Grace Inbae Kim gikim@post.harvard.edu Medical School Personal Statement Medicine is a social science.

This aphorism of social medicine by Rudolf Virchow connected the chasm I felt existed between the hospital ward and the rest of society. The metaphor had married the seemingly incompatible. The winding circulatory system, with a vast maze of capillaries, resembled the streets of urban jungles. The vibrio cholerae in a childs intestine causing profuse diarrhea were linked to global capitalism resulting in sometimes perverse outcomes. Physiological processes maintaining homeostasis paralleled economic policies for a social safety net. The neurological signals of the limbic system were mechanisms for a womans face of despair while begging for change in the New York City subway. I came face to face with this woman one warm evening last July. She had tubes running out of her nostrils to an oxygen tank by her side and took wheezy breaths, with one hand extended for change and the other wiping the tears from her cheeks. Unable to turn away, I found out that the woman, named Iris, needed the change for food. The train came to a halt, and I took Iris to a local McDonalds so she would at least have dinner that day. While she nibbled at a chicken sandwich and sipped a fruit smoothie, she shared that she had worked as a housekeeper since moving to the U.S. from Puerto Rico, until she was hospitalized two months ago for a musculoskeletal disorder and emphysema. At the hospital, she suffered from panic attacks because of her precarious financial situation, but was soon discharged with the oxygen tank after primary treatment. Unable to find work or qualify for disability insurance, she could no longer pay rent and resorted to sleeping on subway cars, unwilling to enter a womens shelter. She said her local welfare office required a New York City address for eligibility for food stamps and cash assistance, and her former landlord required $140 in return for two weeks of rent and the rights to the address. In a clumsy attempt to help, I called 311, the citys hotline, which referred me to Homeless Services, which referred me to Common Ground, which referred me to the number for Catholic Charities, and I left a message. Feeling overwhelmed by the bureaucratic morass and the weight of my own wallet, I pulled out $140 in $20 bills, which I folded into a piece of paper with my phone number and handed over, with skeptical hope and words of encouragement. I clearly remember this encounter with Iris because I had started my position as a case manager for home health aides that same day. Ive since encountered scores of similar stories of personal and familial sicknesses and deaths, of struggling immigrants, of generational poverty, of quiet desperation in the face of biological and economic forces. I have familiarized myself with GED programs, social service agencies, training programs for health care paraprofessionals, and welfare and Medicaid offices. I provide vocational counseling, referrals and financial assistance to combat unemployment and urban poverty. I encourage promising home health aides to pursue careers in nursing. Most of their patients, many of whom are also on Medicare/Medicaid, are victims of the epidemic of non-communicable diseases, including diabetes, cardiovascular diseases, cancer, stroke, Alzheimers, and dementia. Several months after that July evening, I ran into Iris again. Her oxygen tank was gone, but she still looked adrift in the crowded subway station. As I was in a rush to a meeting, I simply

handed over my business card and told her to contact me about working as a home health aide. I have yet to hear from Iris, but those chance encounters on the subway stand as glimpses of the rewards and challenges of service. In diagnosing and working to treat the social needs of my clients as a case manager, Ive developed a perspective born of days of directly providing services. This experience has reified policies that I had before only encountered in texts. It has also solidified my desire to become a doctor who truly cares about the world while caring for the patient, and keeps the patient in mind while having a voice in policy discussions. In college, I studied economics and science to gain the skills needed to help fight global poverty and eliminate preventable deaths. I learned about economic models to explain social phenomena, the intricate structures of the human body, the mechanisms of life and disease, and the physical laws of the universe that intimately connect humans and nature. My studies, research, shadowing and work experiences convinced me that clinical service and health policy are inextricably linked. I wish to enter the medical community as a physician to improve health by directly caring for patients and illuminating optimal policies for saving lives. The opportunity to work with other health care providers, to study the contributions of generations past, to transmit knowledge to posterity, and help patients at vulnerable and critical junctures in their lives, compels me to pursue work in medicine. Another quote by Virchow, Physicians are the natural attorney of the poor, encapsulates my desire to serve patients, like Iris and countless others who suffer from both economic and medical ills, in my lifes work.
Revised 6/10/2011