‘WE CAN D O B E T T E R’
By Cindy Medina Pabon, MD ’18
In the novel “Being Mortal,” Dr. Atul Gawande introduces the idea that doctors are at
war with death — a clear enemy with superpowers that we simply cannot defeat.
Generation after generation, the medical field continues to expand research and
develop new treatment options in hopes that death will surrender one day.
Yet, after caring for patients, I have found that there
is much more to one’s quality of life than mere survival.
As providers, we get to see how, in difficult times,
our patients draw happiness from the love in their
relationships, the pride in their accomplishments and the
strength in their battles.
We are also witness to the untold hardships that
challenge the lives of our patients. In medical school,
I was introduced to the invisibility of the undocumented
immigrant, the loss of control experienced by an addict,
the painful struggle of hiding one’s true gender identity
and the sense of defeat felt by a veteran forgotten
by society.
Three years ago, I was seeing a Spanish-speaking
patient at the Equal Access Clinic for her diabetes. Her
significant other was there and insisted on translating and
guiding the conversation despite my attempts to lead the
visit in Spanish. He was uneasy when I tried to examine
her and insisted that there was no need since she was
healthy and only needed a medication refill. Something
felt odd about their dynamic, and as I presented her case
to the attending physician that evening, Dr. James Grigg,
he agreed that we should speak to our patient alone. As
we returned to the room, we kindly asked her partner to
leave. He was furious and intent on staying, yet Dr. Grigg’s
calm demeanor somehow swayed him to give us some
privacy. I watched as Dr. Grigg pulled up his chair to our
patient and stretched his hand out to hers. “What’s been
going on?” he asked.
She was shaking as she recounted the ways her partner
verbally and physically abused her and how she lived in
constant worry of him outing her undocumented status.
With tears streaming down her face, the woman revealed
an array of bruises hidden along her body. She lived
her days quietly, wanting to go unnoticed by society,
all the while finding herself deeper in this dangerous
relationship. Dr. Grigg nodded as he listened and gave
her his undivided attention. Meanwhile, I watched as
our patient, who had previously felt rejected by society,
reclaimed her sense of self-worth through sharing her
story. Undocumented victims of abuse and domestic
violence are often isolated and silenced by the fear
of deportation.
I have realized that the practice of medicine is a deeply
personal and human experience. Medicine provides an
intersection where people from different backgrounds
meet and disclose their secrets, fears and dreams in search
of a better future and improved health. How humbling it
feels to be the one patients look to for help.
So yes, Dr. Gawande is right — physicians are at war
with death. But I would like to amend his commentary
on the role of a physician. I can no longer think of myself
as just a member of the infantry shielding my patients
from illness and death. I believe that I can do better than
that; we all can. I propose that we are also at war with
the injustices and hardships that stand in the way of our
patients’ well-being and access to care.
As physicians, we have an opportunity to shape our
institutions, our culture and our conversations in ways
that can transform the possibilities for our patients.
As leaders, our actions and opinions can transcend
generations and give a voice to those who feel overlooked
or neglected by the system. We can refashion the way
society views our patients and help preserve dignity and
purpose in their lives.
As MDs, we are advocates for our patients, a support
system for one another and leaders within our
communities. May we always remember to take the time
to sit, listen and make our patients feel heard.
Adapted from the 2018 UF College of Medicine Commencement
Ceremony speech given by graduate Dr. Cindy Medina Pabon in May.
18 | F LO R I DA P HYS I C IAN