Elliot Goodenough, MD, PhD, is board certified in family medicine, and practices at Drexel's Partnership Comprehensive Care Practice. They have a clinical interest in the compassionate care of people living with HIV and/or hepatitis C, LGBQ and transgender people, and people with substance use disorder.
Can you tell me about your work prior to joining the Partnership team?
Until I came to Drexel, I was working at a primary care affordable health clinic in Philly, the Public Health Management Corporation (PHMC) Care Clinic. There, it's really just broad primary care, which for me included HIV medicine, hepatitis C treatment, a medication assisted therapy (MAT) program for folks who have opiate dependence, and treating a lot of trans and gender nonconforming and queer folks. And that's still what I aim to do at the Partnership, although more narrowed to mostly HIV medicine. We offer PrEP and MAT at the Partnership also.
What sparked your interest in medicine to begin with?
I guess that comes from working in basic research labs for a long time, in immunology research and cell biology. And I was connected to that, working in labs in college, before I considered going to med school — it was a recommendation from my boss at the time. She really wanted to encourage me to engage in an MD/PhD program, which is ultimately what I did. She was a GI doctor, but it kind of made sense to me.
They weren't directing me toward primary care, but just having come from a tradition of health care appreciation. Taking care of my friends who were HIV positive and having a connection to HIV activism and other community organizing, it started to make sense.
I started to consider being a doctor to contribute to the culture of health care, especially because so many doctors are not very respectful providers to patients from underserved communities.
How do you think it has influenced your work to have had the experience of caring for friends who are HIV positive?
I think it just brings a lot more humility, and I think fundamental to queerness is this recognition of self-definition and the right to self-advocacy, so it helps to come from that tradition and to understand that my patients are the experts in their own bodies.
It doesn't make me clinically better, but I think we see this generational shift in medicine to a degree, where doctors are slowly becoming less paternalistic. This sort of accelerates that, because I come from these anti-oppression politics of assuming that my patient is the expert in the room.
What was it that drew you to this role at the Partnership, in particular?
At PHMC I was doing a lot of HIV medicine, and as a pretty young doctor it was appealing to come to a place where there are more experienced providers and where I could learn more. The Partnership has a great reputation and a lot of my patients had been there before. A lot of patients are following me over from Care Clinic and it's nice to be in a place that's fairly well-resourced and considerate about offering patients a lot of different resources.
What would you like people to know, if you had to sum it up, about some of the services you've provided during your career, or will provide at the Partnership?
There's a lot of talk in public health systems about ending the HIV epidemic, and of course people continue to get infected. I think it's good in some ways how perspective has changed around that, but still when I see a new diagnosis, a lot of folks have heard a lot of mythology and have a lot of fear. So it's nice to be in a place to say that we have some really good medical options for treatment. I get to explain to patients that those options are improving all the time and soon we'll have better ones, even, that may not require a daily pill.
It's nice to compare that history, because there's a recent history just in the past generation of how much the landscape of HIV has changed. I always like to talk about that with patients and hear their histories and their experiences, because so many folks know a lot more than me about what it's like to live with HIV.
I think it's nice to be in more of a listening space in the kind of work that I do. I think in primary care, especially for marginalized folks and in HIV medicine, of course there are providers who are very directive or blaming of their patients. I think most of us recognize that that doesn't serve us. So more than in some specialties, in HIV medicine there's less advice that I feel compelled to give. It's easier to just be partnered with a patient in their care.
You were talking about being excited to learn from other doctors at the Partnership. What are some of the things you're hoping to learn by working with them and with your patients?
I just have so much respect for people's experience, for doctors and HIV specialist clinicians who have been doing this for a long time. There's a lot there that's specific to how to manage patients with multidrug-resistant HIV, certain questions about dissecting genome types and interpreting labs, but I think that being in a more academic setting has some advantages.
It's hard to be a young, newly trained and fairly inexperienced HIV provider and be the only one or the most senior person in a clinic, and here that's not the case. There's lots of people I can ask questions of, and it's really collaborative, so it's nice to see these discussions happening all the time.
In terms of working in an academic environment, is that where you've seen yourself going, or was joining the Partnership team kind of a happy accident?
More the latter. I didn't intend to work in an academic clinic, although I see its advantages. I was, and still am in some ways, more driven to community care. This is a happy medium in that way.
And are you from Philadelphia?
I grew up in Tennessee, but I moved to Philly when I was 18 and pretty much have been here since, except for residency. And I went to Jefferson for med school.
So you like living and working in Philly?
I do. I love it here.
And when you're not working, what are some of your hobbies and how do you like to spend your time?
That's harder to answer now. Right now, I spend a lot of time reading and working on my house, and I'm still connected to anti-prison organizing in Philly. The way that I'm connected to it is a couple of organizations that offer prisoner support by direct communication with folks, mostly letters. And it's a lot of folks who have loved ones who are inside, so it's this inside-outside collaboration for prisoner support, but with a sort of prison abolition lens to it. So those conversations — I think those things take up the most of my time.
Do you think your interest in activism and your interest in medicine come from the same place?
That's hard to say. Probably, because a lot of our motivations are grounded in the same part of ourselves, but I feel mixed about it sometimes in terms of the ways that I participate in a system where we understand — the medical systems that we are complicit in can be pretty oppressive to people. But also I think there's an advantage to being a politically active person who's working in medicine and gets to have these personal relationships with people.
For doctors who are becoming aware of problems with the system or who want to be more aware of problems with the system, do you have advice for learning more about that and implementing what you learn into your worldview and your practice?
I wish I had better advice. I think that there's so many resources that we can learn from. There are a lot of seminal books that folks can read and — it's hard to direct people in a particular direction, but stuff from Angela Davis or some of the broader disability activism writing ... I was recently watching this video of Stacy Millburn, who had a lot to say with regard to disability activism.
I think we have a lot to learn from folks who have particularly experienced racism and fatphobia and anti-disabled sentiments from doctors in particular. There's so much writing about people's experience of the medical system that we directly participate in.