On Ambulances and Fences

‘

“Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant;
But over its terrible edge there had slipped
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally;
Some said, “Put a fence ’round the edge of the cliff,”
Some, “An ambulance down in the valley.””

— Joseph Malins, 1895

In my sophomore year of college, I nearly cried in class. I was one of about fifteen students, in a grant-funded class on the practices of care. As part of our class, we learned about the Camden Health Care Coalition (as it was called at the time), which focused on holistic, community-based health care for residents of Camden, New Jersey. As my three professors described a system where patients were matched with community health workers who helped them with housing, healthy food, medications, and exercise, I could felt my eyes smarting. Health care like this existed?

My freshman year, I was premed. At a school like the one I went to, most people were premed, at least freshman year. But something would bother me about the motivations of a fraction of my classmates who were also premed. They would talk about helping people, saving people. The language on TV about doctors confirmed these ideas. Surgeons would heroically save patients…