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2026 Tarrant County Medical Society President Cheryl L. Hurd, MD

Feature Article

By Allison Howard Hunter

This article was originally published in the January/February 2026 issue of  Tarrant County Physician.

Dr. Cheryl Hurd, a psychiatrist committed to both clinical care and medical education, believes that organized medicine is the foundation that supports every other part of medical practice. But she’ll be the first to admit that she didn’t realize its importance early on.

“I was a student member of TMA, but I never did anything,” she says. The same was true during her residency in Arizona. But after years of participation, Dr. Hurd’s advice for medical students and residents is simple: Don’t just join—get involved.

When she returned to Texas and entered private practice, it was as the only psychiatrist in her medical group. Feeling alone, she rejoined TMA and immediately found connection in colleagues, committees, and a whole psychiatry track of support she didn’t know she was missing. “The camaraderie was huge,” she says. “I finally didn’t feel like the only one.”

Dr. Hurd’s involvement in organized medicine also offered practical benefits: TMLT insurance, CME funding, and—most importantly—the chance to advocate. Advocacy, she says, is what allows physicians to push back against excessive regulation, protect physician-led teams, and fight for the future of the profession.

She’s candid about the challenges physicians face. “Healthcare is regulated more than almost any other industry,” she says. Yet advocacy has delivered real wins: tort reform, increased medical education funding, and—critically for her field—expanded mental health funding in Texas even during budget-cut years.
“That’s why advocacy matters,” she says. “It protects us, it protects our patients, and it keeps our profession alive.”

And, as she found, those who advocate for you also have your back at the toughest of times, sometimes in ways that are less obvious than legislative wins. In 2020, when physicians were on the front lines of the COVID-19 pandemic and PPE was scarce, putting healthcare professionals at greater risk, Dr. Hurd was surprised to receive a box from TCMS.

“I opened it up and it was five hundred N-95 masks,” she says. “Just this whole box of N-95s. And then there was an email. It was from TCMS, saying, ‘Hey, we’re trying to help you.’ And they sent it to every single member; they sent every member a box because they wanted to protect us.”

Dr. Hurd credits that support as the reason she got even more involved, leading to her serving as our 2026 TCMS president. She saw in TCMS a reflection of her own ideals—a mission to care for patients, physicians, and the physician-patient relationship.

But it is the physicians like Dr. Hurd who give our medical society its heart, inform its values, and guide its vision.

“Dr. Hurd is the intelligent and compassionate doctor that you would wish to take care of your dearest loved ones,” says Helene Alphonso, DO, a friend and mentee of Dr. Hurd. “As a mentor, she nurtures lifelong learning at every level of medical education. She advocates for her patients and fellow physicians with countless hours and innovative solutions. . . . We can’t wait to see how her leadership in the Tarrant County Medical Society will shape the future.”

Though Dr. Hurd is now passionate about all things medicine, growing up, she did not want to be a doctor—or a teacher or a dancer or even a veterinarian (though she does have a major love for animals). No—at six years old, Dr. Hurd was determined that she was going to be a lawyer. She held on to this dream all the way through college, where she earned both a bachelor’s and a master’s degree in English from SMU, still convinced that law school was her next step.

It was during those years of study that Dr. Hurd met her husband, Howard. They had a good plan: he would go to medical school, and she would go to law school. Still, she decided to defer for a year because his education was taking him to Houston, while Dr. Hurd’s was taking her to Austin. As newlyweds, this separation was hardly appealing, and with law school only taking three years against medical school’s four, the choice was easy for her to make.

Dr. Hurd had planned to work in editing or proofreading for the year, but with a competitive job market and no connections in a new city, she had a frustrating lack of success. One day, she asked her husband if she could join him for his classes to give her something to focus on aside from the unfriendly job market, so he brought her along. She was immediately enthralled.

“A couple of weeks into his school, and I’m sitting there in the classroom taking more notes than he is,” Dr. Hurd says, laughing. “And I just thought, ‘Wow—this is fascinating. Why did I never study this?’”

Quickly, her decision was made—medicine was her future. In a short time, a passion grew into something she knew would sustain her in the years ahead.
Dr. Hurd and her husband were both accepted to Texas Tech’s School of Medicine, so they made the move to Lubbock. A couple of years later, Howard matched to a general surgery residency in Temple, Texas, so she transferred to A&M College of Medicine to complete her clinical rotations. When she graduated in 1998, she began her psychiatry internship at Good Samaritan Regional Medical Center in Phoenix, Arizona. Her training was unique—a joint internal medicine and psychiatry program that allowed her to combine the specialties that most interested her.

After her internship and four years of residency, Dr. Hurd was more than ready to begin practicing as a fully qualified psychiatrist. She and her husband knew they wanted to come back to Texas—the question was simply where they would land. Having their friends and family here was a huge draw for the young couple, but they were also motivated by positive legislation for medicine.

“With tort reform in 2003—that’s when I graduated residency—I was thinking it would really be nice to not have escalating malpractice costs,” Dr. Hurd says. “They’d still get money if I actually did something wrong, but the goal was that all the frivolous lawsuits would go away. And by and large, they have.”

They settled in Brownwood, Texas, where Dr. Hurd set up a psychiatry solo-practice collaborating with a larger organization of specialists. She was the only psychiatrist in the area, and she also consulted at the county hospital. At first this kept Dr. Hurd quite busy, but her practice slowed down after the financial crash of 2008. Soon she moved to Fort Worth, where she joined UNT Health Science Center and UNT Health, although her clinical assignment was at JPS. She later transitioned to Acclaim Physician Group when it was formed, and she stayed there until 2022. Throughout that time, her role grew from serving as the consult medical director to being the psychiatry program director and vice chair of education.

Though she was involved in education through TCOM and JPS, she maintained an active full-time practice. However, when she began serving as TCU Burnett School of Medicine’s psychiatry clerkship director, she stepped back from her role at JPS and joined Connections Wellness in a part-time role.

“At Connections Wellness, I still have a clinical job where I see patients and precept students,” says Dr. Hurd. “And then I had my role as psychiatry clerkship director. I do the behavioral health year-one lectures, clinical skills, and things like that. So, I’m all things psychiatry at the School of Medicine.”

Though Dr. Hurd treasures her role within medical education, she did not seek it in the early days of her career. When opportunities first arose in education, she turned them down in favor of focusing on her clinical practice.

“I thought, ‘No, I’m just going to go out and save the world one patient at a time,’” she remembers. “‘I’ll do clinic and just be a doctor, be a practicing physician. That’s what I was trained for.’ When I started at JPS, I just thought I’d be a psych consultant like I was at the county hospital down in Brownwood. So, I show up, do my orientation, and they’re like, ‘Here’s your team.’

“I went, ‘Team? What team?’ I had a resident, I had an intern, I had students. I just tried to base my precepting on some of the best preceptors I’ve had in my training. So that’s how I got involved and learned that I really loved it.”

Much like her discovery of medicine, Dr. Hurd considers this unexpected assignment another act of serendipity—one that was to her benefit, as it was (and is) for the many residents and medical students who have been under her tutelage.

Her colleague, Debra Atkisson, MD, has seen Dr. Hurd make a big impact both in education and practice throughout her career.

