The Art of Asking a Question: My Interview with Disease Investigator and Adventure Traveler, Catherine Dentinger by Monica Mehta

There’s always one person in a room filled with vocal people who quietly listens and then asks the right question.  In our class, it’s Catherine Dentinger.  She has a unique way of injecting humor, introducing a novel thought, and probing others with one simple question.  If you think about it, it’s not that surprising.  This is the skill of an epidemiologist, to disarm and listen without coming across as intrusive. Since I’ve noticed this about her, I’ve been jonesing for an interview, so here goes…

Catherine Dentinger has a cool job.  She’s an “epidemiology field officer” for the Centers for Disease Control and Prevention (CDC).   Historically, this particular position came about post 9/11 when the U.S. government became increasingly worried about bio-terrorism (and rightly so after the 2001 anthrax letters).  Tommy Thompson, secretary of Health and Human Services at the time, wanted CDC personnel in every state, thereby bolstering health department resources.   Catherine explains, “Our goal is to detect communicable diseases, understand who gets them, and help prevent transmission.”

ImageEpidemiology Field Officer is definitely an alluring title. “But how would you describe your job at a cocktail party?” I ask (partly because I have the same problem when describing my job). She pauses and thinks.   She recalls a recent norovirus outbreak on an HBO set where she had to call and ask the affected individuals questions about symptoms and exposures.  She told them that she’s a “nurse with the health department.” Sometimes she says, “disease investigator.”

I wonder how it all started.  Catherine was always interested in health and in being outdoors.  She knew clinical work was an option, but the thought of working in a hospital seemed depressing.  And ironically, she describes herself as squeamish. When she said this, I recalled her telling me a few months prior about an investigation she conducted of a hepatitis A scare involving a pastry chef at a popular West Village restaurant. And how she “really wanted to try the food there” afterwards (which also a testament to vaccination!).

After studying environmental studies as an undergrad at the University of California at Santa Barbara, she joined the Peace Corps and went to The Democratic Republic of the Congo (which was called The Republic of Zaire at the time) to teach in a high school.

ImageShe lived in Lisala, a small town next to the Congo River.  “You can actually find it on Google Maps, which blows me away because when I was there, we didn’t have electricity or running water.”  And in fact, they still don’t.  She notices my surprise and adds, “The Congo is a mess.”  After her two-year stint, she actually stayed on to do administrative work in Lubumbashi, a larger city the border with Zambia.  It was there in 1962 that Congo’s first elected prime minister (and independence leader) – Patrice Lumumba – was assassinated.

ImageIt takes a very hardy and driven person to spend three years in the Congo.  “What were you looking for?” I asked.  After growing up in the suburbs and wanting to make an impact in health and development (but also avoiding hospitals), she found fulfillment and adventure there.  In spite of a lack of electricity, there was comfort in her work. She learned Lingala (the local language) to speak to fish farmers and also French to speak to schoolchildren.   During her time there, she had a lot of students who lost family due to disease.  A couple students had been crippled by polio (the preventable diseases really bothered her the most).

She recalls a young student of hers who was bit by a snake. She took him to the town hospital where the local doctor said that there was nothing he could do; the only option was to amputate.  Catherine was stunned and turned to the Belgian nurses for help.  They responded something like…leave it to an American to fly in and try to change the system.  Catherine held the boy’s hand during the amputation and then took him home to live so he had proper rest and nutrition.  One day, she came home to find he was gone.  Later she learned he had gone to a traditional healer and returned home with what looked like mud and leaves on his amputation site. To her amazement, it healed nicely. The entire experience hit home for her, reminding her of the time her youngest brother lost his thumb bImagey way of hedge clipper during a childhood accident.

Could they have saved the finger?  She wonders about the Congolese boy.

Back stateside, Catherine went to nursing school on the east coast (George Mason University) and then back to Cali for her nurse practitioner (NP) degree (at University of California, San Francisco).  Her nursing work post-school was limited – partly, she believes because of lack of residency training for NPs (a topic she is now passionate about and the subject of her policy class paper).  Most new NPs got jobs in jails, county clinics, and the like until they gain experience).  She was hired by a county clinic for uninsured adolescents, providing primary care, immunizations, birth control, and teaching nutrition and exercise.   She commented that many teens were obese because of lack of education around these issues.

After three years, she applied to CDC’s Epidemic Intelligence Service (EIS) and ended up matching in the division of viral hepatitis.  After some time in Atlanta, she went to Florida to work on a hepatitis A seroprevalence study in Okeechobee among children of migrant farmers.  Essentially, she found that by 10 years of age, 75% of kids had hepatitis A antibodies.  “Kids can be little vectors,” she explained.   She published her work in 1999 and the Advisory Committee on Immunization Practices (ACIP) recommended that children of migrant farmworkers be routinely immunized.  Seven years later, the ACIP recommended that all children receive hepatitis A vaccine. After that, she worked in Romania to better understand the association between hepatitis B and healthcare associated injections.

After completing EIS in 1999, she went to India for three months to work on the Stop Transmission of Polio (STOP) program, the global polio eradication initiative.

ImageAs you may recall, India eradicated Polio in 2011. (more here: http://www.polioeradication.org/Infectedcountries/India.aspx)

After her training, she moved to Alaska and stayed on with the CDC as a nurse epidemiologist.  She was always intrigued by Alaska and loved nature, so it was a good fit (and also fed into her adventurous nature).   During her five-year stint in Alaska, she studied infections that have a high prevalence among Alaska Natives like pneumococcus, S. aureus, H. Pylori, and more).  She also conducted a 20-year follow up of hepatitis B vaccine recipients to understand the effective duration of the vaccine.  And then she transferred to NYC…

How did she end up here at Columbia, perusing an MPH?  Some of her NYC epi work (like antibiotic resistance work in local hospitals) lost funding so she wanted to expand her repertoire.  And “jazz things up” she tells me.

ImageAnd perhaps think about becoming more of a leader in nursing. Prior to joining, at a Mailman EMPH open house, she heard from a nurse who did the program and said that the program was the most interesting thing she’s done.

The future?  Perhaps work around women’s health in developing countries.  But then again, she’s become inspired to think about other things during school.  Like health information technology.  Or teaching public health to nurses.  In any event, I’m confident that Catherine’s adventures will continue and that she will pay it forward.  And always…ask the right question.

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