Month: April 2023

Lizette Castillo Edge wanted to be a doctor for as long as she could remember. Well, almost – there was a period of time when she dreamed of being a marine biologist instead.

“I really wanted to swim with the dolphins!” she jokes (but is maybe only half joking).

Dr. Edge, who goes by Dre (or as some call her, Dr. Dre) is a doctor at Kingston Hospital specializing in family medicine, and she also spends time working abroad to provide care in areas where the need is great. Earlier this year, she joined O+ as Wellness Director and is working with the team to establish a model for year-round care for festival alumni – helping to make a dream that’s almost as old as the festival come true.

Dre was born and raised in Bogotá, Colombia before moving to the U.S. One summer when she was about six years old, she was sent to stay with her maternal grandfather, who lived in a rural area south of the city, where he ran a small appliance store. Dre remembers her grandpa as a generous man who was deeply invested in his community, and who often went above and beyond to help his neighbors.

That particular trip ended up being a formative experience for her. Thinking back on that summer, she can remember overhearing a conversation between her grandfather and a couple who’d come into his shop. The couple was older, and from what she could understand, they were struggling with money. The woman was very sick but they couldn’t access healthcare – both because of the expense and also because there weren’t many doctors in poorer, more rural areas.

For Dre, she says it was a lesson that not everyone enjoyed what seemed like the basics in life. Even as a small child, she says she could recognize how unfair that felt.

“It made a really strong impression in my mind…I remember coming home and telling my family that I was going to be a doctor,” she says.

Dre has good memories of her early childhood in Bogotá. She lived with her mom, Alema, and went to a good private school where she was on the swim team. They didn’t go on lavish vacations or have a car, but they had family and community and lived a comfortable life, Dre says. But growing violence and instability in Colombia eventually forced Dre and her mother to leave their home. When the drug wars were at their peak in the late 80s, she says she can remember her mom waking her in the middle of the night to hide under the bed while the sound of gunfire and explosions rang in the distance.

“Even though we weren’t struggling like a lot of other Colombians were…I think the violence just got to a point where my mom couldn’t take it anymore,” Dre says. When one of her classmates was killed by a car bomb, her mother knew it was time to go. Still, leaving wasn’t easy.

“It was a really hard decision for my mom to leave…[she] had been in Colombia her whole life. I think she saw that the future that I wanted wasn’t going to be attainable there.”

An aunt and uncle who were living in Queens, NY invited them to stay with them for a while, so they made the trip. They arrived on a tourist visa and never left. Dre was 9 years old.

“Knowing what it was like to live all of my childhood and most of my early adulthood without insurance – and what the struggles and realities of that are – I think has really shaped how I look at my work.”

They lived in Queens for a while before moving to New Rochelle in Westchester County, where Alema found work as a housekeeper. Thankfully, that job also provided housing for both of them, something that wasn’t particularly common for domestic workers at that time. The move was a big change. They’d left a relatively comfortable life in Bogota – as Dre recalls, “We always had enough food, I went to a good school, and my mom didn’t have to work,” – and the reality of undocumented life in the U.S. was starkly different. They were able to get by, but it was a struggle to access certain basic necessities and resources, including healthcare. Because of the Child Health Plus program in New York State, Dre was able to get some level of care but Alema wasn’t covered.

“I was able to go to the doctor, but most of the time I was going to clinics or free clinics. My mom never went to the doctor, never had preventive care,” she says. Many decades later, after becoming a citizen and getting health insurance, Alema was diagnosed with colon cancer (for which she was successfully treated and is now in remission, thankfully). Thinking back on it, Dre wonders if the cancer could have been caught sooner had her mom had better access to medical care.

Juxtaposing her own experiences trying to navigate the healthcare system as an undocumented person against that of her friends and classmates in affluent Westchester County only solidified Dre’s drive to work in medicine, specifically family practice and outpatient care.

“I had friends growing up who were very wealthy and I remember one friend and her family had seen the same doctor their entire life, and I had never seen the same doctor twice,” Dre says. “Knowing what it was like to live all of my childhood and most of my early adulthood without insurance and what the struggles and realities of that are I think has really shaped how I look at [my work]. In residency, we worked with a lot of uninsured and underinsured people and I think I can relate in a different way.”

Dre stayed in Westchester County all through high school and never lost sight of her goal to become a doctor. When it came time to apply to college, she applied – and got into – CUNY’s Sophie Davis Program, an intense and integrated curriculum that helped students earn their BS and MD within seven years. The program would be like a fast track to becoming a doctor.

“I was super excited because it was a big deal. I remember getting that letter and thinking, this is it!” Dre says.

