Curing Inequalities: Poverty Studies and the Medical Student

By Rachael Petry

Ms. Petry is in her third year of medical school at University of Tennessee Health Sciences Center in Memphis, TN.  She graduated from Washington and Lee University in 2013 with a Bachelor of Science in Biology and an academic minor in Poverty and Human Capability Studies.

My first exposure to the Shepherd Consortium began before I had even stepped foot on the campus of Washington and Lee University. As an incoming first year, I was immediately drawn to the Volunteer Venture pre-orientation trips that allowed new students to transition into college life while volunteering in cities throughout the eastern United States. I chose the Charleston, West Virginia trip that centered on volunteer activities with Habitat for Humanity. I did not know, however, that this trip would challenge me, inspire me, and set my life on a trajectory that has led me to where I am now.

"I learned some very valuable lessons," writes Ms. Petry about poverty studies and service learning. "Few things in life are clearly cut, opinions should be reserved until you make a concerted effort to become as educated as possible about a subject, and sometimes the wisest judgment you can make is to decide that you are not in a position to judge at all."

“I learned some very valuable lessons,” writes Ms. Petry about poverty studies and service learning. “Few things in life are clearly cut, opinions should be reserved until you make a concerted effort to become as educated as possible about a subject, and sometimes the wisest judgment you can make is to decide that you are not in a position to judge at all.”


During the trip to West Virginia, my peers and I heard evening speakers representing both the “Friends of the Mountains” and “Friends of Coal.” My heart broke as the spokesmen from “Friends of the Mountains” discussed how the coal industry was destroying the homes and land of hundreds of West Virginians, and my brain would spin as I heard the representatives from “Friends of Coal” discuss the jobs that the coal industry provided for thousands of West Virginia natives. I learned some very valuable lessons during my first Shepherd Poverty Program experience—few things in life are clearly cut, opinions should be reserved until you make a concerted effort to become as educated as possible about a subject, and sometimes the wisest judgment you can make is to decide that you are not in a position to judge at all. For the first time in my life, I was forced out of my comfort zone to consider and discuss the problems and struggles of others. Life was no longer just about me—it was so much bigger than the seventeen years I had spent growing up in Winchester, Tennessee. I knew after this trip that I had to continue to be challenged in this way, and I was not disappointed when I arrived back in Lexington, Virginia.

During my undergraduate career, as I gained more knowledge and experiences, I began to believe that I had everything in my life figured out. I was a Biology Major with a Minor in Poverty and Human Capability Studies, and was on the fast-track to medical school to become the world’s best OB/GYN.  I took incredible courses for my minor in areas quite unrelated to my career path such as Journalism, Philosophy, and Psychology; but I was also able to tailor my minor to complement my interest in health care. I completed a Shepherd Consortium funded internship to compare urban and rural healthcare in Thailand, volunteered with the Rockbridge Area Free Clinic to determine eligibility of potential patients, and I even wrote my Poverty Capstone on how and why women of higher socioeconomic status breastfeed at rates that surpass those of new mothers who live below the poverty line. Through my work in the Shepherd Program, I knew inequalities existed, I knew the potential gravity of their existence, and I knew that there was potential in health care to reverse the inevitable consequences of allowing those inequalities to persist.

At this point in my life, I had a very romantic view of doctor-patient interactions.  I was optimistic and idealistic and saw medicine as an opportunity to partner with my patients, be their advocate, and give education and support to those patients who lacked the opportunities and abilities to make informed decisions about their healthcare. Medical school has changed several things.  Shelby County, Tennessee is the home to over 900,000 individuals—most of whom live in the city of Memphis. In 2013, the percentage of individuals in Memphis who lived below the poverty line was 29.8%, compared to around 15.5% nationally. In the Memphis metropolitan area, there are 25 hospitals that serve these citizens—14% of whom lacked health insurance in 2015. Needless to say, Memphis is a very busy place in healthcare. Patient interactions are cut short, documentation takes precedence, and almost daily, I see physicians and even fellow medical students who blame the unfortunate situations of certain patients on irresponsibility or apathy.  I do not have the hours of time I expected to discuss the benefits of breast-feeding with expecting mothers or the importance of resisting drugs and violence to the young man whose bullet wounds are being irrigated in the trauma center.  As a student, I am expected to see a patient, take a brief history, form a differential diagnosis, assessment and plan, and present to a resident or attending in around a 15 minute window of time before I need to see my next patient.

During my post-graduate career, I have gained the wisdom that there is much more in my life that remains to be figured out. I no longer wish to be an OB/GYN, I am constantly reminded of how little I actually know in the grand scheme of medicine, and I have grown to accept that a prescription pad and a 10 minute office visit cannot cure those things that affect the patients that I see on a daily basis the most—inequalities in opportunities, support, education, and expectations.  I know that I will not be able to stop the cycle of poverty for every one of my patients—I may not even be able to scratch the surface—but I do know that I most definitely will not enable it.  I will always be an optimist and idealist in regards to the impact a physician can have on their patients’ lives. This is not because it is easy in the current health care system, and not because it is something I see commonly practiced, but because every human deserves to have someone in their life—whether it is a parent, a teacher, or even a physician—who takes the time to show compassion, understanding, and guidance.  Even if it is only the pregnant teen who I persuaded to get a flu shot, or the young, abused woman whose hand I held as a fellow student sutured her head lacerations, or the patient in police custody with whom I discussed the dangers of methamphetamines—I will continue to do whatever I can to make even a small ripple in the lives of these individuals and pray that I can inspire others to join me to create a wave.

I will be forever grateful to the Shepherd Poverty Program for not only providing me with the education and experiences that opened my eyes to the effect that poverty has on every aspect of human life, but also for guiding me to become the type of future physician who will work relentlessly to make a positive impact in the lives of those who need an advocate the most.

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