Quarter-Life Crisis

I've been doing extensive reading about an important figure in contemporary Haitian history, Jean-Bertrand Aristide. But there is so much controversy surrounding him that I need to read more and gather thoughts before posting, so I figured that before I head to Portland for a week of work, I'd add a few thoughts that I've been dwelling on lately.

Dealing with a relatively catastrophic event like an earthquake doesn't come without its emotional consequences, including, for myself, somewhat of a quarter-life crisis. Over the past few months as I've delved further into the historical, political, and justice issues in Haiti I have often questioned how this new knowledge and passion will ever line up in some- or any-way with a career in Physical Therapy. I seriously considered not finishing the last two years of my program in exchange for a degree more focused on international development or social justice, but luckily I'm still drawn to the practical skills that a degree in healthcare would bring.

I guess overall I decided that, while my DPT will definitely not be my last degree if I want to be qualified to make changes & decisions within NGOs in Haiti sometime in the future, that's okay. I will come out of my doctoral program having skills to truly make change in peoples' lives, and that's universal.

I'm almost done reading Pathologies of Power by Dr. Paul Farmer (who would probably qualify as my personal hero) and here's a quote from Meredeth Turshen about malnutrition during apartheid that particularly speaks to one of the hundreds (or more like thousands) of reasons I feel more than compelled--urgently imperatively violently driven-- to be more than just a healthcare practicioner.

"Medical expertise does not change the system that gives rise to malnutrition nor the environment to which treated children return, an environment in which half of the children die before their fifth birthday. Malnutrition, in this context, is a direct result of the government's policies, which perpetuate the system and promote the poor health conditions and human rights violations."

Another by Dr. Farmer: "In an age of explosive development in the realm of medical technology, it is unnerving to find that the discoveries of Salk, Sabin, and even Pasteur remain irrelevant to much of humanity." (Basically he's saying that while we have the polio vaccine and advances in microbiology that have become routine and commonplace, and these therapies are inexpensive, widely disseminated, and far surpassed by even more developed technology, even the simplest treatments just plain do not exist in so much of the world...)

This book has given me terms and details of an idealogy, based on liberation theology which is slightly ironic to my non-religious self, to which I was already beginning to prescribe - it discusses the inefficacy and downright naivety of practicing healthcare in isolation and ignorance of the political, social, and governmental systems surrounding the practitioner- or, more importantly, the patient. The book is all about the social justice approach to treating patients within a system of structural violence. Structural violence basically means that the destitution causing illnesses, injuries, and death is caused by a system that is, usually intentionally although nobody will admit it, set up to marginalize the poor in a way that is no less "violent" than a civil war or a bloody coup.

So bottom line, I need to learn how to provide health care first. But second and forever for the rest of my life, I need to learn how to advocate for my patients and potentially change the systems that are killing them.