Minor Terror

There were two “Reigns of Terror” if we would but remember it and
consider it; the one wrought murder in hot passion, the other in
heartless cold blood; the one lasted mere months, the other lasted a
thousand years; the one inflicted death upon a thousand persons, the
other upon a hundred millions; but our shudders are all for the
“horrors” of the minor terror, the momentary terror, so to speak;
whereas, what is the horror of swift death by the axe compared with
lifelong death from hunger, cold insult, cruelty, and heartbreak? What
is swift death by lightning compared with slow death by fire at the
stake? A city cemetery could contain the coffins filled by the brief
Terror which we have all been so diligently taught to shiver and mourn
over; but all France could hardly contain the coffins filled by the
older and real Terror–that unspeakably bitter and awful Terror which
none of us has been taught to see in its vastness or pity as it deserves.”
~Mark Twain, sent to me by a good friend.

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Am I a Different Person Now?

Digesting my last five days of immersion in global health education dialogue, politics and plans has become an emotion-ridden evolution of thought leading me to reconsider my basic approaches and practices in promoting the agenda of medical students in global health.

There are different elements to my internal evolution this week.

Firstly is my evolution in thought when it comes to what it means to teach “global health” to medical students. What is its purpose? My growing understanding is that we are not teaching North American medical students global health to have them revolutionize health in the “third world.” Rather, we are teaching them global health so that we can improve health locally. But to move students from conceptualizing global health as “abroad” to thinking about it “locally” takes long-term, intensive exposure to the issues of community health that affect us all. Its almost as if we’ve taken the concepts of public health and made them exotic and appealing in the form of global health, with the hopes that eventually, we’ll all make the link to public health issues happening at home. I’m not convinced that this view of purpose in teaching global health was shared at the meeting, but I am more convinced that this must a major element in the purpose of global health education in the North.

My other evolution is personal, in that I witnessed myself repeated putting myself out there in a scary arena: a room of experts that don’t know me beyond my statements, diplomacy and general ettiquette. Generationally, some individuals in the room would not have done this when they were young. I was informed late in the meeting that in the past, a young person voicing controversial ideas in a meeting like this one could have been commiting a form of suicide for their future career. I felt that voicing different perspectives was part of my role at the meeting, and why my benefactors advocated for my attendance. But it was a fine balance: how much controversy do you introduce in a new environment? Did I produce too much or too little?

A few other key experiences I will share in future blogs – one of which was more thoroughly understanding the reasons why north american medical students should consider not engaging in international health electives. By some of us not participating in electives abroad, I think we can benefit the training of the global health workforce.

Learning at Bellagio

The personal growth is truly astounding. Putting yourself out there in front of twenty-one experts in your chosen field is an experience, especially when you are a critic like I can be. My goal is to be insightful and to think deeply about the proceedings here. I can’t engage in deep thought and not unleash the occasional diplomatically-formed comment. There is resistance to these difficult questions (mixed with occasional experts who warmly embrace it – my personal heroes). I almost feel as though, because I’m a “student”, the questions can be disregarded as if I just don’t have enough experience to know what I’m talking about.

But students must push the envelope – we are the ones with the energy and stamina (and often clarity) to do it. It is important to explore edges and stuck ideas, especially in the rapidly evolving ‘global health’ sector.

I hope to look back on these times when I have grey hair, wrinkles and a lot more wisdom. I only hope that I continue to take my own eager advice.