Struggle

Trying to eat vegetables out here and feeling like this (#theStruggleIsReal):

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Fellowship Essay

(I got rejected, but I love this essay)

I decided to become a doctor because I want to defend the right of every soul that crosses my path to live healthily and happily. When I was honest with my abilities, interests and achievements at that pivotal moment in my life when I chose this profession, medicine made the most sense and the path into it was clear. As a student doctor, I have made a great effort to ensure that my focus was not solely on the human body, but also the humanity which animates it. The human existence is the marriage of a myriad of disciplines and experiences and I never want to forget that.

I believe that my studies thus far in the humanities, social justice, and the health sciences will help to contribute to a vibrant conversation about conscious medical practice, identifying bias in both negative and positive contexts, and the next ethical step in the evolution of medicine, should I be deemed worthy to receive this Fellowship.

It is my sincere belief that this fellowship will help me continue my education in a subject that is a necessary component of modern medicine: ethics. For me, the Holocaust is one of many appropriate beginnings for my continued enrichment in the history of ethics for personal reasons as well as practical ones.

My practical reason is related to my career choice in medicine. The research and evidence demonstrating the existence of the social determinants of health now is astounding. The social determinants of health speaks to an understanding that one’s wellbeing is not just intrinsic to the individual but also contingent on the milieu by which they are surrounded and the sphere they occupy in their society. Race, gender, sexuality, religion, immigration status, socioeconomic status and many other things can affect the severity of the same disease in two individuals with different backgrounds. It has been very well demonstrated that those belonging to marginalized groups tend to have poorer health outcomes for most diseases. We as current and future clinicians tend to focus more on the avoidable, downstream manifestations of these social determinants, an expected consequence of how we are instructed and trained. We’re more likely to treat an anxiety and depression complaint with a medication than take a step back and realize that the anxiety and depression of our patient is a function of a poor, single mother with job and food insecurity, almost no social support and poor literacy skills being denied necessary aid from the government because she filled out her forms incorrectly as English is her second language.

And often, even if we are aware of all of that, our power to help such an individual may be limited to that prescription.  However, we’re uniquely poised in the present climate of medicine to start addressing those identifiable upstream social determinants of health, at the societal level.

The role of the doctor is changing and has been changing for some time. There are a plethora of medical complaints that no longer directly need a physician to be addressed. While I will still defend to the death the need for primary care providers, this role that was once just filled by physicians is now being filled by capable and diverse teams of specialized providers.

As the presence of clinicians is less necessary in the clinical settings, I believe that doctors need to practice medicine in the macro scale: no longer one patient at a time, but in the public health and health policy arenas, where the health of entire demographics can be effected for the better by our meticulous clinical training and problem solving skills. This is important because now we as clinicians, the traditional harbingers of health, can work actively to address those social determinants of health that contribute to the frightening health disparities in the United States and worldwide and unnecessarily burden healthcare systems. What is more, often, the populations with greatest health disparities are those with histories wrought with dark times of humanity that many would like to forget: exploitation, legal and social discrimination, bloodshed, war and deliberate wrongdoing; wounds that have long needed dressing.

As someone who wants to defend the right of every soul that crosses my path to live healthily and happily, how can I not address the social determinants of health that I take so much time educating myself about? The answer is that I cannot and still expect to achieve that goal. Therefore, addressing the social determinants of health and health disparities, learning the history that contributed to them, and the practices that maintain them is a matter of medical ethics.

The Holocaust blatantly demonstrates what I still find to be true in many subtler ways today: the illness that is killing people is a function of a society that is sick. All atrocities committed in the name of supposedly advancing science must not be forgotten and the medical ethics which evolved in response to should be a pillar in the education of all future physicians. The Holocaust changed Medicine forever. The unspeakable human experimentation carried out by doctors can serve as both a cautionary tale and a lesson of the importance of practicing medicine methodically but also with a conscious.

Ignoring the past and not addressing the wounds that it left behind on the present would be irresponsible.  We deem ourselves healers. That being said, if we are silent then we are complicit in the sickness that afflicts our society and we betray our oaths and divine calling of medicine. I hope contribute to the field of medical ethics and medicine in the future, addressing health disparities and continuing the work of exposing all wrongs committed under the guise of advancing the field of Medicine. Whether in Auschwitz, on Indian Reservations or in the underserved rural south town of Tuskegee, Alabama, there is much learning and atonement to be done.

