I Almost Didn't Come Back - Relaunching Scrub Talk

I almost didn't come back.

Not because I ran out of things to say — but because I started to wonder if any of it mattered. If the system was too broken. The people too far apart. The gap too wide to cross from where I was standing.

But here I am. And I think I finally understand why I couldn't stay away.

Scrub Talk is back. And it's different now.

Heads Up: 

The conversations on Scrub Talk are meant to inform and inspire, not replace medical advice. The voices on this show — including mine — come with strong professional backgrounds and even stronger opinions. That doesn't mean anything you hear is medical guidance for your specific situation. Always talk to your doctor or a qualified healthcare provider about your own health. We're here to explore, not prescribe. 

Transcript

Speaker 0:02

Hi everyone, I'm Dominick Ramos, and this is Scrub Talk. Okay, I'm back. I have been on hiatus for the last year, and I wanted to give you some context. Ever since I relaunched my academic journey, I have been grinding hard. I have been working full time and going back to school. Something I honestly don't recommend. For years, I've suffered with this anxiety and shame that I didn't accomplish my goals in a timely manner or line up to the standards that I set for myself. And in hindsight, I realized that maybe my standards and goals weren't so realistic, but oh well. These last five years, I've tried to make up for that time. I decided to pursue my bachelor's in health administration because I listened to my family talk about how much administrative and financial burden they had to keep up with. Like it would have been nice if they had had that training when they were in med school or nursing school. At the same time, I decided to work on the front line by getting basic clinical experience because I feel like getting into any graduate school nowadays requires so much more than what I was raised to think about: a high GPA, a great MCAT score, and maybe some extracurriculars with shadowing and volunteer work. Working in the healthcare system and getting your bachelor's in administration is not the optimal scenario, as tempting as it might be. There's just so much to unpack from my professional and academic experience. And as I move into the last year, I found that the field I was practically raised in is different. I remember the way my grandfather interacted with his patients. It was like watching two friends have a conversation over a cup of coffee. He had a natural ability to connect with people in that way over and over again. And that was his superpower. Medicine has always been, at its core, a human being sitting with another human being. And I know that sounds romantic. At some point, a person became a patient. A patient became a diagnosis. And a diagnosis became a code. If you walk into any doctor's office nowadays, you'll find that the idea of two people sitting with each other and having an organic relationship is far from the truth. Nowadays, it's all about the numbers, how many patients you see in a day, how many procedures you bill for. And you can see this replicated in other areas of life too. Take Chick-fil-A, for example. I remember when I was a teenager, and I would go after school with my friends, and we would go into the restaurant and eat. Drive-thrus were there, but they were also kind of an inconvenience back then. They were for people who were busier. And nowadays, in a post-COVID world, people are busier. The drive-throughs at Chick-fil-A have become a little more mainstream. Um, instead of using an intercom, they now have people standing outside taking as many orders as possible. It almost feels like an assembly line. And, you know, as a consumer, I personally don't have a problem with that because nobody likes to wait in a long line for food. But through my own experiences, and I've seen this mentality get adapted throughout healthcare. The reason why I bring this stuff up is because there was a point where I was becoming increasingly overwhelmed with work, with school, with all of it. At work, I was finding myself in really toxic environments where people would bully you and throw you under the bus just to survive. It felt like me being curious, none of it was enough. It felt like caring deeply was a liability. Like the more you gave, the more isolated you became. A lot of the time, it felt like our discussions were going nowhere. And it made me realize that there are many people who go into healthcare, healthcare leadership who don't understand the profession at all. For me, that's really annoying because I was raised in a family of doctors. And nowadays, there seems to be a lot of people who miss the point entirely. On the flip side, when I'm working in the clinic and taking care of patients, you can see that happen in real time. I've worked with people who thought they knew better than doctors because of the way the system had hurt them. And you can't argue against that because there's some truth to it. I have sat there as a patient and I've been totally disadvantaged by the system. And the first thing I reached for was blame, whether it was a nurse or a doctor or just anyone who happened to catch my line of sight. There was a point where I was ready to give it all up. I left the job I loved. I was exhausted. I was burnt out. And with everything going on in my personal and my family life, I was becoming more and more apathetic, more nihilistic. I was ready to move on. When I was working in oncology, I had developed a real rapport with a patient, the kind of relationship where I think he trusted me more than his own care team. And for months, everyone around him, from me to the nurses to his attending physicians, were trying everything to get him to accept treatment. He was hesitant. And honestly, I'll be straight with you, the treatment that we had planned for him was brutal. And it seemed like he just wanted to live his life on his own terms. And I had spent the better part of those months pouring myself into that relationship. And when he ended up refusing treatment, which was his right, I was devastated. I felt like I had let him down, as if all the work I had done had gone to waste. And later that same week, I was in class, and one of my classmates, a nurse, by the way, had sparked a debate about vaccines, about how bad they are for you. And I remember getting very upset because I thought to myself, here you are, a nurse, a trusted health educator. And