A few days after her acceptance letter arrived, Dre says they got a call from the admissions asking for her and her mom to come for an in-person meeting. “They basically told us that they had to withdraw my acceptance [to the program] because they’d learned that I was undocumented, and because of that I wouldn’t be able to fully participate in the program,” she says, explaining that while the CUNY system offered education pathways to undocumented students, things would get more complicated or potentially problematic once she started working within the hospital networks during medical school rotations. “I was devastated.”

She says that even though the threat of consequences of being an undocumented person in the States loomed large in her life, this was the first time she felt like she really confronted that reality.

“That experience of being an undocumented immigrant was obviously very present in our lives all the time because of the fear of deportation or the fear of being found out. We were obviously very secretive about the whole thing…I don’t think any of my friends knew, we never talked about it. That was my mom’s and my secret,” she says. “I remember having told my friends that I got in [to the program] and that was the first time I had this realization that, ‘oh, this is real. Way real. I’d had this fear of deportation and the repercussions but I had never faced anything head-on until that meeting.”

Despite that major setback, she pressed on. She enrolled at Hunter College for a year before transferring to SUNY Ulster, and later SUNY New Paltz to complete undergraduate studies.

“If it wasn’t for the fact that CUNY allowed undocumented people, and the fact that my mom valued education and she really believed in my dream that I had, I don’t think I would have gone to college,” Dre says. “We worked hard to be able to pay for the tuition and for me to go. I can see how if I hadn’t had the privilege of such a supportive parent I could have been very easily dissuaded from going to college.”

In school, Dre started a relationship with a classmate. It started as a close friendship and quickly grew. After they had been dating for a while, they decided to get married – because they were young and in love, but also because it could open the door for Dre to become a citizen. “Under other circumstances, I might not have gotten married so young…I was a young feminist and definitely didn’t think marriage should be the highest goal for girls,” she says. At the same time, she says she’s grateful that her relationship gave her the opportunity to gain citizenship.

When she talks about this, she laughs a bit nervously and jokingly wonders out loud if Immigration officials are going to come out of the woodwork to rescind her citizenship, even though they were married for almost two decades before eventually separating. All these years later, that old fear still creeps up on her sometimes.

Around the same time, Alema also found a path to citizenship. She’d stayed in Westchester after Dre left for college and began working for a family with whom she became very close. The couple, who were both lawyers, eventually sponsored Alema’s citizenship and she received her green card in the early 2000s – more than a decade after initially coming to the U.S.

“That family was amazing, they really loved my mom and took her in,” Dre says. It was a pivotal time for both of them.

Dre enrolled in the Medical University of the Americas, where she spent two years studying in Nevis and then two years in clinical rotations back in the U.S., working mostly across Brooklyn and The Bronx.

During her rotations, she says she started to get a glimpse of the challenges within our healthcare system but didn’t feel like she got a full picture of it until she was in residency at Ellis Hospital in Schenectady.

“As a medical student, you’re under so much pressure and you’re just trying to keep up. By the time I got to residency, I was a bit more mature and able to analyze things on a deeper level,” she says. “That’s when I started recognizing the bits and pieces of the system and where they seemed broken.”

For her, it was a reality check on her childhood dream that, as a doctor, she wasn’t just going to spend all of her time helping people and fixing problems.

“As naive as that little person was, I reach back for her during the tough times to remember why I’m doing this.”

“I spent a lot of time on the phone with insurance companies fighting to get tests approved for my patients, realizing that people were really underinsured, or hearing from people that weren’t able to afford their bills or their meds,” she says. “Obviously those aren’t the things you think about when you’re a little kid who wants to become a doctor someday.”

Dre says she also started to see the limitations of healthcare alone during both her clinical rotations and her years in residency – and that as a physician, there was only so much within her control.

“I can tell my patients, ‘You should eat more fruits and vegetables’ or ‘You shouldn’t drink,’ but the reality is that sometimes people don’t have access to those things..for example, if they live in a food desert or they can’t afford it, or if they live in a household with other people who are using substances,” she says, reflecting on how frustrated she felt with the lack of integration between medicine and other social programs to help offer more well-rounded, holistic, community care.

After residency, she got a full-time job at Ellis. Even though she’d since moved more than an hour away to Kingston, she stayed on throughout the early part of the covid-19 pandemic, feeling called to serve at the place where she cut her teeth as a doctor.

When asked about her experiences working in the hospital during the pandemic, Dre hesitates a bit.