Through these hard lessons, we can better heal the gaping wounds that still mar us.

Threatened Independence – Conversation with an Elderly Veteran

Right now, I’m here.  I don’t want to go down.  Like down, a hole in the ground, in a grave.  I’m almost 90. Most people my age are vegetables.  But I do alright by myself.  I do what I want, go where I want, take care of myself and I have my own finances, no romance, I’m too old for that.  But I don’t want to be a burden.  I got a good family. I live with my son, but we don’t hardly see each other.  My youngest son comes sometimes, and he cooks for me, when I don’t feel like doing it myself.  I’m independent, I’m satisfied.  But now, I’ve fainted and they’re trying to figure out what’s wrong and I want to stay where I am, avoid the decline.

 

Maybe you’ll find it hard to understand, you’re a young lady.  You’ve got a good education, good job and your whole life to live.  Me, I worked the same job for more than 30 years after the navy.  They respected me.  I didn’t complain, knew my job, they called me ‘Old man H’.  There hasn’t been anything I haven’t been able to provide for my family, anything they wanted.  I’ve been halfway around the world, now I just want to do what I want.  My son sometimes acts like he’s the boss, but he ain’t.  I’m the kingpin.

 

If you done been through what I’ve been through, seen what I’ve seen and know what I knew…  I do what I want now.  They’re talking about sending me to a rehab, but I got things to do, I got to the to the bank, I got places I need to be.  I take care of myself.

 

I’ve had hemorrhoids; I got them cut out.  I have a hernia.  I’ve had diphtheria.  People would die from that; put a big black cross on the front door and say, don’t go in there, ‘so and so’ died.  There wasn’t one on my door then; there ain’t one on my door now.  I don’t need that. At my age, I’m satisfied.  I do what I want, I take care of myself.  I’m satisfied.  You probably think I’m nuts (sidenote: I didn’t and I told him so).

After the Silver Screen Fades

Every year, I try to write a novel for National Novel Writing Month (see deets at nanowrimo.org).  I have never completed the task, haha.

But I’m going to try again this year.  Just for the sake of it.

I don’t know if it’ll be any good, but here a short synopsis about what my novel is about.  My friend once called me a rom com gone wrong, so it’s kind of related to that:

This is the story about a girl.

You know the one.  She gets left at the alter when he realizes his one true love.  The one he’s with before he comes to his senses and realized it was someone else all along.  Yeah… her.  Nobody really tells you what happens to her after all the rigmarole that the leading man put her through.  But she lives on.  When everyone else is feeling good about the inevitable plot twist that take the main characters to their happy ending, she’s feeling something, too.

I’ve always felt that she feels matters.  She is not the smiling American sweetheart or heroine of the story who steals our hearts in the end.  Nonetheless, she matters.

I’m sure she had many names and stories, but for the sake of our purposes, her name here is Evie.  And this is Evie’s story.

Continuum

This image really spoke to me today.  I was just reminded that when we encounter people, we get a small slice of someone on a continuum of life.  And for that one or handful of interactions, there’s so much more leading up to that moment…  While we may want to write off someone for a terrible first impression, you have no way of knowing if they are going through a loss, trauma or just hit a rough patch… not all of us were blessed with the skill of “faking it until you make it”. Because before that heart develops those scars that reinforces its strength, it’s wounded, it hurts and it has to heal…

So I try to give each person I encounter the benefit of the doubt unless I have some compelling reason not to.  If our interaction was sour, maybe that’s not the best version of themselves…. we’ve all been there.  I give them a chance and I’m usually pleasantly surprised.  Hope you all do the same.

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PSA

Intolerant atheists are as just bad a intolerant religious zealots.  It’s not your belief system that’s the problem, it’s the ignorant, hardheaded idiocy that you choose to conduct yourself with.  So please respect everyone, as long as they’re not hurting themselves or anyone around them, even if you don’t agree with it.  And life will be better for it.