Of all the ways our journey through medicine rewires our minds, the need to be useful is one of the most peculiar. Somewhere along the path, amongst the delayed gratification, endurance for long hours and poise amidst crises, we develop an unrelenting desire to be difference makers. It is an unusual curse. For some, it may be mild. Perhaps a nagging feeling as if they must always be productive. In others, it could be as grand as a savior complex, where anything less than ridding the world of injustice is unacceptable. I see the former in my mother, a nephrologist in Washington D.C. who packs her paradoxical days “off” with superfluous errands. For better or for worse, I am also beginning to see that I, too, have been “cursed.”
The Green Family Foundation NeighborhoodHELP program has been a flagship component of the Florida International University Herbert Wertheim College of Medicine (HWCOM) curriculum. Students are assigned households to follow longitudinally during their tenure at HWCOM. This program provides a unique opportunity to simultaneously learn medicine as well as give back to the greater community. The idea of being entrusted with the health care needs of a family is exciting for us as medical students. There are so many success stories of how students dramatically improved the lives of their households. Going into the experience, I could not help but have grand expectations. Interestingly, my expectations were met in ways I did not anticipate.
When I began working with my NeighborhoodHELP family, the head of the household, a young woman in her 20s (who will be referred to as Maya for privacy reasons), had just become pregnant. She and her husband had been attempting to conceive for several years. As one can imagine, they were elated. Rather than a medical complaint, the family’s primary concerns were a lack of health insurance and citizenship. If it were not for the Mobile Health clinic that is associated with the NeighborhoodHELP program, prenatal visits would be unaffordable for them.
Our first plan of action was to organize a social work referral for Maya so that a social worker could help her fill out an application for Medicaid. Unfortunately, soon after submission, the application was denied. How would she be able to establish care with an OBGYN physician for consistent fetal ultrasounds and the subsequent delivery? How was she going to provide for her infant after birth? What if immigration officers came knocking at her door as they did with her cousins? These were some of the questions Maya wrestled with.
Fortunately, within a couple of weeks after our second visit, Maya found a path to both citizenship and health insurance. Driven by a natural intellect, strong English, and a child to provide for, Maya navigated her citizenship application and passed the interview. Once granted citizenship, she was approved for health insurance and visited an OBGYN within her network. All of this occurred within a month. She delivered a beautiful, healthy, baby girl at the beginning of 2020 and is adapting to motherhood well. I could not be happier for her. The fact that she secured health insurance for herself and her daughter, especially before the onset of COVID-19, is an additional blessing. As pious as she is capable, I can almost hear Maya saying “Thank God,” in the grateful tone I have come to associate her with.
My experience with my NeighborhoodHELP family left me with conflicting emotions. On paper, things could not have gone better for my household. Nevertheless, I feel as if my involvement was not a necessary factor in their success. In all honesty, I am past deliberating whether or not this feeling is valid or not — for it is. I did nothing essential for my household, and they would be in the same position right now, whether or not I (or likely any other medical student for that matter) was assigned to their case. What I am attempting to reconcile, at this point, is that this feeling is ok.
Physicians exist to treat the patient. Patients do not exist for us to treat. What we should hope for as medical professionals are patients who do not need us. No matter how well trained we are as providers, there will never be better treatments than preparation and prevention. Platitudes aside, despite not being able to strut in and save the day, I am thankful for being able to learn from a patient as resourceful as Maya. Who knows what lies on the road ahead? In clinical practice, I am sure I will think of Maya and yearn for patients so simple.
I now see how medicine has “cursed” me. While I do not think that I suffer from more of a savior complex than any other medical student, I cannot help but acknowledge an urge to be productive. With Maya, this manifested as a desire to be the difference-maker. In other areas of my life, this urge takes different forms.
It should come as no surprise that I am grappling with these feelings during the COVID-19 pandemic. A couple of months ago, my reality consisted of eight-hour study days and mandatory classes. The only thing I wanted was for the pace to slow down. With much of my coursework shifting online, I am finding myself with more free time than I have ever had in medical school. Ironically, the more I rest, the more guilt seeps into my conscience. Once it became apparent that virtual learning and social distancing was going to last longer than a couple of weeks. I noticed my entire mentality shifting. Rather than using the period to recuperate after a demanding second year of medical school, I found myself flirting with new skills to learn and remote volunteering opportunities. I may never have this much free time again.
Several wellness articles and some of my more enlightened peers have been preaching that relaxation and self-care are just as productive as busyness. I have been trying to take heed of this advice. Recommendations notwithstanding, I still think some productivity is good. The key, like most things in life, is to strike a balance. Idling is not the answer, but it would also be foolish to overwhelm myself especially considering the already overwhelming global events occurring at this time. This “curse” likely affects most medical students and professionals in some way, shape or form. Perhaps it is equal parts the nature of the individual, who chooses this path, as it is the nurturing that the path provides. In any event, I do not think this “curse” is a bad thing — and as long as I continue to control it, I will embrace it.