And yet so many of these areas are medically underserved. Rheumatology deserts dot the map, not just in rural regions but in urban centers as well. Disparities in access aren’t limited to geography. They intersect with ethnicity, income, disability and more. If we want to expand our impact and keep these communities connected, we must look beyond our own clinic schedules and begin advocating for system-level solutions. Not surprisingly, that was also a theme at this year’s ACR Convergence.
Looking back to the highway, the clouds were layered like curtains, rippling and gray. They moved quickly, pushed by fierce gusts that made my car shimmy from side to side. Thunder growled somewhere in the distance. It was beautiful and terrifying all at once. Nature was reminding all of us on the road who was truly in control. And it was warm. Too warm for late October in the Midwest. Only a decade ago, this same weekend would have likely seen frost on the ground and, potentially, snow. I remember first arriving in Iowa a decade ago and seeing children in heavy coats covering their costumes while trick-or-treating. Now that seems quaint in the midst of a late October rainstorm. I couldn’t help but wonder how these changes would affect our patients’ health and that we need new strategies to build our resilience.
Coming Home
Crossing the Mississippi River into Iowa, the storm still swirled around me, but seemed to ease. The bridge arched gently over the water, and a billboard welcomed me to my current home state. As clouds parted, the sun was directly ahead of me. The journey was nearing its inevitable end.
Eastern Iowa’s rolling hills greeted me with familiarity, even though, quite frankly, they don’t look very different from the ones in Illinois. My heart beat a little faster, not from caffeine, but from the anticipation of being reunited with my family. Work is clearly important, but it is never the whole of who we are. I was eager to share stories, laugh over spilled coffee and simply be present.
Still, I had to stop for gas. Even with momentum, we need moments to refuel. The pit stop was a great reminder that none of us can run on empty. As was mentioned in the opening session by Tait Shanafelt, MD, self-care isn’t an indulgence, but a necessity. As I filled up the tank, I thought about all I had seen and felt over the past few hours. From gridlock to tollways, from suburbia to silos, from storms to silence. There were certainly many things I learned at Convergence within the lecture halls and plenary sessions, but I would contend that I learned a lot in the otherwise idle moments in the car as well.