“I have known her for more than fifteen years and have observed her dedication to her patients and the medical students and residents she has taught,” says Dr. Atkisson. “She has provided our community and the state of Texas with outstanding education about psychiatry. . . . We are very fortunate to have Dr. Hurd serve as our president for Tarrant County Medical Society.”

Dr. Hurd has had variety in the roles she has held throughout her career, but they have all hinged on one overarching goal: supporting mental health for physicians and patients alike. This has involved making petitions both to TMA and the Texas Medical Board, being involved in mental health legislation through First Tuesdays, and serving on councils and boards supporting mental health—including TMA’s Physician Health and Wellness Committee, where Dr. Hurd served for the maximum nine-year term, including two years as vice chair and two years as chair.

Though progress has been made in mental health support and treatment, she sees that much more lies ahead.

“I want to continue to work on reducing the stigma and also try and get more involvement in the community itself to support and encourage and grow mental health access.”

But the problem goes beyond the average patients—physicians struggle greatly when it comes to accessing mental health.

“We’re the last ones to go seek help,” she says. “There used to be punishment for physicians with their licensure when they were under treatment. So, they didn’t seek treatment, or they felt like they couldn’t be honest about treatment. And there’s been a huge effort to flip that narrative and get physicians to understand it’s actually okay to get treatment, and this is thanks to both the TMA and the Texas Society of Psychiatric Physicians, after much work and many, many years.”

As she begins her term as TCMS president, Dr. Hurd does so with the goal of continuing this mission.

“One of my goals is to get the community more informed of opportunities for mental health support,” she says. “We are also trying to work on increasing access and bringing more behavioral health and mental health programs to the area.”

Those who know her believe Dr. Hurd will thrive in this role and ably utilize the opportunities it provides.

“I knew of her leadership at the Texas Medical Association, where she served on the Physician Health and Wellness Committee,” says Angela Self, MD, who has been friends with Dr. Hurd for many years. “She works tirelessly for her patients and for the practice of medicine. . . . She sacrifices many hours volunteering, advocating for the improvement of healthcare for physicians and patients across the country.”

As Dr. Hurd looks toward the future, she does so remembering the many physicians who have impacted her career. Carol Nati, MD, was a great mentor for Dr. Hurd, especially during her time at JPS. Dr. Atkisson encouraged her to get involved with TCU’s School of Medicine and Connections Wellness, and Greg Phillips, MD, helped give Dr. Hurd the drive she needed to get more involved with TCMS. Dr. Hurd credits these physicians—alongside many others, and her ever-supportive family— for helping her become the doctor she is today.

Though medicine always keeps her busy, Dr. Hurd loves spending time with her husband; their two children, Dawna and Perry; and their dogs (they always have several, and there is usually a rescue in the mix). If she has a spare moment, you’ll probably find her reading a book—all genres are welcome!—or joining in a multiplayer computer game that her husband got her involved in years ago. She’s now the only one in her family that plays, but through it, she has developed a network of friends spanning the globe.

“It’s kind of fun to have long-term friendships that are not based on just your circle,” says Dr. Hurd. “It gets us out of our comfort zones in those boxes we live in, where we only do things with people who are pretty much like us.”
Dr. Hurd is eager to widen her scope of friends and colleagues even further in the year ahead as she partners with physicians and other change-makers to make a difference for medicine in Tarrant County and beyond.

“I’m excited to see what we accomplish for medicine in 2026,” she says. “There’s a lot of work to be done!”

Project Access Tarrant County: 2025 in Review and Building Toward 2026

Project Access Tarrant County Update

By Kathryn Keaton

This article was originally published in the January/February 2026 issue of  Tarrant County Physician.

Another year has come and gone at Project Access Tarrant County (PATC), and as we close out 2025, we reflect on a year marked by both meaningful growth and strengthened community collaboration. Through the efforts of our volunteer physicians, hospital partners, and community collaborators, PATC continued its mission of bridging gaps in specialty and surgical access for uninsured residents of Tarrant County.

Patients Served and Clinical Impact
In 2025, PATC supported 243 patients through specialty and surgical care that would otherwise have been treated through emergency departments or would have gone untreated. These services included surgical care in general surgery, gynecology, colorectal surgery, urology, orthopedic surgery, cardiology, gastroenterology, ENT, and ophthalmology, as well as other non-surgical specialties. Despite continued high demand, we eliminated our gynecology waiting list, leaving only general surgery with a significant waiting period.

“I never thought this type of help existed for people in my condition. Even though I work, I don’t have health insurance and cannot afford medical care. I do all kinds of jobs; I don’t look for handouts. I am beyond thankful.” – Joe, 74, prostatectomy

Provider Engagement & Volunteer Leadership
None of PATC’s impact is possible without our network of volunteers. In 2025, over 60 physicians donated their expertise as well as ten hospitals and surgery centers. Our ancillary partners are vital as well, providing required imaging, anesthesia, pathology/labs, physical therapy, and other services. Volunteers see patients in their own offices and choose the maximum number of patients they see annually.

“Volunteering for Project Access is easy. PATC sends physicians the workup needed for patients vetted for our specialty. We just show up and treat the patient!” – Omar Selod, DO; Physical Medical and Rehabilitation and Project Access Tarrant County volunteer

Program Innovation & Process Improvements
In 2025, PATC expanded our technological capabilities. We broadened our patient communication tools to reduce no-shows and improve follow-up adherence and continued integration of CareMessage for appointment reminders, health and disease education, and multi-lingual patient support. In addition, we introduced Salud en Tus Manos (Health in Your Hands), in-person classes that address a variety of social drivers of health issues that our patients face. Thirty-one patients attended four classes held over 2025, and more curriculum is being added for 2026.

“Because of this class, I feel more confident in asking my doctor questions so I can better understand my diabetes care.” – Yolanda, Salud en Tus Manos “How to Communicate with Your Doctor” attendee

Community Value & Financial Stewardship
The collective value of donated care in 2025 is estimated at $1.5 million, reflecting both the generosity of our volunteers and the community’s investment in equitable access. Despite these high service levels, operational efficiency has kept PATC’s cost per surgical procedure coordination at approximately $1,500.

By facilitating specialty care, PATC reduces unnecessary emergency department utilization, prevents costly complications, and supports patient well-being beyond the clinical encounter, underscoring the value of collaboration and reflecting strong stewardship of both financial and human resources.

“The emergency department is the least efficient and most expensive way to deliver gynecologic care. Hemorrhaging women are transfused and sent home, only to return the next month when their menses return. Project Access identifies these suffering women and connects them with the definitive care—usually hysterectomy—they need. My role as the volunteer surgeon is made incredibly easy. Project Access coordinates the facilities, supplies, OR staff, and nursing—all I have to do is operate.” – Michelle Arevalo, MD; Obstetrics and Gynecology and Project Access physician volunteer

Challenges and Lessons Learned
While 2025 brought significant milestones, we also encountered challenges—including our wait list in general surgery, variable engagement across certain ZIP codes, and continued navigation barriers tied to social determinants of health. We are using these insights to expand patient education efforts and approach partnerships from a data-informed angle.

2026 Goals & Momentum
As we enter 2026, PATC is focused on expanding our capacity to meet growing needs. Our priorities include recruiting new physician volunteers—especially general surgeons—as well as expanding patient education related to social drivers of health.

With continued support from physicians and partners across the county, we anticipate a year of elevated impact and strengthened patient outcomes. We thank our physician community for their commitment and look forward to what we can achieve together in 2026.

