Hunger for Change

Sharlay K. Butler
SMDEP, Class of 2006
Nobody should ever go hungry.

“We lived in a van, then a highway motel, and eventually a camper. My mom always made sure we had enough to eat. Nobody should ever go hungry.”

Genuine words. True experience.

For Sharlay Butler, 27, the past is distant and ever-present. The oldest of three raised by a single mother, she grew up impoverished on the Coeur d’Alene reservation in northern Idaho—an unsettling start to a purposeful journey that has put her within reach of a medical degree.

The University of Washington School of Medicine student has memories of a near nomadic life, in highway motels, nights of wishing away hunger pains and days of staring at bare kitchen cabinets.

Since then, she has inspired medical school classmates to partake in field trips to food banks and written cookbooks to help low-income people prepare healthy meals.

Butler’s story of chronic food insecurity, experienced by an estimated 49 million Americans, uniquely prepared her to understand patient and community needs often overlooked by other health care providers.

Butler’s journey to medical school was punctuated with personal twists that increased her sensitivity to the profound chasms between “the have’s” and “have not’s.” Raised on the “rez,” as she calls the reservation, Butler and her family have no official tribal affiliation. Her mother is Mexican and White; her father is Black. She is proud of her indigenous roots: her grandmother is part Mescalero Apache.

Butler and her siblings survived on government food. According to the United States Department of Agriculture Food and Nutrition Service (FNS), one in four American households lacks continuous access to food annually. FNS works to increase food security and reduce hunger via access to healthy food.  It does this through 15 federal nutrition assistance programs supporting Women, Infant and Children, school meals , and Supplemental Nutrition Assistance Program (SNAP).

For practicing physicians, a thorough understanding of a patient’s lifestyle plays a significant role in providing holistic health care, prescribing medications, and delivering wellness services. According to the American Academy of Family Physicians, households headed by a single woman with children are at highest risk of food insecurity.  Research increasingly links obesity, behavioral problems and learning challenges to food insecurity in children.  

In the chaos of life, Butler discovered a natural talent that would provide both a temporary escape and a bridge to opportunity: basketball.  She thrived on the court, earning a scholarship to play ball at Treasure Valley Community College (TVCC) in Oregon, where she made the dean’s list and learned about SMDEP, which would ultimately change her initial career focus from law to medicine.

Something to Offer

The Summer Medical and Dental Education Program (SMDEP), a Robert Wood Johnson Foundation-funded program, is offered at 12 university sites across the country—including the University of Washington, where Butler applied and was accepted in the summer of 2006.

Since its first cohort in 1989, SMDEP has served as a pipeline to ensure greater inclusion of applicants from underrepresented racial and ethnic groups are reflected in medicine—particularly Blacks, Latinos, and American Indians, whose perspectives are often missing but essential to delivering quality health care for an increasingly diverse U.S. population.

What Butler encountered during her six weeks at the UW site was more than she ever imagined.

“My most vivid (and welcomed) memory of SMDEP was being around people who looked and thought like me,” says Butler. “It was the most ‘at home’ I’d felt with a group of people.”

Butler, reflecting on the experience, says, “It made me see where I could fit into medicine. SMDEP showed me I could be a doctor.” 

“They helped reinforce in me that there was every reason I should enroll in medical school. “

Through a basketball scholarship, Butler attended Midland University, a small school located in Fremont, Nebraska, approximately 25 miles from Omaha. There, she majored in biology with minors in chemistry and Spanish. Next stop: medical school.

From Defeat to Triumph

It wasn’t going to be an easy journey for Butler, who was trained in overcoming challenges. Her first hurdle was not scoring well on the Medical College Admission Test (MCAT).

Despite the testing defeat, Butler drew lessons from her mom, who had successfully completed nursing school, as a source of inspiration. As a single mother raising three children, she suffered setbacks—first by entering into bad relationships, and then from a serious kidney infection that at times prevented her from working.

“My mom couldn’t afford medical care,” says Butler. “Her employer was unsympathetic to her needing time off work. We lost everything. And she still made it through.”

Today, Butler’s mother is a rehab and psychiatric nurse. If she could overcome so many odds, Butler thought, “so could I.”

“My mom was my motivation,” she says. “Seeing her thrive convinced me that I could succeed.” Butler also credits her basketball coaches, who instilled in her a conviction that hard work and belief in self were keys to success.

Nothing Wasted: Pain Paves the Way to Purpose 

During her formative years, Butler and her family often visited area food banks that provided groceries consisting of high-sodium processed and canned foods. She says she is determined to educate others, particularly those dependent on food banks, about how to select healthy foods and the importance of good nutrition.

Butler offers that a clinician’s role is not merely to treat people who are sick but to help patients stay well.

During her first year at the University of Washington School of Medicine, she organized a food bank field trip for first-year medical students to a gain hands-on understanding of the food insecurity that afflicts so many underserved Americans. She went a step further by producing and distributing a “delicious and nutritious” cookbook of easy recipes for low-income patients who visited the local free clinic. Butler and her team also shared information with patients on how to read nutrition labels, recognize hidden harms, and substitute healthy ingredients. She included tips and techniques ranging from “must-have utensils,” how to flavor foods without adding extra fat or salt, and broiling or steaming versus frying, to rinsing canned vegetables as a way of removing salt and preservatives before cooking.

“I was old enough to see my mom rationing food,” she says, adding that she’s cautious now about what she donates to food banks, and tries to make sure it makes sense for a meal.

“Sometimes you get a bag with scalloped potatoes and garbanzo beans. What are you supposed to make with that?”

Gravitational Pull

A year and a half away from finishing medical school, Butler is still deciding on where to fulfill her residency. She initially considered pediatrics, but gravitated toward obstetrics and gynecology following a chance occurrence: in January 2013, with little experience, she served as a labor coach to a pregnant Honduran teenager whose family had disowned her, unable to cope with her situation.

It was an experience Butler will never forget.

Since then, Butler’s OBGYN rotation has furthered her interest in the field. She says, “I like emboldening women to view their bodies as powerful.”

In January 2014, Butler traveled to Managua, Nicaragua, where she performed a six-week clinical rotation offered by UW’s global health department. She observed how to deliver health care in attainable and responsible ways, focusing on infectious disease and obstetrics.

She applauds SMDEP for identifying people who will return to serve their communities. For her part, Butler notes that in the rural areas where she grew up, access to medical care may be a 45-minute drive away. She sums up the overall affect SMDEP has had on her life in one weighty word: “empowering.”

“I owe my career to the program,” she says. “I’m very passionate about helping other students get through it. I hope it’s as big a stepping stone for somebody else as it was for me.”