Wednesday, February 1, 2017

We are mortal humans, we suffer and love, hopefully together, and then we each die.

by Drew Rosielle

I went into medicine because I thought it'd be something practical, to help people.

I majored in English and Religion at the University of Iowa in the early 1990s, and didn't have clear career plans. I guess I thought I'd become an English professor. Late in my undergraduate days I was enamored with the more experimental sides of 20th Century poetry (Gertrude Stein, Lorine Niedecker) and figured I'd go on to grad school. To make ends meet in college, I got a part-time job cleaning a group home overnight for teenage boys with profound developmental disabilities. I liked to stay up late, and I could clean the house overnight and listen to the BBC World Service. And smoke (gosh I wish smoking cigarettes was a benign activity - so many pleasant memories). In the morning a couple other employees would come over, we'd get the boys up, dressed, fed, teeth-brushed, and off to school.

By my senior year, I was an assistant group home manager, and found myself in the surprising position of really, really liking working with these kids: dressing, feeding, toileting them, helping them do the few things they seemed to enjoy, trying to make meaningful connections with them. The latter was difficult - they all had autism (along with other developmental challenges), and several of them weren't verbal, or were so very rarely.

We played music constantly in the home (mostly for the pleasure of those of us who worked there), and one of my warmest memories of that time in my life was one of the boys seemingly spontaneously coming up to me, grabbing my head and gently bringing my forehead to his as if he wanted to privately confer about an important matter - it was a brief but distinctly intimate gesture - and muttering to me "She's a brick...house," then walking away.

I graduated, traveled, moved up to Minneapolis, got another job working with folks with developmental disabilities, and was contemplating applying to graduate school, when I had a sort of career crisis, and realized I didn't want to be an academic, and instead wanted to do something tangible and practical, that helped people. Undeniably, my experience caring for those boys was critical to my decision. However it wasn't otherwise a well-thought out, or particularly sophisticated decision, and I don't have much insight otherwise into why I decided to try to go into medicine. No one in my family is a doctor, or even in health care.

I wanted to help people, in a straight-forward, material way. It seems naive 20+ years later, but only a little. That human connection I felt with those young men whose lives were very, very different than mine, turned out to be a good guidepost for me.

There are many pleasures to being a doctor. One of the deepest, and most abiding, is the sheer breadth, depth, and diversity of people you meet, and share a form of intimacy. It's a professional form of intimacy, to be sure, proscribed by the duties and obligations and boundaries of our profession, but nonetheless at times profound. You hear about and witness, sometimes glancingly, but sometimes in great detail - deep, important, and very personal aspects of people's lives. Their hopes, joys, failures, traumas, sins, sex lives, fears, weaknesses; their beliefs about what matters most in the universe, what they love the most, what they can and can't live without.

You try not to love or judge your patients too much, you need to stand apart a little, watch them, seek to understand and appreciate, but not love or judge too much, but it's tough not to. There are your patients, and their families, going through things you can only imagine, and it's all just right there in your face, impossible to ignore. 

Doing this, you quickly realize, and are reminded on a near daily basis, that the things you find virtuous, and laudable, and good - poise, grace, pugnaciousness, grit, humor, humility, gratitude, self-sacrifice - know no color, creed, language, gender identity, national origin, income bracket, faith, insurance status, ambulatory status, employment history, etc. Who you are, where you're from, who you love, how you love - these things are important to be sure - but the work of medicine is a constant reminder to me that no one group in this sense monopolizes any of these virtues.

Every door you open, you are constantly, palpably, in the most concrete and non-abstract way,  confronted with the common humanity you share with your patient & their family - the sick and suffering body, the sick and suffering person (and those who care for them). Whether it's the newly arrived Karen refugee, or the Wells Fargo executive with a very bad cancer.

We are mortal humans, we suffer and love, hopefully together, and then we each die.

I'm not religious, but I think I know what some people mean when they describe healthcaring as God's work.

I'm writing this because of the current political scene in the US. Pallimed has avoided politics, at least partisan politics in the US. I personally care a lot about politics, including partisan politics, but Christian and I feel good about that decision to not go there. It's not what the blog is supposed to be about.  But we've always discussed ethics and morality - it's central to healthcare and medicine - our beloved (science-informed!) healing art that has called us to help our fellow mortals. Christian and I have been talking, and we wanted to speak up and be very clear about our moral vision as individuals, citizens, health care professionals, and the founders of this blog we love so much.

We think people in the US can and should and will argue, in good faith, about the best policy solutions to our nation's challenges.

However, we are appalled, and frightened, that seemingly the very fundamentals of our democratic society are being undermined, our democratic institutions are being eroded, and certain cultural groups are being singled out for suspicion and discrimination.

We reject the idea that some people's lives matter more than others. Refugee lives matter too, as do Black, Muslim, immigrant, brown, native, queer, disabled, poor, uninsured, unemployed, addicted, paroled, and imprisoned lives. We should love our neighbors as ourselves, and do the deep moral and internal work it requires to come to grips with the deepest human truth out there - that everyone on this planet is our neighbor. The moral mandate of medicine requires us to stand up and stand with the powerless & the persecuted: they are our neighbors, we all do better when we all do better.

We reject the lie that we don't have the resources or the wherewithal in the US to care for the refugee, the sick, the bereft, the homeless, the dispossessed, the persecuted, the alone, the disabled, the penniless, the waterless.

The US is imperfect, but the balance of powers structure has served us well. Any likely alternative will be a human catastrophe. Elected and public officials are here to serve we the people, the citizens and residents of the US -  all of us.

May we all live knowing true peace and justice,

Drew

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