“This experience changed my mentality—that there are people that may not know someone but still care about them. Sometimes people aren’t willing to donate five minutes of their time, so the doctors giving their services and time is incredible.” – Marisa, 48, hysterectomy

What We Carry: Reflections of Tomorrow’s Physicians

TCOM Student Article

By Jean Nie, OMS-II

This article was originally published in the September/October 2025 issue of  Tarrant County Physician.

While weaving through the Oculus in New York City, I found myself drawn to a small storefront with walls covered in handwritten notes. The space, The Strangers Project, invited passersby to pause and read the anonymous stories of others—fragments of lives laid bare in ink. I wandered slowly, absorbing confessions of heartbreak, illness, hope, loss, and quiet resilience. As I read, I was reminded that every person is carrying something—often invisible, often unspoken—and how unjust it is to reduce a person to a single narrative, a surface impression, when human beings are anything but simple. Despite the many ways we might differ, I felt a deep familiarity with their words. Suddenly, in a city that often feels vast and indifferent, the room felt like a heartbeat—small, warm, and profoundly human.

Fast forward to my first year of medical school. That experience stuck with me, and I found myself trying to recreate a version of that space—this time in the halls of my own school. I organized a “reflection wall” for SOMA, a student-led advocacy organization, not knowing how it would be received. Nevertheless, I wanted this reflection wall to serve as a space for medical students to share their feelings and thoughts in the midst of a seemingly never-ending study session. Over the course of the day, I watched as students came in, some in waves, some peeping their heads in out of curiosity. Some students I knew, others I had only smiled at in passing. But gradually, the wall became filled with notes. Some were long, taking up the entire allotted half page, while others left short yet equally impactful single liners. The vision for this wall was to provide a space for students to pause in the middle of the relentless pace, to process what we often suppress, and to speak without needing a response—only to be heard.

There were papers written with bubbly letters that matched bubbly attitudes. Several students wrote about the moment they knew they wanted to enter medicine: a family member that was saved, a compassionate healthcare worker who made an exception to hospital policy so a patient could say goodbye to a loved one, and personal anecdotes of healthcare saving the writer. These stories echoed familiar themes of wanting to make a difference, to help people feel seen, to be a source of hope during dreary times. Many mentioned that despite the difficult journey, they are reminded of the privilege it is to be in this position, and by expressing gratitude, they are able to see the light at the end of the tunnel, even during the late nights.

But alongside the gratitude, the wall became a fuller picture. Many of the students were tired—beyond tired. Not just from studying, but from what feels like a constant negotiation between who they are and who this profession demands them to be. There were reflections that whispered of burnout and others that screamed of it. There were fears that ran deeper than fatigue—fears that this profession might not deliver on its promise of fulfillment and that a patient’s care would be determined by billing codes and insurance coverage rather than sound clinical judgment. Some reflections expressed fear of the future as well as scars from the past, especially moments where the healthcare system abandoned them or a family member physically or fiscally.

But the pain extended beyond the personal. Threaded through many reflections was a sense of despair about the system itself. Students wrote about the deep inequities they had witnessed: how wealth shapes not only who becomes a doctor but who gets to see one. How poverty, often the root of illness, remains beyond the reach of prescriptions. How medicine tends to treat symptoms while the structural causes—housing, food insecurity, systemic injustice—go untouched. One note captured a particularly painful irony: that even physicians, trained to heal others, often struggle to care for themselves.
I stood in front of the wall in silence, letting each emotion resonate with a part of me that’s felt it before. Like those notes in the Oculus storefront, the ones we wrote were acts of vulnerability—honest, unfiltered moments that revealed the beating heart beneath the white coat. That tension between inspiration and injury felt like the core of the wall. I realized that in creating this space for my classmates, I found myself reconnecting with the essence of why I chose medicine: to confront, to share, and to bear witness to the human experience alongside others. Because at its core, medicine is not just a discipline of diagnoses and treatments—it is a deeply human endeavor. It asks us not only to learn but to listen. Not only to act but to bear witness. Science may guide our hands, but it is our humanity that allows us to truly heal.

The fears expressed by my peers are real, and some will undoubtedly come to pass, if they haven’t already. But within the fatigue and frustration, I felt a reprieve. It’s in these moments of reflection, both quiet and collective, that I find the thread connecting all of us—not just as students or future physicians but as human beings. If we can protect that thread and create space for our own humanity as fiercely as we do for our patients’, then perhaps we won’t merely endure this profession; we’ll have a hand in reshaping it.

2025 Gold-Headed Cane Recipient David P. Capper, MD

Feature Article

By Allison Howard Hunter

This article was originally published in the November/December 2025 issue of  Tarrant County Physician.

When asked about the best aspect of practicing medicine, Dr. David Capper doesn’t miss a beat. “It’s the people,” he explains. “I think it really just boils down to the opportunity to have in-depth relationships with people.” This makes perfect sense when you look at the trajectory of Dr. Capper’s career—it’s always about the people, whether it’s the unhoused, the underserved, or the dying. From his involvement in street medicine to his longtime work in hospice care, Dr. Capper’s passion for people has led his peers to select him as the 2025 Gold-Headed Cane recipient. For those who know him, it doesn’t come as a surprise.

“David truly embodies the spirit of the Gold-Headed Cane,” says 2024 Gold-Headed Cane recipient Stuart Pickell, MD, a longtime friend of Dr. Capper’s. “I once heard of a patient he treated for skin lesions caused by an arthropod infestation. Not only did David provide medical care, but he also arranged—and personally paid—for the patient’s home to be exterminated. That story captures who he is at his core: physician, colleague, advocate, educator, ethicist, disciple.”

Dr. Capper’s life can be defined by many excellent things, but he defines himself by what is most important to him: his faith in Jesus. As a longtime Christian, Dr. Capper says his motivations ultimately come from his desire to honor God by serving others. He cites Matthew 5:16 as his guiding scripture: “Let your light shine before others, that they may see your good deeds and glorify your Father in heaven.” (NKJV)

He is humbled to receive the Gold-Headed Cane, which he has a unique tie to: his father, Robert Capper, MD, himself received the recognition in 2005.
“It’s not something you strive for,” says Dr. Capper. “What I thought about the Gold-Headed Cane over the years is that it’s a recognition of the peers of a physician whose life was committed to the profession and those professional values. And so, it’s very humbling, and it’s honoring.”

Dr. Capper has long had a passion for service, but he wasn’t always sure that medicine would be his medium. Though his father was a physician and his mother a nurse, he didn’t decide to pursue medicine until he was near the end of his collegiate career.

“I had an extremely high regard for my father and his peers,” he says. “The people that I was introduced to through my parents that were physicians were of the highest integrity, and I thought that’s the way physicians all were. And I didn’t quite see myself in that same category.”

It wasn’t until an emergency appendectomy between his junior and senior years of college that his path became clear. In a way, this was a blow—Dr. Capper was the captain of his football team, and he had recently gotten an All-American honorable mention, yet he would not be able to play the first half of the season. But being forced to slow down gave him the opportunity to spend a lot of time praying about his future. By the end of his stay, Dr. Capper felt a clear calling to become a physician in spite of his reservations. And instead of being intimidated by the excellence of the physicians he knew, he used it as a standard to strive for.

