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.
Regardless, with this data in mind, it is important for students in medical education to understand that we are entering the profession at a time where the reputation that precedes us is not ideal. This also means that the capacity to alter this perception is dependent on the way we practice upon entering the workforce.
I entered the office of the Community Health Council of Wyandotte County, Kansas City, on a muggy, late-summer day during my family medicine rotation. The air-conditioned building boasted a large front room with sporadically placed desks, children’s books and toys, and what looked like a large food pantry. I flexed my elbows and wagged my arms to fan out the sweat from my Black body enshrouded in my white coat.
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.”
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.
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.
Rather than ask elderly poll workers to risk their health on Election Day, medical professionals and students can volunteer to work at polling locations. Health care professionals and students tend to be in a lower-risk population and are also well-versed in the public health practices critical to safely conducting an election during the pandemic.
I have learned that patients seek health care services at free clinics for a myriad of reasons and some are atypical. There were specific populations I expected to see: the uninsured, underinsured, undocumented, and those without access to transportation. Yet there were other populations I was more surprised to see, namely patients who had insurance but preferred their experiences at free clinics.
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.