The year is 2022. Like the thousands of freshly minted new medical students around the country, we sit in this liminal space between a life past and the journey to come. In a time when the word uncertainty does not begin to describe the climate of our health care systems around the world, we are truly stepping into a global institution marred by systemic fatigue, constant entropy, and profound grief. For as long as I can remember, I wanted to be a doctor. Although my motivation and vision of what my life would look like has changed, returned, and changed countless times over the years, being a medic has always been a part of the story, no matter how big or small. In many ways, I am still that naive child who wanted to be a trauma doc that traveled to the most war-torn places of the world and provided care and comfort to another human. I don’t know if I’ll ever stop being that child. However, as I have grown and experienced slightly more of the world, I have begun to realize many of the intricacies and complexities of the systems that govern (and restrain) us as people. The ways in which our health, both physical and mental, and access to wellbeing, is still very much an upper-middle-class, suburban, cis-heteronormative, patriarchal, white, Western commodity. Lying between some of the intersections of these identities has meant that I have profited from the very systems that have profoundly wounded, silenced, and even killed those with whom I share other parts of my identity. Despite being a profession that always has and always will need to touch every soul from every background, experience, and walk of life. As an institution, medicine is still grappling with a profound unidimensional identity crisis. Homogeneity is the name of the game. Historically, this uniformity in western medicine looked very white, male, and affluent. Although significant change has seen the inclusion and empowerment of women and racial diversity within the walls of health care, medicine is still a deeply privileged and inaccessible profession. Albeit, this seems reasonably innocuous at first glance. Potentially appearing more as a workforce diversity issue, or something more internal. However, the ramifications of an ignorantly homogenous workforce are insidious, profound, and very much external. An institution that does not hear all voices at its table hears only one. For the millions that fall outsides the margins of this uniformity, a system designed in theory to protect, transforms into one that silences, maltreats, and exacerbates an already debilitating disparity. Although an argument can be made that protecting those that fall at the margins is a workforce strategy issue that can be fixed by diversifying recruitment and empowering those that do enter the halls of medicine. It is just as much an institution-wide issue. We are entering this profession to save lives. Many of us will happen fall within the uniformity of privilege. Some of us won’t. But for those that do, this is our call to recognize that identities disparate from our own exist. Not to just recognize those identities, but to centralize them. We are entering the institution of medicine in a time where chaos, tribulation, and abnormality are the norm. While we are being called to push the system forward and keep moving from day to day, let us remember those who will fall through the cracks, those who have been historically wronged by the system meant to protect them. Let us remember the people who may not yet have the voice to step up for themselves. Let us remember those whose lives are uprooted and ravaged in unimaginable ways by this pandemic. Let us remember those both similar and vastly different to us. As we embark on this journey together, let us believe that our greatest strength will always lie in our differences and that our greatest achievement will lie in remolding the institution of medicine into one that heals all of us, with no one left behind. Mihan De Silva is a medical student in Australia. Source
