My first day of medical school, back in the 1980s, I met my cadaver in anatomy lab, and I named her, to help me humanize a disturbing transition into the harsh world of medicine. But science quickly became for me both a science as well as an art.
The goal was to learn to be dispassionate enough to perform the necessary treatments, using the tools I was quickly acquiring, yet not sacrifice my humanity in the process. That was and has always been the goal.
Luckily, I shared that goal with all my fellow medical students as we learned to examine and analyze bodily organs and how they functioned. We also learned that this amazing physiological and anatomic reality was shared among all our patients. None were better than the others. All were equal in the eyes of science, and yes, of God.
This has been the goal of medicine since the time of Hippocrates. Everyone is equal, no one is discriminated against.
This sense of equality was amplified during my residency at Bellevue hospital in New York City at the height of the AIDS epidemic in the late 1980s.
We took all comers. In fact, Bellevue, the oldest public hospital in America, was famous for taking all comers.
We learned not to distinguish among races or ethnicities or gender, among the rich versus the poor, or even between criminal and victim.
We simply tried to save lives and relieve suffering.
As physicians, we knew that we needed to accommodate the special needs of our patients or their cultures or their specific medical needs or predicted diseases because of their race or gender or ethnicity.
In clinic, I was proud to use my French to speak to those who only spoke French or my fledgling Spanish to those who spoke or understood Spanish only.
At Bellevue, I learned to take blood from drug-using patients in the middle of the night, where success meant a precious hour or two of sleep.
Our patients were mostly assertive and would not tolerate condescension or pomposity.
Bellevue hospital was a great melting pot for physicians in training for this exact reason, not to mention the challenge of taking care of multi-system diseases with AIDS foremost among them.
I recognized early on that many patients were more comfortable with people they could relate to directly, such as young patients with younger doctors, or female patients with female gynecologists or obstetricians. In some cases, patients also preferred to see doctors of their own race or ethnicity.
I realized that the medical profession needed to do more to accommodate this need, and was very happy to see more and more female gynecologists emerge. We still need many more Black and Hispanic physicians.
But at the same time, returning to my medical roots, I was proud to learn the language of different generations and different cultures.
For me, it has always been a privilege to be allowed into worlds different from the ones I inhabited growing up. People tell me their secrets in the process of telling a medical history or being examined, and I do not take this for granted. And I do not judge them for it.
Which is not to say that there isn’t room for reminders. I do not object to any institution or society I am allied with or a member of, having a policy commensurate with the same equality and overcoming of disparity that I have tried to base my career on.
Remind away, but don’t assume that every physician is automatically biased or prejudiced to their core. In fact, it’s just the opposite. And by the same token, don’t assume you can teach away prejudice or bias with a course or a conscription. The solution needs to be much more granular than that. It must emanate from a physician’s core system of beliefs.
From the very outset, our training teaches us to respect the dignity of every human being.