The young man was homeless. He had recently had a life changing illness, and was no longer able to work. His homelessness and precarious financial situation had led to severe depression, as well as physical vulnerability. He had difficulty getting transport to medical appointments and often missed them. He had little family support and had faced systematic discrimination for most of his life, being of indigenous background. The circumstances of his life meant that despite receiving the best of first world medical care, his outcome was likely to be poor. With all the will in the world, his doctors struggle to help him.
This is a familiar story to most doctors. Health is not just physical robustness; it is mental health, spiritual health and social health. Medication may correct your biochemistry, but it cannot tackle the rejection a young homosexual patient feels, or the sense of limbo and hopelessness that is almost universal amongst detained refugees, or the extreme heat from unbridled climate change that is far too much for an elderly body to withstand. Medical practitioners, and the colleges that represent us, enjoy societal privilege and an unparalleled view into the intimate details of human life. Our patients are everyone – the esteemed judge, the retired politician, the recent immigrant, the alcoholic, the unvaccinated child, the depressed new mother. It could be argued, that with this privilege and viewpoint, that we must draw attention to any threat to health; as if we don’t, then who will?
Nevertheless, many doctors still profess to be ‘apolitical’ or uninterested in activism. Our workplaces are often public hospitals, which have strong policies on involvement in the political world. We are relentlessly busy with an ever increasing patient, paperwork and mandatory training workload. We are consumed by the internal problems of the medical world – the burnout, the gender discrimination, the terrible working hours. We often look out at world problems and wonder how to make a difference, and whether it’s worth investing our time and profile into issues so large that they seem insurmountable.
There is however, a tradition of the physician activist. Rudolph Virchow, a 19th century German Physician is known as ‘the father of modern pathology’; but also as the founder of social medicine. He is quoted as saying: ‘If medicine is to fulfil her great task, then she must enter the political and social life.. The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.’ Virchow was the architect of the city’s sewage system, and advocated on behalf of the poor. Following on from this are many other notable examples: H. Jack Geiger came to activism through the civil rights movement and advocated for improved health care in poverty stricken black townships. Judith Longstaff MacKay has tirelessly worked to ban or restrict smoking and has been credited with Hong Kong having one of the lowest rates of smoking in the world.
In Australia, Dr Helen Mary Caldicott, a paediatrician, has campaigned to ban atmospheric nuclear testing in the South Pacific, to ban exportation of uranium by Australia, and has become a symbol of the world movement to oppose nuclear weapons in any form.
There are current local issues deserving of urgent action from the medical community – the suicide rate in Indigenous children, the ongoing off-shore detention of some of the world’s most vulnerable people, the increasing change in our climate and the looming consequences which are likely to be catastrophic for health. We doctors have the benefit of education, we have the benefit of both a close view of the minutiae of people’s lives combined with a wide angle view of the general threats to community health, and we hold a position in the community which allows us to voice opinion and
be heard. Not all healthcare professionals can change the world, but many can influence the community, assist in writing policy, or be a voice for our most vulnerable. Doctors, pick up those placards and megaphones, sign those petitions, and get interested in public health issues. A thriving society depends on it.