infections and inequalities...

I would consider myself a pretty avid reader. I always have books stacked on my desk and nightstand, strewn around my car. I try and pass on books that I think others will enjoy...it makes me happy when they actually do enjoy them. It makes me sad when I can tell that they didn't read them. There have been a few books that have inspired/challenged me about medicine...so here is my journey, told through books.

Fearfully and Wonderfully Made, by Dr. Paul Brand (with Philip Yancey) -- I picked this one off of the shelf at a Christian bookstore in 1999. I liked Psalm 139, and I had no idea what the book was about, but I took it home and devoured it. I read it a second time the next day. I have read it probably 4 or 5 times since. Dr. Brand challenges us to view the similarities between the human body and the church...to look at cells and chemistry and see the deeper meaning behind them. It was amazing. I started off college in 1998 thinking I was an engineering major; I stayed an engineering major for about 5 minutes into my first math class, where the professor literally did not speak a lick of English. I walked out of the classroom and went directly to the Junior Division counselors, where I dropped all of my classes and rescheduled as a psych major. After reading this book, I wasn't sure I wanted to be a doctor, but I knew I wanted to go into some kind of scientific field. I ended up loving microbiology, and so I switched my major spring of my sophomore year to micro.

Ten Fingers for God: The Life and Work of Dr. Paul Brand, by Dorothy Clarke Wilson -- Naturally, after reading a book by Dr. Brand, I wanted to know more about his life. I read about his life growing up in India, about his reluctance to go into medicine, about how God used his training in woodworking and house-building to lead him to orthopedics, and how he made so many advances in the modern understanding of leprosy as a disease. Being a micro major at this point, I loved hearing about the bug that causes leprosy...the tiny, slow-growing organism that invades nerves at their most superficial points (it apparently likes cooler temperatures than 98.6). It was neat to hear about his experiences using the new "wonder drug" during WWII -- penicillin. I was both fascinated and repulsed by some of the stories. I considered medicine as a career, but I wasn't certain of my own abilities. I did well in school, but I since I didn't think I was going to be a doctor, I didn't try and get straight A's. I also took random classes like "Intro to Anthropology" and "Greek and Roman Mythology." But I eventually found myself in medical school. I was as shocked as you are, I'm sure. J

Mountains Beyond Mountains, by Tracy Kidder -- This book made me incredibly uncomfortable. I was exhausted after I read it the first time. The book chronicles some of the work of Dr. Paul Farmer as he built and staffed a hospital in Haiti and served the people there. As an M.D. with a Ph.D. in anthropology, he views medicine and sociology as inextricably linked. He fights a noble battle against those that say that it is a waste of money to provide modern-day healthcare to "resource-poor settings" (a euphemism for third-world countries, so that we don't have to think about the shitty conditions that these people live in). Dr. Farmer is an Infectious Disease doctor, and he states several times in his book after telling a case story about the experience of a patient who narrowly escapes the jaws of death, only to be rescued by an antibiotic..."It's almost as if they had a treatable infectious disease." I could taste his sarcasm. I long for the passion and grit to be an advocate for the poor and the weak. When I was trying to make my decision about what kind of medicine I wanted to practice, it seemed obvious with my background in micro and my love for infectious disease that internal medicine/I.D. would be a great fit.

Right now, I am reading a book called Infections and Inequalities: The Modern Plagues by Paul Farmer. I guess that I should say, more accurately, that I'm reading the introduction to this book. It's incredible. I will have to give a more thorough book report when I get past the intro.

"Infections and inequalities: in a wealthy country, the specter of biological warfare...triggers a sort of officially blessed paranoia. In a poor country tightly bound to the rich one, real infections continue to kill off the poor, and we are told sternly to look harder for cheaper, more 'cost-effective' interventions. At best, those of us working in places like Haiti can hope for trickle-down funds if the plagues of the poor are classed as 'U.S. security interests.'"
Paul Farmer

"Medical statistics will be our standard of measurement: we will weigh life for life and see where the dead lie thicker, among the workers or among the privileged."
Rudolph Virchow, 1848