Invisibility
Three women sit at the reception desk. More glass separates the sick from the well. Masks make everyone look like no one. A hand reaches out to grab my parking ticket and stamp it. Cancer is the price you pay for free parking.
Three women sit at the reception desk. More glass separates the sick from the well. Masks make everyone look like no one. A hand reaches out to grab my parking ticket and stamp it. Cancer is the price you pay for free parking.
I never told my father that his physicians had diagnosed him with pancreatic cancer. Since he was ninety-eight years old, I decided that telling him would only cause him profound mental and emotional anguish—a fear that would diminish however long he had to live but would not alter the reality. To have Dad endure rounds of chemotherapy or radiation at his age would also be physically cruel.
Most of all, I did not tell Dad because not even the doctors were one-hundred percent certain of their diagnosis.
For months, Dad had experienced attacks that left him light-headed and disoriented. By giving him something to drink or eat, I was able to bring him back to reality. Although I told his primary care physician about these frightening episodes, he dismissed them as the concerns of an overly-emotional and loving daughter. Then, while leaving his office after a check-up, Dad had an incident in the waiting room; within minutes, a physician’s assistant had wheeled him to the emergency room.
A multitude of tests led to the rare diagnosis of insulinoma. When Dad’s blood sugar plummeted, he required sugar and/or protein to stabilize him. I had to wake him up every two hours
“She plays with you when you’ve got no one to play with.” Those words were used to describe a young girl in a Sunday school class many years ago.
The adult equivalent of “not having anyone to play with” might be the experience of being in the minority.
Being a black female physician in the US, I am no stranger to this. It seems like I have been “in the minority” for the majority of my life. Those who don’t know me may be surprised to hear that I experienced “minority status” even while growing up in Nigeria. Not only was I a year younger than my classmates, I was also one of the few Nigerians in a boarding school where the majority of students were white North Americans. Later, I was the “American” in a predominantly Nigerian school. Decades later, as a “second career medical student,” I was on the other end of the age spectrum.
The only female in a group visiting a traditional ruler in Northern Nigeria during a year of national service, I wondered why I wasn’t offered a handshake along with my male colleagues, only to realize later that it was for religious reasons.
This perpetual
Starting pre-med in 1948, my intention in becoming a physician was to learn how to be a healer. To learn how to relieve pain and suffering.
At that time, medical education viewed the physician’s role as a mechanic. Physicians were mechanics who fixed a malfunctioning machine: the human body.
My medical school professors “trained” us to be objective, to view patients through their separate parts, and never to view patients as persons. With the benefit of hindsight and the autopsy table to uncover the pathology, they viewed the “local medical doctor” and “the local hospital” as second-rate.
My medical school professors marginalized the art and humanity of medicine. They did not treat their students as persons. They did not address the cultural aspects of health, such as racism, sexism and homophobia. They marginalized the palliative needs of dying patients. They failed to address the spiritual dimensions of sickness and suffering.
As a medical student, I felt like a stranger in my own land. I felt isolated.
After completing my training, I joined one of those “local hospitals” my medical school professors had disparaged. And it was at Morristown Medical Center that I discovered that I was not alone in wanting
It was the first day of a course in medical ethics at the University of Vermont medical school. As a graduate student in public administration, I had been invited to sit in on the class because of my research interest in health care distributional ethics. That made me the only student in the room who wasn’t training to be a physician.
I entered the classroom and took a seat. I barely had time to say hello to a couple of other students before the professor walked in.
Saturday night in my living room, I was surrounded by the parents of the children in my daughter’s kindergarten class. I had boldly offered to host a parent social. We were playing Two Truths and a Lie, one of my favorite icebreakers. My turn had come, and I shared three statements. One of my truths was that my daughters were intentionally born at home. Immediately everyone declared this as the lie, joking that I asked for an epidural as soon as I arrived at the hospital. I understood that no one knew me, yet I was thrown by this gross misunderstanding of who I am and the deliberate choices that I make.
When I was pregnant for the first time, I could not conceive of walking out of my house as two people and then returning home as three. As a family physician who practiced obstetrics, I was well-acquainted with the ups and downs of hospital births. I had seen intervention beget further intervention. I resented the television mindlessly blaring while a woman was laboring. I cringed at hospital staff who would chitchat as if the birthing woman was invisible. Once I learned about the improved outcomes for low-risk home
The Brooklyn Bridge and the water running beneath it shimmered in the evening sunlight as I gazed out the window of my Pace University classroom. Class had just gotten over, and my classmates were making plans to go out for a drink and unwind. Snippets of conversation reached my ears as I gathered up my books and unplugged my computer.
“What about Esther? Shall we ask her?”
“Oh, no! She is Catholic, Indian, and married. She wouldn’t come!”
My ninety-year-old friend gets her hair styled weekly, goes out to dinner often, and invites friends into her home—all during the pandemic. A fifty-year-old friend rented a local movie theater to entertain his friends and himself, held an ice cream social under a gazebo to memorialize his mother (herself a big fan of the icy treat), and spends most evenings at a local pub—all during the pandemic. A close friend is patiently waiting for me to give a thumbs-up to a get-together. More and more people are embracing the freedom of vaccinated life by returning to a somewhat pre-COVID normalcy.
My heart rate increases, and I feel color coming into my neck and cheeks. I’m not a clinician: I say this phrase inside my head as I take a deep breath, trying to slow my heart, which feels like it might beat out of my chest.
Then I say—this time out loud, to the person sitting across the exam table from me—“I’m not a clinician,” before continuing with, “… but on your physical exam I noticed something out of the ordinary, and I’d like to have one of our physicians take a look at you.” I wait and smile my warmest, most empathetic smile.
“If we are in an end-of-life situation, can I be with him?” I asked Lisa, the veterinary technician. She’d brought Alex, my springer spaniel, to my car after his oncology re-check.
COVID protocols had upended vet appointments. I’d park in a numbered space and text the receptionist. A tech wearing PPE fetched Alex. I’d wait in my car for the oncologist’s call, praying for continued remission.
“He looks good; I don’t find anything of concern,” I’d hear, and breathe relief. But as the months since chemo went by, the possibility of recurrence grew. The prospect of not being present to say goodbye, for Alex to feel safe and loved to the end, haunted me.
“Yes, we do allow clients to come inside then,” Lisa answered.
Prior to COVID, the waiting room overflowed with somber pet parents cradling grey-muzzled dogs; dogs with shaved abdomens, amputated limbs, or coats moth-eaten from chemo. So much innocence and vulnerability, love and fear. I’d feel guilty witnessing these sad tableaus, when Alex’s report read, “No evidence of disease.”
During his year-long treatment, I’d come to know the oncology staff. I wondered how they coped, day after day, treating pets with life-limiting illnesses, knowing that each case
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