We Are Only as Strong as the Most Vulnerable Among Us
As a physician, social assistance and benefit programs for the poor and marginalized are more powerful in saving lives than any medication that can be prescribed or any procedure performed.
I took this one when I was on my way to work at Chemawa Indian Health Center last month. We were beginning our descent into Seattle. That’s Mount Rainier. In the distance from left to right is Mount Adams, Mount Hood, and Mount St. Helens.
I’ve had a great summer as I’ve been at four different locations each month- May was on the Yakama Reservation in Central Washington, June was the Colville Reservation in north-central Washington, July was the Warm Springs Reservation on the eastern slope of the Oregon Cascades, and August was at Chemawa in Salem on the western side of the Oregon Cascades in the Willamette Valley. Each place is a joy for me to work at, they all have their own unique atmosphere and feel. I would be hard pressed to pick a favorite place to work when I am on an IHS duty period.
But for all the varied landscapes, weather and patient populations I have seen, this view is constant. I see it when I am heading to work and I see it when I am heading home.
Now that I’m on my third year of doing this, I’ve been at enough places to know quite a few of the patients at the different service units. Quite a few of them know me, too. It’s not unusual in the first week I’m somewhere to have patients say to me “We heard you were back on the Rez” and the second week is “We wanted to see you before you went back home.”
It’s kinda cool to go through a patient chart and see that I’ve been involved in their care not just this year, but last year and my first year with the IHS in 2020.
One patient from one of the places I worked this summer was a drug addict and homeless in the past. That was his situation in 2020 and it was the same in 2021. I saw him again this summer for the first time in 2022. He was clean and sober, had an apartment, and had a job with health insurance. He was a completely different guy from when I’d seen him in the past. I asked him if he was able to pick up extra shifts on weekends since his employer was short staffed, but he spends his weekends doing errands for the elderly residents of his apartment complex.
I asked him why he was doing that and he replied “A lot of people helped me get to where I am now and I need to be one of those people for others.”
All too often the social discourse in this nation about the poor and marginalized centers on this corrosive myth that they just need to pick themselves up and they lack resolve to get out of their situations because America is the land of opportunity.
It’s fucking bullshit and a half.
This patient that I’ve known since 2020 at this particular service unit didn’t get to where he was on his own. There was a whole legion of people helping him along, from psychologists and social workers to case workers helping him get housing and drug treatment. There were charity groups to help him get on his feet, community advocacy groups that helped him find a job. There were people to help him figure out how to open a bank account, sign up for health insurance.
There were a ton of folks who took one look at him and didn’t cast him off but recognized his humanity and said “We are only as strong as the weakest amongst us” and did what they could because that’s what you do if you have any shred of integrity and morality.
These are the sort of programs that are derisively labeled “entitlement programs” or “hand outs” by the privileged.
From my perspective as a physician, these programs save lives. They’re more powerful than any medication that can be prescribed, more powerful than any procedure that can be performed.
These programs are what save our shared humanity. Failure to recognize the inherent value in everyone in our society is what got us to where we are today.