Seder Doctors.
(aired on All Things Considered September 29, 2003)

 

Some of my medical school professors have a bad habit. When they lecture, they'll say something like, "Now, you and I can handle this pathogen fine, but someone with a compromised immune system is going to have a problem." Or, "Now, young healthy people like yourselves are going to have a clearance rate approximating this level."

I suspect that the idea underneath this is, we're fine, we're healthy, and we're here to talk about the other people, the patients. And they are not fine. They are sick.

I'm sure my teachers, in their rational minds, must realize that there are many people with illnesses of one kind or another sitting in any medical school amphitheater. All I can think is that their remarks must come from a fantasy, a sort of wish that the doctor and the patient are two opposite sides of a coin. The doctor represents health, and the patient represents illness. The patient is the sufferer, and the doctor dispenses charity.

Recently, I spent a couple of months working with an AIDS activist group in South Africa, the Treatment Action Campaign. I helped produce some educational materials and did a bit of fundraising. The group included people who had HIV and people who did not; it included people with a lot of education and people with very little.

The people of the Treatment Action Campaign say "we". In fact, I've come to think that the unconscious and truthful habit of saying "we" is a clear sign of a successful grassroots movement. We might say, "we need better medicines" even when only some of us will need to take medicine at all. We say "we are dying" when some of us will live much longer than others.

I know that we who work in medicine are not all activists at heart. Nonetheless, we don't have to be activists to think in this way. For instance, consider the Passover Seder. Jews recount the history of the time of Moses by saying, "When we were slaves in Egypt." In fact, there is a point in the Seder that specifically teaches participants to say "we", and teaches that saying, "when they were slaves" is wrong. It teaches that the stories of our ancestors are also our own stories. And in this way, the Seder binds generations together.

Maybe you couldn't write it just like that on a medical chart. And I imagine that some of my teachers will tell me that a doctor can't afford to become too emotionally attached.

But I still think there should be some part of doctors and medical students and medical school professors, some part of us that should say to ourselves, "when we were sick." To think of the stories of our patients as our own stories. When we shot heroin with a dirty needle and got Hepatitis C. When we got oral thrush and could hardly swallow. When a tumour went to our lymph nodes and spread. When the price of medicine was too much for us to afford; when a hospital would not admit us because we did not have insurance. When we were scared of dying, when we reached out for help, when we needed the love of those around us.

 

copyright 2003 joe wright