SHU Alumnus Forges Social Justice Path in Medicine

Pre-med graduate helped turn NYC’s Javits Convention Center into a field hospital to treat COVID patients

In March 2020, Colin Smith ’11―a chief internal medicine-psychiatry resident at Duke University Medical Center and lieutenant commander in the U.S. Public Health Service (USPHS) Commissioned Corps―was assigned to help establish a field hospital at the Jacob K. Javits Convention Center in New York City. The makeshift medical center was necessary to help treat the overflow of COVID-19 patients from city hospitals. During its service into early May 2020, the facility treated more than 1,000 patients.

Smith was one of the eight team members whose training focused on both psychiatry and internal medicine, giving him the ability to care for patients’ medical and mental health needs.

During clinical rotations at medical school, all students must complete rotations in both internal medicine and psychiatry. “When I did my internal medicine rotation, I felt that this was what I wanted to do. Intellectually, you need to think about all the problems people have and come up with solutions to treat them,” Smith says.

“I did my psychiatry rotation next and thought ‘I really want to do this,’” he continues. Smith discovered about a dozen combined programs in the country and selected the internal medicine-psychiatry resident program at Duke University in Durham, NC. “I couldn’t see myself doing anything else. I think there’s a false dichotomy about what happens between the mind and the body. Med-psych doesn’t allow you to separate the two when you are caring for somebody. It’s thinking about how someone’s medical illness impacts their mental health, and how someone’s psychiatric illness impacts their physical health, and the entire spectrum in between.”

Smith concentrates on multiple aspects of his patients’ lives. “People who have persistent, severe mental illness and are medically ill often have other structural and social things that are happening in their lives that make them particularly vulnerable,” he says.

This method of treatment was paramount to his treatment of patients at the Javits Center.

“When a population is affected by a certain problem, we’re pretty good at figuring out who is going to be disproportionally affected. We know that people with severe mental illness or addiction will be disproportionately affected. I felt that I was in the unique place to be able to figure out individuals who had comorbid mental illness and to advocate for those people while treating them.”

Smith attended Uniformed Services University, the medical school for the nation’s military and public health service. He entered the university as a commissioned officer in the USPHS. Physicians there give back through work with underserved populations after they complete their residencies. Smith will be working with the Indian Health Service, which is an agency in the U.S. Department of Health and Human Services responsible with providing health services to American Indian and Alaska natives.

Currently, Smith’s residency includes inpatient/outpatient psychiatry and inpatient medicine. “We have a combined inpatient medicine and psychiatry service for people who have both medical and psychiatric needs, which is a program unique to Duke,” he says.

As a master’s student at the Duke Global Health Institute, he also researches racial disparities and outcomes in hospitals’ emergency departments (ED). His focus is on the difference between the treatment of Black and white patients, including the use of chemical or physical restraints, likelihood of being placed in a locked area of the ED and probability of being transferred to a state psychiatric facility. Smith also collects patients’ stories to understand their experiences directly from their perspective. He believes these stories are essential to consider along with the data to create a more equitable health-care system.

A friend of Smith’s from high school who attended Sacred Heart University suggested he check it out. When Smith stepped onto SHU’s campus, he says, “I just had a strong feeling that this was where I wanted to be, and it was as simple as that.” He liked the feel of being in a community that you don’t get from most larger college campuses. “I wanted to get to know my professors and the people in my class.”

“I’ve always been interested in behavior—why people do the things that they do,” Smith says of his reason for becoming a pre-med biology major with a concentration in neuroscience at SHU. “I guess I always wanted to be a physician. When I was in med school, a friend from childhood said, ‘You always did say you wanted to be a doctor.’ But I didn’t actually recall that.”

Neither of Smith’s parents went to college, so “it wasn’t a space that I knew I was going to fit into,” he says.

He found SHU’s biology department to be a close-knit community. “I got to know my professors very well; many of them were hugely influential during my time at Sacred Heart. Professor Mark Jareb was my mentor, but everyone in the biology department was fantastic.”

“Colin was an amazing and very memorable student as an undergraduate at SHU. He excelled in his classwork, was active in undergraduate research and involved in activities related to social justice,” says Jareb. “Being a first-generation college student coming from a working-class community in Framingham, MA, while going to prep school (because of hockey) gave Colin a unique perspective when he came to SHU. I could have a conversation with him about health disparities regarding undocumented immigrants, segue into discussing our next experiment looking at axon growth in neuron cultures and, in the next breath, talk about the latest news in the NFL. He was a student who truly embodied the Sacred Heart University mission; who personally and professionally is making a difference in the global community.”

Smith also credits Michael Ventimiglia in the philosophy department for having a tremendous influence on his social justice path. “His courses pushed you to challenge how you think, and that was important to me,” he says.

“Colin loved to learn, loved to question, and loved to discuss,” says Ventimiglia. “He was in my office constantly, chatting about evolution or Plato or hockey. I always appreciated that he was drawn to both the sciences and philosophy. It seems like he’s done an extraordinary job synthesizing them in practice.”

“No matter what my classes were, whether they were honors classes or biology, they were infused with questions about our own work in the world,” Smith says. “When we are thinking about neurobiology or evolution or another subject, how do we consider the things that we value, and how does that influence the questions we ask in those areas? The honors program in particular had courses that led to very thought-provoking, challenging discussions.”

For the last few years, Smith has led Healthcare for the Homeless, a volunteer clinic in Durham for people experiencing homelessness who need mental health care. “That’s been a very important experience for me,” he says. Smith has been recruiting trainees and attending physicians, setting schedules and supporting the volunteers. Since he is graduating in June of 2022, he is transitioning leadership to another resident.  

Smith serves on the board of visitors for Sacred Heart’s College of Arts & Sciences. “It’s been nice to meet other people who similarly had positive experiences at Sacred Heart and continue to give back to the school by serving on the board. One of the coolest experiences was judging student capstone experiences. It was great to see students from different areas across the University presenting their expertise to a board with diverse professional experience.”

Photo courtesy of Jeremy M. Lange