In many ways, emergency rooms are the frontlines of health care, serving as the initial point of contact for people experiencing sudden and severe health problems or accidents. In other ways, emergency rooms are the last line of defense, serving as a critical catch-all for vulnerable populations who have nowhere else to go. How can doctors reconcile the tension between the desire to help others with the frustrating inability to address the many systemic causes of health problems encountered in the ER—homelessness, mental illness, domestic violence, substance use disorder, and more? Here to explore this question is Michele Harper, MD, an emergency room physician and New York Times bestselling author of the memoir The Beauty in Breaking, in which she shares her journey from an abusive childhood home to working in busy ERs. Over the course of our conversation, Dr. Harper discusses the unique challenges she faces as a black female doctor, how healing from her own trauma was key to connecting with her patients, and how the issues she encounters in the ER are a reflection of broader societal ills. 

As a content warning, this episode contains discussions of domestic violence and sexual assault, which may be uncomfortable for those who have experienced trauma or are otherwise sensitive to these topics.

In this episode, we discuss:

2:42 - How Dr. Harper’s experiences growing up in an abusive household drew her to a career in emergency medicine

12:40 - The limitations ER doctors face in managing the underlying causes of the health problems they encounter

17:38 - The importance of fighting for health equity and what that entails

27:41 - What the individual clinician can do to advance health equity in the US

31:44 - Contending with the reality of race- and gender-based discrimination within hospital systems

38:58 - Connecting with your “calling” when making career decisions 

44:23 - The importance of healing yourself in order to better show up for your patients

In this episode, we discussed Thich Nhat Hanh’s Living Buddha, Living Christ.

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