In my junior year of high school, I applied for and went on an educational mission trip to the Dominican Republic. Being the son of Uruguayan immigrants, I felt at home in the rural setting while my many classmates marveled at their first view of a culture different from theirs. On that trip, my ability to fluently speak two languages formed a common ground on which I could build relationships. I came to understand a desire to use my privilege in the service of others. After expressing this to my parents, I learned of a family lineage full of physicians who were pillars of Uruguay’s medical community. In this history, I understood my own purpose on this Earth: to continue a lineage of individuals committed to selfless sacrifice. My heritage has privileged me to interact with diverse people from an early age. The summation of these encounters forms the core of my identity, as they have shown me the human dignity characteristic of all people.
As the past year has shown, no one ever has complete control over their circumstances. A catastrophic event—like a pandemic—will always disproportionately affect individuals of lower socioeconomic status. This leaves under-privileged communities vulnerable to the whims of those who prioritize greed and power over the needs of the people. For these reasons, it is the community’s responsibility to come together and provide for the needs of those lacking access to the most basic of rights. During the pandemic, I began volunteering as a care coordinator for a mobile outreach clinic (MOC). Care coordinators provide follow-up and administrative services for the clinic, using community resources to address patients’ barriers to care. A typical care coordination shift consists of answering missed calls, calling, and discussing action items with my current patients, followed by creating plans for patients who have yet to be contacted.
As public health concerns the health of populations, it offers exposure to heterogeneous personalities and cultures. Providers in any health care field will have to interact with diverse individuals from across the world. With one of the world’s most advanced medical technology, the United States is a beacon of hope for patients who cannot be treated in their home countries. This phenomenon, medical tourism, incurs a great cost on the health care system and presents a moral dilemma to present and future providers. Before my work with MOC, I knew of but had never witnessed medical tourism. During my third week, I was assigned a Spanish-speaking patient looking to establish care in our clinic. Upon calling the patient, John (name changed for confidentiality), I greeted him in his native language with a brief formal introduction and summary of our services. John greeted me warmly and brought me into his suffering by telling me his story. John received an early-stage cancer diagnosis in his native country. He sought treatment there, but the tumor was unable to be removed. John had come to the U.S. in hopes of a better outcome.
Thankfully, John had come to the right place. The mobile outreach clinic offers referrals for specialized care to underserved patients through a financial assistance program. I had him scheduled to see a provider in the clinic and made a note to follow up in two weeks. Upon calling back, John’s humility and gratitude were apparent: He had been referred and accepted to the program. He was going to be treated. While my actions were rewarding at the moment, I would not come to understand their implications until my final phone call with John. In it, John repeatedly expressed gratitude for my choice, as a first-generation immigrant and Spanish speaker, to volunteer with MOC. Ironically, I had only felt like I was performing my normal duties at the moment.
Once again, heritage and family history privileged me to a relationship with an individual where I could affect tangible change in their life. John’s suffering, more so global suffering, can at times be overwhelming. But in these moments of anxiety and fear, I find comfort in understanding my role as a continuation of the past. My parents are immigrant physicians who came to the U.S. seeking a better life for themselves and their families. Others facilitated my own position, and by that very nature, I must strive to lift others out of their own suffering.
Juan Arnoletti is an undergraduate student.
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