I was on the night shift of my internal medicine rotation the week the riots happened here in Baltimore, the city where I live and go to school. As a result, I saw a tiny glimpse of the profound effects the riots had on the city’s health. Quite a few patients who were admitted to the hospital during that time came for acute exacerbations of chronic health conditions secondary to having run out of their medications and not being able to get refills because their pharmacies had been looted. I had of course seen and heard all about the pharmacy looting on TV, but then coming face to face with the reality of what that meant for people was a different situation entirely. When possible, we vouchered (paid for) those patients’ medications until they could be refilled properly again. And even so, we only saw what must have been a tiny fraction of patients with this issue. Primary care doctors in the community likely had a lot on their plate as well in dealing with this problem.
The whole situation was deeply saddening, and the city was clearly grieving on several levels–and in many ways still is. That week in particular gave me a deeper understanding and appreciation for the interaction of health with the general state and wellbeing of the community. To be an excellent clinician requires not just an understanding, for example, of regional pattens of disease and antibiotic sensitivity, but also of local issues surrounding socioeconomics, education, politics, and culture. The practice of medicine does not exist in isolation from these factors.