stray away from the activity for a little bit and focus on getting them to share their stories. That's also really meaningful for us, too.
Rahul: The executives of HARC are so helpful in helping us fit into this role. Alekhya mentioned the HARC training, so what that was was training on how to properly communicate with people living with aphasia because there's a communication barrier. You have to be perceptive of the condition. We received training on some strategies that are useful in some ways to make it a little bit easier for them to understand speech, for example, writing things down instead of speaking fast, and that really helped us. Once we did actually just start interacting with the participants, it was so easy to learn so much about them. I remember one of the first sessions, I was super excited because I'm a huge college football fan, and one of the participants is a huge fan of Michigan's football team. And we had a 30-minute conversation about “you like Michigan's team? did you watch that game?”, just simple things about that.
Alekhya: Also, that conversation came from painting because they were using blue and yellow and talked about why they were their favorite colors!
Rahul: Exactly. We'll make bracelets a lot, and participants will make bracelets for their kids, for their wives, for their husbands. It's so interesting to see how everyone makes bracelets for the people that are important to them in their lives. That's also another way to learn about people and what's going on in their lives, and it's so nice and fun to have conversations about that sort of stuff as well.
What’s been a big takeaway or impact on you from this experience so far?
Alekhya: I think the biggest takeaway has been not everything has to go according to a plan we make. I feel like I'm very much of a planner, and I'm always wanting to know our next schedule for HARC for the month. Even though we have a general idea of what we want to do for each session, the hours go by really quickly, and we don't realize that the activity takes longer than we expect and that it's okay if they don't finish. Getting to start up the project and be able to talk and share stories is more meaningful, and I think that's what ends up being the biggest goal of our project: giving the space for participants to express themselves, not necessarily the physical output of what art they create or if we're able to finish learning a dance for the whole session.
Rahul: I honestly think one thing I learned about was the power of silence, and that sounds a little bit counterintuitive, right? In medical school, we're taught to ask questions and, of course, listen to our patients, but to have conversations with our patients to get as much information as we can so that we can help them. But in HARC, we just have conversations in such a new way because a lot of people living with aphasia, when they're having difficulty getting a certain word out, sometimes all they really need is just silence and someone who's listening patiently. If they're having difficulty with the word, I've learned that the thing that they most appreciate you doing is just to wait while they try to get the word out. It's really reinforced the power of being patient and just listening actively. Counterintuitively, we have the best conversations when there's some silence in the conversation as well.
Is there a special story you’d like to share from your project?
Alekhya: My story is back from a few months ago when we were painting sombreros. We started playing Latin music and a lot of the participants just started singing along to the songs, even though the activity was painting. They were singing along and laughing with each other and having so much fun, and that was such an awakening moment for me. A lot of participants, even when we do have singing or karaoke sessions, find it harder to keep up with the pace of songs because they're not able to keep up with the beats or be able to say the words as fast as the songs and we do slow them down, but it's definitely harder to engage them in that sense. But then, for that session, when they just started singing by themselves, it was so wholesome to see that they really do enjoy the singing and music parts, just more so when it's in a less structured way. I feel like just having that open space to paint gave them that freedom to sing whatever they wanted and laugh, and it was just so amazing to see that happen.
Rahul: One of my favorite memories was a day when we were painting ukuleles. We got some ukuleles and asked if anyone had ever used one. We were painting them, and at the end of the session, I heard a guitar playing, and I was really confused. We didn't even have guitars; everyone had ukuleles! I was looking around, and one of our participants had pulled up a video of him playing the guitar from like 10 years ago. It turns out that he used to be in a band that has music out; they used to tour the country, and he was the lead singer and guitarist. It was so insane to build a connection to something that was such a big part of his life. He was so excited to paint the ukulele because it reminded him of playing the guitar, and he scrolled back 10 years in his photos and found videos of him practicing his own songs that he wrote. He just started singing along to his songs. It was just such a spontaneous connection that formed. We had no idea that he used to be in a band. It was such a huge part of his life, and it just came up so organically through painting. It was such a great moment to connect. After that session, I just remember thinking, “Wow, I might have never found that out about him if we hadn't painted ukuleles today.” It was such a random thing that built such a deep connection.
Anything else you’d like to add?
Rahul: We've honestly enjoyed our time so much. We started this project kind of focused on singing and dancing, but it's grown so much past that. It's such a sacred time for us to make connections with the participants at HARC, and it's one of the most rewarding things I've done in medical school.
Alekhya: We genuinely are always so excited to go to Houston and spend time with the participants. I feel like, especially for me, because I have known them for almost five years now, it is just so meaningful that they’ve been such a big part of my medical journey and even before I knew I was gonna be a doctor. I had so much of Eleni and the HARC family’s support. When I left the first time as I was transitioning to medical school, the participants all made cards and signs, and right at the last moment before I was about to leave, they all pulled them up and were like, “Bye, we love you.” And I literally was about to cry. HARC is such a special place, and we’re so glad to be doing our project with them.
About Alekhya and Rahul:
Alekhya Gurram is a second-year medical student at UTMB John Sealy School of Medicine. She is originally from San Jose, California, but came to Houston, Texas to study at Rice University. She received a BA degree with majors in Health Sciences and Spanish & Portuguese Studies, and a minor in Medical Humanities. She grew up enjoying hobbies such as dance and art, which she continues to pursue in her free time. Now in Galveston, she likes to relax at the beach and stay active by playing tennis and pickleball.
Rahul Nanduri is a second-year medical student at the University of Texas Medical Branch. He is originally from Hyderabad, India, but grew up in Houston, Texas. He obtained a BS Degree in Public Health and a Certificate in Elements of Computing from the University of Texas at Austin, where he exercised his hobbies in road biking, singing, playing the guitar, and playing sports, including basketball and volleyball. In Galveston, he likes to serve with various community service organizations, compete in intramural sports, and spend time with friends.
They are working to address the disparity in access to creative therapy options for people with aphasia by instituting the "Creative Connections" project at the Houston Aphasia Recovery Center. They hope to target and address the mental health needs of people with aphasia by exploring creativity through dance, music, and arts & crafts to improve quality of life.
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