CC Issue 17 / Reflections / Social Work

The Pull of Poverty

Tuberculosis is an infection mainly of the lungs that can affect many different parts of the body and can kill if left untreated. It is often thought of as a disease of the past. What comes to mind are airy Victorian infirmaries with patients convalescing for months on end, perhaps waiting to be sent for a dose of clean mountain air in Switzerland. If it does occur today, it’s usually somewhere abroad, distant, irrelevant.

In fact the reverse is true. Incidence of the disease is increasing in many areas of the UK, such as in the area of London I work in. Who gets it? Often immigrants, the poor, people with HIV. To those of us in the medical profession this is nothing new. But what did strike me the other day was hearing that there are certain resistant strains of the infection cropping up in very specific groups. One example is inmates in Pentonville prison. Knowing a patient has previously had a spell there is enough to add an additional antibiotic treatment into his prescription before we even know what bug is there, such are their chances of having the deadly strain. Another is the strain that is almost exclusively found in the brothels and massage parlours of Soho. Immigrants, poor, prisoners, prostitutes. All congregating on one disease.

Liver disease paints a similar picture. Alcohol abuse, hepatitis from intravenous drug use…. Cirrhosis is not a disease of affluence.

As a junior doctor I will soon find myself in one of those major crossroads in life. Which specialty will I choose, and how will I make that decision that will shape my trajectory for the next 40 years? As we talk about these decisions in the hospital, there are those who are drawn to the easy life, those who are drawn to excitement, those who are drawn to power, those who are drawn to successful private practice. But as a Christian one of the fundamental questions I find myself asking is, if Jesus had been a doctor, how would he have decided? Well surely he would have chosen the speciality that brought him into the lives of the fringes, the outsiders, the despicable. Drawn away from power and towards weakness.

For the time being I remain undecided. But surely I have to ask the question, who am I gravitating towards?

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