There are a few things that make the UW School of Medicine uniquely special. Foremost among them is the WWAMI experience which offers a truly incredible opportunity to see new places and meet new people. I’m sure no other school in the country provides such ‘diverse’ opportunities for travel and clinical exposure. I use air quotes because most of WWAMI is fairly racially and politically homogeneous. When you travel to rural Washington, Wyoming, Alaska, Montana, and Idaho you are going to spend your days alongside a lot of very nice conservative white health care workers. This is not to say that there are not people of color wherever you travel, but they are rarely represented in medicine. Even given all of this, there is still a ton to glean from trips to the Northwest Heartland. If anything, the physicians you meet are often some of the most liberal power brokers in these areas. My first trip to WWAMI was on the Coeur d’Alene Reservation during the Summer of my first year. Unfortunately this trip sucked and so I’m going to talk about Great Falls, Montana where I did my Pediatrics rotation instead.
Interstate 90 shot @ roughly 90 miles per hour
There is something truly ephemeral about driving East on I-90. The highways of the West are one of the last truly free bastions in this country. There are no tolls so it is just you and the open road. It probably makes no sense that roads such as these are not subsidized by those who drive them, so you might as well take advantage of them while they’re free. After a couple long drives across the heavily-tolled France and Switzerland I now appreciate this gift even more so. As a half-brown these sort of trips are a journey into uncertainty. On one hand I’m pretty light-skinned, on the other hand my last name is Ajeto which looks pretty damn Hispanic. On one hand people are friendly and nice, but on the other hand a flaming liberal like me is about as welcome as a trump Supporter at a rap concert.
There is immense value in working in areas with sociopolitical demographics that are different than yours. Surviving these trips as a minority student is the hard part. Medical students who wear a hijab or have a clearly Muslim name are frequently refused as providers. We experiences discomfort that ranges from micro-aggressions to the tangible fear my LGBTQ classmates fear for their safety. I am somewhat on the outside of these experiences. I sure as shit do not fit into these communities, but I’m very quickly labeled as “one-of-the-good-ones.” I was invited to a family dinner by an acquaintance one day and the next day a surgeon intensely interrogated me about my liberal beliefs in middle of a thyroid removal procedure. He simply could NOT understand how someone could operate in this world without the 10 commandments to guide them. The power dynamic between medical student and physician is already wide, when you add the heightened emotions of race, religion, and/or politics this divide can quickly become a chasm.
To be clear this isn’t the South. N-words with hard “r’s” are not tossed around freely, but the post-racial world espoused by its people is hardly appreciated. The more I think about the divide between my world and these, the more I struggle to envision a future where both coexist. Rural America seems to cling to the powers and ideas of the past. Storefronts from decades ago persist like age old dreams of a grand white America. I understand that jobs have been lost and good families have lost their momentum, but manufacturing is simply dead. Nobody killed it, rather years of development in technology, polymers, and plastics have rendered its machines obsolete. The hands to turn wrenches are no longer needed. Below the world of professionals now stands a country of service workers. Cities have done their best to adapt to the changing times while the rest of WWAMI-land stands firm.
I sure hope there is a path forward that can unify our cities and rural-scapes but I don’t see it. When people say that diversity for the sake of diversity is not enough they are probably right. But what do you do when people do not even see THAT as a starting place? We can not simply skip the equity building and integration steps and pretend things like race, religion, gender, and sexual orientation are not important. I like to tell my friends that until we are all some shade of taupe there is little hope for progress. Unfortunately I don’t see this happening in my lifetime or that of my kids, hell even their kids. You can’t ask others to see what you see or feel what you feel. Really all you can do is stay woke.. cause niggas creepin…
But stay woke
They gon’ find you
Gon’ catch you sleepin’ (oooo)
Now stay woke
Now don’t you close your eyes
Childish Gambino – “Redbone”