3 - Shame in Medicine: 3. Golden Ticket
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What does the train‑station metaphor reveal about entering the medical profession?
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So just imagine for a second a train station. There are people rushing back and forth. Times clicking by on the train schedule. Platforms leading to all sorts of different destinations. And you're looking around for the right platform. The train with medical school listed as one of its stops with a final destination of the medical profession. As with any train, you need a ticket. And you look down at your hand and you're holding a ticket. You've put an immense amount of time, energy, effort, and sacrifice into getting this ticket. So you rush through the crowd, clutching your ticket in one hand and your luggage in the other, and you finally find the right platform. As you await the arrival of the train, you look around at the others crowding the platform with you.
And you can't help but notice that at this gateway into the medical profession, some people have gilded luggage carried by butlers. and others carry their own baggage and knapsacks tied together with string. Some carry massive cartloads of luggage, and others are waiting for the train with nothing but the shirt on their backs. In this luggage are your childhood experiences, your educational achievements and failures, your hopes, your desires, and your flaws. And there you all are, waiting for the same train that will take you to the same destination. While boarding the train has been your focus for years, you also wonder, will there be room for my luggage on board? Will I be able to carry it all to my final destination?
How will its contents change along the way? You hope it all fits. And so it goes with admission to the medical profession. Through this gateway walk people from a myriad of backgrounds and experiences that define the road already traveled and will shape the journey ahead. You see, to understand the role of shame in healthcare, we have to understand where this journey began, how our origins shaped the way we know ourselves and interface with the exhilarating and grueling trip to a medical life. So that's where we begin. On the platform, waiting to board the train. You're listening to Shame in Medicine, The Lost Forest. I'm Emily Silverman.
So it's kind of hard to describe the way that I grew up because most people in North America have never seen it. But one time I was on a medical mission in Uganda and I went to a Ugandan slum. So I was in Kampala and I went to this slum. We were working with three kids. And I was grabbed by one of the women in the slum and taken into their house. their house and when I walked into the house I thought shit this is like the first time I've been in a house that reminds me of where I grew up because the floor was dirt and the whole family was living in one room and the wall hangings were like you know blankets hung up and it smelled really bad and I felt very like comfortable and I was like I sat down on the bed and I was talking to them
And the med students that I was in the slum with came in the door, and they're like, what's the matter with you? Why are you sitting down in this person's house? It's so unsanitary. And I had this really strange moment where I realized how much of a trajectory I had crossed into medicine. Now, I grew up in the US. I grew up in central Idaho, off the grid, no power, no running water. We were homeschooled. I lived in a religious commune, anti-government commune. And I wasn't very comfortable there and I didn't fit in very well. I was into Dostoevsky and I read the encyclopedias. So I tested into university and in 18, I left and I really never went back. And when I got into med school, the first thing I did was I called them and I said, I know you made a mistake.
I totally understand mistakes happen. You can take my name off the list.
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