Conducting research in vulnerable populations and historically marginalized groups can be a delicate process, and because of this, safeguards intended to protect these exact groups can ultimately hinder the research process.
The elegant sport of tennis has evolved over numerous decades, from using wooden rackets to the graphite rackets of today. The historic grass-court stages of Wimbledon have also undergone changes as champions were crowned. Likewise, medical innovations have advanced greatly.
Understanding the origins of words is helpful in medicine. “Genu” and “corpus” are Latin for knee and body, respectively. “Hippos” is Greek for “horse” and “kampos” for “sea monster.” (Can you tell I am in a brain sciences block)?
In 1913, nine years before his death, the physician and medical historian Eugene F. Cordell gave his presidential address to the Medical and Chirurgical Faculty of the State of Maryland. His topic was the “The Importance of the Study of the History of Medicine.”
Outside apartment 13C the street is empty. It is early in the morning, and yet sounds echo from the metal shop beside the lake, roosters crow, and the children upstairs patter back and forth across the tiles. I roll up my yoga mat, shaking dead cockroaches from its rubbery bottom. Through the grated windows I catch a glimpse of Lake Victoria, shimmering out from the cluttered shore of shanties and deconstructed docks to eventually blend with the blue of the morning sky.
With the future of the Affordable Care Act uncertain under President Trump, many Americans are left worrying how they will manage without health care. The Americans who must shoulder this burden are disproportionately people of color. It should come as no surprise to those familiar with the history of health care in this country that once again our system, purportedly built to protect and promote health, is systematically ignoring the right to health care for communities of color.
Like most people, I watched the Ebola plague tear through Africa two years ago with a feeling of helpless horror. I saw the victims dying by the thousands on television, all eulogized by the same stark words: “No cure.” There seemed to be some unstoppable and malevolent force in the universe, seeking not only the destruction of human life, but hope itself.
The field of medical ethics is often ambiguous, esoteric and paradoxically arbitrary. Discussions about ethics during training revolve around case studies of patients without health care proxies and Beauchamp and Childress’s four accepted principles — and stop there.
A ubiquitous hierarchy pervades all levels of medicine. Medical students are anchored firmly at the bottom of medicine’s social ladder, rendering them functionally powerless. Although students theoretically have a “voice”, their precarious position low down makes them apprehensive to use it. Students’ grades, evaluations and recommendations, etc.– which have real, tangible impacts, not only on students’ academics, but also their future careers and lives — are contingent on appeasing those higher up on the so-called social ladder.
While I could list close to 100 lessons, I believe focusing on three of the most important ones would aid other future health professionals in managing and ultimately treating the chronic illnesses that will become even more prevalent in many of our future patients. As a disclaimer, I do not claim to be an expert on this topic, but these ideas spring from my own personal reflections.
In light of this recent occasion, I would like to draw attention to the sexual harassment of a particularly vulnerable population that is a result of a unique power dynamic: they have no income, they have amassed significant debt and they depend on the subjective opinion of their abusers for validation of their work. Most frustrating, is that many of the corrective actions taken over the last 25 years have had a limited effect on changing this specific culture of abuse. This specific population is medical students.
Medical students are subjected to a barrage of advertising that inevitably leads to a physician-industry connection that can be harmful to our health care system. Medical students’ exposure to pharmaceutical marketing begins early, growing in frequency throughout their training.