A few months ago, I signed up for a virtual conference for women in medicine. Its a group of women, over 10,000 of us, who have watched me and supported me through the past two years of my career. Two years of struggle. Two years of personal and professional pain. Two years of opportunity for growth, and two years of numerous setbacks that were only overcome with all of their assistance. At the close of each interview with women leaders in various industries, the organizer asks them what 2020 has taught them. A friend of mine from the group reached out to a few of us and asked us what 2020 had taught us. In my response, I referenced so much of what we have touched on in this class and things that have been brought to the surface by the turmoil of this year. The only way to save medicine, save our country, and to save ourselves is to pivot.
Absolutely nothing that is happening in 2020 with any of us as individuals, as a profession, or as a nation is spontaneous or mere chance. Everything is rooted in what was built within ourselves, within our medical system, and within our society prior to 2020. Politics aside, racism didn’t get elected in 2016. It was already here. Police brutality didn’t start when phones became cameras. The pandemic isn’t unprecedented, the west coast burning isn’t surprising, and the fallacy of profit over people is hardly a new concept. The honest truth is that the average White American who has lived in relative prosperity cloaked in American exceptionalism is finally forced to face the ugly underbelly of what this prosperity cost others: their lives. The facade is over. Reality is here, and pivoting is essential for our survival.
In medicine, we always point to “To Err is Human” in 1999 as the turning point for patient safety and the need for greater focus on patient outcomes and prevention of medical errors. The paradox is that this is happening in parallel to the medical infrastructure, becoming a commodity for various companies to buy, consolidate, and sell-off. So in the pitting of patient safety against the need for cost savings, the only thing that is destroyed is the humans involved, and this is not limited to the patients themselves. The answer for so many people is that burn out is a symptom of this impossible equation, in which we are asked to balance our oath with someone else’s budget, but I caution us from hearkening back to the “golden age of medicine.”
What exactly was golden about it? Anyone who has taken the time to read books such as The House of God or The Blind Eye would wonder if this is the equivalent of “Making America Great Again.” Giving medicine back to physicians and nurses will only work if we are willing to move forward, not retreat backward. And embracing that “reaching across the aisle” is going to be a much harder endeavor when the person across from you does not look like you, does not speak like you, and does not think like you. This is called diversity and inclusion, and it is uncomfortable, but embracing it may just allow 2020 to be our pivot point.
Nicole M. King is an anesthesiologist.
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