Fellows’ Face to Face
Sita Strother ’20, Anthropology
Sita Strother is a premed student and senior in Morse College majoring in Medical Anthropology. As an undergraduate fellow with Women’s Health Research at Yale, she works under the mentorship of Dr. Lisa Freed, a cardiologist at Yale New Haven Hospital and director of the Women’s Heart and Vascular Program at Yale.
What are you working on?
I am working with a cardiologist, Dr. Lisa Freed, who is the Director of Yale New Haven Hospital’s Women’s Heart and Vascular program and a collaborator with Women’s Health Research at Yale on integrating health research into clinical practice. She not only treats women but focuses on women’s heart health because of a gap in research and care that developed over time. I’ve been shadowing her in the clinic and gaining a lot of experience observing how she interacts with patients, particularly women. I’ve also been assisting with clinical research on adherence to cholesterol-lowering statin medication for women. Part of what I’m doing is updating the most recent literature review conducted in 2017. Statins are used to treat high blood pressure and lower levels of LDL cholesterol, the so-called “bad” cholesterol, decreasing the risk of heart attacks. The rest of my work is gathering data by examining patient records and conducting phone interviews. Basically, I follow up with patients, to see if they are taking statins and if they are adhering to their prescriptions, and if not, asking why. We are trying to see why women would stop following medical advice to improve their heart health.
Are problems of adherence to statin prescriptions more prevalent in women?
According to the literature, women have lower rates of adherence. It is unclear whether those reasons are specific to their gender. But it is clear that more attention needs to be paid to why women are less likely to take statins when they are prescribed. The most common reason why both men and women are reluctant to take statins is a fear of side effects. And in fact, when they first became available, there were lots of articles reporting their side effects. However, statins are the number one recommended drug to lower the risk of cardiovascular disease, and side effects are relatively rare. If they do occur, they often can be relieved or limited with help from a doctor. Most importantly, statins have been shown to be highly effective in both men and women in reducing the risks of cardiovascular disease, so it’s important that women get access to this treatment.
What have you observed about the way Dr. Freed interacts with patients?
One of the things that’s most impressive about Dr. Freed is how she makes every patient comfortable. I’ve noticed how she builds trust by remembering details about families and just being very conversational. You can tell that she has built relationships with the women she treats. It’s less “I am a doctor telling you what to do” and more “I care about you.” A lot of recommendations for heart health involve lifestyle changes, such as diet and exercise. Dr. Freed delivers these in a supportive, nonjudgmental way. There is a societal stigma around things like food and weight, and Dr. Freed has shown me how to talk about such topics in a sensitive way that does not seem punitive.
What drew you to this kind of research?
This is my first time doing clinical research and shadowing. When I applied for the WHRY fellowship, I asked for a clinical research placement because I’m thinking of going to med school and wanted to see what it’s like to be a doctor. It’s particularly rewarding to watch a female doctor who understands the barriers to succeeding in this field as a woman. I have a specific interest in cardiology because my mom is suffering from supraventricular tachycardia. Both my mother and I have mitral valve prolapse, which is a condition that is not life-threatening in most people, and Dr. Freed specializes in it. When I was younger, I had myocarditis, an inflammation of the heart muscle that can cause shortness of breath and chest pain. That was difficult to overcome, and I built a close relationship with my cardiologist at home who was a woman. It was influential to see a female doctor when I was that age.
Can you tell me more about medical anthropology, your major?
Medical anthropology is the study of how different communities and people interact with the medical system — from access to care to how people conceive of their own health and well-being, to how barriers to care affect communities differently. Medical anthropologists use techniques of anthropology, such as ethnography (getting to know a community very well by understanding their beliefs and practice), to influence medical care. A lot of it is being applied to policy and clinical practice. I’m doing work now for my thesis that is also related to women’s health. I’m studying inherited trauma among Native Americans and Jewish women and seeing if there is a path toward collective healing. I hope that by putting these groups in discussions with each other, I can learn more about the individualized experience of trauma and see if collective trauma is an effective way to talk about it.
How do you think your work has influenced your future goals?
At the beginning of the year, I was unsure about going to med school. I knew I was interested in global health research and medical anthropology, but I didn’t know if I would enjoy being a practicing physician. Watching Dr. Freed, the way she interacts with patients and the effect she has on them, convinced me it’s something I want to pursue. Doctors have the potential to do a lot of good. I value the doctors I have seen who believed me and validated my pain.
What are your plans after graduation?
Eventually I want to pursue an MD PhD in medical anthropology because I want to be both a doctor and an anthropologist. I think both skill sets reinforce one other. Understanding someone’s sociocultural context, their access to medicines, and the power dynamics underlying why someone might or might not trust medical professionals are important to understanding how to treat a patient. But first I want to take a few gap years doing more research related to inherited trauma and women’s health.
