My current reading material: The Spirit Catches You and You Fall Down, by Anne Fadiman. I’m reading it for a community pediatrics rotation, wherein I’m supposed to be learning how to be more culturally sensitive of my community and patients. The book is irritating me, though — there’s a lot of blame laid at the doorstep of doctors for doing their job, a generous amount of idealistic attitude about what doctors should be doing for their patients, and a conspicuous lack of stressing the responsibilities that go along with being a parent.

Strangely, after all the activities that this rotation has thrown at me over the past three and a half weeks, I have the same feelings about a lot of what goes on in my hospital’s community. There’s a ton of emphasis placed on how doctors don’t do enough to understand the community; there’s no emphasis placed on how the community doesn’t do much to understand the hospital.

It’s frustrating always being the bad guy.


The hospital exists to serve the community, not the reverse. It seems to me the agency that seeks to serve has the obligation to know and understand the needs of those it wishes to serve.

Having said that, I’m not sure how well any service agency can truly understand a given community, since communities are made up of thousands of people, often with vastly disparate characteristics apart from being members of “the community.”

I think the value of the book you’re reading lies in raising the awareness of how these types of failures can occur so that the potential for such a problem might be identified early enough in the process. Presumably then, whatever remedial steps may be necessary can take place before an undesirable outcome is attained.

You know you’re not a bad guy. What I think you’re saying is you’re frustrated that the people you serve don’t have the same view of medicine that you have, or even one approaching it. But how can they? You have years of specialized education, experience in the field, a personality that lends itself to undertaking this kind of work and enjoying it; and most people have, what? A few seasons of ER?

Should the author of the book have been more understanding of doctors? I really can’t say, I haven’t read the book, but perhaps. But I think most people will always have extremely high, perhaps even unreasonably high, expectations of doctors and anyone in the helping professions, especially those in health care. It’s a frightening experience being ill enough to require help, and chances are the actual process of receiving help is almost equally as frightening.

I’m sure you already know all this, so perhaps you were just having a bad day and blowing off a little steam? I admire the work you do, Jason. I know I couldn’t do it. You’re a good guy, and you know that. Keep up the good work.

• Posted by: dave rogers on Feb 6, 2002, 10:12 AM
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