Hope Ferdowsian, MD, MPH is an internist and preventive medicine physician now affiliated with the University of New Mexico and Physicians for Human Rights. For more than a decade, she has cared for patients, evaluated and treated survivors of torture and sexual violence, taught medical students and residents, and led key research and policy initiatives. Internationally, she has worked in the Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, South Africa, Uganda, and the Federated States of Micronesia. In the United States, she has worked with nonprofit organizations providing health care and advocacy for homeless, immigrant, underinsured, and other marginalized populations in urban and rural settings.

Her forthcoming book, Phoenix Zones, shows how people and animals across the globe can help each other recover from trauma and heal—an experience known as the “Phoenix Effect.” It is scheduled for publication by University of Chicago Press in Spring 2018. In addition to writing her book, she writes regularly on her personal blog.

I first heard about Dr. Ferdowsian through our DWC advisor Dr. Amy Waldner, a PGY3 emergency medicine resident who helps lead the Penn Human Rights Clinic and does medical asylum evaluations through Physicians for Human Rights. She had been inspired by Dr. Ferdowsian’s work for human rights on a global scale, and recommended I speak with her to learn more about how she balances all her passions:

Vidya: When did you know you wanted to be a doctor?

Dr. Ferdowsian: I knew I wanted to be a doctor since the age of 9, due to my interest in human rights and global public health issues. My parents were human rights advocates and they had books laying around the house that spoke to the human rights violations around the world. Through their example, I learned more about what was happening to people outside my small hometown in Oklahoma. Of course, things change and when I got accepted to medical school I thought, “I don’t know if I want to do this—if medicine is still the best route to effect change.” But then I thought, “Well, it isn’t every day that I get into medical school, so maybe I should just go and see if this works out.”

Vidya: When you were in medical school, especially in the beginning where it’s a lot of basic science, did you feel you were still able to advocate for human rights and preserve that part of your identity?

Dr. Ferdowsian: I really had to look for those opportunities outside the traditional path of medical school. Looking back, I can see how difficult it is to be in the middle of medical school and maintain the hope of effecting broader change. I think medical schools have changed since I was a medical student, and more and more are adopting curricula that speak to the interests of medical students who care about social justice. Back then, I had to search for opportunities. I got involved with the Red Cross, learned about international human rights law, and tried hard to explore my interests.

Vidya: How did you choose internal medicine and preventive medicine/public health?

Dr. Ferdowsian: The preventive medicine and public health track fit well with my interest in international public health and human rights issues. I wanted to pursue a career that would prepare me deeply for some of the clinical challenges that I would confront, working here in the US and overseas. It was a little bit of a challenging decision, because my primary interest was in pediatric neurology. I just loved the patient population, working with kids who were so incredibly resilient after dealing with so many neurological challenges. But I felt internal medicine would be the best complement to preventive medicine to prepare me for the breadth and depth of clinical and public health experience that I needed. And, I liked working with adults of all ages, too.

Vidya: Tell me about your consulting for Physicians for Human Rights, and your international work.

Dr. Ferdowsian: When I was in my preventive medicine residency, I found out about a  training on how to conduct forensic medical evaluations of people who had been tortured in their home countries and who were seeking asylum in the US. I participated in the training and, soon after, I became a volunteer for Healthright International and Physicians for Human Rights. A few years later, I began working on policy issues in Washington, DC and continued my clinical work—mostly caring for individuals who were homeless, underinsured or uninsured. I also continued to work overseas on medical and public health issues. Over time, Physicians for Human Rights offered me the opportunity to be a medical consultant for their Program on Sexual Violence in Conflict Zones. That grew out of my experiences evaluating torture survivors: many of the torture survivors I had examined were women, men, and children who had also been subjected to sexual violence as a form of torture. The Physicians for Human Rights Program on Sexual Violence in Conflict Zones focuses on a number of different things: for example, training other health professionals on how to forensically evaluate sexual violence survivors, but also working across sectors with law enforcement and legal professionals toward securing justice for those survivors.

Vidya: It sounds like really amazing but probably very challenging work. What are some of the challenges you faced in doing these evaluations and working on these problems?

Dr. Ferdowsian: I think there are professional challenges and personal challenges. The professional challenges relate to training issues, personnel development, and advocacy efforts. My colleagues in Kenya and the Democratic Republic of the Congo deal with significant challenges like resource limitations, corruption, and communicating efficiently with one another. Through the program at Physicians for Human Rights, I—and many others—try to help address these challenges. From a personal perspective, confronting stories of violence can lead to what has been called “compassion fatigue,” or “vicarious trauma.” It can be a challenge to take care of ourselves and maintain perspective and hope to continue to do the work that needs to be done. Though we can become secondarily traumatized, the work serves as an opportunity to develop what’s been called “vicarious resilience.” Survivors are incredibly resilient individuals, and they can emerge as really powerful examples of how to thrive after horrible circumstances.

Vidya: I know you’re writing a lot about animal rights, and was wondering how you got interested in that topic and how you are incorporating that advocacy into your career?

Dr. Ferdowsian: I was originally drawn to the field of medicine because of its potential to alleviate and prevent suffering, and over time I’ve realized that we have to address the legal, political and social determinants of health, including the links between violence against humans and other animals. There’s incredibly important common ground occupied by people working on behalf of people and animals. I’ve done some of my own research looking at the mental health sequelae of violence on nonhuman animals, and as it turns out, they can develop PTSD, depression, anxiety, and compulsive disorders when their needs and rights are violated, much like humans. For me it’s been a bi-directional learning process; I’ve learned more about what animals need and the suffering they incur, and it has helped me understand more about human suffering.

Vidya: What are you working on now?

Dr. Ferdowsian: I still work as a medical consultant for Physicians for Human Rights, both in the US and overseas, and I’ve joined the University of New Mexico faculty in the Department of Medicine. Recently, I also finished writing a book that draws upon my experiences in human rights and animal protection, showing how people and animals across the globe can help each other recover from trauma and heal.  It’s scheduled for publication by the University of Chicago Press in the spring of 2018.

Vidya: What motivated you to start your personal blog?

Dr. Ferdowsian: It was born out of an interest to give voice to issues that few people were giving voice to, particularly from the lens of a physician considering social justice issues from a medical and public health perspective. And also, to provide a check on how I’m thinking about things. It has provided a platform to meet, collaborate, and dialogue with other people. It’s another layer of work but it’s certainly worth it.