When Seth Ammerman, MD, first meets his patients, he asks them what they're good at. He wants to know what sort of long-term goals they have in mind for their lives, and which pieces of those goals they want to tackle first. It's an unusual line of questioning for a doctor, but Ammerman isn't a typical doctor. He is the medical director of the Mobile Adolescent Health Services Program, better known as the Teen Van. It's a medical clinic on wheels, a service of Lucile Packard Children's Hospital Stanford, that targets young people around the Bay Area who can't afford health insurance.
A new feature story I wrote for the relationship-themed issue of Stanford Medicine magazine explains how Ammerman and other adolescent medicine doctors like him can have a positive impact on the lives of at-risk teens. For patient Jessica Villeda, now 24, who has been treated at the Teen Van for the past eight years, finding a doctor willing to address the overall trajectory of her life made all the difference:
“In some ways she’s a typical patient because she had so many things going on,” Ammerman says ... When Villeda [first] showed up at the Teen Van, she needed blood tests to monitor her thyroid function, evaluation and treatment for menstrual irregularity, allergy treatment and advice on healthy weight loss. And there was the most challenging problem: She screened positive for moderate-to-severe depression.
Ammerman and his team began working on these problems, following Villeda's lead about what she wanted to address first. They made sure she knew they were consistently available to help, which was especially important since Villeda found it hard to get support at home, where her single mom was struggling to support their family of eight:
Villeda found it easier to confide in the people at the Teen Van, who always had time to pay attention. “Even if I didn’t want to tell them what was going on, they knew if there was something going on with me,” Villeda says. “And even if I didn’t have any illness, I could go and talk to them and get everything out.”
Ammerman kept reassuring her that he saw progress, remarking that Villeda was remembering to take her thyroid medications, was gradually losing weight, had brighter moods. “When you’re living it day to day, people around you may notice that you seem better before you do,” he says. “I kept the focus on the small but positive changes she was making, small steps that would ultimately make a big difference.”
Ammerman's support paid off in an especially positive way. Today, Villeda is a certified nursing assistant who credits Ammerman for encouraging her to pursue her interest in a health care profession. She empathizes with the elderly people for whom she provides assisted living support; after experiencing depression, she knows what it's like to struggle through basic daily tasks. When I asked if she sees this work as "paying it forward" after all the help she received, she had a concise answer: "Yes."
Previously: Ties that heal: Stanford Medicine magazine examines relationships, "The need is out there": A look at the new Teen Van, Stanford study of mental illness in incarcerated teens raises policy questions and Online health records could help high-risk teens, study finds
Illustration by Greg Clarke