Another Speech I Never Gave

Back from another commencement, where I heard a great speech on neglected tropical diseases and the possible impact that doctors who treat them could have on child health, world poverty , and thereby war and other ills. As inspiring as that was, I wish I could have shared a very different experience with the graduates.

A couple of weeks ago, I evaluated a refugee applying for asylum. He was an accomplished professional who had been persecuted and harassed for decades in his home country, because of his activities against corruption and mistreatment of others. Before he finally fled, leaving his wife and children in very perilous circumstances, he was detained and tortured. Upon coming to this country, he was detained again, in stressful and humiliating conditions.

He recounted his entire history with little affect, breaking down only once, as he talked about losing his family and his country because of his beliefs. As part of my evaluation, almost by rote, I asked about his medical history. Since coming to the US, he had had to make a visit to an emergency room. Although the hospital knew he was destitute, they were still dunning him for the bill. This bothered him terribly—-not as much as being tortured, of course, but it was by no means a trivial stress.

He mentioned that the hospital had found him to be hypertensive but did nothing about it. Though not part of my usual protocol, I put on a cuff and found that his blood pressure was indeed way up. At the end of the interview, I spent a few minutes scouring the internet and calling around, and was able to get him a follow up appointment in a free clinic. After I completed my affidavit for his attorney, I received a message: “He was very pleased about the appointment for his blood pressure.”

This comment really struck home. My simple act of medical care, freely given, was something a first year student could have done. Yet it seemed to redress in some small measure the injustice and the tragedy inflicted on this man by his countrymen, and by the moneychangers in our own temple. I wanted the students, now doctors, to reflect on the profound impact that they will have on others, even if they don’t cure thousands of children of parasites, or never perform lifesaving surgery, or make a million dollars. Moments of grace occur in every field of medicine, in the most unexpected ways. Recognizing them and, occasionally, sharing them with others, is a feeling like no other.

That’s what I would like to have said to the class of 2010.