K. Jesse Lopez, MS4, George Washington University
A 15-year-old girl, living in the nation’s capital and the home of freedom and opportunity, checks herself into the hospital emergency room. Her mother is aggravated at us from the start, speaking with knife-edge tones toward those her daughter sought help from instead of her. She’s exhausted and scared as most mothers would. Her daughter should have a stomach ache from eating too much candy on Halloween last night. Instead, she has excessive sweating, fevers, muscle aches, diarrhea, and restlessness that would rattle meditating monks. She should be worrying about what to wear to prom, but rather she worries about what combination of grey and black clothes makes her less noticeable when she meets strangers in the local alley. She should be sneaking out late to watch R-rated movies with friends, but she sneaks out to smoke from shared pipes behind the dumpster at the local gas station. She and her friends should be discussing which classmates have crushes on them, but they discuss which dealer has the cheapest product. She should be learning the wonders of biology and chemistry in science class with awe and wonder, but she is researching on Reddit how to test if her drugs are pure without contaminants using at-home toy chemistry sets. She skips dinner, not to avoid having awkward conversations about her future, but rather to prevent her family from seeing her withdrawal symptoms. This is the life of many teenagers across the country. Scared, misunderstood, alone, and caught in an endless cycle spiraling downward until we lose hope in them and they in us. They eventually become invisible to the world. We project the broken system onto their souls as if they are the same. We blame them, hoping to not blame ourselves for our evident failures. If you knew her story, and the reasons why she turned to drugs as a relief mechanism for her internal pain, you would know she is not at fault for her addiction. Dangerous drugs are the only remedy that relieves her internal turmoil when we cannot or choose not to treat her properly. They are the only thing that stops her ever-present nightmares. Her only escape. The concept of “No Child Left Behind” should not just be regarding education, but also for a child’s physical and mental health.
I have asked myself and brilliant colleagues: "Why does she do this?" No one satisfies my curiosity. When it is asked to me, I stifle the first answer that comes to mind. I strongly wish to scream out towards whoever is in charge. I am eager to teach them about socioeconomic health patterns in disadvantaged populations, especially surrounding mental health and the "War on Drugs." I long to speak my truth, similar to how a forgotten soul in the Underworld longs for the sunlight it once cherished but will never see again. However, my voice remains silent. Society does not wish to battle this war properly, as that would mean admitting our failures and shining a light on the broadening inequalities around us. We must save face. We righteously exclaim "We can't help someone who does not want to help themselves.” I remain tormented, cringing with sharp disdain for myself and the modernized capitalistic healthcare systems that pay me, desperately wanting to guide us onto a new path.
Fate knows my patient all too well and is ready to remove her from her wonderful existence at a moment’s notice at the expense of her high-risk behaviors. I can no longer stand it. Like a bellow into a flame, I breathe in as deeply as I can to somehow concentrate my courage, puffing out my chest to its fullest circumference. With all my inner heat and flame, my pain and sorrow, my depression and anxiety, and the endless longing and waiting, I power my inner drive and hope for humanity, bellowing my truth towards anyone with open ears. I begin to ring out my most powerful statement in decades.
At that precise moment, I hesitate.
I recall the advice given to me by a wise man with a face and story like mine; that helping one individual is not the same as helping many.
To teach is to lead by example, rather than preach from a presumed pulpit that I was not awarded or earned. I am not in the right moment to have the most impact. I must bide my time. I must wait. I must churn for what could be another decade or more. If I speak now, my words may fall on deaf and unconcerned ears, cast away by the greedy wind that powers the current medical system, making us forget the purpose and roots of medicine.
My explosion is snuffed instantly, but an ember escapes from my breath as I hesitantly reach out to catch it. It floats away along the windy breeze and is destined to spark wildfires that will clear millions of acres of brittle health policies, allowing for the desperately needed new growth within our ancient and once-beautiful forest. Medicine will finally return to its roots. Like a sweet melody, my stifled message rings out from my lips and resonates deep within my core- “We have failed her, that’s why.”
My patient’s story would inspire millions to march into the streets, call their congresspeople, and write prose better than Hemingway, Dickens, or Sir Olsen. Speeches would ring out from pulpits like MLK’s did that day, changing the direction of history and societal evolution. Presidential addresses would use her as an example while calling for cooperation and all would stand to clap. It is a shame she will most likely die before she can share her story. Before she could be healed of her addiction. She will become another statistic that bears no name or identifying information, essentially invisible to the world, confirming her worst fears. I can assure you: she was never invisible to me. Her story lives on in my soul, ringing with elaborate melodies and harmonies that channel all the rage, fear, and optimistic hope I have felt, producing the words and phrases you have just read. Now go. Spend your day feeling the interwoven complexity of innumerable emotions I do each morning when I remind myself of her story, and why I practice medicine.
About the Author: I began writing poetry during college to aid in the complicated task of unraveling the repressed emotions I gathered throughout my childhood. I quickly realized poetry allowed the inner recesses of my soul to connect with my imagination, spewing forth a wonderful concoction of syllables, metaphors, and outright madness on dozens of sticky notes. Since then, I have used poetry as a form of memoir, detailing significant events in my life in a free-flowing form, allowing the free thought process to ink itself onto a note app. To my loved ones, they were unique and insightful. I now share my inner thoughts with you to foster one of the most beautiful and powerful concepts in history, human connection.
About the Work: This recollection details one of the most difficult aspects of medicine I have faced during medical school. I share it to let others know what goes on behind the scenes. Medical professionals share your frustration towards the broken medical system. We want to fix it. Eventually, we succumb to it. We hope to make a little ripple now and again from the inside of the beast, guiding others on where to focus their efforts. Here is a little ripple for the reader.
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