Tearing down inequities in medicine

How do we treat the often forgotten, overlooked, or easily chastised members of our society in our healthcare system? The homeless, drug addicts, sex workers.. do they receive equal care?

I once walked into a code for a man whom we knew was going to die. This was a man with no family, no resources, and shackled with drug addiction. He had failed a few rounds of resuscitative medications and was still in asystole (flatlined). The nurse lifted the arm of the lifeless patient, and dropped it, as if to say “he’s gone, let’s call it”.  It left me in shock, horrified by what I considered a blatant disrespect for this man’s life. Some would argue that he had already thrown his life away by succumbing to drug addiction. In fact, one physician said just that. When I was later reflecting on this and stating what a sad case this was, he said, “No, it’s not. You live by the needle, you die by the needle.” So empty and so cynical. It added a little extra weight to my shoulders that night.

I understand why health care workers can become so cold about these things. They have seen people at their very worst, people who have experienced such pain and hardship that they seem to lack an ounce of humanity. How can we express compassion for people like this? How can we bridge what seems like such a vast divide and still give the very best of ourselves as health care providers?

What helps me banish away pre-judgments and treat each patient equally is starting out with a clean slate. I can’t help but think, this person was someone’s baby once. Strip away all the bad, the onion layers of hopelessness, darkness and despair.. And we are left with the core of a being, a hurt soul with little reserve to heal. For it is people like this who often need and deserve that extra bit of care and compassion even more than the rest. A little bit of grace can go a long way. 

It is not our job to judge others. It is our job to treat everyone with the utmost respect and  preserve their dignity in the hospital, a place where dignity is often stripped away in the storm of illness, weakness, and powerlessness.

This isn't life-altering stuff, people. It's walking into the room of the homeless man that's been admitted three times in the past month with just a shred of extra patience. A smile, even! Be a beacon of hope, the exception to the rule-- the person who actually steps up to the challenge with humanity. It isn't easy, but that's what makes it all the more important. Just as these patients might feel nourished by genuine kindness, we, too, gain perspective and deeper compassion by hearing their stories, acknowledging their struggles, and supporting their perseverance.