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Serendipity and Disparity

Serendipity and Disparity

John “Jay” Ogunkeye was fascinated by the clinicians and facilities as a kid when he visited his grandfather at a hospital. That’s what his parents tell him, at least. He has no memory of it.

But Ogunkeye remembers all too well the patients, including his father, he has encountered in recent years during their prostate cancer treatment, and those experiences have partly driven his desire to pursue research and clinical practice in urology. Now set for his second year at Rush Medical College, Ogunkeye talked to us about his background, interest in urology and his research in prostate cancer disparities as Rush’s newly appointed Reddy Fellow.

Tell us a little bit about your background and what led you to pursue a career in medicine.

John Ogunkeye: I grew up in the Philadelphia suburbs and got my undergraduate degree with a double major in biology and psychology at the University of North Carolina at Chapel Hill. Then I decided to stay in North Carolina for a year before medical school, working as a clinical trials assistant in a prostate cancer lab at the Durham VA Medical Center.

At the same time, my dad was diagnosed with prostate cancer, so studying the disease became more personal. And I had even more interaction with urologists as my dad went through treatment. My dad’s diagnosis also helped me better relate to other patients with prostate cancer.

I also knew the science behind it from my research work. It was serendipitous in a way, because I was able to provide my family — my mom, my sister — with some peace of mind by telling them what I know about the condition. My dad was fortunate to have his cancer caught early and is doing very well. At the end of that year, I really thought urology was the specialty that would fit me best.

When did you first start think you might want to be a physician?

JO: Actually, elementary school. Part of it was exposure. Both of my parents are involved in health care. My mom is a clinical psychologist, and my dad is a health care administrator, so I was always around health care.

But I don’t think it was any one thing that led me on this path. My parents would probably tell you that when I was young my grandfather was in the hospital at the end of his life, and I was very fascinated by the hospital when we would visit. They say I was always asking the doctor, “Can I listen to his heart?” I really have no recollection of it. Becoming a physician, though, is something I’ve never wavered from.

You’ve recently been named Rush Medical College’s Reddy Fellow to pursue research in community health. Tell us more about that.

JO: You’re paired with an adviser to work on a research project, and I wanted to join my interest in urology with Rush’s focus on the community. One of the things I’ll always remember from orientation is Dr. David Ansell talking about the health disparities among Chicago neighborhoods. Life expectancy in one area might be 85, but it might be just 61 or 62 in another neighborhood only four Blue Line stops away. These people are so close in proximity, but they're living drastically different lives when it comes to how different factors impact their life expectancy.

I thought about that disparity and wanted my research to focus on my prior experience with prostate cancer, which is the most common cancer among men in the United States. For African-American men, the incidence is about 2 ½ times higher than for white men, and their mortality rate is roughly 1 1/2 times higher. Prostate cancer is a fairly slow-growing cancer, and the prognosis is very good when caught early and treated, so why is prostate cancer disproportionately affecting African-American men?

I’m looking at what the incidence and mortality for prostate cancer are in West Side neighborhoods such as Austin or North Lawndale or Garfield Park compared to the more affluent neighborhoods downtown and north of the Loop, like Lincoln Park and Lakeview. Then I’ll create an intervention using the evidence to target neighborhoods with the worst outcomes. So far, the data is pretty consistent with what I expected from national trends and disparities in Chicago: Men living on the West Side have a mortality rate that is almost double what the rate is in the Loop.

My idea is to go into the neighborhoods that have the worst outcomes and provide prostate cancer education and screening this fall. Because prostate cancer can be easily screened for by testing PSA blood levels, we may go into a church or community center and offer education and do the blood draws for free. Ideally, I would inform all patients of their results, and If their PSA levels are high enough to warrant additional follow-up, I will contact them to schedule an appointment with my adviser, Dr. Chris Coogan.

Dr. Coogan has been a terrific mentor along the way. I really wouldn't have been able to do any of this without his guidance.

Are you interested in continuing to pursue research once you’re practicing as a physician?

JO: Definitely, though I never thought I would be interested in research until late in college. Research has become kind of a creative outlet for me. I like the writing and the opportunity to contribute something new to the field you are working in. My goal is to work in an academic medical center and be involved with health outcomes research or clinical trials.

What made you decide to choose Rush as the place pursue your goals?

JO: Everybody says it, but Rush really feels like a community. You get different vibes from different schools during campus visits, and at Rush everybody was very friendly.

Another big thing with Rush is the community service aspect. Rush actually makes it part of their mission to give back to the West Side community. That was unique compared to other schools that seemed more focused on being research powerhouses and didn’t have the same commitment to improving the community.

I was also ready to leave small-town U.S.A. and go to a big city after being in North Carolina for a while. Rush has been everything I hoped for.

What advice would you give to potential medical students or students ready to start their first year in medical school?

JO: One of the biggest mistakes I think I made as an undergraduate was to pick a major because I thought I needed to be a biology major to be a doctor. Do what interests you. It's OK to explore a broad range of interests as an undergraduate student — especially for pre-med students — because once you start medical school you're going to be doing science and medicine and biology for the rest of your life.

For students about to start medical school, I’d say don’t compare yourself to other students. Do what works for you. There’s an old joke: What do they call the person who finishes last in medical school? Doctor. Nobody knows they finished last. You’ll always feel like you’re behind if you’re worried about what everyone else is doing.

There’s an Ernest Hemingway quote that has always stuck with me: “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” That’s something I try to live by.