Last semester I spent an afternoon shadowing Dr. Patrick O’Donnell, a general practitioner who runs a low-threshold clinic at the Ana Liffey drug project in Limerick, Ireland. Ana Liffey specializes in dealing with individuals who struggle with addiction issues. They are a dynamic team of key workers and physicians that work to implement harm reduction strategies such as a needle exchange program and naloxone training for potential overdoses. The experience gave me a window into one part of the community that I will be studying and working with for the next four years and some of the marginalized populations within it. I sat there listening attentively to patients recount intimate details of their addiction history to the doctor. They intermittently engaged me to explain a detail of an event or an Irish turn of phrase that I didn’t understand. This being in part due to my being a Canadian and additionally that many issues surrounding drug addiction are completely new to me. The patients were willing to share not only the personal details of their life, but they also described their thoughts and struggles, and their fears and anxieties about the future. It was overwhelming to realize with such clarity that during the last decade, while I have been studying, learning and living my comfortable life; the patients sitting across from me have had a completely different course. I could almost see the trajectory of our lives hurtling through space; the inertia of our history carrying us in the vastly different directions that we continue to travel forward. These patients have every right to health, to education, to a good life as I do; yet they have spent a majority of their lives struggling with addiction and a multitude of other related issues. Only three months into my first year of medical school at the time, I was medically useless to a patient. I cannot advise, prescribe or treat them yet. The learning value for me of shadowing in that consultation room is infinitely greater than anything I can contribute to a patient at this point. Yet, just being present there in that room for a few hours, felt like it was worth hours of lectures or my own reading. It was like the difference between reading a textbook and reading a work of fiction. The textbook describes a term or a definition objectively, whereas the work of fiction transports you, allowing you to feel what it might be like to be in that body, during that time, or in a particular place. Without conscious thought, my brain automatically created a vivid imaginary picture of what it would be like to be sleeping rough in Limerick, to be in and out of prison, and feeling trapped in a relentless cycle of drug addiction. This opportunity afforded me the space to reflect on how due to sheer chance and luck; I have been given a life of health and wonderful opportunity. I feel incredibly grateful to have the privilege to study medicine. I hope that as I continue to observe in clinics and learn in my classes, I will one day have the opportunity to have as positive an influence on my patients as I witnessed the doctor and key workers having that afternoon on the health of their patients and ultimately, on the course of their lives. Norah MacMillan is a 2nd year GEMS student at the University of Limerick
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CaesuraRotating views on various subjects concerning health (in)equity Health Equity NutSome streams of consciousness on the subjects of the tragic and the mundane. Archives
February 2021
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