Monday, January 6th, 2014

Reflection Outside the Classroom

Tehreem Rehman

Photo Credit: Wikipedia

I spent Thanksgiving evening on the floor of my mother’s one bedroom apartment, carving out pieces of turkey seasoned like chicken masala while swirling endless amounts of whip cream on home baked pumpkin pie. Amidst the gnawing and munching, bursts of roars would erupt as we became increasingly competitive in the ongoing game of ludo (South Asian version of Parcheesi). I was surrounded by old and new family, with a broad grin plastered on my face.

There was so much to be grateful for.

I know that I will be returning to class this coming week with a rejuvenated soul. These past weeks had become gradually more and more burdensome as I struggled to get through the drudgery of medical school work while losing focus of my initial intentions for entering the profession. Feeling demotivated, I was falling further and further behind.

My college education had strengthened what life experiences and my mom had already instilled in me – the need to dedicate my life to redressing social injustices. As a Women’s & Gender Studies major, I immersed myself in feminist scholarship and embarked on a journey of questioning and dismantling all paradigms I had assumed to be fundamental truths. One of these paradigms entailed the perception that a lack of social mobility for some communities existed solely due to an inadequate work ethic. It was such a naive conclusion that was fed to me as far back as I can remember – with U.S. history teachers clamoring about the greatness of my nation being based on the principle of “pulling yourself by the bootstraps.” However, my last four years were spent in an environment with highly encouraging professors and like-minded peers who all recognized that with privilege (such as an Ivy League education) comes the responsibility to engage in civic work. Engagement with communities that avoids any elements of self-aggrandizement or co-optation was an ideal I sought to continuously strive for moving forward in my career.

Perhaps it was the abrupt departure from this academic bubble to enter another environment with different priorities that had left me feeling disoriented. Instead of analyzing strategies used by grassroots movements or critiquing problematic aspects of economic development proposals that dehumanizes the indigenous communities, I was now spending hours poring over reactions or physiological reductions of human disease. Granted, this knowledge is crucial for my career and becoming capable of providing treatment to my patients,  andmy medical school does do an incredible job of periodically bringing back focus onto the humanistic part of medicine.

The physician-patient relationship is hailed as a sacred and involves  great ethical and responsible behavior. We are all encouraged to incorporate a “patient-centered” section as an integral part of our medical interviews, as a means of letting patients speak for themselves without expanding the intrinsic power dynamic that exists between the physician and patient. We’ve taken classes on the significance of psychosocial factors on the manifestation of various symptoms and we, in turn, have been expected to appropriately address them in our interviews with standardized patients, and now real patients, through the preclinical clerkship. My clerkship sessions are held at the VA hospital and every week I walk away in awe of the great degree of intimacy that can be established between me and the patient in front of me solely due to the white coat I have begun to wear.

What was then missing you may ask?

My medical school places an undeniable emphasis on “hard-science” research and highly specialized medicine. This emphasis is clear in interactions with faculty and shadowing opportunities that are available for pre-clinical students. My goal has been and still is to work on health disparities, with a growing interest in areas such as clinical interventions for trauma. I have been fortunate to finally form bonds with peers with similar passions as mine and to receive much needed advice from the less visible faculty members here who insist that there is a great and increasingly needed space for community based research in medicine.

So while my motivations for entering a career in medicine are not immediately being met at the moment due to a lack of ongoing research projects or physician mentors in the areas I am interest in, I feel reenergized to keep searching. I am incredibly grateful for being in the position I am in right now and am going to maintain a strong grasp of my overall vision. A vision in which marginalization of identities, experiences, and backgrounds no longer prevents a fundamental human right to good health is what will continue to sustain me as I tread forward in my medical education. Briefly stepping back from the daily toils of being a student during Thanksgiving reinforced the need for me to engage in moments of personal self-reflection in order to preserve my initial intentions of becoming a compassionate agent of change for health justice work.

About Tehreem Rehman

Tehreem Tehreem Rehman is a first year student at Yale School of Medicine.  She recently graduated from Columbia College as a John Jay Scholar with a B.A. in Women’s & Gender Studies. As a Co-Founder of Columbia’s Public Service Initiative, Tehreem was selected to be a People for the American Way Foundation’s Young People For (YP4) Fellow for the 2012-2013 academic year in order to expand the program. Tehreem has previously served as the National Chair of the American Medical Student Association’s Race, Ethnicity, and Culture in Health committee and as a National Editorial Advisor for the New Physician Magazine. She is currently a Humanity in Action Fellow through which she intends to create a multi-school platform to address institutionalized racism and sexism in the medical school admissions process. Tehreem is interested in clinical interventions for violence, addressing gender power dynamics in the clinical setting, and the impact that health inequities have on women of color and low-income backgrounds.

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