I was only thirteen and Dolly, with her blonde wig and her look of perpetual surprise was staring me down. Kneeling beside her life-size torso with plastic bags for lungs, I performed CPR until a grunt from Rita, the nurse who was Dolly's keeper, let me know that I had saved Dolly's "life." Doctors were saints, healthcare was free, science saved lives, and I knew I wanted to become a doctor.
My idyllic concept of medicine could have stood unchallenged for many years had I continued to live in southern California, but my parents abruptly decided to return to our home state of Montana. Shortly before my fourteenth birthday, they announced to me and my three younger sisters that they had quit their jobs, sold our home, and purchased a small resort marina on Flathead Lake in Bigfork, Montana. One day I was a suburban middle school student - a month later I was cleaning cabins, training boat renters, and chopping firewood on the eastern slopes of the Rocky Mountains.
As a small business owner, the healthcare that had seemed so readily available in California was much harder to access, and with the meager medical insurance my family could afford, I was no longer able to go the doctor whenever I felt sick. My three younger sisters and I shared antibiotic prescriptions, and I squinted my eyes instead of buying the glasses I needed. My idealized vision of freely available healthcare was shattered when I faced the reality that the quality of my healthcare depended not on available technology, but on my ability to access it.
I left the resort to attend Grinnell College with this interdependence of healthcare access and socioeconomic status foremost in my mind. Seeking a way to further investigate these links, I realized I might gain perspective on this issue by investigating how other nations administer health care. Fluent in Spanish, I contacted Dr. Guttierez, an anesthesiologist in Costa Rica, who helped me undertake an exploration of two clinics and a hospital in the socialized healthcare system of San Jose. There I witnessed how universal healthcare, provided by government agencies, was made possible through public investment. As Dr. Guttierez stated, "In Costa Rica, healthcare is a social program, not a science." To contrast the Costa Rican system of universal access, I next sought out a healthcare experience in a country totally devoid of a comprehensive health care system - Bolivia. Without formal medical training, I was given a uniform and a badge and began working twenty-four hour shifts as a paramed
ic serving Quecha and Aymara Indian communities in the Cochabamban Valley. In these desperately poor communities, the economics of healthcare are a matter of life and death. I cradled the head of an elderly priest as he died because our ambulance ran out of oxygen; the previous day, our company had not had enough money to fill the tank completely. As a paramedic, I was treating the symptoms of a larger illness: political and economic instability prevented the development of a Bolivian healthcare system.
My once naive views of healthcare are now far more complex than when I saved Dolly's life a decade ago. I want to be a physician, but I have realized that I need more than science to serve a community. My experiences in the United States, Costa Rica and Bolivia have shown me that in order to best serve patients, I need to look beyond the health of the individual to the factors that determine the structure of healthcare. To that end, when I returned to Grinnell, I added to my biology major a Global Development Studies (GDS) Concentration - which requires enrollment in anthropology, political since, and economics courses. To further my GDS concentration and my understanding of alternate healthcare systems, I created and organized the Grinnell Student Symposium of Healthcare Experience 2001, which provided a forum for fourteen students, including myself, to share our international healthcare-related experiences with over two hundred community members.
I have done fieldwork and coursework that has deepened my understanding of the complexity of the determinants of community health. By pursuing a Human Sciences degree at Oxford, I will develop the tools to fully evaluate healthcare systems in context. The degree's interdisciplinary approach to understanding the fundamental challenges confronting contemporary society, of which healthcare is one, will allow me to ask and answer questions I see as important. Intensive study of demography, the biology of disease, and culture will enrich my multidimensional understanding of human health. I choose the Human Sciences Program because of this interdisciplinary approach and the excellence and rigor of Oxford. Additionally, study of health care issues in a country with a National Health Service is different, intriguing, and challenging. I will be a better doctor and a more capable public steward because the skills I will gain from the Human Sciences Degree will prepare me to be a part of the solutio
n to the healthcare inequalities that exist today.
Although I am fundamentally the same person who worked the shores of Flathead Lake, my once innocent views of healthcare have been informed by personal experiences. These life experiences did not create my passion for humanity, but rather provoked me to seek out new and creative ways to impart service.
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