As physicians, we must work to lift patients up when they are struggling, rather than shaming them into well-being. As Dr. Donald Berwick once noted, it is not always patients’ diagnoses, but their helplessness that kills them. Indeed, the helplessness we instill through our focus on individualism and molecular pathology in the clinical setting will ensure that this epidemic kills millions prematurely and costs billions of dollars. If obesity is a disease caused by society — its inequities, trauma, and expectations — then the solution for obesity should address more than just the patient sitting in front of us.
In 2018, a patient filed a complaint against a medical student for wearing a “Black Lives Matter” pin on her white coat. When the student reached out to her school’s administration, she received this response: “It is best to not raise barriers in the way we present ourselves…Some of your political pins may offend some people, and it is probably best not to wear them on your white coat or while you are working in a professional role.”
The notion that a person’s health is only impacted by the clinical care they receive is not a reasonable one. Currently, as a first-year medical student, I have had the privilege to learn from a variety of professionals that have once again reminded me why I am on this path and why I want to serve underserved populations.
We will recall when, during the summer of 2020, the moral and political duty to engage with the most momentous anti-racist movement since the 1960s reanimated a nation paralyzed by fear. By the fall, cataclysmic wildfires on the West Coast poisoned the air from San Francisco to New York City. Coronavirus, cultural upheaval and manifestations of climate change all bore down on us as we entered the most consequential and divisive national election in living memory.
Mercedes drove two hours to the nearest healthcare clinic to get her first physical exam in ten years. I met Mercedes while shadowing a primary care physician, Dr. L. In the clinic, Mercedes divulged to me how nervous she had been driving in – she knew what the meeting held in store. Her fears were confirmed: just five minutes into her exam, Dr. L advised her, “Mercedes, you have to lose weight.”
Gather a group of American and Chinese first year medical students in one lecture hall, and you will notice some obvious differences right away. The Americans will likely be older with more work experience under their belt already. There will be more women on the Chinese side, and most have been full-time students all their lives. Dig beyond appearances and ask them what their daily curriculum consists of, and you will find even more interesting differences.
As I reviewed the notes, it occurred to me that many of my peers and I have displayed some of the signs and symptoms of mental illness. Our professor’s lectures emphasized the importance of recognizing these features in patients, but what about identifying them in ourselves? Should it also be our duty to recognize the signs and symptoms in our colleagues?
This unrest reached a high point in September, when nurse Dawn Wooten filed a formal complaint against Dr. Mahendra Amin, a Georgia physician working at an Immigration and Customs Enforcement (ICE) detention center, who she claims performed mass hysterectomies on detained immigrant women without consent. While the country reacted in shock, the reality is that coerced sterilization against communities of color is not new. The United States has a shameful history of exploiting Black and brown women’s bodies as part of a larger objective for population control rooted in white supremacy — and the medical field is partly to blame.
In a profession where we are trained to fight death around any corner, any day, students need to not only understand how to handle death in a medical setting but also how to cope with the weight we bring upon ourselves in end-of-life situations. No matter our past experiences, no matter our clinical training or how academically prepared we think we may be, it can be traumatic to feel the burden of responsibility for the loss of a life.
It was a Saturday morning and there were close to fifty volunteers who gathered at a homeless shelter in Riverside, CA ready to give out hygiene care packages and offer free showers, haircuts, clothes, and food. Eager medical students and physician assistants provided free health care screening and visits. Efforts like these are fairly common — nothing groundbreaking.
As stressed medical students looking for an eventful destination to spend our spring break, my friend and I chose to take a trip to America’s Big Apple, New York City. On a sunny day in NYC, I remember enjoying our morning cups of coffee and walking into a subway station when, suddenly, an older man shouted at us, “Take your corona and get out of my country!”
This piece is focused on the applications of empathy and compassion in decision-making. How can we distinguish between them? In its simplest form, empathy deals with feelings while compassion deals with understanding.