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A Piece of My Mind
January 22, 2019

We Are All the Same

Author Affiliations
  • 1Family Practice Center, Mifflintown, Pennsylvania
JAMA. 2019;321(3):249-250. doi:10.1001/jama.2018.21366

As neighbors gathered around their Christmas trees, Mrs Martin worried about her newborn child. None of her seven other babies had been so disinterested in nursing and not a single one had been so limp and quiet. One week postpartum, she wrapped herself in a thick black shawl and trudged the half mile in the snow to my sister’s door to seek help.

My sister, a nurse, was surprised to see Mrs Martin. As part of the Old Order Mennonites, deeply faithful and private people, the Martin family denounced all things modern. They lived on a farm with no electricity or indoor plumbing. Visits to the doctor were few and far between, and modern medical care, even for childbirth, was simply not part of their culture. The baby boy had been delivered by a midwife who cleaned and weighed him. After laying him on his mother’s breast, she promptly packed her things to attend to another expectant mother. Hearing the panic in Mrs Martin’s plea for help, my sister immediately picked up the phone. Skipping the holiday greeting, she tersely told me, “Get your bag and come over here as soon as possible. The neighbor baby is very sick.”

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    1 Comment for this article
    The Privilege of Sharing Grief
    Susan Ivey, MD, MHSA | UC Berkeley School of Public Health and UCB-UCSF Joint Medical Program
    Dr. Maneval: Thank you for sharing this beautiful story. As a mother, as a physician, it delivered a spectrum of emotions and memories for me of how cultures can collide as we care for families, and yet how, in this case, you could be simply in the moment with the Martin family and their baby. You made the quick decisions that had to be made, and demonstrated that your sister and you would sacrifice to move this baby to the care needed, able to look past any differences in culture, religion, class, education - though certainly those were there. To see the bond this created, one that the Martin family then reciprocated to your family in your own time of grief, is a precious lesson in our fundamental humanity, underlying all of our fears, hopes, sorrows, dreams. It also harkens back to gentle ways in which women have practiced mid-wifery and medicine, even when we were denied official titles, while also reminding us of the advantages our high technology conveys in dire medical situations. Thank you for reminding us of why we go into medicine. It is to have bona fide connections with others in times of crisis, to be capable of helping and comforting as you did. You give me hope that we can find a way through the systemic inequities, inefficiencies, and bureaucracies of the US health system at this precise moment in time. Some days we all need that hope.
    Susan L. Ivey, MD, MHSA