After Dr. Capper completed his undergraduate degree in liberal arts from Austin College and fulfilled his prerequisites, he began his tenure at the University of Texas Medical School at Houston. This was an enriching time that opened Dr. Capper’s eyes to the many possibilities of medicine.

He graduated from medical school in 1982 and was accepted into Good Samaritan Hospital’s internal medicine residency program in Portland, Oregon. It had a multidisciplinary pain program and was home to one of only two hospices in the state, both of which Dr. Capper credits as being formative to his education.

Throughout his medical training, Dr. Capper did extensive mission work, with the goal of eventually working in foreign medical missions. During this time, he met his wife, Dianne, who shared his passion for ministry. When he completed his residency, they planned to pursue mission work together, but a number of life circumstances kept them from taking the leap.

They ended up moving to Tyler, Texas, where Dr. Capper filled in as an emergency room physician. The family eventually came to Fort Worth, where he worked in the Harris Methodist Hospital Emergency Department and then joined E. Richard Holden, MD, a hematologist who needed help in his practice. Ultimately, Dr. Capper pivoted his ministry mindset to a local one—for the most part. Though he never went into foreign mission service full time, he has participated in over 30 short-term mission trips, the majority of which had a medical basis.

In the years since, Dr. Capper has worked in a variety of positions. He would not consider himself a traditional internist—he has a background in emergency medicine, pain management, geriatrics, cardiology, and palliative care that have played extensive roles in his career.

“I don’t know what I’m going to do when I grow up,” he says, laughing. “I’ve worn so many different hats and continue to do so.”
Throughout his extensive career, Dr. Capper has been heavily involved in medical education for both students and residents, was among the founders of a hospitalist program, worked in private practice, had a leadership role in an independent physician association, was the medical director of a PPO, and served as the medical director of one hospice program and CEO of another. He was among the founding members of a charitable clinic and helped to start JPS’s street medicine program, serving as their de facto medical director in its earliest years. He has worked as a nocturnist and helped to start several medical organizations.

Through the many roles he has held, one he has continually been drawn to is the critical but challenging practice of palliative and hospice care. While there is nothing easy about this field, he values the opportunity to help complex patients manage their conditions and terminal patients pass their last days with the greatest possible dignity and comfort.
Currently, Dr. Capper serves as the CMO of Community Healthcare of Texas, where he also oversees both their hospice and supportive care programs. He is on the faculty of both the TCU Burnett School of Medicine and the Texas College of Osteopathic Medicine (TCOM).

Dr. Capper has been impacted by many people throughout his career, but his greatest support has always come from Dianne, who has worked in ministry alongside him—all while raising their six children and, for a time, their foster daughter.

“I can’t have this conversation without talking about my wife,” Dr. Capper says. “She has supported me and managed our family in my life of craziness; it’s really remarkable.”
He is also grateful for his many siblings and their spouses—he is one of seven—and his parents for the impact they have had on him.
“I have a phenomenal family,” Dr. Capper says. “And you talk about influence on your life. . . . There’s a natural motivation when you have such great people who are encouraging you to do well.”

He views his parents as his ultimate medical heroes and says that their hearts of compassion were critical in the formation of his own worldviews. There are many other mentors and friends he would like to acknowledge for the impact they’ve had on him, and a few are the late John Richardson, MD; Drew Ware, DO; Michael Ross, MD; John Burke, MD; and Bob Keller, MD.

Dr. Capper is grateful for the impact his colleagues have had on his life, and many of those he has worked alongside over the years return the sentiment.
“David is a solid, conscientious physician, and I always felt secure knowing that he was helping my patients when I was away,” says Greg Phillips, MD, a friend and former colleague. “His work in our community helping the underserved and uninsured is without equal.”

Dr. Capper stresses that for patients who are underserved, it is critical to meet them where they are.

“The old saying goes that healthcare is local, right?” he says. “And it’s also true for disenfranchised communities.”

After Dr. Capper began practicing medicine in Texas, he and a group of dentists, physicians, and nurses worked together to start Beautiful Feet’s charitable clinic. It was 1988; JPS only had one central clinic, and the Fort Worth city-run clinics were in the process of being shut down, leaving a gaping hole in the community. The new clinic saw its first patients in 1989, and they have been going strong since. Dr. Capper has served as the group’s volunteer medical director since their doors opened.

“Dr. Capper has been leading [the] . . . clinic through Beautiful Feet Ministries for over 40 years, targeting the homeless and poor living in the Historic Southside of Fort Worth,” says Sarah Myers, Beautiful Feet Ministries co-director. “Through this clinic, countless people have benefited from Dr. Capper’s expertise and compassion.”

Approximately 80 percent of the clinic’s patients are unhoused, which creates unique challenges for continuation of care. His longtime work with this population made Dr. Capper an ideal fit for heading up JPS’s work in street medicine. Later brought on to oversee the palliative care program at JPS, his role grew from working as the volunteer medical director to eventually becoming the staff medical director of their unhoused program.

Though he stepped away from the position in 2022, Dr. Capper is proud of the strides JPS has made in street medicine.

“When we were able to get the 1115 waiver grants—well, I’m not proud of a lot of things, but I am proud of what we were able to structurally do with that,” says Dr. Capper. “And that allowed us to create a program that really addressed the needs of Tarrant County homelessness.”

Though there is a great need for medical care among the unhoused, Dr. Capper has had a broader outreach than that. He helped to form Project Access Tarrant County (PATC), Tarrant County Academy of Medicine’s (TCAM) program that provides specialty charitable care for those who have no resources outside of emergency rooms and primary care charity clinics. He has been on the PATC board since the organization was formed in 2011.

“Dr. Capper was integral to the creation and success of Project Access,” says PATC Director Kathryn Keaton. “His knowledge of charitable care is second to none and is only exceeded by his passion for accessible, comprehensive care for every individual in Tarrant County.”

Dr. Capper is heavily involved in charity care, but he still makes time to focus on a sister cause: medical ethics. He has been on a number of ethics committees, including TCAM’s ethics consortium, and he currently chairs the ethics committee at Medical City Fort Worth.

Because of his work in palliative and hospice care, this has continued to be a significant focus throughout his career.

“You have a lot of potential ethical conflicts in this world,” he says, “so I started going to conferences 20 years ago and then eventually entered a master’s program in biomedical ethics.”

He graduated with his master’s from Trinity International University this past December, and he plans to keep teaching medical ethics not only to physicians but to the public at large.

“So many of these conflicts that we deal with in clinical ethics, they come back to just people living their lives,” Dr. Capper says. “How many of these ethical conflicts could be avoided if people only took a knowledgeable approach to their own advance care planning?”

Like many things, Dr. Capper believes it comes back to education—one of his greatest passions.

Dr. Capper knew he liked to teach early in his career. When he had an extended year in his residency as the chief resident, it was a heavily teaching-focused position. He loved sharing with and learning from other doctors to make the group better as a whole.

When he moved to Fort Worth, teaching at TCOM—which his father had also done—was a natural transition. He works in their geriatric medicine department, and he also joined TCU’s faculty when the medical school was started in 2018; he serves as the chair of clinical sciences. He had also been involved in teaching residents at JPS and Medical City Fort Worth.

He has three charges for those who are just starting out on their careers: physicians must consciously subjugate their own desires for the good of the patient; they have to recognize the unique role of the profession and the responsibilities it entails; and they should always practice with humility.
“We must realize we are no better than our fellow human beings and treat them with respect, no matter what the circumstances of a fellow human being are.”

