(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.