Chronic

Side note: I didn’t write yesterday! I meant to, but life got in the way. Sometimes that happens. You just gotta forgive yourself and move on. 😘

Mm-kay, I’m going to talk about something that not everyone likes to talk about.

Being ill.

In my case, being chronically ill.

Susan Sontag once put illness and health like this: “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”

Some of us — in fact, a good half of us, according to the CDC — find ourselves to be near-permanent citizens of “that other place.” Chronic illness affects about 117 million people in the United States, and includes everything from hypertension — common, preventable and/or treatable diseases — to autoimmune disorders, which often aren’t treatable and often come with chronic pain.

I fall into the later category. Unfortunately, about a week ago, I came out of remission and started experiencing a recurrence of my symptoms, which make many daily activities — including leaving the house some mornings — very, very difficult. Fortunately, through rest, proper diet, and treatment, I seem to not be headed for a full-blown flare up that will strongly impact my life for the next few months. I am hoping to be fully functional in another week. So that’s good.

It got me thinking, though, about my chronic illness in relationship to medical school. I am entering medical school in a couple of weeks, and flaring up at this moment would be devastating. In general, flaring up would make any part of medical school, from my preclinical years spent in the classroom to volunteering at clinics to my rotation, frustrating and difficult. Many people would consider having a chronic illness such as my own to a huge disadvantage in my medical career.

And the truth is: it could be, and I should be willing to to admit that. Trying to appear ‘tough’ while dealing with a chronic illness really only reinforces this idea that asking for the accommodations makes you weak. I have already gone through the process of getting accommodations, and I will challenge anyone who thinks I should be able to get through medical school without these accommodations. We accommodate everyone else’s inabilities and illnesses — for example, if someone gets a stomach bug and can’t leave the bathroom, we don’t expect them to go to class — so we can also accommodate mine.

However, I also refuse to think of my illness entirely as a deficit. Having a medical disability means that I am more aware of how a lack of infrastructure, as well as anti-disability norms and narratives, make it more difficult for disabled or sick people to live full and unhindered lives. Physicians and other medical staff are often in a position to advocate for, empower, or serve their patients with disabilities or illness — but often, due to a lack of knowledge or bias, they let their patients down. I am hoping my own experiences will allow me to work with my peers to challenge their own biases about disability and illness, so that we all can become better physicians.

These biases include thinking of chronic illnesses as the fault of the patient. While most people have moved beyond thinking that needing to use a wheelchair is the result of your parents’ sins, we typically place undue burden on our patients for diseases they have. Think: IBD is because the patient is fat; diabetes is because the patient is lazy. In a world where a huge chunk of health is determined by social factors, we can’t blame patients even for “lifestyle” diseases without first considering the understandable or inescapable reasons this “lifestyle” is lived.

But I digress. That’s a separate (and long) blog post, one I hope to write about in length soon and link here. In the meantime, I want to bring it back to my disease (see, I really am trying to write more about myself, no matter how uncomfortable it is).

To summarize: I am not weak for needing accommodations. Without accommodations, my illness would greatly impact my ability to do well in medical school. If they did impact my ability, the fault would lie with the school for being unwilling to accommodate me in the same way the accommodate their other students, whose needed accommodations are simply more common than mine. However, my illness will hopefully allow me to be a more compassionate physician, one who is able to teach their peers about anti-disability and anti-illness biases that harm patients in the long run. Although there are days I hate living with my illness, I realize that it’s the hand I’ve been dealt, and I will make the best life I can out of it.

For now, though, I will focus on resting and getting better. Because still — it would be awful to have a flare-up during the first few weeks school. Fingers crossed for me, please. 🤞🤞

Photo by glasseyes view on Foter.com / CC BY-SA. Greyscale added by author.

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