Dr. Capper does not limit his teaching to the classroom; he marries his love of education with caring for the underserved most Saturdays when he oversees the student-run clinic at Beautiful Feet. As he works with students, he encourages them to make sure they have the right perspective when caring for their patients.

“My warning to the future of medicine is that we need to come back to more of a standard that is time immemorial,” he says. “We shouldn’t bend to the culture; we still need to hold true to ultimate or eternal values.”

Ultimate and eternal values drive Dr. Capper in all that he does. When he isn’t working, he has often spent time ministering to others alongside his family; years ago, when his children were growing up, they did family mission trips together every summer instead of family vacations.

He is incredibly proud of the people they have become, and whenever he and Dianne have the chance, they love spending time with their children, their children’s spouses, and their ten grandchildren, as well as close friends they have worked and served alongside over the years.

Looking back over his career, Dr. Capper is grateful for the path his life has taken.

“You have a relationship with people that exceeds that of any other relationships between people and a profession,” he says. “It’s not just contractual but covenantal; it’s about making a difference.”

Project Access Tarrant County

Salud en Tus Manos:
Medication
Management

By Kathryn Keaton

This article was originally published in the September/October 2025 issue of  Tarrant County Physician.

On July 16, Project Access Tarrant County (PATC) held its second Salud en Tus Manos class. For those unfamiliar with it, Salud en Tus Manos (“Health in Your Hands”) is a new initiative under PATC that addresses the social drivers of health (SDOH) faced by many of our patients. These classes, provided through Texas Health Community Hope as part of our Community Impact Grant, are designed for patients with diabetes and/or hypertension who live in one of five priority ZIP codes: 76010, 76011, 76104, 76105, and 76119.

The July class, “Managing Your Medications,” guided participants through the entire prescription process—from the doctor’s visit where a medication is prescribed to understanding labels, following directions, and knowing how to request refills.

Why This Curriculum Matters
Medication adherence is a challenge nationwide, especially for chronic conditions like diabetes and hypertension. When compounded by SDOH such as language barriers, limited formal education, or financial insecurity, the consequences can be severe.

In fall of 2024, PATC saw this firsthand. A 39-year-old woman had waited more than a year for gynecological surgery. When she finally received a surgery date, her pre-op testing revealed dangerously uncontrolled diabetes. Records showed she had not returned to her primary care provider since her initial PATC referral, and she admitted she skipped follow-ups because she “felt fine.” Without those visits, she never received medication refills. Her surgery was canceled, delaying treatment another five months. Though she eventually had a successful procedure, her experience underscores the importance of consistent care and medication compliance—the very issues Salud en Tus Manos seeks to address.

Who We Reached
Our July participants were foreign born with a median age of 45. All had lived in the United States for at least 18 years. The highest level of formal education completed was eighth grade, with 75 percent of the attendees’ education taking place outside the United States. Every participant had hypertension, and half also managed diabetes. All reported attending medical appointments every three to six months.

While all participants felt “extremely confident” in understanding their medications, half believed they could take prescriptions however they wished as long as the medication was prescribed, and all believed they could not receive their medications in their preferred language.

Encouragingly, the post-survey showed significant improvement: 100 percent of participants correctly recognized the importance of taking medication exactly as prescribed.

Hands-On Learning
The class combined instruction with interactive activities. Participants identified warning labels, practiced interpreting dosage and timing instructions, and learned when and how to request refills—not only for their chronic condition medications but for all prescriptions.
Like our first class in March, participant satisfaction scores reflected both engagement and impact. The curriculum is clearly filling an important knowledge gap and helping patients feel more confident in managing their health.

Looking Ahead
Medication management is a crucial step toward improving long-term health outcomes, and Salud en Tus Manos is proving to be a meaningful resource for patients navigating barriers to care. With every class, PATC and its partners continue working toward healthier futures for our community.
Our first class, “How to Communicate with Your Doctor,” gave patients the tools to ask questions and advocate for themselves during medical visits. This September, we will be offering that class again—this time with two sessions, one in English and one in Spanish. The program will continue to grow. The next planned class, “Food as Medicine,” specifically requested by half of past Salud en Tus Manos attendees, will explore how nutrition choices can support patients in managing chronic conditions and improving their overall well-being. Together, these classes are building a foundation for healthier lives—one step, one conversation, and one patient at a time.

The Last Word

Lifestyle Modifications

By Hujefa Vora, MD, Publications Committee Chair

This article was originally published in the September/October 2025 issue of  Tarrant County Physician.

With your annual physical last week, we drew annual labs. We’ve got to discuss these results today. Your cholesterols need better control. Your total cholesterol is greater than 200 mg/dL, but to really understand these results, we’ve got to look at the breakdown. Your HDL, your “good” cholesterol, should be higher than 40 mg/dL. It looks like we have some work to do on this.

No, you don’t need to increase your cholesterol intake. To raise your HDL level, you need to increase your aerobic exercise. You need to make some lifestyle modifications. Your LDL, your “bad” cholesterol, is markedly elevated, and this is not a good thing. This combination of low HDL and high LDL can dramatically increase your risk for cardiovascular disease. I want to finish reviewing these lab reports, and then we will take a few minutes to circle back to this issue. Let’s see here. Your kidney and liver function tests are normal. Your fasting blood sugar is a little higher than expected. Your blood counts, red blood cells, white blood cells, platelets—all look good, which means your inner factory is working. The implication here is that your nutritional status is good. Your body has all of the raw materials it needs to produce all of these cell lines. Your thyroid appears to be functioning at normal levels. Finally, and most importantly, there is the matter of your glycosylated hemoglobin level. This has nothing to do with the blood counts and hemoglobin we reviewed earlier. It is actually also called hemoglobin A1c. This is a measure of your average blood sugar level over the past three months. And your A1c is just a tad on the higher side here. The World Health Organization defines diabetes as an A1c of 6.5 percent or greater. Your numbers landed in the prediabetes range. So now we’ve really got some more issues to talk about.

Alright, no time to panic. I want us to relax and really understand what it is we are talking about here. Prediabetes is like a warning shot. Your body is telling us that if we don’t take action in the here and now, then you are at significant risk of developing diabetes.

No, you are not diabetic. I understand that you feel fine, that you don’t feel diabetic. The thought I want to stress to you is that this is a preventative visit. Our goal is to prevent the complications of low HDL, high LDL, and borderline hemoglobin A1c. Those complications include heart attacks, strokes, kidney disease, vision disturbances, all ultimately negatively affecting your quality of life, possibly even your quantity of life.

No, these levels are not fatal, but if we let these things go long enough without addressing their root cause, the complications can be detrimental to your overall health. The most effective ways to lower your risk of developing diabetes when you are prediabetic are by losing weight, increasing physical activity, and eating a healthy, well-balanced diet. I don’t expect you to go out and run a marathon (although that would be amazing!) but rather just make some modest lifestyle modifications. If you are able to effectively make lifestyle modifications, then we may be able to avoid full-blown diabetes. We may not necessarily need to prescribe medications right off. Lifestyle modifications most certainly can help to decrease your risk of heart attacks and strokes.

