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Practicing Medicine Without a License
Nov. 20th, 2020 12:02 pmI heard from my beloved Nafisa yesterday, so that was nice. Also chatted for an hour with Ichabod, finished another bor-r-r-ring white paper (this one only 4,000 words), checked off every last thing on my To Do list, and even managed to sleep—although that last raises an interesting question: If you fall unconscious and breath regularly without a FitBit to monitor your sleep cycle, are you actually sleeping?
###
I figured the reason that Nafisa hadn’t been in contact with me in the two weeks since she took the USMLE is because she flunked the exam.
But I figured wrong.
She hasn’t gotten her scores back yet.
She thinks she flunked it. But not the writing part of it (which is what I was working with her on.). She thinks she flunked the reading comprehension part of it.
“Reading comprehension on standardized tests is hard,” I told her. “The good news is that there are tricks you can learn, if it turns out you need to learn them. Maybe you won’t! But if you do, you’re a quick learner.”
In the meantime, she is on the verge of accepting a job as a “clinical assistant” at some horrible pill mill in the Bronx where basically she’ll do everything an MD would do except she’ll do it for $15. (This is less than what they pay certified nursing assistants.)
No, she doesn’t need the money.
But she’s deathly afraid that no residency will consider her because of all the “gaps” in her curriculum vitae.
The gaps represent the time she took off to give birth to her children.
She thinks this pill mill job will fill in the gaps.
“But that’s insane, Nafisa,” I said. “Commuting to the Bronx? Roundtrip, that’ll take you four hours. And that’s on a good day. Plus they’re exploiting you! Fifteen dollars an hour? That will barely cover your commuting costs.”
“I know, I know, but what else can I do?” she said. She was practically crying. “Nobody else will consider me.”
The kicker is that she is so, so bright and so, so compassionate, and she really knows her medical stuff.
And in the grips of the coronavirus crisis, the U.S. generally and New York state specifically is really hurting for doctors.
But she couldn’t pass an idiot reading comprehension test! (Maybe.)
###
Back when I was haphazardly considering applying to medical school—though knew I would never survive an internship and residency ‘cause I can’t function if I don’t sleep—I was a volunteer medic at both the Berkeley Free Clinic and the Berkeley Women’s Feminist Healthcare Collective.
There I cheerfully practiced medicine without a license for three years. I gave injections, and I drew blood. I smeared slides with dishonorable discharge from a thousand gonorrhea-ravaged snatches and dicks. I was on familiar terms with every rash known to medical science, including scabies, impetigo, poison oak, and—in one memorable instance—secondary syphilis. I did not prescribe medications, but I did disburse them—antibiotics mostly, but occasionally Tylenol with codeine.
Who knows how many women I taught to look at their own cervices! I still think that’s a very valuable exercise though I haven’t owned a plastic speculum for years and thus, haven’t looked in on my own cervix in a very long time.
We took our responsibilities very seriously, and whenever we came across a patient whom we even suspected was beyond our limited ability to treat, we referred that patient to one of the small group of doctors who’d agreed to see our referrals free of charge.
This was in the early 1970s. Simpler times, yes? Less litigious times. I won’t argue that they were better times. But we did do a little bit of good.
Sadly, Nafisa has no such options open to her.
###
Today, it’s bright and sunny, and the temperatures are flirting with 60°, so it’s off to exercise!
###
I figured the reason that Nafisa hadn’t been in contact with me in the two weeks since she took the USMLE is because she flunked the exam.
But I figured wrong.
She hasn’t gotten her scores back yet.
She thinks she flunked it. But not the writing part of it (which is what I was working with her on.). She thinks she flunked the reading comprehension part of it.
“Reading comprehension on standardized tests is hard,” I told her. “The good news is that there are tricks you can learn, if it turns out you need to learn them. Maybe you won’t! But if you do, you’re a quick learner.”
In the meantime, she is on the verge of accepting a job as a “clinical assistant” at some horrible pill mill in the Bronx where basically she’ll do everything an MD would do except she’ll do it for $15. (This is less than what they pay certified nursing assistants.)
No, she doesn’t need the money.
But she’s deathly afraid that no residency will consider her because of all the “gaps” in her curriculum vitae.
The gaps represent the time she took off to give birth to her children.
She thinks this pill mill job will fill in the gaps.
“But that’s insane, Nafisa,” I said. “Commuting to the Bronx? Roundtrip, that’ll take you four hours. And that’s on a good day. Plus they’re exploiting you! Fifteen dollars an hour? That will barely cover your commuting costs.”
“I know, I know, but what else can I do?” she said. She was practically crying. “Nobody else will consider me.”
The kicker is that she is so, so bright and so, so compassionate, and she really knows her medical stuff.
And in the grips of the coronavirus crisis, the U.S. generally and New York state specifically is really hurting for doctors.
But she couldn’t pass an idiot reading comprehension test! (Maybe.)
###
Back when I was haphazardly considering applying to medical school—though knew I would never survive an internship and residency ‘cause I can’t function if I don’t sleep—I was a volunteer medic at both the Berkeley Free Clinic and the Berkeley Women’s Feminist Healthcare Collective.
There I cheerfully practiced medicine without a license for three years. I gave injections, and I drew blood. I smeared slides with dishonorable discharge from a thousand gonorrhea-ravaged snatches and dicks. I was on familiar terms with every rash known to medical science, including scabies, impetigo, poison oak, and—in one memorable instance—secondary syphilis. I did not prescribe medications, but I did disburse them—antibiotics mostly, but occasionally Tylenol with codeine.
Who knows how many women I taught to look at their own cervices! I still think that’s a very valuable exercise though I haven’t owned a plastic speculum for years and thus, haven’t looked in on my own cervix in a very long time.
We took our responsibilities very seriously, and whenever we came across a patient whom we even suspected was beyond our limited ability to treat, we referred that patient to one of the small group of doctors who’d agreed to see our referrals free of charge.
This was in the early 1970s. Simpler times, yes? Less litigious times. I won’t argue that they were better times. But we did do a little bit of good.
Sadly, Nafisa has no such options open to her.
###
Today, it’s bright and sunny, and the temperatures are flirting with 60°, so it’s off to exercise!
