On Race, Privilege, and Medicine
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Children of Privilege

8/23/2010

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One of my friends' mom has a theory that she calls the "third generation syndrome." An immigrant from Poland, she, like many immigrants to this country, has spent most of her life working hard to get to a country that is perceived to have more opportunities in the hopes of a better life for her child. Similar to many syndromes, her evidence is entirely anecdotal, only vaguely understood, and based on many generalizations and conclusions (any of which are likely false) that we're all unconscious of. It is not surprising, therefore, that our initial reactions, regardless of how much we qualify it in our minds, tell us that it's true.

Her observations and conclusions: When the first generation of immigration comes from a modest background, they work as hard as they can to get to the US where their children can have more opportunities. As such, they actively and passively instill a sense of importance of hard work and educational achievement on their children. The second generation, having personally witnessed the actions of their parents, and having direct contact with their grandparents, a generation that did not necessarily immigrate, has an internalized understanding of what privileges they were afforded and the importance of capitalizing on them. However, by the time the third generation comes around, if the second generation has been successful, they are now far enough removed from the immigrant generation to understand the hard work that got them to this country, as well as only exposed to the privileged and comfortable life that their parents have created for them. This combination creates a more lackadaisical generation with lower achievement and drive.

I don't know if her conclusions are true. My instincts tell me that sweeping generalizations combined with leapt to conclusions rarely synthesize accurate understandings of the world. However, her thoughts did make me think about something very important: how does one responsibly raise children that come from a privileged environment?

Like many other institutions, the medical school offers medical students that chance to go abroad and volunteer in various humanitarian missions around the world. One of the most popular ways is during your M1 year; there are various groups that travel during spring break and work in charity clinics for underserved communities mostly throughout South and Latin America. It's not surprising that these trips are popular: where else can you get to travel to new and exotic places all while "giving back" and feeling good abour yourself? As an additional bonus, since these clinics are usually the only healthcare available, medical students are allowed far more freedom and liberty to "play doctor."

However, there is always of contingent of eye-rolling, usually well-traveled students who can't help but feel that these trips, however well-meaning, are definitely misguided. There's a long list of grievences that one can pick from including (but I'm sure not limited to) issues concerns for sustainability, care continuity, lack of community self-empowerment/perpetuating the global power dynamic, continuing to support a larger system of inequalities by providing a crutch for irresponsible governments and global citizens, exploiting underserved communities for medical education, over-self-congratulation of what is actually accomplished, and exoticizing poverty and other countries. What's less recognized is that most of us scoffers are not morally superior, we just did all that naive stuff a few years earlier.
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Ultimately I begin to wonder, is it possible to educate someone who grows up with privilege without using other human beings as exihibitions? Some have argued it's ok to do so, as long as everybody is aware and honest about what's going on. Or maybe there's a more community empowering way to go about all of this. This question plagues me as important not only from a theoretical standpoint but my own concerns about how to continue to live responsibly as someone with privilege. This question frightens me because somehow I've become old enough to not just ponder these questions in a broader sense, but also in the context of how I hope to raise my kids. That transition of self to kids - ugh - like fingernails on a chalkboard.

I don't know the answer, but I think there are a few things that are definitely true. Humans internalize through experience and relationships. Working in programs that are community led and directed is always better. If a person of privilege is "the star" of the program, something is definitely wrong.

And another thing... This drives me crazy so before we get too far ahead of ourselves in this discussion, I want to call it out now. At some time or another these discussions have been used as a place to wallow in privilege guilt, fuel self-congratulations on how truly enlightened and righteous we are, and generally do nothing but talk about ourselves. I know I'm guilty of this as well. We have got to call party foul on that shit.
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