High stakes in the city health offices
Commissioner juggles pandemic, racism
As an undergraduate pre-med student, Mysheika Roberts became her dormitory’s health monitor, posting messages about preventing sickness on lobby bulletin boards and doling out helpful tips to peers.
That responsibility at the University of California, Berkeley, strengthened a passion for public health within a young Roberts, who always assumed she’d become a doctor just like her father.
Nearly three decades later, she’s still doling out health advice – except now it’s to nearly 1 million people as Dr. Roberts, the health commissioner for Columbus Public Health.
Wash your hands. Stay six feet apart. Wear a mask. Get vaccinated.
COVID-19, of course, has raised the stakes. That was evident in early March when she found herself in a large meeting with the governor and boldly advised him to cancel the massive Arnold Sports Festival during the early stages of the pandemic.
“You know that’s in your job
description and in your authority, but I don’t think anyone daydreams of the day they have to use it,” Roberts said.
But the global pandemic, which disproportionately affects people of color, hasn’t been the only thing on her mind. Issues of race are ever-present.
After all, 2020 was a year when protests of police brutality against Black people broke out in Columbus and across the country. Health and government entities declared racism a public health crisis.
And as a person of color looking out for the health of a city where nearly 30% of the population is Black but only 5% to 10% of the physicians are, she said she feels a responsibility to do something about it.
“We need more health care providers who look like the community they live in,” said Roberts, 50, who lives Downtown with her husband. “As a Black woman, I feel compelled that I need to do more than the average person to try to reverse that disparity.”
Modeling change
Sometimes that work takes the form of major health initiatives. Sometimes it happens one person at a time.
That’s the case with Omonivie Agboghidi, a third-year medical student at Wright State University in Dayton who has been mentored by Roberts since 2018. The two were paired through the Physician Diversity Scholars Program, an Ohiohealth initiative that connects minority medical students at area schools with local physicians.
Agboghidi, who is from California, said Roberts has advised her on topics such as professional development, course loads and navigating family dynamics as a busy health care provider.
Most important, she’s affirmed her decision to become a doctor by offering a model.
“She was motivated like me to implement change at a population level,” Agboghidi said. “She was literally doing what I envisioned, but I didn’t know what it looked like.”
It helped that Roberts was a mentor who looked like Agboghidi, who often hesitates to wear her hair naturally — anything to keep from drawing attention to the fact that she’s usually the only Black woman in the room.
“Sometimes you know when you feel like an ‘other,’ ” said Agboghidi, whose parents emigrated from Nigeria and who completed her undergraduate work at Uc-berkeley, just like Roberts.
She said Roberts has helped show her how to be authentically true to herself as a Black woman while still achieving success in medicine.
And so one day earlier this month, Agboghidi proudly wore a “big ‘ole curly afro” to the Dayton VA Medical Center for her psychiatry rotation, having learned from Roberts: “Hey, I can be comfortable in my own skin.”
Getting past the pandemic
Growing up – first in Ann Arbor, Michigan, and then in Los Angeles – Roberts always knew she wanted to be a physician. She worked in her father’s internal medicine practice and volunteered as a candy striper at area hospitals.
Then, Earvin “Magic” Johnson, – the
star of Roberts’ favorite basketball team, the Los Angeles Lakers – announced he had HIV in 1991 while she was an undergraduate.
“To have a straight, Black athlete say he was HIV positive, it startled the world,” Roberts said. “As a collegiate African American woman on a college campus, it was eye-opening.”
That event, she said, led her to pursue a master’s of public health at the University of Michigan. She followed that by going to medical school at the University of Maryland at Baltimore.
“As a physician, I thought people would take me more seriously,” Roberts said. “As a Black woman, I felt I needed as many credentials as possible to make me relevant and to make my voice heard.”
And it would help her reach her ultimate goal: leading a health department. She thought that would be the best way to combine her skills of medicine and public health while helping the most people.
Roberts spent three years running a sexually transmitted disease clinic in Baltimore before joining a program at the Centers for Disease Control and Prevention that allowed her to investigate epidemics as a “disease detective.”
While in that two-year appointment, she was assigned to work with the Ohio Department of Health from 2004 to 2006 to travel the state dealing with outbreaks. Then, at age 36, she was named medical director for Columbus Public Health in 2006. She took over as commissioner in December 2017.
Immediately, she began making inroads with the city’s infant mortality rate, and her department took over the county’s opiate addiction plan. Working with partners around the area, she worked to bolster the city’s response to mental health and reduce the stigma surrounding it.
“I felt really optimistic we were starting to move in the right direction on a lot of those issues,” Roberts said. Then, the pandemic hit. COVID-19 has become her team’s No. 1 priority – the only one, really.
In the early days of the pandemic, she and her team set up testing sites, rapidly expanded their contact tracing efforts and helped the city plan for hospital overflow problems with a makeshift facility in the Greater Columbus Convention Center.
For nearly a year, she’s had the ears of local and state government officials, school board members and even area
business owners, guiding them on what policies to implement and how to follow best practices to protect the community.
