Why is the percentage of female patients who receive inappropriate medications from their healthcare providers significantly higher than male patients? Why is the quality of American healthcare improving much faster than access or disparities? Why do Americans need Go-Fund-Me pages to pay for basic life-and-death healthcare expenses? Why do twice as many African American and Native American babies die before year one compared to Caucasian babies?
When I finished my four years of premedical courses as an undergraduate, I was in many ways just as perplexed as when I started. I felt like I had learned everything and nothing. I studied biology, chemistry, physics, anatomy and math, but I had no idea how to answer any of the questions above. I felt unsettled because I could see disparities in treatment and outcomes along lines of gender and sexuality, but I have come to see that this is just a part of a much larger fragmented system. Physicians can’t just be gears in a machine that allows for such gross discrepancies in treatment, and taking this year to try and understand the global systems that result in such discrepancies has been invaluable.
The highlight of my second semester at UCD has been my World-Systems, World-Literature class taught by Sharae Deckard. Each week we read a novel that deliberately attempts to “write the world” by taking on a global perspective, often by thinking about globalization, capitalism, and the impacts of transnational corporations. These books also question the assumption that Western knowledge and Western styles of thinking are inherently superior to other histories and perspectives about the world. One week we read The Swan Book by Alexis Wright, an indigenous Australian author who includes indigenous conceptions of time within her novel. Instead of envisioning time as a line, always moving forward and progressing, the indigenous characters in her novel envision it as a snake biting its tail or as a circle. Things move forward, but reminders of past events continually influence present circumstances, much like a palimpsest. At the same time, I was reading about immunotherapies, especially checkpoint blockade, and I realized that this conception of time was much more useful in understanding the cell cycle. At a cellular level, life operates much more by this circular conception of time where cells grow and divide and grow and divide.
Academia today has a dogmatic insistence on demarcating areas of knowledge within firm boundaries, and generally discouraging “experts” from stepping outside their prescribed territories. One of the best metaphors for academia that I have ever heard is that academia is like an enormous round room with the secret to the world in the middle. The room is covered by a ceiling, but has a walkway around it with windows peering in so that can each view can see a section of what is inside the room. Each disciplinary approach can see its own view of the center, but only together can a full picture of what is inside be pieced together. Gender theory, race theory, postcolonial theory, transfeminist theory, literary theory, Marxist theory, feminist theory, biology, chemistry, physics, anatomy and math together can give complementary insights into the systems that are responsible for generating the questions above, and perhaps how the systems that they arise from can be changed.