It’s easy for medical students to think of medicine as presented in our textbooks and PowerPoint slides: clear, defined, and explained with objective data. Especially in the preclinical years, when we are not talking regularly with patients, it is easier to conceptualize the disease from a pathophysiological perspective, with less emphasis on its complex socioeconomic underpinnings.
As a result, after a year and a half of “textbook-based” preclinical training, I noticed that my initial motivation for pursuing a career in medicine – the opportunity to connect and serve other humans – was no longer there. more to the front of my mind; I had been privileged to focus on my studies (thanks to my good health and finances), but this came at the expense of remembering my true inspiration to become a doctor.
Things changed when I started volunteering regularly at the free student-run clinic at Saint Louis University, the Health Resource Center. As director of the SLU view program, I coordinated eye medical care for underserved populations in Saint Louis. The SLU Sight program has brought together medical students, optometrists, ophthalmologists and optometry students to offer free diagnosis and management of eye disorders and prescription eyewear.
Working at HRC gave me pause as I faced the significant disparities in health care within my own community. Many patients had no job opportunities, lacked housing, faced language barriers or were affected by other oppressive forces. With limited resources, these patients had to prioritize their basic human needs over other concerns, including vision health.
In one of my first encounters with patients at the clinic, I remember a seemingly uninterested young patient who walked in with headphones plugged into her ears. Her hands gripped the arms of the examination chair tightly as she waited impatiently for the clinic’s optometrist to arrive. As I examined her visual acuity, I understood why she felt uneasy: an urgent need for corrective lenses as well as undiagnosed cataracts had reduced her to near blindness.
According to my supervising optometrists, this was typical; when individuals are insecure, they often neglect their vision until urgent intervention is needed. As we offered a treatment plan, her shaky leg revealed her discomfort as she raised concerns about costs, time off to attend future appointments and finding transportation to and from the clinical.
Later, the patient returned to the clinic to try on a pair of bifocals that we had measured and ordered. As she tried them on, I immediately noticed her crossed arms and tense facial expression starting to relax. I held up a mirror and saw that vision wasn’t the only thing restored: her previously anxious demeanor dissipated as she laughed softly at the clarity of her reflection. In those relieved, tired eyes, I saw someone who had long been at the mercy of circumstances beyond their control, only now I also saw a way to help them in a practical way.
I left this experience with an indisputable evidence: to take care of others holistically is our responsibility as medical providers. We may not be able to change the life circumstances into which people are born, but we can minimize the damage caused by systemic barriers to health. Tackling such massive hurdles will require multifaceted effort, but direct service in the community at risk is an important starting point. This is where free clinics shine: by simply providing underserved patients to access to the healthcare system, free clinics can have a disproportionate influence on people’s quality of life.
Service is a necessary and mutually beneficial component of medical education. Although volunteer work can be exhausting when combined with the other demands of life, it provides challenges and opportunities for growth that we might otherwise miss during our preclinical years. As future physicians, we will soon have major impacts on the lives of our patients in obvious ways – like our major clinical decisions – as well as in more subtle ways – like the small efforts we make to act on their social determinants of health. health. As for me, I am no longer angry with the state of my community, but rather eager to use medicine to create more positive identities for its members – a perspective that I could never have developed within the barren confines of a preclinical conference room.