Now, she finds herself busy coordinating public vaccination clinics and hosting virtual vaccine question-andanswer sessions to ensure people have accurate information.
“It’s been exhausting,” said Roberts, who has been named Executive of the Year in Columbus CEO’S Healthcare Achievement Awards for 2021. “It’s been very stressful. Sometimes it feels overwhelming. As soon as you think you get something going, and we’ve got a good cadence, then a curveball comes.”
And she doesn’t expect things to relent even after the COVID-19 crisis subsides.
Violence, drug overdoses, suicide, STDS, food insecurity and other problems all are on the rise, partially because of the pandemic, Roberts said. And through the city’s creation of a Center for Public Health Innovation, she’s been tasked with helping Columbus implement programs to handle inequities and racism in health care.
“I want us to get through this pandemic, obviously, but what’s going to be the public health condition of our community on the other side?”
‘I don’t know how you do it’
Part of improving health care postpandemic will involve supporting more people of color as they become doctors, Roberts said.
Agboghidi wants to be part of the solution.
During medical school, she said she’s learned that some medical professionals prescribe different medications based on a patient’s race or otherwise treat them differently clinically. For example, there’s a long held myth that Black people have a higher pain tolerance.
Agboghidi said it can be difficult to question these decades-old practices, especially since there’s a pressure to be perfect and not cause trouble as a minority student.
“There’s this idea of Black excellence,” Agboghidi said. “Our communities are looking at us, our elders are looking at us. When I see other Black medical professionals, they’re looking at me like, ‘Hey, make us proud. Be the best.’ There’s this weight on our shoulders.”
Having a mentor like Roberts helps lift that, Agboghidi said. Even at the height of the pandemic, Agboghidi said she received texts from the health commissioner checking in on her and reminding her about self care.
“I told her, ‘I don’t know how you do it,’ ” Agboghidi said. “Of course, there’s hits and misses, but when I look back to last year ... she continuously showed up, and that’s not easy to do.”
Roberts can attest that the past year hasn’t been a walk in the park – inside the health world and on the streets of her community.
“It’s been very, very hard for me to watch what has happened across our community with our Black and brown people being hurt and killed at the hand of people who are supposed to protect us,” Roberts said. “What I remind my staff and what I remind my friends and family, it’s OK to acknowledge that you’re not OK after seeing something like this.”
She’s hoping the past year’s struggles will lead to systemic and lasting change in Columbus – particularly as it pertains to racism as a public health crisis.
“I feel very strongly that one way to get out of it and to reverse those disparities is you have to do some uncomfortable things,” Roberts said. “You have to do some radical things. You can’t keep doing the same work we’ve been doing.” award@dispatch.com @Allisonaward
Doctors recommend patients schedule their mammogram before receiving a COVID-19 vaccine, or space out the two appointments, after some women have been mistaking swollen lymph nodes for breast lumps.
These swollen lymph nodes, which are a side effect of the COVID-19 vaccine, can also show up in mammograms and other types of imaging scans, experts say.
“There have been a couple of situations where the patient went for a mammogram and on the mammogram, there it was,” said Dr. Harold Burstein, a breast oncologist at Dana-farber Cancer Institute.
Lymph nodes are specialized tissue in the body’s immune system that contain white blood cells and help fight against infection and disease, according to the National Cancer Institute. They’re normally the size of a lima bean and are all over the body, Burstein said, but the most prominent lymph nodes are located in the armpits, neck and groin area.
The ones located under the armpits are most likely to swell after vaccination because they’re closest to the injection site. They could begin swelling as soon as a few days after vaccination and could last as long as 12 weeks. Additionally, the vaccine shouldn’t create any abnormalities in the breast itself, only under the armpit.
But health experts emphasize this is completely normal as increased inflammation suggests antibodies are at work protecting the body against SARSCOV-2,
the virus that causes COVID-19.
“This is a normal immune response to a potent vaccine,” Burstein said. “It’s to be expected. It’s a well-desired consequence of the vaccine.”
Other vaccines elicit a similar response, such as vaccines for influenza and the human papillomavirus. Some experts speculate this may be happening more frequently as more people get vaccinated against COVID-19 at the same time.
The two MRNA vaccines that are authorized for the disease are highly effective. They have been known to evoke other side effects like low-grade fever, chills, headaches and fatigue.
It’s possible the potent MRNA vaccines are causing swollen lymph nodes at a higher rate than other vaccines as they appear to cause more side effects, said Dr. Jessica Leung, professor of diagnostic radiology and deputy chair of breast imaging at the University of Texas MD Anderson Cancer Center.
“But with the non-mrna vaccines (like Johnson & Johnson), it’ll be interesting and educational to see what happens,” she said.
Even though swollen lymph nodes could mimic a concerning lump during a self-exam or mammogram, it’s still important to get both the COVID-19 vaccine and screened for breast cancer, Leung said.
To avoid confusion, she recommends getting screened before getting vaccinated. If that’s not possible, MD Anderson Cancer Center guidelines say to wait around four to six weeks after receiving the vaccine. “Don’t wait too much longer after six weeks,” Leung said.