Next week I am supposed to take the third and final exam I need to pass in order to practice medicine independently. I don’t know if I can do it with a clear conscience. I was first scheduled to sit for the exam in November, around the time of the presidential election. I was helping our hospitalized patients vote through the Social Justice Coalition at Cambridge Health Alliance and trying to study at the same time. When I woke up to Donald Trump as our new president, I realized that my activism was just beginning. The test would have to wait. With Saturday’s protest march in D.C. looming, I’m once again struggling with how to balance my work in social justice with my work as a doctor. Last weekend, I joined Massachusetts Senators Elizabeth Warren and Ed Markey and Boston Mayor Marty Walsh at a rally to save the Affordable Care Act. Instead of studying for my exam, I braved the bitter cold for five hours to affirm that health care is a fundamental human right in this country, and not a privilege. With my exam just around the corner, I really should have been studying. But how could I not be at the rally? How can I be part of the solution if I’m not willing to sacrifice for the greater good? Inauguration weekend poses the same dilemma. I want to attend the women’s march in D.C., or maybe the local demonstration in Boston, but I have this unshakable feeling that my professional obligations are holding me back. I do have to study. I do have to pass this test. At times like this, I remember my interview with Dr. Eve Higginbotham, vice dean for inclusion and diversity at the University of Pennsylvania. She told me it’s all “a matter of prioritizing where you are going to place your energy.” She gave me this example: When she was a student at Harvard Medical School in the 1970s, one of her professors wrote an editorial in the New England Journal of Medicine that suggested minority students were bringing down the quality of medicine. The article was published two months before she was supposed to take Step 1, the first and most grueling of the medical licensure exams. “A lot of students of color were upset about it and actually had a rally and called for [the professor’s] dismissal, but all that energy could have been better placed if we could have been able to focus on passing step 1,” Higginbotham said.“Certainly there are going to be these distractions…It’s just the way you respond to it that you can control.” Distractions. I feel distracted every time the president-elect entertains an anti-vaccine advocate, says something disparaging about women, or disregards the legacy of a living civil rights legend. It makes my skin crawl and I feel the need to do something. Do anything. But I know the 1,500 practice questions I need to get through aren’t going to do themselves. This test I need to take isn’t a huge hurdle; 98 percent of doctors holding an M.D. pass it on their first shot. Still, it is essential to study because the exam covers a range of subjects in a variety of different specialties. Even though I’m focusing my training adult psychiatry, I will still need to know how to manage the medical care of pregnant women, newborns and children. I was recently reminded of this quote by author Toni Morrison: “The function, the very serious function of racism, is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being. Somebody says you have no language, so you spend 20 years proving that you do. Somebody says your head isn’t shaped properly, so you have scientists working on the fact that it is. Someone says you have no art, so you dredge that up. Somebody says you have no kingdoms, so you dredge that up. None of that is necessary. There will always be one more thing.” It makes me wonder: Are all these “-isms” I’m fighting against preventing me from reaching my full potential as a doctor? How do I know when to focus on my professional life and when to jump all in on social action? When to engage? And when to sit on the sidelines? From the 9/11 attacks to the election of President Barack Obama, I remember exactly where I was and what I was doing during the highest and lowest moments in my lifetime. In my view, another low point is approaching. But I still don’t know what I’ll be doing in the days surrounding the inauguration. I don’t know whether I’ll march. I do know I’ll face a lifetime of such choices. Source
