I always wondered what the saying “the apple falls so closely to the tree” meant. I never bought into the concept of similar cliché sayings of “like father like son” or “mother like daughter.”  I viewed these ideas as being founded upon by poorly defined concepts of traits and inheritance. Such notions completely undermine the ideology of “I think, therefore I am” as coined by Rene Descartes. I maintain that people have within themselves the inherent ability to change their present circumstance and make it different from what their history suggests, and what others may foretell. The path to changing one’s circumstance is not easily achieved, and one will experience many failures before they are to succeed. Encountering failure is more of a transient concept, and not nearly as important as understanding why failure and not success was achieved. This understanding has a very powerful influence over self, and can be the source of change that can benefit a multitude of afflictions in our society; for example, the transformation of health care.

As a medical student, one of my volunteer experiences included community outreach to help address some social and health needs. In one instance, I helped someone with ways to overcome a perceived social barrier, and I remember feeling excited about providing information that they once felt was unattainable. But, the reception that I received from them was not what I expected. At that moment, I felt that they were ambivalently satisfied. After talking with them and trying to find out why they were not extremely delighted to be able to start on their new pathway to success, my perspective had certainly changed. They told me that they would not pursue the proven path to success lay before them, but would rather take an unproven and riskier path. At first, I was puzzled over this and did not immediately understand their motivation for doing so. During several days of contemplating this, I reflected upon an experience that I had read about pertaining to the working girls of one of the red light districts in India.

This article, focused on how the working girls of India are born into prostitution. Once they reach a certain age, they are required to work as prostitutes foregoing education, and any professional or career aspirations. To many of these children, going to school was merely a dream because it was unattainable and foreign to their realities of life. None of their parents, siblings, friends, or anyone that they knew went to school. To them, it was something that was reserved for the elite and the kids that they saw in Bollywood movies.

However, a group of international church members went to the red light district in this part of India, and established a school that would provide free K to 12 education, housing, boarding, books and uniforms to these girls. The one condition was that the parents of the girls who worked as prostitutes must leave their daughters at the school and promise that they would never call them back to work in the red light district. The parents wished a better life for the girls, and the girls were delighted to be given an opportunity to fulfill their dreams. However, after the first few days of being at the school, the story of delight turned into a social experiment. The mother of some of the girls called their daughters home to work for them, while other girls themselves chose to return home and enter a life of prostitution rather than receive an education. In the end, very few of these girls actually stayed at the school and avoided a life of prostitution. This experience, reminded me of the situation with my work as a community outreach member, but in a different part of the world, and a different set of social determinants.

I have concluded that the outcomes of both scenarios can be attributed to the familiarity of one’s aspirations. When the working girls of India went to the school and were given all the tools to change the trajectory of their life, very few were able to profit from such an opportunity. Some had external factors that removed them from school, while other’s voluntarily left. They all struggled because they were not familiar with the concept of being in school, and applying the things they learned to a new life, one they felt was unreal compared to the raw, uncut, realm of prostitution in which they were born and raised. They were away from their families, sacred, and they ultimately failed because of misguidance.

My outreach recipient pursued a pathway similar to their peers. They felt more comfortable doing so because they could relate to others who did so before them, even though it did not guarantee success. This experience taught me that when dealing with people, emotions such as fear, anxiety or whatever other emotional verb one would like to use, presides over logic. But, familiarity is not an emotion. It is something that can be taught through guidance by responsible parenting and mentorship. Those who are successful in whatever relative idea that may include, pave the way for others to follow.

Learning from this experience, perhaps a rule of familiarity can be employed to change social determinants of our society be it health care, education, or general welfare of the masses. For example, to implement a truly preventative service in medicine we must lead by example. This, in my opinion, falls upon the responsibility of health care workers universally. We must show others who are unfamiliar with the benefits of eating well and caring for our bodies that the majority of illnesses that plague our society today truly are in many instances preventable. This in turn will create a grassroots movement to implement change. Not through passively lecturing to people about the things that they have to change in their life to be in better health overall. Rather, change will be rooted in showing them how to do so and providing them with access to ensure success.

Lastly, I understand the age old saying of the Apple and Tree, albeit it, now in a different perspective.

Dharam Persaud-Sharma is a medical student.

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