“Yes, this guy says yes to everything. Are you pregnant, sir?” asked the hospital ambassador. “Yes,” replied the young man. “You are pregnant? A pregnant man?” The ambassador laughed. While volunteering at a local hospital, I’ve seen first-hand how immigrants like myself can receive unequitable treatment compared to their English-speaking counterparts. I speak both Russian and Spanish and grew up surrounded by some of the challenges that immigrant populations face. In the interaction above, I stepped in to ensure the patient checked in with dignity. His gratitude led to my initial belief that I could be a hero to others like him by speaking their language and providing them with the care they needed in a more welcoming way. Recently though, I’ve realized that the idea of doctors being heroes isn’t realistic and I’d been missing what medicine actually is. It took a few meaningful experiences and my own internal reflection for me to come to this realization.
My desire to become a doctor began when I cared for a nursing home resident with late stage dementia. She was bedridden and often cried due to the hallucinations caused by her debilitating disease. No matter how hard I tried, I couldn’t calm her. I recall feeling helpless in a way that I never had before. It was my first real encounter with my own limitations and I had to confront the fact that sometimes a task as simple as drying someone’s tears, may not be possible despite my best efforts and intentions. This initially shook my confidence and I started questioning whether I was good enough to be a doctor. At the time, I’d believed that doctors were superior citizens capable of anything. I was someone who always met or exceeded expectations despite significant barriers. At her bedside, I was responsible for her physical, mental and emotional well being to the extent of my skillset. My expectation was that I would comfort her and stop her tears for a little while at least, but I couldn’t. I couldn’t meet expectations, something that at that point, nearly defined my self-perception. This experience resulted in a nearly desperate need to learn about her condition in order to improve her state. I wanted to acquire the skills and knowledge necessary to never feel that helpless or incompetent again.
While shadowing primary care physicians, neurologists and a laryngologist however, I realized just how untrue the idea of doctors failing to feel helpless can be. In neurology, I saw children whose ailments were terminal and wondered how it was possible for patients to never get better due to the severity of their ailments. Looking back now, I realize that what I’d seen then was a gap in medical knowledge. At the time; however, I didn’t yet comprehend that doctors were human and didn’t always have all of the answers. This was my first encounter with the limitations of medicine.
It was daunting to think that I might not have the answers for my future patients, so I considered research. In research, I wouldn’t be faced with the consequences of problems I couldn’t solve—I would be solving a problem. What prevented me from pursuing research though were the patient interactions I yearned for and regarded so highly. The most impactful of these interactions was while volunteering at the [name of hospital] for the Homeless Program, I spoke to a woman recovering from substance abuse disorder. She trusted me with her story, the dreams she lost, her frustrations with addiction and her own lessons learned in the process. I never told her what to do to recover, just listened and encouraged her endeavors. For me, this was a powerful moment on my journey towards medicine because of the trust she placed in me, a stranger. I realized then that I can create safe spaces for others to discuss sensitive matters. My mentees had mentioned it before but this was the first time I believed it myself. It gave me confidence in both my communication and listening skills and I was reminded yet again that if I went into research, I wouldn’t be able to make the direct impact I want to have. Perhaps I won’t always be able to cure my patients, but I can individualize treatments so they work for the specific patient and family. I aspire to give patients and their families more quality time together and help them adjust to and understand their new situations to the best of my ability. In a research lab, I wouldn’t have the interactions necessary to fulfill the role I want to.
The knowledge I’ve gained since helping the Spanish speaking patient navigate check in has changed my perception about the role of physicians. I have come to see doctors for what they are: facilitators doing their best for patients, not heroes with all of the answers. Having witnessed and experienced some of the barriers that patients and especially immigrant populations face, I want to apply my compassion and willingness to go the extra mile. I aspire to advocate for and equip patients with the knowledge and resources required to overcome disparities and take control of their health. By attending an osteopathic medical college, I can accomplish my goal by focusing on the care of underserved populations, while simultaneously appreciating the interconnection of body systems, pathology and determinants of health.
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