Writings: Poverty

I want to be like my Cardiology attending. Of course there are many important differences between him and me: he is 72 years old, white male with blue eyes that have the shape of happy arches like those of a smiling Disney cartoon character. There are many reasons why he should be an intimidating presence but his happy, bright eyes paired with an agreeable temperament and thick-soled SAS shoes make him quite approachable. He told us once that he was a conservative in every way except for in his beliefs on healthcare policy; since our team is comprised of a Black man, Hispanic man, and Asian woman I'm sure all of us briefly wondered if that meant he did not entirely believe we belonged in medicine, but it's hard to have suspicions against such an easy-going, kindly man. Despite our definite physical differences and perhaps more ideological ones as well, I find him to be so thoughtful and clear-minded that I would venture to call him a wise man. I say this because he is able to talk intelligently on many topics, not just those concerning cardiology, and one can tell that he has spent time thinking and analyzing these issues. He is articulate, lucid, and blessed with an excellent memory, which is very impressive considering that at 40+ years his junior I can barely remember the day of the week. The first time we met, I said to him, "Hello, I am the medical student on your team, nice to meet you." And he smiled at me kindly and then patted me on my shoulder. He knew, and now I know, his knowledge is infinite in comparison to mine.

I want to share his theory of poverty. Of course I'm not saying he developed this theory, but I think it's a very good way to think about the poor. According to him, there are three main categories of people that comprise the very poor. The first group are those that have drifted downward in society due to mental illness. The second group is poor because of drug / other addictions that keeps them from getting out of the downward spiral. And finally the last group are born poor and never taught the skills to become contributing members of society. He focuses on this last group because with them there is no organic causes for their poverty, rather he attributes their poverty to a lack of "coping" skills to handle basic life challenges such as opening up a bank account, drafting a resume, applying for jobs, etc. These are people who never learned life skills and therefore are trapped in a cycle of poverty that is passed down from one generation to the next, not through genes but through environment. My attending alluded that our education system does a poor job of teaching life skills, and those not fortunate to receive that education at home fail to ever acquire the skills needed to obtain and maintain a trade.

In terms of solutions, my attending said that our education system needs to incorporate more practical life skills training into the curriculum. I felt my attending has somewhat of a paternalistic attitude toward the adult poor. He basically said the only solution is to help them do a lot of the things they can't, such as filling out their paperwork to get them insurance or writing their resumes for job searches, kind of like they are children who will never be able to grow up. He said there needs to be more social programs to do this, (which doesn't exactly sound like a conservative concept to me) and I agree with him that as a part of the social contract we must support our poorest and most vulnerable members even if they cannot contribute to the economic or social welfare of our country. Perhaps poverty is inherent in society, and therefore we all have a responsibility to take care of those who cannot take care of themselves. However I wonder if we are not just perpetuating their inability by essentially doing everything for them - does that not leave them at the whim of the kindliness of others? Can charity ever be empowering? And if not charity then what else for our country's poor?