For me, becoming a physician presents the opportunity to make a positive impact within my own community and the larger society within which we all live. My interest in medicine began when I was 11 years old. My father was injured in a work accident and experienced constant pain and paralysis — I still remember coming home from a family Christmas party to find him sitting in the exact same position I had left him hours before. Thanks to expert and dedicated care, he was able to walk again. It was definitely very motivating to see him regain much of his functionality. As a result of his injury, however, he also developed chronic disease which still impacts his life. Seeing how a very acute medical issue — despite being treated — can change someone’s health was also very motivating. Health doesn’t exist in a vacuum, and I want to be a physician with that perspective.
I studied history and science at Harvard, with a focus on medicine and society. We studied not just how medical inventions came to be, but how societal norms during different time periods directed which research was deemed worthy of funding, which medical interventions were created and who got access to health care.
Doctors should focus on the human aspect of patients
Science is very much subject to our cultural values. There’s this other side beyond all the data and lab work in science today — the human aspect. I want to live that experience, and health care is a great way to do that. In college, I had the privilege of working with an organization called Health Leads, which provides social services to patients at Boston Medical Center. I was placed in the newborn nursery. Many of the moms who had just given birth were what we call underserved patients: immigrants, refugees, local women of color and women in poverty.
I continued similar work after graduating from college. Through the Harvard Center for Public Interest Careers, I landed a postgraduate fellowship as a case manager at Montefiore Medical Center in the Bronx — a very high-needs, low-resource and high crime area. A case manager provides patients access to social resources that can help with whatever they’re going through. We work closely with social workers. I was 23 at the time, and I don’t think many 23-year-olds are prepared for that level of intense engagement with health, disease and how it intersects with our social factors.
My time at Montefiore defined my goal: become not just a doctor, but a doctor who is actually doing something about what we call the social determinants of health and health equity. As physicians, we have the platform and privilege to advocate for communities — like the USC community in Boyle Heights — who don’t typically have a voice. Our community has a very strong spirit, but also a lot of strife often invisible to others. As a physician, if I can manage to get someone into an addiction program, but they experience domestic violence and severe poverty, then can I really expect them to be successful in their recovery? The only way we, as physicians, can be effective is if we pay attention to the interconnectedness of these issues.
Coming to USC was definitely the right choice for me. The Trojan Family spirit is real. Here, upperclassmen give their books away and share notes to those following behind them. We bring food to our friends on a 28-hour shift on trauma surgery in the hospital. We call our friends to make sure they’re OK. We take care of each other.
Asking the proper questions
The social aspects of medicine have received a lot more attention lately. They are very much within our purview, and we should address them. Clinics, medical centers and school-based clinics are hubs for people to go to. We have a chance to intervene during vulnerable periods of their lives, not just through surgery, but through intervening in the social aspects as well. Case managers, social workers, mental health professionals, everyone who can make an impact — medicine is the center through which we can do that. It starts by just asking our patients, “You’re having trouble sticking to your medications. Is there anything else going on?” To be able to ask that question and follow up is very important.
The hard truth is that, historically, medicine hasn’t always treated disadvantaged patient populations with the respect and compassion that they deserve. So now we have communities who still do not trust physicians and it is with good reason. Plenty of history books have been written about exploitation of minority communities, exploitation in which physicians were complicit. We may not remember, but they do.
We now have the opportunity and the responsibility to rectify that. We as physicians need to see ourselves not as separate from the communities we serve, but as part of those communities. We need to approach them with humility and respect. At each stage of my training — Harvard, Boston Medical Center, Montefiore and USC — I’ve learned that we all have implicit biases, myself included, and we need to be aware of them. We need to understand how our communities work. We need to care about their overall well-being. We need to advocate for them. We really need to become a part of the community.
This historical, paternalistic model of medicine has given way to doctors who act as guides, providing patients all the information they need and helping them make decisions. It’s not a one-way conversation anymore. We need to humble ourselves enough to understand and even respect a patient who says, “I understand, but no thank you” to a treatment option.
The other part of building relationships with communities is showing up and standing up for them. Advocacy will always be an important part of my career. Even as a student, I participated in groups that met with legislators to tell them about social issues we saw in our communities that affect health, and to hold them accountable to do something about it.
My mentors at USC really helped to foster my interest in advocacy and to develop the skillset necessary to be an effective advocate. Specifically, Michael Cousineau in preventive medicine was my advisor while I pursued a master’s in public health here. He taught me how to analyze policies, communicate with stakeholders — hospital management, legislators — and how to look past the data to find the story behind a piece of legislation.
After graduation, I head up to San Francisco, which has its own underserved communities in need of advocates. I’ll always be a Trojan, though. USC’s faculty, staff and my fellow students encouraged my fervor and strengthened it with the education and experience I needed. I’ll be staying in touch with them because another thing I learned here is that to really change things, one “physician with a perspective” isn’t enough. It takes all of us.
— Cory Johnson is a fourth-year student from Florida at the Keck School of Medicine of USC. He will be completing his residency in family medicine at the University of California, San Francisco. He spoke with Paul Boutin of HSC News.