I remember hearing an important piece of advice: “If you are passionate about something, you will make time for it in medical school.” This advice, however, was soon countered by a snarky follow-up: “It is not that you did not have time for it; you did not make time for it.”
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.”
Recently two prominent children’s hospitals have made unprecedented announcements. Boston Children’s Hospital and Chicago’s Laurie Children’s Hospital announced that they would stop performing certain surgeries on children born with intersex traits. These announcements come after huge direct efforts by advocacy groups like The Intersex Jusice Project, lead by Pidgeon Pagonis, and InterAct, a national intersex youth advocacy group.
I’m not the first to think / under my breath, even out loud: / To test positive for Covid. / Even after this morning.
If there is one thing I have learned, it is that what we, the medical providers, think is important may not necessarily be the priority of the patient. We want to know: why are your sugars uncontrolled? How is your diet? Have you been able to take your metformin? However, for the patient, these things are often trivial. The patient wants to know: how will I be able to afford these medications with my part-time job? How am I expected to see a specialist without insurance? Should I be going outside to exercise, or will I contract coronavirus?
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.”
Moreover, homelessness and COVID-19 both disproportionately burden marginalized populations — in particular, Black communities and Native Americans. When COVID-19 began spreading through the community, it came as no surprise that it would disproportionately impact those living in congregate homeless shelters. Overcrowded shelters, the inability to physically distance, and poor access to handwashing and hygiene facilities are coalescing for an unsafe environment that could accelerate disease transmission.
I wish it were different — / Dying patients, struggling hospitals, overworked health care workers, / topsy-turvy economies, politicized safety precautions, and the / uncertainty / of tomorrow.
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.
Now, I am a fourth-year medical student standing at the foot of a tall ladder. The hierarchy of medicine requires that I follow some unwritten rules in order to climb. Throughout my training, I have gotten the sense that one of those rules is: avoid trouble, good or bad. Of course, now, doctors are beginning to find their voices through movements like White Coats for Black Lives. But as a young trainee, I sometimes feel the sentiment directed at James in 2018: shut up and doctor.
I am worried that these stories of heroism are harming the very people they celebrate. By creating an ideal “health care worker” as an endlessly altruistic individual, it stigmatizes the medical workers who refuse to take on these risks — even though there are many legitimate reasons not to.
So, what is planetary health? It refers to a burgeoning field focused on understanding the health impacts of human-caused disruptions of Earth’s natural systems, including climate change and environmental pollution. This also encompasses the immediate and downstream health threats from such disruptions, which have impacts on communities at the local level — Philadelphia is no exception.