“It wasn’t something I ever thought I would live through…I don’t think anyone did. It was scary at first when we didn’t know what we were dealing with,” she says. “You sort of had to just buckle down and put in. In the hospital where I was working, we were actually getting a lot of patients from NYC brought up because of overflow…that was intense. But at the same time, I was glad that I was able to be there.”

She talks about learning to adapt to the lack of resources at the beginning of the pandemic when hospitals everywhere were struggling to find enough personal protective equipment for staff. Having to improvise and find creative ways to sterilize and reuse masks, learning more about the virus and how best to treat it in real-time.

Reflecting on that experience, Dre says that the sense of isolation, along with the stress of being on the frontlines of the pandemic, crept up on her.

“I remember feeling a little bit alienated. For anyone working in the healthcare field, everyone kind of shied away from us,” she says. “I was definitely very lonely, and working very hard.”

She’s also seen firsthand just how much the pandemic has impacted healthcare workers. When she thinks about the last three years, she says there’s almost this imaginary line marking the “before” times and what it feels like now.

“Obviously we’re still dealing with Covid, but we have more resources and more knowledge and a better understanding from a medical perspective. I think the changes I see are more around the energy and the morale,” she says. “I think there’s a huge amount of burnout. A lot of people quit medicine – a lot of doctors, a lot of nurses, a lot of people who retired early. Just recently I’ve been seeing that people are seeming to rally more, but the morale has been very down and it’s been hard to recoup from it for sure.”

During the most challenging times, Dre turned to nature – and to music – to cope.

“There were some dark times, but my salvation was being outdoors and being really fortunate to live in this community and be so close to The Catskills…that was probably my saving grace. I felt like at least being outdoors and hiking, I could be kind of around people,” she says, adding, “I also had a lot of single-person dance parties in my living room…I probably put in a lot of hours of just dancing by myself during those two years.”

During the times when she feels especially beaten down by the challenges – a broken healthcare system, the struggle to find resources, the burnout – she calls up that vision of her younger self; the enthusiasm and idealism of that six-year-old girl who knew she would grow up to be a doctor to help people and save the world.

“As naive as that little person was, I reach back for her to remember why I’m doing this.”

She also gets energized by work happening here in Kingston, and people who are dreaming of ways to make things better.

“One of the reasons I moved back to this area was to get back into being more active with a community,” she says, adding that she relocated to Kingston from Berne, NY back in 2018. “I learned about O+ and I think within my first year in Kingston I volunteered with the festival clinic doing primary care work.”

It’s very exciting, imagining and creating [Exchange Wellness]…We’re just in the very beginning, and honestly I feel like with such an amazing team of people and such passion and energy, the sky’s the limit.”

Shortly after her first volunteer experience, she met O+ co-founder Joe Concra at the Surviving the Future conference, where they connected over their shared frustrations and concerns around access to healthcare in the Hudson Valley. Joe later invited Dre to join a panel that O+ was sponsoring called Future of Care, which was trying to reimagine another way of having care within Kingston.

From there, Joe and Dre’s paths continued to cross, and conversations around expanding the O+ Artist’s Clinic to a year-round model happened organically.

“That’s when the seed was really planted,” says Joe, referring to their initial meeting at Surviving The Future. “I’d met someone who was young, who cares about community care, and who understands the limitations of the current healthcare system.”

Dre’s medical expertise and lived experiences navigating the U.S. healthcare system give her a unique vantage point on how to build out more sustainable models of community care. As Wellness Director at O+, she’ll play a crucial role in establishing Exchange Wellness, PLLC, a year-round, exchange-based health center for artists and musicians. The goal is to take the services that are offered during the festival clinic and expand that into a holistic and sustainable model for care that’s available 365 days a year.

Though the foundational work to establish the year-round exchange is just beginning, the idea is as old as the festival itself.

“We were blown away by the need [for accessible healthcare] in the beginning,” Joe says, recalling the first O+ Festival in 2010, recalling that one of the first people to access the Artist’s Clinic at that inaugural festival was having a heart attack and was able to receive life-saving care because of that interaction. He added that while he’d always dreamed of building out year-round services, making it happen in a practical way was a different story – it’s taken a while to get the right people, resources, and funding in place.

“I couldn’t be happier to have Dre on board and get this going,” he says.

Currently, Exchange Wellness, PLLC is in its infancy. “It’s all the foundational stuff right now – paperwork and legal details,” Dre says. The next stage will be to work directly with O+ alumni to assess what that community wants and needs and start to build the framework of the exchange platform. That’s when the fun begins.

“It’s very exciting, imagining and creating this amazing entity, whatever it’s going to shape up to be,” Dre says. “We’re just in the very beginning, and honestly I feel like with such an amazing team of people and such passion and energy, the sky’s the limit.”