A Patient of Privilege Speaks Up and Asks the Question "What if?" presented at Stanford...

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In sociological circles, privilege refers to having advantages by way of association. As a middle class, middle aged, heterosexual white woman from the Midwest I carry with me many privileges. In health care circles, I carry even more. I am a former medical school faculty member. I currently work to develop and implement health education and policy initiatives. I have remained friends with many of my former medical students and in fact it was one of them that suggested I submit to this conference. All of these associations provide me with the vocabulary, the credentials and knowledge to navigate the health care system. In August of 2013, I was diagnosed with breast cancer and those navigation skills were put to the test. There were 189 days between when I confirmed the mass in my right breast and when I finished chemotherapy – if it was not for my privilege I believe that time would have been much longer and my outcome may not have been as positive as it is. Privilege permitted me access to screenings. Privilege afforded me the ability to be assertive rather than passive in seeking treatment. Privilege allowed me to overlook more than a few ‘cultural’ barriers and not let them deter my efforts towards remission. Privilege provided me with a job that allowed me to take short term disability so that I could focus on my treatment and my recovery. Privilege granted me the opportunity to share my story via social media and, to date, reach people in 22 countries and 37 states. As we think about care, technology, cures, quality of life and saving the world – we have to consider the privilege we bring to the table. We must acknowledge the privilege or the lack of privilege of our patients. We will consider the “What if’s” of lacking privilege. What if an individual can’t get access to the screenings they need? What if they think that passivity is the best way to show deference? What if a cultural misstep derails an appointment? What if an individual can’t focus entirely on their recovery? What if that patient is alone and does not have a social network to support them? We will question our assumptions and recognize the privilege that comes with being part of the system. If one of us can get lost, confused, frustrated, denied or deterred, what happens to someone without the vocabulary, the credentials, the knowledge or the privilege?

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