Two week follow-up

Kavya Rao, MS3 at UCSD SOM

This is a piece I wrote after watching a surgeon interact with a woman with dementia he operated on at the 2-week follow-up. She thought he was her check-out man, and he just played along instead of contradicting her. I was moved by his humility. He had no need to be recognized as her surgeon in that moment. He just needed to make her feel good. I think you can do a shoulder exam either way, don’t you?

her eyes danced with delight as she said hello to him.
his wrinkled kindly around the corners.
where have i seen you before? i must have seen you at the grocery store. you were my check-out man,
she said,
to the man who spent four years in medicine and six in surgery and twelve hours awake that day alone
and without taking a second to consider whether his actions were proper,
ethical,
allowed, even,
he crawled into her mind and confirmed that he had indeed bagged her oranges,
taken the moldy one out.

Ethics in the medical profession

Juliet Siena Okoroh, MS4 at UCSD SOM, PRIME-Health Equity
I will maintain the utmost respect for human life

She left, my aunt left… and I can’t believe she is gone
Joining the developing world of women who have lost their lives to pregnancy
Nothing about my training thus far, would ever bring her back
My country Nigeria, continues to rank 10th out of 196 countries in maternal mortality, spending less than $22 US dollars per person annually in healthcare.
This is saddening as I think about the 750 billion dollar annual waste industry called the United States’ health care system of which 30% is in unnecessary services.

What does it mean: to train in a system that doesn’t even protect my family from the consequences of poverty and false commitments of the country’s leadership?

What does it mean: to loose an aunt to pregnancy, an uncle to appendicitis, and three other loved ones to trauma because no one would operate or stop their bleeding?

What does it mean: to travel to a country where a body is left on the streets after an accident, like road kill with by-standers too scared to call the corrupt police?

When we ask ourselves if people need help in Africa, why is it that the first thought that comes to our minds is can we afford it?

In the United States, we are not trained to think about this question when patients come to see us, as if we are economists and not clinicians: A life is a life and everyone is entitled to enjoy the highest standard of physical and mental health: not just the absence of disease or infirmity but improvement in social wellbeing. Yet when I ask, if my aunt and uncles deserved necessary care, some health professionals say “Can we afford it” as if there is a better alternative to obstructed labor or ruptured appendicitis.

We take an oath that reads, “I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient. I will maintain the utmost respect for human life…” Do we value people differently? Is the experience of the poor with the healthcare system the same as the rich? Are the lives of Africans discounted to mean less as a result of us being born in a resource rich but economically disadvantaged continent due to relics of colonialism?

Martin Luther King once said, “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” We have a moral obligation as physicians to desist from perpetrating the disparities that exists in our society by; treating our patients with the uttermost respect, valuing their well being and dignity, consecrating our lives to the service of humanity, and contributing to advancing the ethics of our profession.

The WHO estimates a minimum of 44 dollars per person per year is needed to provide basic life saving services. Yet my country’s government continues to invest only half of this amount. I wonder, what the world would be like if we all just traded a pair of cheap shoes to save more women like my aunt.

Boundaries

Karen Levy, MS4 at UCSD SOM, GHHS Class 2014

The last few days of my medicine rotation were emotionally challenging for me. At the beginning of the rotation, I had an 83 year old patient who presented to the emergency room with pain in his shoulder. His only past medical history included Parkinson’s Disease and atrial fibrillation. Continue reading “Boundaries”

Liver of love

Anonymous

A woman s/p liver transplant. Her yellow eyes gazed passively, soullessly on as I sutured the hole in her abdomen where moments ago we had removed the drain. She seemed to barely notice we were there, much less flinch as my classmate injected lidocaine and I drove a needle through her skin with my inexperienced hand. Continue reading “Liver of love”