you're making the claims that vaccines are dangerous. I was furious. And I ended up getting into a very heated debate with them. And I kept thinking to myself, how in the world did you get here? How did we let this happen? When I think about that moment, the first thing that came to my mind is, God, we're cooked. Society was at a tipping point for me. I had spent years trying to understand how we got here, trying to find strategies to build a better workforce, trying to get people on the same page. And it felt like I was fighting a battle I could never win. And so I came to a conclusion. This is not the field for me. This is not a place where I'm going to find fulfillment. But for some reason, I couldn't do it. I couldn't turn away. Maybe out of spite, maybe out of something more. I know that in a way I'm a masochist and I have this unflappable need to be there for people. I just couldn't shut it off. I found my way back because I couldn't stop asking the same questions that had almost broken me. I recently interned for a nonprofit where I participated in qualitative research. During my internship, I was tasked with sitting down with people from underserved backgrounds and asking them about their experiences, navigating the healthcare system. I went in expecting to hear about access, about cost, about discrimination. And yeah, all of that came up. But what I kept finding underneath those conversations was something I wasn't prepared for. Something more fundamental, more human. It turns out that people didn't just want better resources. They wanted to feel like they mattered to the people taking care of them. And there's this theme that I keep circling back to from one of my courses, a philosophy of technology course, where we learned that technology didn't just advance our understanding of the world, it consolidated power and authority in the few. It made the world more utilitarian, more efficient, and in doing so, more disconnected, more polarized. Throughout my time in this program, I kept trying to find the fix. If I just knew the lingo, if I understood the system, if I could think critically enough, I could mold it, I could make it better. But every lesson I learned, every debate I had, every patient I sat with, every personal and academic setback I experienced led me to the same conclusion. The healing profession is in trouble. And facing that reality, the mortality of it all, made me ready to walk away. I've been sitting with that for a while now, trying to figure out what that actually means. Because it wasn't a dramatic turning point for me. There was no moment where everything just clicked. For some reason, I just kept showing up to clinic, to class, to the research, to the conversations that frustrated me and still frustrate me to this day. And somewhere in all of that, I stopped trying to fix the system long enough to actually listen to it. What I kept hearing from the people I interviewed and from the patients I've worked with, from my own experience on both sides of this, is that we are all in some way experiencing the same trauma. We just don't realize it because the system has pointed us at each other instead of the actual problem. You ever see that meme of the two Spider-Man pointing at each other, trying to prove who's the imposter? That's exactly what we're experiencing today. And it feels like we're talking past each other and not with each. Like they were two friends catching up. Like time wasn't a commodity being rationed out in 15-minute increments. Like the person across from him was the only person in the world who mattered. And I don't think that was unique to him. I think it's what medicine has always been. I'm not naive enough to think that we can just go back to that. The system is what it is. The pressures are real. The assembly line is real. The burnout is real. I've lived it, and I'm still living with it. But I'm not ready to stop believing that we can get closer to it. And I don't think I'm alone in that. There are shows that explain the science, and there are shows that carry the stories. And I want to be in the place where those two things finally talk to each other. I haven't really found that place yet. And so that's why I'm here, trying to build it. That's what scrub talk is. I'm not here to give you the answers. I'm not a physician yet. I'm not a policy expert. I'm a medical assistant. I'm a student. And more importantly, I'm someone who's been on both sides of this thing. And I'm still figuring it out in real time. And I think that's exactly where I'm supposed to be. Because I know there's a lot of you out there who are figuring it out too. And you deserve someone who will walk alongside you in that, not talk down to you from a podium. A few weeks ago, I came across a creator on TikTok. He was going off about dermatologists, calling them clueless, calling them shills. And my first instinct was honestly to hurl my phone across the room. Um, I just rolled my eyes because he had no clinical training, no direct patient care experience. And what I found in doing my doom scrolling was that he also had his own skincare brand, which, come on, make that make sense. But something made me stop. And I looked closer. And what I saw underneath all of it wasn't someone with an agenda. It was someone who didn't feel like his experience mattered to the people who were supposed to help him. Someone who felt unseen by the system and found an audience to witness that pain instead. And I recognized that because I felt that. So frustrated and so unheard that I needed someone, anyone, to validate that what I was experiencing was real. The difference between me and him right now isn't that I'm right and he's wrong. It's that I have a framework for what's actually causing it. And he hasn't found that framework yet. That's the work. And that's what I'm asking you to do with it. So next time you feel dismissed by a doctor, by a patient, by a coworker, by someone on your timeline, before you react, ask yourself two questions. What's driving their behavior? And what do I actually have control over? That's it. That's where we start. Not with fixing the system, not with winning the argument, just those two questions. Because if we were speaking candidly, doctors and hospitals and healthcare, they're not going anywhere. And neither are the people who need them. So we can either keep pointing at each other or we can start making sense of this together. Thanks for listening. I'm Dominic Ramos, and this is Scrub Talk.