POLITICIANS SHOULD HEED THEIR DOCTORS
If you’re a practicing physician, even one running the hospital, you examine the feet of your diabetic patients. It’s not because health care costs are rising or because it’s the right thing to do. It’s because you still feel his feet on your hands — and he couldn’t feel your hands on his feet. You hold their toes with your fingers. You poke for sensation, check for abrasions and search for other signs of nerve damage. When you walk into a boardroom later that day to review the case, you understand, viscerally, why it’s important that your patient has shelter to sleep, food stamps to eat, a refrigerator to store his insulin.
As a medical resident, I’m starting to carry moments like this around. When I’m intubating an unconscious man after a heroin overdose, I know he’d have done better at a rehab center than in a jail cell. When I hear a woman crying outside her husband’s hospital room, trembling at the thought of the bill, I wonder why even today so many patients don’t have insurance.
STORIES TO TELL
Doctors are among the most welleducated, well-compensated and resourceful professionals — but we’re also intimately familiar with the most marginalized populations. We don’t just grasp intellectually what it means for poor families when politicians cut affordable housing initiatives, slash food-assistance programs, or refuse insurance expansions. We feel it.
As physicians, we’re uniquely situated to give voice to the voiceless. We have stories to tell, particularly for those who can’t tell their own. But we have other stories, too. They’re stories of the regulatory burden we face. They’re stories of metrics and measurements, documenting and box-checking, rankings and red tape. And most doctors, as members of an autonomous profession, resent this wave of bureaucratic intrusion into medicine.
Medicine is not a force for liberalism or conservatism. Physicians as a group, historically Republican, are now evenly split between parties. Physicians as individuals hold both conservative and liberal views. In some ways, medicine models the compromise and bipartisanship absent in our politics — because it has to.
If Occupy Wall Street protesters or the Oregon Bundy gang showed up in my office, I would treat them the same way. I don’t mean with antibiotics. I mean with compassion.
This decency is what’s being destroyed in this election. It’s what we lost when John McCain, who as the Republican presidential nominee corrected his supporters’ racially laced comments about President Obama, gave way to Donald Trump, who gleefully broadcasts his fans’ obscenities about Ted Cruz. It’s what we lost when George W. Bush, who emphasized “Islam is peace” after Sept. 11, gave way to Ben Carson, who opposes any Muslim running for president. LEVERAGING OUR POSITION If there’s any tempering force in politics, it’s close contact with groups different from one’s own — the interaction at the heart of medicine. People consciously or subconsciously develop a liking, or at least an understanding, for what we’re familiar with.
Ultimately, it might be that medicine needs more politics and politics more medicine. As doctors, we don’t do nearly enough to advocate on behalf of our experience — either as caregivers for marginalized patients or captives in a money-centric, regulation-ridden health system. Instead of leveraging our position to influence the economic and social factors affecting our patients, we shy away from the political process.
We know, for instance, that most factors influencing health are present in communities, not in hospitals. We know that your ZIP code more strongly influences life expectancy than your cholesterol, and that substance use and suicides kill more Americans every year.
But the deeper significance of a more politically present medical profession lies not in its advocacy of issues, but in its approach to people. The broader, potentially transformative consequence could be the propagation of an ethos that demands acceptance of those different from ourselves — one that acknowledges that it’s OK for groups to have opposing beliefs, but also for individuals to hold conflicting views that don’t conform to a single ideology.
Our nation’s politics are increasingly rigid and childish. Doctors can be that way, too. But when we care for patients — Democrat, Republican, gay, straight, prisoner, prison guard, gun enthusiast, or gun control advocate — we do so with compassion and respect. Medicine, at its core, is still about recognizing another person’s humanity. It’s a shame that politics no longer is.