Week 6: No Apparent Distress: Narratives of Health Inequity in Medical Education

*Rachel Pearson, No Apparent Distress: A Doctor’s Coming-of-Age on the Front Lines of American Medicine (pgs 1-93)

*Health Inequity in Medical Education: Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians

**Mid-term Narrative Analysis Paper Due.

Since your mid-term paper is due this week, feel free to keep your reflection on this week’s reading brief. Comment on a quote or idea or story that intrigued you, OR  you may choose to unpack one of the following quotes: 

“What does a good doctor do, when the institution she works for compels her to abandon patients who obviously need her help?” (pg 52)

“This is the precise strangeness of learning to see like a doctor. If you believe hard enough in the truths of biochemistry and anatomy, what surrounds them– people with their suffering, the politics of a society that lay this particular body into your hands– seems not to matter at all.” (pg 69)

“By discouraging us from seeking psychiatric care, it makes both us and our patients more vulnerable. It drives a suicide-prone population away from the help we may need.” (pg 92)

OR Reflect on why the ‘hidden curriculum’ might perpetuate health inequities in medicine. How might narrative medicine approaches reveal and challenge the ‘hidden curriculum’? How do we get rid of the disconnect?

For the first half of class, we unpacked some of the challenges of the hero narrative in medicine. We talked about how our society endorses the hero narrative for physicians, and the implications that this has on providers. We explored how barriers that limit our ability to provide the best patient care can be frustrating, and how sometimes providers speak about patients and misplace this frustration on them instead of on the barriers. While it is important for providers to advocate for their patients, we unpacked how desires to provide the best patient care can lead to tension between providers when there are different perspectives about what is best for a patient.

Following this conversation, we split into groups and worked through cases that represented the following three questions. These cases revealed some of the challenges in

1. How do we respond to these narratives in real-time?
2. How do amplify the voices of those experiencing health inequity due to race?
3. How do we change the dominant narratives about racial inequity?