As medical students, we are familiar with the Triple Aim for health care improvement in the United States — to improve the patient care experience, improve the health of populations, and reduce the per capita costs of healthcare. While the move towards a quality-focused and patient-centered health system is encouraging in many ways, it cannot be accomplished by a workforce of burned out and jaded professionals.
Medical school can be an overwhelming journey for many students as the pace, quantity of content, and work hours far exceeds even the most prepared students’ expectations. The overall demand of medical school makes having a “normal life” very challenging; that is, the ability to attend happy hours or frequent social events, see local professional teams play or cultivate hobbies all become difficult to orchestrate between the endless pages of reading or practice UWorld questions.
In the five years that have passed since I met the 14-year-old girl who opened my eyes to the terrible crime of sex trafficking in the United States, much has changed. We have made strides in state and federal legislation to protect survivors, national human trafficking prevention months have been declared, and victims are no longer treated as criminals.
Debate about some of the most pressing issues facing our country were lost in the horse race of the 2016 presidential campaign. Among those issues was healthcare. While millions of Americans received health coverage under the Affordable Care Act, an estimated 30 million remain uninsured and medical bills continue to be the leading cause of bankruptcy in the United States.
I only realized that I was an optimist on November 9. Crushing disbelief is cliche, and yet — as I walked home, hot-cheeked, through rain and yolk-colored streetlights just after midnight, past a dive bar where neighbors tallied states and feverishly refreshed fivethirtyeight — I felt trampled.
Post-election, many of us in the medical field have become ever more aware of the somber sentiments expressed by the groups that were rhetorically and literally targeted throughout the election cycle. Many of us are women, immigrants, people of all faiths, people of color, refugees, disabled individuals and members of the LGBT community. We understand that policies and hateful rhetoric impact us, impact our colleagues, impact our families and impact our patients. We can see how the communities we serve have already started to be affected by this election.
Black hellebore, a flower of the deepest black and with petals the sinister shape of blunted arrowheads, grows wild in the cool, mountainous regions of the Balkans. Despite its unintimidating label as the “Christmas rose,” the hellebore has a much darker history, one bespoken more by the flower’s ebony hue than by its innocuous nickname.
Jamming to Vampire Weekend’s “Diplomat’s Son,” I walked passed two women on 95th Street between 2nd and 3rd Avenue. Each woman had an unlit cigarette in her mouth, and one woman was pushing a stroller. Thinking that the stroller could be empty, holding groceries, or carrying a small dog (as is the trend in parts of New York City), I turned around and was surprised to see a child, no more than a few weeks old, quietly sitting in the stroller.
My struggle began around nine months before my eventual diagnosis. This was on a background of an entire lifetime governed by this haunting feeling that something was different. Or that something was not right. Yet being the overachiever that I was, no one noticed. I was always left to question whether my reactions were just a disproportionate reaction to certain life events. And I was repeatedly told the same thing.
On Thursday, many of you will gather round a dinner table with your loved ones and give gratitude for your friends, family and good fortune. Many of you will think of the meal associated with the inception of this holiday, be filled with warm fuzzy feelings and gloss over the real history surrounding the relationship between those who supposedly attended the first “Thanksgiving” dinner. After eating a second helping of Grandma’s famous pie, few will be concerned about the side of historical oppression or racist colonization offered with this dinner because well, that isn’t so palatable.
Gun violence as a public health issue is not a new phenomenon. In 2014 alone, there were 81,034 injuries and 33,599 deaths due to gun violence in the United States,which equate to 222 Americans injured, and 92 killed, by firearms every day.
During my last visit home, my mother waited less than an hour before showing me her medical records. She offered them up the way I’d once presented my middle-school report cards, steering the papers across our kitchen table between bowls of peppercorn chicken and eggplant until they slid to a stop in front of me. Looking at them made my head spin, as they were written almost entirely in Chinese.