Lifestyle modifications. That’s a buzzword that we talk about in our offices all the time. I’m going to give you some food for thought at this point. Lose excess weight. For people who are overweight, losing just 5 percent to 7 percent of your body weight can reduce your risk of developing type 2 diabetes by over 50 percent.1 Increase physical activity. The CDC recommends getting at least 150 minutes of moderate-intensity aerobic exercise per week.2 This can include activities like brisk walking, cycling, or water aerobics. Regular exercise helps your body use insulin more effectively. Combine cardio with strength training. Incorporating strength training for all major muscle groups at least two days a week further improves insulin sensitivity and glycemic control.2 Quit smoking. Smoking can increase insulin resistance, making it harder for your body to manage blood sugar. Get enough sleep. Poor sleep is linked to insulin resistance and weight gain. Aim for seven to nine hours of quality sleep per night. Manage stress. Chronic stress can increase blood sugar levels. Find healthy ways to cope, such as meditation, yoga, or deep breathing exercises.

Lifestyle modifications also include making dietary changes. Focus on whole foods. Emphasize a balanced diet rich in vegetables, fruits, whole grains, and lean proteins and low in saturated and trans fats. Choose high-fiber foods. Fiber-rich foods, such as vegetables, fruits, and whole grains, slow down digestion and prevent rapid blood sugar spikes. Limit refined carbohydrates, processed foods, and added sugars. Avoid or limit sugary drinks, processed foods, and refined carbohydrates like white bread and pasta, which can cause blood sugar levels to spike. Drink more water. Water is the best choice for hydration and helps to maintain healthy blood glucose levels.

In the American medical system, we don’t emphasize preventative medicine as much as we emphasize reactionary medicine. We are taught to take care of the problems, treat the complications of underlying symptom-free subclinical metabolic issues. As primary care physicians, our role is to work to prevent disease, keeping you healthy so as to avoid illness. Most of what I discuss with my patients in clinic was not given to me through books in medical school but rather acquired through years of experiential learning, caring for the healthy, and teaching them to avoid disease. Lifestyle modifications don’t always get into our medicine textbooks but they should. The point of my diatribe today? Make sure that all of you are going to see your primary care physicians. Make sure that you are taking care of your health, so that all of us can better understand and serve our patients. My name is Hujefa Vora, MD, and this is my Last Word.

References:

  1. “Diabetes Prevention: 5 Tips for Taking Control,” Mayo Clinic, March 12, 2025, https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639.
  2. U.S. Afsheen Syeda et al., “The Importance of Exercise for Glycemic Control in Type 2 Diabetes,” American Journal of Medicine Open 9 (June 2023): 100031, https://doi.org/10.1016/j.ajmo.2023.100031.

The Magic in Medicine

by Justin Choy, MS-III

A five-year-old boy sat nervously on the exam table at Cook Children’s Neighborhood Health Center on McCart Avenue, his small hands gripping the crinkled paper as his wide eyes darted anxiously around the room. His mother murmured reassurances, but the unfamiliar setting left him frozen with apprehension. Noticing his unease, I reached into my pocket and pretended to pluck something from the air—only to reveal a bright, red sponge ball between my fingers. His eyes flickered with curiosity.

“Wait, where did that come from?” he whispered, his guarded expression beginning to soften.

As I continued, I gently tapped his ear and produced another sponge ball from its depths. His nervousness gave way to delight. A hesitant giggle escaped as he reached out to touch the impossible object. Weaving magic into the physical exam, I guided his gaze with each sleight of hand, subtly assessing his eye tracking and coordination. By the time I placed my stethoscope on his chest, his fear had vanished, replaced by eager anticipation for what trick might come next. In that moment, I saw how magic could do more than entertain—it could transform the clinical experience, turning fear into fascination and apprehension into engagement.

Bringing magic into pediatric care was never something I consciously planned. It began organically—during a clinical rotation, I encountered a young patient anxious about an upcoming procedure. Hoping to provide a distraction, I performed a simple card trick. To my surprise, her face lit up with delight, her fear momentarily replaced by curiosity and laughter. That single moment sparked a realization: magic could be more than just a hobby. It could be a tool for healing, a way to build trust, and a means of humanizing the hospital experience.

As my training progressed, I began incorporating magic into patient interactions regularly. I witnessed how it eased not only the children’s anxiety but also their parents’ worries. A simple trick could transform a tense clinical encounter into one of warmth and engagement, shifting the dynamic from apprehension to familiarity. This newfound approach allowed me to connect with families instantly, making medical visits less intimidating and more inviting.

Recognizing the profound impact of these moments, I sought out ways to bring magic to children in more meaningful ways. I started volunteering at the Dialysis Unit at Cook Children’s Hospital, performing tricks for kids as they received treatment. These sessions became transformative—not just for the children, but for me as well. I watched withdrawn patients brighten with curiosity, asking to see another trick, then another. Parents, often weary from the emotional toll of chronic illness, smiled as they watched their children experience moments of joy amidst their challenges.

Medicine is as much about connection as it is about science. Patients do not care how much we know until they know how much we care. A patient may not recall the specifics of a physical exam, the precise words a physician used, or even the exact diagnosis. But they will remember how they felt—whether they were comforted or dismissed, reassured or anxious. This is why, while medical knowledge and technical skill are essential, the ability to connect with patients on a human level is just as critical. A patient who feels at ease and trusts their provider is more likely to engage in their own care, leading to better outcomes. Just as a magician carefully crafts an experience that leaves a lasting impression, physicians must be intentional about creating clinical encounters that prioritize empathy, understanding, and connection. Whether it’s taking an extra moment to offer reassurance, explaining a procedure in a way that alleviates fear, or simply engaging with a patient on a personal level, these efforts make all the difference.

Magic serves as an unexpected yet powerful bridge in this dynamic. When a child sees a physician not merely as an authority figure but as someone who brings joy and wonder, the clinical setting becomes less intimidating. This principle extends beyond pediatrics into all areas of medicine.

As I continue my journey in medicine, I will carry these lessons forward, striving to cultivate human connection in every patient interaction. I encourage my fellow medical students and physicians to bring their passions into patient care—to find ways to forge deeper connections with patients. Whether through music, art, storytelling, or something as unexpected as magic, these personal touches can transform a hospital experience, offering comfort in moments of uncertainty. Medicine, after all, is about more than just curing illness—it is about nurturing hope, fostering connection, and proving that even in difficult times, moments of magic can still exist.

Reflections at the Conclusion of a Longitudinal Preceptorship

By Yun Tran, MD, MPH; Assistant Professor, Burnett School of Medicine at TCU; Staff Physician, Department of Family Medicine at JPS Health Network

On the last day of practice with the medical student whom I had been precepting for over two years, I couldn’t help but become emotional as I reflected on how the relatively new model of medical education called Longitudinal Integrated Clerkship (LIC) has reignited my passion for medicine.

Three years ago, I resigned from a primary care physician position in a large healthcare system. I was burned out and ready to give up medicine altogether. I enrolled in a Masters of Public Health program, thinking that I would transition away from direct patient care.

Then a phone call came just as I was in the midst of grappling with biostatistics and epidemiology. The chair of the family medicine department at TCU’s Burnett School of Medicine was looking for a course director for the first-year medical student clerkship. My name came across his desk because I had expressed interest in precepting a medical student when I was still working at the aforementioned healthcare system, which had an affiliation agreement with the new medical school. He saw that I was trained at the JPS Family Medicine residency and talked to the program director, who recommended me for the course director position.

