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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Thursday, 12 March 2015

A Man's a Man For A' That?

The first lines of Rabbie Burns' poem will be well known to anyone who grew up in Scotland.

Is there for honest Poverty
That hings his head, an' a' that;
The coward slave - we pass him by,
We dare be poor for a' that!

I recently read the memoir of a woman who had been exiled to Siberia from Poland during the Second World War.  Near the end, she talks about how hunger, a theme that is interwoven at every stage of her tale, is the worst form of torture.  She describes how hunger eats away at your soul, takes your energy and removes your hope.  When I was a 22-year-old living in London, I lived on £1 a day for a week to increase my understanding of the impact of hunger.  One week of carbs and not much else allowed me to empathise with hunger and poverty in a way I could scarcely have anticipated beforehand.  After just one week I felt tired, fed up, focus-less, disinterested and out of steam. I couldn't believe the all-encompassing impact hunger would have on my ability to do even the most basic tasks, let alone study or work.  And I only had to do that for one week - I am clearly not suggesting I can relate to the long-term suffering experienced by the woman I was reading about in the book, or the many millions of people in the world who are hungry everyday.  Hunger is torture.

Every day I walk to work through the centre of my Connecticut town.  Usually it's a quiet walk; a few others head to the medical laboratories on foot.  But as I cross the two main roads near the hospital, I usually encounter a few of the city's homeless community.  The hospital resides in one of the more troubled areas of town, and we are advised not to venture beyond the other side of the hospital for our own safety.  When I finish late in the lab, I get the university shuttle bus to my door because it is apparently too dangerous to walk home alone.

Despite my travels and clinical experience in a few developing countries, poverty in the USA exists in a way I have never seen before.  This is not just the lot of my city of residence - I don't think I've taken a single ride on the subway in New York without being accosted by someone begging with a speech in the tube carriage.  Homeless people live on many a San Francisco street corner.  Many have mental health issues - which is worth noting given the recent shooting of a man in Los Angeles who was homeless following treatment for mental illness.  The chasm between rich and poor feels enormous, and intensely along racial lines. Is it like this back in the UK and I just haven't noticed?  Having trained to be a doctor in one of the most deprived parts of the UK, perhaps, but nowhere near to the same extremes.  In my as-yet brief medical career in the UK, I have seen many sides of society through my patients, and feel we can relate to each other in some way, regardless of wealth, poverty or anything else.  Here it feels like the divide is astronomically bigger.  Add gun control (or lack thereof) to the equation and it's a toxic mix that feels very much like 'us' versus 'them'.  When you have nothing, I guess what is there to lose?

The political divide here reflects the manner in which people do, or don't, want to deal with this.  I guess it's basically socialism versus conservatism - is the state responsible for supporting everyone to give them a fair shot, or is it up to the individual?  Personally, I find it very hard to stomach the latter argument; when the abandonment from society is so complete with regards to housing, education and healthcare, where is the individual supposed to start when they can neither shave nor wash, buy new shoes never mind a suit, or be adequately nourished to the point where one can think straight?  If this was a country struggling to make ends meet I would understand - but this is the wealthiest country in the world, no?

We are made to feel like we don't matter as individuals all the time - either by people who we know (argh!), or by the bigger institutions that rule the world (double argh!).  I hate it when people make me feel like I don't matter - not because I think I'm the most important person in the world, but because I'm a person with feelings, ideas and thoughts, and in my old age have learnt my worth in the world.  I struggle to know how to deal with living in an environment where so many people must feel like no-one cares, and to know what I can personally do about it.

As Spring seems to finally be arriving in Connecticut, and the piles of snow beside the road finally have a chance to melt, I am relieved also for those who call the frozen pavements 'home' for the night that warmer times are coming.  Certainly more so than in the UK, I give up my spare dollars when I have them, accepting this is a short fix, and that the reasons for this divide are far more complex than this blog has space for.  I can't change an entire social set up on my own, as a foreigner, in nine months - but feel utterly dissatisfied with the apparently rhetorical question of 'well what can I do?'.  I'm running a half marathon next month in NYC.  I'm not doing a formal fundraising thing, but if you are so inclined, I would much appreciate your throwing a few pennies/cents to Columbus House which is based near where I live.

On the wall by my mother's desk at home is pinned a prayer that has always resonated with me, increasingly so as I get older (written by Reinhold Niebuhr, American theologian who, as it turns out, studied at Yale Divinity School.)

'God grant me the serenity to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
enjoying one moment at a time;
accepting hardships as the pathway to peace...'

I hear what he's saying. But when it comes to poverty, it's overall rather depressing to think that we haven't progressed much from Robert Burns' sentiments, despite the fact they were written over 200 years ago. And when it comes to the USA, it is this powerlessness to help one's fellow man that is probably the number one thing that stops most Brits I have met from contemplating a long term emigration to this side of the Atlantic.

 America, land of the free. Well, if you can afford it.  

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