You know a pediatrics clinic is good when it’s the one that all the local doctors take their children to. This was the oupatient pediatrics site that I was stationed at. It was a lovely, bright, clean place, with relatively healthy, wide-eyed children who were easy to smile and laugh.
One afternoon, I was assigned to work with a doctor I hadn’t met before. Her name was Dr. G. After I finished eating lunch, a short, wiry woman with impeccably matched coral jewelry and shoes blew into the office.
“All right!” she barked. “Let’s go.”
My afternoon was a whirlwind of patients, getting quizzed on the ear exam and how to check for scoliosis, and watching Dr. G gracefully interact with parents, delight babies, and tactfully ask teenagers about their sexual history. I was impressed, and intimidated. There was no way, I thought, that I could ever be this good.
At the end of the day, we got to chatting and she asked me what I thought of the practice site. One of my fatal flaws is honesty, and I told her that although it was a wonderful clinic, I felt almost guilty at being in such a nice setting, knowing that there were lots of children in underserved communities who would never be able to experience this kind of care. I asked her if she had ever struggled with this feeling as a student and how she reconciled it.
She was as generous to me as she was to her patients. “I grew up as the daughter of a lobsterman in New York, and I’ve always wanted to give back to the kind of people who raised me and supported me. I knew how to work hard from the time I was a kid, and I attacked med school knowing that I was doing it in order to help those people.”
She worked in our city’s public health system in one of the community health centers. “It was tremendously satisfying, especially as someone who grew up poor. I felt like I was giving back to the community.” She said that she had a reputation for being “strict” so only proactive, responsible patients came to her. “The bad ones who didn’t have much initiative for their health didn’t want me as their doctor anyway because I would call them and harass them to get things done.”
She got a wistful look in her eyes as she talked about her patients. They were largely working-class Central American immigrants and many did not speak English. They brought her presents like sequin-encrusted toilet paper roll covers because “they had a ridiculous sense of how fantastic my life must be as a white doctor lady.” She said she loved working for these patients because “I was caring for people who were living the American dream. They couldn’t get good care otherwise, and if I made one phone call for them, I could change their lives dramatically.” What she most enjoyed was seeing children praised for their smarts and talents, and growing up with dreams and ambitions of their own that they could actually act on.
But the bureaucracy of the clinic was too much to bear. She said it drove her crazy and after almost a decade of working in the clinic, she’d had enough and moved to this cushy, well-run private clinic. As a compromise, she took her community clinic patients with her, so that they continued to see her in this nicer setting.
Her story made the rest of my outpatient experience there easier. It was reassuring to hear her acknowledge the inequalities in the healthcare system, and inspiring to see that she found a way to leverage the system for the benefit of her patients. It was also a reminder that an individual’s practice of medicine is an ever-changing thing, and that the field is flexible. Although it’s been a long time since I worked with her, I’ll never forget her determined, plucky attitude towards improving the health and lives of her patients.