Equity in health care: a student’s perspective

[摘要] THE GUILT OF PRIVILEGE Man’s Search for Meaning by Viktor E Frankl1 is one of the most influential books I’ve ever read. Frankl, an Austrian psychiatrist, developed a psychological approach called logotherapy, inspired by his experiences in Auschwitz concentration camp and the work of Nietzsche: ‘He who has a why to live for can bear almost any how’ (Twilight of the Idols, 1889).I bought into this mantra. However, a 3-week elective GP placement with the Health Service Executive (HSE) Adult Homeless Integrated Team in Cork Simon Community forced me to challenge this school of thought. It assumes a baseline resilience, learned in childhood that can be employed during difficult times experienced in adulthood. The beginning we get in life is a lottery. I have struggled with the guilt of privilege since being exposed to the origins of homelessness and addiction.From the moment I was born I’ve had two loving parents, clothes on my back, a roof over my head, and food on the table. I have a grand total of zero adverse childhood experiences. I have never witnessed violence in the home, never seen a family member abuse alcohol or drugs, and thankfully neither of my parents have suffered mental illness. I never feared for my safety. I have always been encouraged. I was taught discipline. I was enrolled in music and sport. I can read and write. I attended a private secondary school and my parents helped to fund 4 years of undergraduate studies, a 1-year masters, and 4 years of postgraduate medicine.Now take a child born into a dysfunctional family unit, with inherited trauma and living in a socioeconomically deprived community. Add in childhood abuse, household violence, and family members suffering from addiction or mental illness. How do children thrive in such an environment? I think it’s unfair to expect someone with this background to go out into the world, make sense of the injustice, and ‘find their why’, as if it was that easy.

[学科分类] 卫生学