A Singular Event
The five years that Meredith “Misty” Fils, MS ’14, PA-C, lived and worked in post-Hurricane Katrina New Orleans, was an immersion in community and the structural forces that shaped the health of her neighbors. The most destructive hurricane in U.S. history, Katrina made landfall along the northern Gulf Coast in late August 2005, leaving in its wake more than 1,800 people dead and $186 billion in property damage.
Into the devastation stepped Ms. Fils, a new college grad with a degree in social work on her first deployment as an AmeriCorps volunteer. She moved into a tent city in Algiers, a neighborhood on the other side of the Mississippi River, and worked with FEMA on providing ground-level disaster relief — delivering new refrigerators and donning a hazmat suit for mold remediation.
“Everyone was struggling,” she recalled. “Everyone was miserable, hungry, with nowhere to go. Looking back, I realize people who had the funds to leave left for other states. I saw the disproportionate effect in lower socioeconomic areas like St. Bernard Parish. And people with chronic health conditions — heaven forbid they had a COPD exacerbation or DKA (diabetic ketoacidosis). Maybe an ambulance would get to them in time, maybe not.”
A 2010 study by the Population Reference Bureau found that Black residents bore the brunt of the disaster. The mass trauma and displacement and the glacial pace of recovery, all which scholars trace to a century of policy decisions that drove inequities, spurred Ms. Fils to deepen her commitment. She earned certification as an EMT/paramedic at a community college in St. Bernard Parish and worked as a paramedic/emergency department technician at Tulane University Medical Center near the French Quarter, then as a paramedic for the city’s 911-response agency in health resource-poor Orleans Parish.
“I remember being a paramedic and just constantly thinking, ‘I want to do more. I’m capable of more. How can I do more?’ The PA profession was the perfect fit.”
“Post-Katrina New Orleans was a singular event in my life,” Ms. Fils said. “It’s what really prompted me to become a PA. We all had sort of an expanded scope of practice in those first months after the storm, because there weren’t enough people to do the work. I remember being a paramedic and just constantly thinking, ‘I want to do more. I’m capable of more. How can I do more?’ The PA profession was the perfect fit.”
Now director of didactic education and instructor for RFU’s Physician Assistant program and assistant medical director of the student-driven Interprofessional Community Clinic, Ms. Fils advocates for diversity, equity and inclusion across her academic roles.
“In every lecture, I intentionally uncover and teach the inequities,” she said. “I am sad to say that I have yet to find a health topic in which a disparity does not exist. I do my very best to give context to disparities, even when that context is incomplete because research into health inequities is so lacking.
“For instance, why are outcomes for CPR in the U.S. different for people of color and for white people? Why could that be? We’re all doing the same CPR, so why are outcomes different? We may know, we may not. And how are we going to change that? When a PA student gets that first job in the ER, what can they do to help eliminate this disparity? To me, that’s the big question.”