Humans of NHC: Meet Elizabeth Abbs!

Dr. Elizabeth Abbs (she/her) is a primary care provider at the Tom Waddell Urban Health Clinic, located in the Tenderloin neighborhood of San Francisco. She sees patients for all primary care needs and runs specialty clinics for addiction medicine, and for the transgender community. She is also the clinical subject matter expert on quality improvement projects for the San Francisco Department of Public Health on controlled prescriptions and opioid safety. Read on to learn more about her career and life experiences!

Grace: So, I know you balance a lot of different things, of course seeing patients, and running quality improvement projects for the Department of Public Health. But can you explain what a day in the life of Elizabeth looks like?

Elizabeth: Every day is a little bit different, which provides positive variety, but also is a little bit of a balancing act. Five days a week I have clinic at the Tom Waddell Clinic in the Tenderloin and those days can vary depending on how many patients show up, and I get to have some specialty time both in a transgender clinic as well as doing addiction medicine. And then other times, I'm working on quality improvement metrics for opioid safety within the network, so getting to work on a variety of things related to managing controlled prescriptions to improving access to buprenorphine.

Grace: It’s so great to see all the work you do, and how much you're helping your patients too. So, what initially interested you about becoming a doctor?

Elizabeth: In college one of my jobs was, I was a personal caretaker for a woman who had had a traumatic spinal cord injury, and I worked with her. She was a teacher, and she swam every day, and she had a family member, her father, who was a doctor, and she really encouraged me to pursue the medical field. And so, in college, I was feeling that although I really liked science, I was more focused on Psychology and Environmental Sciences, but she pushed me and I expanded my studies and learned to gain confidence that I could go forward with pursuing a medical type of career. Then actually, when I graduated from college, I was an AmeriCorps member in the Bronx, and I worked in a Community Health Center there, and that was a really helpful, transformative experience in terms of determining where I wanted to work, what kind of community It really opened up my eyes to how lifestyle changes can really support patients and how community health centers reduce isolation and help in all these different various layers of health that we don't always focus on.

Grace: That's wonderful. What interested you then about going into addiction medicine specifically?

Elizabeth: Yeah, well I've always been interested in the human psyche, and mental health, and the ways in which we as humans sort of are powered, and what makes us make decisions, and how our prior experience and trauma kind of influences our day-to-day life. And so that was a background that had always been something I was interested in, and then I think that in combination with my experience working in the community health center where we were focused on behavioral change was more related to diet and exercise and mindfulness. But, working at the San Francisco General Hospital in residency and discharging people to the street, that was a really terrible experience. It led me to feel like one way of being able to do something that was useful for people experiencing homelessness was to be able to provide an extra service that, you know, while I wasn't a psychiatrist and didn't really have the skill sets of holding space for their trauma and other mental health, that I could at least provide support around their coping strategies with drugs.

Grace: So, you shared a little bit about being an AmeriCorps member, and one of my questions was about that. I wanted to ask a little bit more about what that experience was like for you, and how it's helped you in your career.

Elizabeth: Yeah, that was one of, I would say, one of my favorite years of my life. I was living in New York City, you know, I lived in Brooklyn, but I worked in the Bronx. And I was a part of this community of National Health Corps workers and people were doing various things across the city, so it was a really fun community to just kind of feel like we were all being thrown in after college with our limited experience, but a lot of enthusiasm.

My role was as a Geriatric Case Manager, and I was placed at the Urban Health Plan, which is in the South Bronx, in New York City. And it was amazing, because I got to do all these evaluations of patients, I was speaking Spanish every day, I got to do dementia screenings and write people for durable medical equipment and get to know them in all these ways. Then one of my favorite experiences there is we did interviews before and after for this lifestyle change program. Again, that was sort of this transformative moment where I got to interview people before and after for this program, and their levels of depression and healthy eating and exercise just completely improved with this intervention where they were building community and having all these comprehensive opportunities to promote wellness. And I was like, wow, these things really work - it's not because of a medication, it's not because of a doctor, it's because of them holding each other together and building friendships, and that was really powerful.

Grace: That's super cool. Okay so we kind of talked about this next question, too, a little bit. But obviously, medicine, and especially working in San Francisco and working with the patients that we do, it can be tough. What was something that was maybe a more discouraging moment in your career, either before or after being in your position now, and how did you deal with that situation?

Elizabeth: Good question. I think that there's a lot of feeling like an imposter, especially, I mean, I'm from Wisconsin, I went to state schools, and then coming to San Francisco, where, you know, everyone had a very shiny education, a lot of people had gone to Ivy League schools and had all these very incredible experiences. It's hard at times within medicine, I think, to not compare yourself to other people and feel that, oh, “I'm lesser than” because I don't have these scientific facts memorized, but I think what was helpful with time was starting to learn what I did feel more confident in and what were the core reasons of why I wanted to continue, or why I wanted to be a doctor. And so, I think that those were things to keep coming back to, and I think it's one of those things that continues to happen.

I will say, when I did end up doing a specialty training in addiction medicine, for the first time, I felt like a real expert in something and that helped a lot with my confidence. But I think there's just so much to know, and learning to be humble about it, and recognizing that this is sort of a career of lifelong learning. Also being able to admit when I don't know something, or challenging myself to keep learning is something that I'm continuously working on. Then just realizing that there's so many different people who go into this type of workforce and we all have so many different strengths to bring to the table. So even if I forgot all the ways that some sort of kidney disease process can happen, I can still be present with my patient and show compassion and you know, help to make their quality of life better, and that matters.

Grace: Awesome, yeah, thank you. Okay, I have two questions left. So, one is who or what inspires you and why?

Elizabeth: My first thought was my cat hahaha. So yeah, I know that's sort of a funny thing, but he's just, his life is so simple, and he focuses on rest and pleasure throughout his day. And I think that those are things that right now, I’m trying to continuously balance my world and remembering and giving time and giving prioritization to rest and relaxation is such a goal because I think in school and the track of medicine, it's like “go go go” and you always feel like you have to be climbing some sort of ladder or something. I feel like, at this point, I actually want to fill my other cup, my personal cup, and so yeah, at this time, my cat is really inspiring to me.

Grace: That’s an awesome answer! Okay great, my last question is about what advice you have for someone who either wants to become a doctor, or just wants to work in addiction medicine in any capacity.

Elizabeth: I guess my advice is to continue to find the things that bring you back to the reason you want to do it. So, if that's patient stories, and connections with patients, making sure that you're giving yourself the time and the space to connect to those experiences. Because I think there's this amazing opportunity within any sort of medical practice where you are privy to these really vulnerable parts of someone's life, and you know, they share things with you that most people don't get to hear. And so, I think that's something that can be really restorative, of holding that with honor and dignity and just letting it kind of restore you because there's a lot of extra work and notes and phone calls and other things that take you away from the reason, from the actual service. So, I think being able to, as much as possible, lean into those human experiences that this type of work allows you to have and continuing to work within your advocacy role of humanizing people who use drugs and humanizing people who are vulnerable and experiencing homelessness or other adversities, so that you're continuing to find purpose within this work.

Grace: Thank you so much for all your responses, that was awesome!