Although I had years of experience teaching residents and medical students in the past, I had only a vague understanding of what the duty of a course director at this new medical school entailed. The medical school was two years old at the time and only provisionally accredited. However, with this position, I could see patients on a part-time basis at a county clinic. This would do beautifully while I worked on my MPH degree.

So I jumped in.

The learning curve that followed was steep and difficult, but it was also one of the most rewarding journeys I have taken in my life.

First, I had not considered fully the responsibility of crafting the course curriculum, which involved much more than simply sending students to clinics to learn from their preceptors. I was tasked to develop learning objectives, curate educational materials, and create written assignments to assess students’ learning. Fortunately, the course director before me had a curriculum that I could use as a blueprint to redesign and improve.

Second, the medical school has built based on an LIC, a concept that was foreign to me. In an LIC, throughout the first year, the students are paired with a primary care physician in the community. They go to clinic approximately every other week for a year to learn how to take a history, conduct a physical exam, and practice clinical reasoning, oral presentation, and documentation. The students concurrently take all of their other courses, including clinical skills with standardized patients. My job is to help prepare the students so that they can successfully transition into the second year, where they will have both inpatient and outpatient rotations in their eight core specialty clerkships that are longitudinal.1

Those were formidable challenges on their own, but the most intimidating prospect of my new position, in fact, was having to precept a medical student.

Recall that I was a burned-out and possibly somewhat cynical physician at the time. My fear was that I was going to discourage my student just as she started her first year of medical school. As much as I was unsatisfied with my career in medicine, I understood the need for developing the physician workforce and I still cared about people. I did not want my student to decide medicine was not for her after having me as her preceptor.

So with apprehension, I started this new phase of my career with my brand-new medical student, whose enthusiasm on her first day in the clinic motivated me to be on my best behavior. I took extra care to be a better listener when my patients talked, remembered to ask open-ended questions and wait for them to finish speaking without interruption, and summarized their problems and the plan of action while making sure that I had answered all their concerns. When my student asked me a question I was not too sure about, I acknowledged my ignorance and encouraged her to find the answer and teach me. One of her activities that day was to shadow a patient from their check-in to check-out to gain the patient’s perspective, and during her debriefing, she described how I had helped put the anxious patient at ease during the visit, and she hoped to learn to do the same.

Little did she know that her comment had put me at ease. I had not corrupted her view of medicine on her first day in the clinic. More importantly, I was not faking compassion with the patients. I truly relished being there for my patients and advising them to the best of my ability. I enjoyed the practice of medicine again!

Over the following year, my student grew to be someone who could conduct a full history and physical exam. She could also present her assessment and propose management plans. And by pending orders and having a useful chart note for me, she made me a more efficient clinician. I was also able to evaluate our course curriculum from the perspective of a preceptor. Being an MPH student at the same time also gave me a unique perspective about the needs of students, particularly adult learners. Both roles helped me tremendously as I worked to enhance the curriculum. The clinic itself also went through a transformation. At first, the nurses and medical assistants were inexperienced in navigating the intricacies of having a medical student who would be there long term, but they adapted and grew to value the partnership with the medical student as well.

When my student returned in her second year to complete her family medicine clerkship, she quickly grew to function at a sub-intern level. The patients appreciated having a medical student that they knew and frequently gave her compliments, which boosted her confidence in her ability to become an empathetic physician. I also benefited. As I witnessed my student’s development, her curiosity and eagerness to acquire knowledge, and her caring attitude, I was able to learn much more from her than information on the most up-to-date medicine that she obtained from concurrent clerkships. I also gained a sense of immense fulfillment, knowing that I had a part in putting forth into the world a physician who will be trustworthy, patient-centered, and always in pursuit of continuing education and self-improvement.

On my student’s last day with us, there was a Thanksgiving potluck at the clinic. As she was saying thanks to the staff members who had been her colleagues over the last couple of years, a surge of mixed emotions overcame me. My student would not return after that day, so there was sadness. There was also pride in how “grown up” she was. She was no longer green and unsure. Rather, she was confident, mature, responsible, while still compassionate, humble, and driven to explore and learn. Above all, there was gratitude. After two and a half years of having the privilege to serve as my student’s preceptor, not only had I not ruined her outlook on medicine, but I had also been gifted with a renewed commitment and a purposeful future.

There are many people for me to thank: My program director who recommended me; my chair, who trusted me to learn on the job and perform; and the senior leaders at the medical school, who guided me as they allowed me the freedom to put my vision of what a first-year clerkship could be into reality. I participated in the process that resulted in full accreditation of our avant-garde school, and I witnessed the construction of our school building near the historic grounds of what was once Fort Worth Medical College, the school that had graduated Dr. Frances Daisy Emery Allen, the first woman to complete medical school in Texas. I am thankful to be connected to this exciting part of Fort Worth history as our school is making history again with innovative and progressive initiatives in medical education.

I thank my medical student. She made me a better physician, a better educator, and a much better person altogether. As I have also completed my MPH degree at the same time as this transition, it feels as if I am being propelled into a new phase of my career while she begins the next step in hers. I am full of hope and optimism. I have no doubt I will feel sadness for each subsequent medical student when their time with me is concluded, but I also know that I will feel pride and gratitude over and over and that will serve as fuel for me to continue my work in healthcare.

Notes:

1. This experience changed my career and could also impact yours. Please reach out if you are interested in learning more. An LIC student in their second year may be in the pediatric clinic one morning, the psychiatry clinic in the afternoon, and the operating room the next day. For each core clerkship, they are paired with a preceptor, and they go to each clerkship every week for nearly a year. Hence, it is longitudinal, and the idea is that the student will integrate knowledge and skills from concurrent clerkships to make them better-rounded physicians, and they will not forget information like they might in block rotations. This is a curriculum design known as interleaving. Another component of LIC is for each student to have a panel of patients that they follow over many months to strengthen their ability to deliver empathetic, patient-centered care in addition to learning about disease progression over time. Patients often value these relationships with the medical students and feel more satisfied with the quality of their care.

My Journey to DREAM

by Jackson Tobler, OMS-I

When I first met Alex in high school, I never anticipated that we’d become life-long friends. Alex has an intellectual and developmental disability (IDD), and we met through Best Buddies—an organization that promotes inclusion and friendship for individuals with disabilities. Alex and I developed a good friendship in high school, and we still maintain it today. We talk on the phone each week, and he participates in my family’s March Madness bracket pool each year. He lives in a different state now, but I was recently able to fly out to visit him and his family. His face lit up when I surprised him at his door, and we enjoyed spending a few days together. I am grateful for my long-lasting friendship with Alex and that I have gotten to know him beyond his intellectual disability. Meeting Alex in high school is what first sparked my desire to serve the IDD community—a desire that grew during college and has continued into medical school.

As an undergraduate student, I expanded my involvement with the IDD community by becoming president of my university’s Best Buddies chapter. I got to connect students to community members with IDD and plan fun events celebrating inclusion. Some of our biggest events were a talent show, a bowling night, and a Halloween party. I was moved when one of the parents told me how much our program meant to her adult son with Down syndrome. She shared that her son sometimes felt lonely or excluded, but our events provided him a welcoming environment where he felt he could belong. This experience showed me the power of inclusion.

