I think America is really in denial about the degree to which residents, particularly foreign medical graduates, man the county hospitals of this country, and but for their services, I'm not sure how exactly we could manage.
I joke, but I only half joke, that if you come to one of our hospitals missing a limb, no one will believe you till they get a CAT scan, MRI, or orthopedic consult.
I think we can see how blessed we are in America to have access to the kind of health care we do if we are insured, and even if uninsured, how there is a safety net. Now, as to the problem of how much health care costs and how we reform health care ... it is another story altogether.
What we need in medical schools is not to teach empathy, as much as to preserve it. The process of learning huge volumes of information about disease, of learning a specialised language, can ironically make one lose sight of the patient one came to serve; empathy can be replaced by cynicism.
When I use the word 'healing', by that I mean that every disease has a physical element that we're very good at handling, but there's always a sense of the violation. 'Why me?' 'Why is my leg broken on the ski trip and not anyone else's?' And I think that medicine has done a terrible job of addressing that spiritual violation.
My sense is that the wonderful technology that we have to visualize the inside of the body often leaves physicians feeling that the exam is a waste of time and so they may shortchange the ritual.
The flip side of suicide is that it leaves a lingering question in the minds of the people who survived. Its like a cancer thats metastasized. The suicide is the cancer and the metastasis is all these people saying, Why? Why? Why?
Rituals, anthropologists will tell us, are about transformation. The rituals we use for marriage, baptism or inaugurating a president are as elaborate as they are because we associate the ritual with a major life passage, the crossing of a critical threshold, or in other words, with transformation.
I was angry with myself because I still loved her, or at least I loved that dream of our togetherness. My feelings were unreasonable, irrational, and I couldn't change them. That hurt.
The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.
My VIP patients often regret so many things on their deathbeds. They regret the bitterness they'll leave in people's hearts. They realize the no money, no church service, no eulogy, no funeral procession no matter how elaborate, can remove the legacy of a mean spirit.