Manuel Cintron, MS4, University of Illinois College of Medicine
As healthcare providers, we have all encountered challenging cases that push us to the limits of our skills and expertise. We all have memories of patients who taught us important lessons, whose struggles inspired us, and whose stories will stay with us forever. For me, one such patient was a 50-year-old man with chronic lymphocytic leukemia.
I first met this man in the emergency department, where we had admitted him for pneumonia, alarmingly abnormal labs, and a myriad of musculoskeletal injuries. He was thin, tall, had broad shoulders and had olive skin that was worn from years of duress. He had brown, bushy hair and a modest beard. He was not just a medical case but a complex human being, with a rich history, hopes, and regrets - just like you and I. He was born into a system that failed to protect him, and his past mistakes made it difficult for him to receive the care and support he needed. Despite his combative behavior and challenging medical condition, he periodically shared golden moments with us, where he expressed his innermost thoughts and feelings.
From the outset, we knew that managing his care and securing a safe discharge plan would be a daunting task. After all, he had a complicated medical history, criminal past, no family, and no friends. Additionally, he was homeless and awaiting a criminal trial prior to admission. It was these factors that made it difficult for us to find appropriate post-discharge placement. These were major barriers that we had to overcome if we were to provide quality care and ensure a safe discharge plan.
We worked tirelessly as a healthcare team to manage his care and try to find a solution to an endless list of systematic challenges that threatened his health and safety. However, we encountered many obstacles along the way. One of the biggest challenges was his criminal history, which prevented us from securing him any form of housing on discharge from any of the housing partners in our hospital's network. We explored various options, but all of them seemed to hit a dead end.
Moreover, a pending criminal trial further complicated matters, by producing the dreaded “denied” response on every single query that our social work team ran. With hospital administration no longer considering his acute care to be life threatening in nature, we were given a timeline to discharge him, so that another individual in need of immediate care could occupy his bed.
Unfortunately, we could not secure any form of post-discharge placement, and we were left with only one option – to provide him with a one-month course of antineoplastics to prolong his life and send him on his way. We knew that this was not a sustainable solution, but it was the only option we had at that moment. We discharged him in a taxi to his childhood neighborhood, knowing very well that he had nowhere to go or stay.
As healthcare providers, we are in a unique position to make a difference in the lives of our patients. We can advocate for policies that promote health equity and social justice. We can work with other stakeholders, such as policymakers and community leaders, to create a better healthcare system that addresses the needs of everyone, regardless of their background or past mistakes.
We can also work to change the way society views individuals with a criminal history. Rather than stigmatizing and punishing them, we can help them reintegrate into society by providing them with the necessary resources and support. We can help them break the cycle of crime and poverty and give them a chance to lead a meaningful and productive life.
As healthcare providers, we have a responsibility to be agents of change. We must use our expertise, compassion, and advocacy skills to create a healthcare system that is equitable, just, and compassionate. We must work to break down the barriers that prevent our patients from accessing the care and resources they need to live a healthy and fulfilling life.
Although the fate of this man may forever remain unknown to us, let us embrace the power of our choices today, tomorrow, and well into the future, for they have the potential to revolutionize the healthcare industry and pave the way for a brighter future for generations to come.
About the Author: Manuel Cintron is a fourth-year medical student at the University of Illinois College of Medicine, who proudly calls Chicago, Illinois, his hometown. Being a first-generation medical student, Manuel's journey is defined by his unwavering commitment to his community and a relentless drive for positive change. His path took a pivotal turn when he served as a NIH Medical Research Scholar in The Social Determinants of Obesity and Cardiovascular Risk Laboratory led by Dr. Tiffany Powell-Wiley, gaining invaluable experience and insight into the world of research with a special focus on its potential to benefit underserved communities. Notably, Manuel's impact extends beyond the research realm. His published work zeroes in on language-access and cardiovascular disease disparities, which disproportionately affect minority communities. This resolute dedication underscores his mission to advance healthcare equity for all. In addition to his academic endeavors, Manuel has been a devoted delegate for the LMSA, channeling his energy into policy advocacy. He believes that change often commences with policy advocacy. Manuel's unique approach to both his studies and advocacy work is a blend of quiet strength and deep-rooted community ties. Every achievement is not only a personal success but a testament to the aspirations of his family and the community that has shaped him. His commitment to serving the Hispanic community reflects his desire to uplift those who have been historically underserved. Manuel's multifaceted journey underscores his dedication to creating a more inclusive and compassionate healthcare system. His research interests span diverse fields, from epidemiologic methods and geographic information systems to epigenetics and community-based interventions. His ultimate objective is to ensure healthcare accessibility, regardless of one's background. Outside of medicine, he enjoys spending time with his family, traveling and working on home improvement projects—having previously worked as a licensed mason.
About the Work: This piece discusses a specific limitation within our healthcare system and emphasizes the crucial role healthcare providers play in patient advocacy.
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