When I began medical school at TCOM, I was excited to discover the DREAM student organization. DREAM, which stands for Disability Rights, Education, and Advocacy in Medicine, has allowed me to merge my interest in the IDD community with my career in medicine. DREAM’s mission is to advocate for individuals with disabilities and to prepare future health professionals to care for their unique needs. I attended the first meeting and was inspired by the story of DREAM’s faculty advisor, Brandie Wiley. Brandie is the mother of three adopted children with disabilities. She shared some of the challenges that her children have faced when receiving healthcare, such as barriers in accessibility and communication. She also detailed the qualities she saw in the physicians who were best able to interact with her daughter. Hearing Brandie’s experiences strengthened my desire to advocate for patients with disabilities.

I became a first-year representative on DREAM’s leadership team, which we aptly call “the DREAM team.” We began planning DREAM’s main event of the year, Project Dream Big. In collaboration with Special Olympics Texas and the Fort Worth ISD Boulevard Heights School and Transition Center, we arranged to host over 50 individuals with intellectual disabilities on campus. We planned to pair them with medical student volunteers for an afternoon of games, crafts, physical exams, and a multi-specialty provider panel. The goal of the event was to help medical students learn inclusive healthcare principles and to help the individuals with IDD become more comfortable around medical professionals.

After months of planning, the event successfully came together. As the Special Olympics athletes arrived, it was rewarding to watch them mingle with the medical students and bond at the cornhole and coloring stations. When the physical exam portion began, the medical students were instructed by physician faculty on how to properly obtain consent from individuals with IDD. It was a valuable experience to practice our bedside manner and physical exam knowledge on a different demographic, one that we get little exposure to in the normal curriculum. Connecting with the individuals in both a casual and a clinical setting that day was impactful for everyone. This exposure is helping us become compassionate future physicians and equipping us with the tools to provide quality care for our friends with IDD.

From high school to medical school, advocating for individuals with intellectual disabilities has been a meaningful part of my journey. Each experience—from developing a friendship with Alex, to leading my college’s Best Buddies chapter, and now being involved with DREAM—has reinforced the importance of inclusion, empathy, and advocacy for individuals with IDD. Each step has influenced the kind of physician that I aspire to be. As I continue my medical training and involvement with DREAM, I look forward to more opportunities to help create a healthcare environment that is compassionate, inclusive, and equitable for people with intellectual and developmental disabilities.

The Poison, the Clouds, and the Clearing: Mindfulness in Medicine

BY SETU SHIROYA, MS-II TCU , WITH NEHA SOOGOOR, MS-II TCU; EDITED BY JAYESH SHARMA, MS-II TCU

Breathe in. Breathe out.

It is my first day in the clinic. My heart is racing in my white coat that I have little confidence wearing. My anxiety skyrockets, as do my feelings of not belonging.

What if my attending doesn’t like me? What if I make a mistake? What if my patient starts crying? How do I do a lung auscultation again? What does losartan do?

I can’t remember. I can’t think.

Breathe in. Breathe out.

I have been studying the whole day, my career-defining board exam is in one week, my head is throbbing, my eyelids are drooping. I am clicking through flashcards but nothing sticks. The days are merging into one; someone asked me for the day of the week, and I came up blank.

Breathe in. Breathe out. Breathe in. Breathe out.

Only one year into medical school, and everything feels like a dream. I’ve made it so far, yet the future seems so daunting. I love my life but also fear it at the same time. I want to keep going. I’m excited, but I’m nervous. Where am I in my life? Do I even belong here? Am I the only one thinking this?

Breathe in. Breathe out.

I say it to myself over and over again—my thoughts have been spiraling for days. I need to breathe. I need to calm down.

Breathe in. Breathe out.

I do belong here. I’ve made it so far in this journey; the hard work, the endless hours were not in vain. There is so much more to go and I remind myself that I am excited. I just need to take it one step at a time.

Breathe in. Breathe out.

I am going to be present for patients. I will be a doctor. One step at a time.

Breathe in. Breathe out.

The rampaging thoughts settle, my mind clears, and I open my eyes.

It’s going to be okay.

The morning alarm rings, and my first thought is always the same: “Can I sleep for five more minutes and not think about the long day ahead?” I have stressful exams to take and sometimes dread the workload awaiting me. It feels like the only quiet time I get is in the morning, when I am drinking coffee, working out, or just embracing the quietness. I try to find time to relax, but burnout feels like it is always looming over my shoulder. However, mindfulness and meditation have helped me reorient myself and develop a healthy way to process these feelings.

What does it truly mean to be mindful? To me, mindfulness is staying grounded to what is in the present moment. It can be easy to think of the past or try to anticipate the future. However, the only inevitability we hold is this present moment. Not a second before, not a second after.

How can we practice this? Mindfulness comes in many forms; some find relief in running or weightlifting, making it a point to have a constant regimen at the gym. Others find it through meditation, focusing on breathing and relaxing the mind. These share one commonality: a mental space we create where we stop thinking about the past or trying to anticipate the future, focusing instead on what is present within and around us. There isn’t one answer to seeking mindfulness; the greatest difficulty lies in knowing where to begin.

As medical students and future doctors we are expected to quickly calm ourselves after these stressful moments and proceed. Sadhguru, a guru who is the founder of the Isha Foundation, states: “Fear, anger, resentment, and stress are poisons you create in your mind. If you take charge of your mind, you can create a chemistry of blissfulness”.1 It is especially easy in a hectic and high-paced environment or period of life to get lost in our thoughts about the stressors we experience. Our thoughts are like clouds. We can either let them pass, or we can dive into them. Taking control of our mind to let the clouds pass, helping our mind become still and focus on the present, is difficult.

This is where meditation techniques can help train our mind. Meditation techniques often involve bringing awareness to a single action or sound. For example, they can be used to bring awareness to your breathing or the repetition of a few words. One method I use is called “4-7- 8 breathing.” Close your eyes. Breathe in for four seconds through your nose. Hold your breath for seven seconds. Breathe out for eight seconds through your mouth. As you inhale, stay aware of how the air flows through your body, from the tip of your nose to your navel. As you exhale, follow the air out from your navel to your mouth. Repeat this about two to three times.

At TCU Burnett School of Medicine, our Meditation and Mindfulness Student Interest Group aims to educate medical students about techniques such as 4-7-8 breathing and help them stay engaged in healthy mindful practices to avoid burnout. Our goal is to cultivate a supportive student community dedicated to mindfulness, fostering connection through monthly meditation sessions, inspiring physician guest speakers, and meaningful community volunteering.

It is going to be okay.

My mother always told me, “Take it one step at a time, one day at a time.” As medical students, we’re often exposed to patients and situations that can take an emotional toll on our mental well-being; times such as witnessing a patient’s death or delivering a life-shattering diagnosis. Before we can process what we’ve witnessed, we’re often thrown back into a fast-paced environment without a moment to rest. In such a high intensity life, grounding ourselves with activities that bring comfort and ease becomes crucial to our mental well-being. My hope is that we future physicians can practice mindfulness early, so that we can be present for our patients. In turn, we can help our patients be mindful as we work together throughout our most difficult moments to maintain healthy behaviors.

References:

1. Sadhguru Quotes – Fear, anger, resentment, and stress are poisons you create. If you take charge, you can create a chemistry of blissfulness within yourself. Accessed February 13, 2025. https://isha.sadhguru.org/en/wisdom/quotes/date/december-06-2021

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