Frank Baudino has been a physician specializing in Family Medicine for the past forty-two years. He believes strongly in medical volunteerism. His Field Notes essay “Her Eyes” appears in our Fall 2022 issue.
Moral injury can occur when someone “engages in, fails to prevent, or witnesses acts that conflict with their values or beliefs.”
My Field Notes piece “Her Eyes” (Intima, Fall 2022), describes an infant under my care in southern Sudan who was saved from malaria and dehydration. Many of my patients’ outcomes were less favorable. I was working in a “resource poor” environment: no x-ray or operating room, minimal lab, few medications. My own competencies in tropical medicine and surgery were limited. My moral injury stemmed from the blunt realization that patients I lost in Sudan could have been saved in America. The enormous abyss between medical care in rich countries and poor countries weighed heavily on me. Then, as now, I still see the children I lost.
Jeffrey L. Brown, M.D., describes a similar feeling of moral injury in his essay “The Moral Matrix of Wartime Medicine” (Intima, Fall 2015). He served in a war zone where psychological survival “required a decision to make do with what they had—not what they wished they had.” It brought him to a place where “[t]here were no ‘right’ answers.” One year after graduation, he was thrust into front-line combat medicine.
Healthcare workers in 21st century America face a new source of moral injury. The Supreme Court decision in Dobbs v. Jackson Women’s Health Organization (2022) placed thousands of pregnant women at increased risk for injury or death due to state-by-state restrictions on provision of safe, legal abortions. Healthcare providers face the double dilemma of risking prosecution by choosing to provide potentially lifesaving care or choosing to protect their own licensure and the continued ability to deliver healthcare to others. Ironically, healthcare in America has become an issue of politics and geography rather than compassion, justice and necessity.
Frank Baudino has been a physician specializing in Family Medicine for the past forty-two years. He practiced in Merced, California, for 30 years and then moved to Aptos, California, where he did volunteer work with Salud Para La Gente, a rural health clinic in Watsonville serving largely a Latinx population and Elderday, an adult day health care center in Santa Cruz. He believes strongly in medical volunteerism and has worked in southern Sudan with Doctors without Borders, in Guatemala twice with Catholic Healthcare West, in Haiti twice with Remote Area Medical, and most recently in Mexico at the southern border cities of Reynosa and Matamoros providing medical care to refugees from Central America. His Field Notes essay “Her Eyes” appears in our Fall 2022 issue.