Privilege
My initial breast cancer diagnosis came 6 weeks before I was scheduled to lead a student trip to Nicaragua. I was determined to go. I rushed through surgery and felt well enough to make the trip. I wasn’t able to zip-line with students, but I could live with that. The hard part was when we reached Leon where I had visited on a previous trip. I was familiar with the health care system and the lack of resources. I had spent time at the teaching hospital and had become friends with several of the doctors. Seeing them again was a stark reminder of my privilege. My cancer had been picked up on a routine mammogram. There was no such thing as a routine mammogram there. A woman was considered privileged if she had one mammogram in her lifetime. A breast cancer diagnosis usually came when the cancer was at an advanced stage. Survival was rare. I was struck with survivor guilt.
Survivor guilt or survivor syndrome occurs when someone survives something that others did not. The survivor asks “why me,” and feels intense guilt. I felt guilt and shame in Nicaragua. My friends were happy for me, glad that I was healthy, but I felt shame. Why should I have healthcare access when they did not? It was all so unfair. It was a harsh reminder of something I had been aware of all my life: disparity, particularly healthcare disparity.
Privilege and disparity are hot topics now because of COVID-19 and recent social unrest. More people of color are seriously ill or dying from the pandemic. This disparity cannot be explained simply by race or preexisting conditions. It goes much deeper. White women are more likely to be diagnosed with breast cancer than black women, but black women are more likely to die as a result of that cancer. It doesn’t have to be that way. We have a lot of work to do to eliminate disparity and equalize access to care and care outcomes. The first step is to recognize historical privilege and to use that privilege (those of us who have it) to make changes. We need to keep in mind that effective change will only come when all voices are heard and respected. My question to readers is: what can you do to help eliminate disparity? Pick your piece of the action, one that matches your passion, and run with it.