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Essay: Close to Medicine's Roots

Spencer Platt
Getty Images
Doctors and nurses aid a man sick with cholera at a hospital run by the Haitian government where Doctors Without Borders (MSF) is treating cholera patients on November 6, 2010 in St. Marc, Haiti.

There are a lot of debates about the direction of medicine in this country, but the experience of being a doctor was brought into sharp relief by a trip Lake Effect essayist Bruce Campbell took:

US medical students are dismayed by the overwhelming health care issues faced by Third World countries and many seek out opportunities to visit places like India, Africa, and Central or South America. The doctors and healthcare workers in those other parts of the world face enormous challenges, and our students would otherwise never have the opportunity to see these problems.

For example, sub-Saharan Africa carries one-quarter of the global disease burden yet has only 3% of the global healthcare workforce. Illnesses that are easily treated or have been eliminated here still sicken and kill hundreds of thousands of people each year. The doctors in those other places do their best and the US medical students want to pitch in and learn a bit about how Third World doctors are able to accomplish what they do.

 A couple of years ago, I heard a presentation by a university physician who regularly brings medical students from the US to Africa. She described what she learned in a teaching hospital working with a group of medical students from the US and a group of African medical interns.

The students spent their days working with their African counterparts. They were shocked by the huge numbers of patients arriving each day with diseases they had previously encountered only in textbooks. They heard lectures about - and saw patients with - malaria, untreated HIV/AIDS, and the late stages of tuberculosis. Far advanced diseases and longstanding illnesses were distressingly common, and they had little to offer. The students noted the lack of resources, inconsistent electricity, limited x-rays, bare bones laboratory testing, and the scarcity of affordable treatments.

They remarked, however, that their new friends - the African interns - were very bright. The Africans shared and demonstrated their physical examination skills and many hoped to someday train or work in the United States or Europe. They read journal articles about Western medicine and were aware of the latest trends in imaging and treatment.

After the two weeks, the US students said goodbye and returned home. The African interns stayed behind, knowing that they would soon receive assignments to rural health clinics and realizing that they had only a slim possibility of ever obtaining permission for further training.

The university physician spoke to both groups to get their mutual reactions.

The US students were clear-eyed about the enormous challenges that their new friends would face, but they envied the African interns' finely honed examination skills and their lives practicing medicine "closer to its roots," free of the burdens of paperwork and bureaucracy.

The African interns, for their part, envied the US students the unlimited opportunities and their chance to practice medicine in a stable environment with the latest of technology, devices about which the African doctors had studied but had never actually seen.

She commented that both the US students and the African interns thought that the other group was destined to be the group to have the "real doctor experience."

In a sense, I suppose, they were both correct.

Lake Effect essayist Bruce Campbell is a head and cancer surgeon at Froedtert Hospital and the Medical College of Wisconsin.  Many of his essays appear on his blog, “Reflections in a Head Mirror.”

Bruce Campbell
Bruce Campbell , M.D., was torn between career objectives in college, eventually choosing medicine over a life in radio. He is a Head and Neck Cancer Surgeon at the Medical College of Wisconsin, holding faculty appointments in the Department of Otolaryngology and the Center for Bioethics & Medical Humanities.