Reflections on Being a Physician During Two Epidemic Epidemics

Reflections on Being a Physician During Two Epidemic Epidemics

My first interest in medicine was anger.

When I was in high school, my father collapsed on the floor with a severe headache. In the emergency room, my father was diagnosed with meningitis. Meningitis is a potentially fatal inflammation of the lining of the brain.

The diagnosis was simple: my father had immigrated to the United States from South Korea in 1999 and had no English language skills or health insurance. Later in medical school, he also did not have access to a medical interpreter, as required by federal law. He could not ask why the medical technicians were taking his blood or what the nurses were putting in his IV. He was at the mercy of his caretakers. He later told me that he felt more like a prisoner than a patient.

The doctors may have treated my father's illness, but at the time they failed to treat him with dignity. Was it because of the extra effort required to communicate with non-English speaking patients? Perhaps it was a combination of both, including what I now know about how burdensome doctors are and how complicated and expensive medical care is.

After many all-nighters, standardized tests, and countless questions, I received my M.D. last month. I work at a safety-net hospital (an institution that provides health care regardless of a patient's ability to pay), fulfilling a promise I made after my father's ordeal to treat all patients with respect, regardless of language barriers, educational level, or socioeconomic status. However, his sense of accomplishment in his professional development has been colored by his frustration with the twin epidemics of COVID-19 and racial injustice.

This year's physician graduates - 30,000 with medical doctorates and 6,600 with Doctor of Osteopathy (D.O.) degrees - are entering adulthood as our nation reckons with its history of novel coronaviruses and racial injustice. Against this backdrop, the medical profession will not be the same.

For one thing, every physician must consider what the pandemic means for his or her own health. In the first weeks of this crisis, I witnessed doctors and nurses begging administrators and elected officials for protective gear, distancing themselves from loved ones, and even losing their lives in the line of duty. As cities have eased their closures, the number of people infected with COVID-19 is once again on the rise. In the last two weeks of May, the number of new infections in the United States jumped by 80%. The country now holds the ignominious record of accounting for a quarter of the global deaths from COVID-19. I would be lying if I said I was not concerned. Mask daily, wash your hands often, and pray that you don't contract the virus again.

New doctors are also entering the profession as recent protests against racial injustice force the medical establishment, including the medical field, to reflect on its own biases and shortcomings.

Indeed, racism and health outcomes are inextricably linked. The inequalities in health care are evident in the COVID-19 statistics. The pandemic has disproportionately affected African American and Hispanic patients. According to the Centers for Disease Control and Prevention, African Americans and Hispanics/Latinos have COVID-19 infection rates five and four times those of whites, respectively.

Much of this disparity is likely rooted in socioeconomic inequality. Compared to other racial and ethnic groups, African Americans and Hispanics are more likely to live in densely populated areas where they have less access to healthy food, medical facilities, paid leave, and health insurance. In this light, the causes of disparities in health outcomes can be traced back to economic deprivation, social trauma, and lack of access to health care, rather than to race itself. The same is true for other medical conditions that disproportionately affect African Americans (and exacerbate the severity of COVID-19), such as diabetes and hypertension.

In these turbulent times, I have two goals. One, to advocate for the safety of myself, my colleagues, and my patients; and two, to practice allyship on behalf of my patients and the role that racism and socioeconomic disparities play in my field. Then I must translate that knowledge into practice and provide more equitable care for all, for example, by making qualified medical interpreters available to all patients with limited English proficiency. Perhaps if my father's doctors had considered these factors more than a decade ago, I would never have been inspired to become a physician and change the system from within.

Yoo Jung Kim, M.D., is a recent graduate of Stanford University School of Medicine and currently sees underprivileged patients in San Jose, California. She is also the author of What Every Science Student Should Know (University of Chicago Press), a guidebook for college science students. follow yoojkim.

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