Although this is a politically charged topic in our space in medicine, this isn’t political. For many of us, it’s doing our job — taking care of a patient’s mental and physical health. Making sure they are safe and doing no harm. Living in the Midwest, I had the realization today that in the near future, I will need to refer a patient in need of some reproductive services out of our state, and I’m not sure how far away that will take them. I never had to refer out of state for something like this or not know where I would send a patient for service.
I will recognize that some are celebrating the decision made recently by our Supreme Court, but a large majority are grieving, women and men. In areas of well-being and burnout in medicine, we talk a lot about empathy — being present and listening when others need to be heard. And yet, in times like this, there is a roller coaster of emotions and being able to breathe, clear out the noise, and assume positive intent in others is nearly impossible. Sometimes speaking your heart is necessary, especially when it feels so deeply personal.
The last three years of medicine have been filled with politics — something that was not a daily occurrence for us before the pandemic. Most of us did not pursue this rigorous training to be caught in the fray of political parties. Disagreements about mask mandates, vaccinations, and medications to treat COVID-19 were driven by skepticism seeded by misinformation and not evidence-based. Still, we kept showing up and taking care of patients, trying to have conversations to dispel these myths at a high physical and emotional burden. And we have since watched colleagues leave the profession due to the toll it took on them. They don’t feel heard, valued, or as if they matter. Much like the majority of women right now.
And so, I recognize those grandmothers I will see in my office and community who are reliving history and grieving a right they saw come true during their lifetime. Protection that realized autonomy over their body and reproductive safety. And we will see mothers raising daughters now who will worry about the shifting environment their children are growing up in and the rights they will have when they reach puberty and beyond. We will see victims of domestic violence who will relive harrowing experiences in their minds. Not only were their bodies affected, but their souls accosted. We will sit with all of these women who are distraught and feel powerless over their health and well-being over this decision.
As we celebrate 50 years of Title IX, the irony is that we claim that opportunities are equal and teach that to our daughters and sons, but the reality is that they are not. We still have so far to go, and the journey is moving backward. As we help our patients and colleagues work through this, we will feel this emotional burden too. It is so important you have the space to share, time to reflect, and not push down emotions or be silenced during this experience. In the appropriate venue, we hope you will give yourself the grace to surround yourself with those you can share and speak your voice loudly to — for your soul.
Astonishingly, less than two years ago, we paid honor to a Supreme Court legend when she passed, Ruth Bader Ginsburg. My daughter did a 4-H project on RBG and wanted the world to know the impact she made on her life and the lives of women and men. We taught our children about the walls she had been instrumental in breaking down for gender equality, women’s interests, and civil rights and liberties. When I wondered what Justice Ginsberg would have said, I was reminded of her quote, “The decision whether or not to bear a child is central to a women’s life, to her well-being and dignity. When the government controls that decision for her, she is being treated as less than a full adult human and responsible for her own choices.”
Part of our experience with burnout in medicine is feeling powerless among the demands on our time and attention. Just like we must find opportunities to change the landscape to improve burnout in medicine, the same must be done after the recent Supreme Court ruling overturning Roe v. Wade. Sharing our experience and being part of the solution by speaking out is of the utmost importance if there will ever be a change. We can’t resign ourselves to the current decision, shrug our shoulders, put our heads down and trudge on. It will slowly eat away like cancer until we are left unrecognizable. In the words of the Notorious RBG, we must “Fight for the things you care about, but do it in a way that will lead others to join you,” as a beacon of what to focus on now.
Segen E. Smith Chase is an internal medicine physician.
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