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Against the Current

I feel like a salmon swimming upstream, constantly fighting the current: the current of a system designed to dehumanize students, residents, and patients—a system in which “health” and “care” are often afterthoughts, while profits and media image take precedence.

That feeling began in medical school, which I entered after spending two years in a remote village in Liberia, teaching agriculture as a Peace Corps volunteer. When I told my classmates that I wanted to go back to Africa to work after I completed my training, one remarked, “Why should the taxpayers of Minnesota spend money for you to become a doctor just to have you go take care of people in Africa? Let them find their own doctors.”

In my second year of med school, an instructor showed a photo of an African man with the parasitic disease filariasis; his lymphedema caused his scrotum to hang to his knees. The professor joked about how great it would be to have balls that big, a comment that drew laughter from my classmates. What I saw in that photo was a suffering man, likely outcast, unable to work or do much of anything because of his disease. I was irate and met with my professor to talk about my feelings; he informed me that medicine is full of serious issues and that if I did not learn to laugh at them, I would not survive in the profession.

During my residency, on my internal medicine rotation at a county hospital, I encountered a 40-year-old Hmong woman dying of cancer. Chemotherapy was not working and she was clearly close to death, yet the oncologists continued to give her toxic meds. Incensed, I questioned the ethics of this and was told in a mocking tone by our chief resident, “You talk to the oncologist; you’re the patient advocate around here.” He all but spat the words “patient advocate” at me.

Now, 28 years into practicing, I am resigning as a clinician and the medical director of an organization that continues to cut the resources needed to serve our impoverished, non-English speaking, undocumented, computer- and health-illiterate patients. All while boasting to the media about how much they care about health equity.

There have been many who have supported my tenacity in raising my voice at every opportunity, but few who have dared to raise their own voices. While being alone can be difficult, remaining quiet in the face of systems that harm those who entrust their bodies, hearts, souls, minds, and families to me is not only more difficult, it is not an option I am willing to consider.

Kelley Rae Jewett
Minneapolis, Minnesota




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