Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative



“Powershield:” a poem about power and responsibility. 

I was in Africa 

The first time I felt the power that came from being a 

White doctor 


And I was horrified 

I tried to drop it on the ground like  

A live coal 

And my eyes were wild 

Like a mustang roped and brought to ground 

With the fear of what I had  



Power does that to us if we are conscious of it 

It’s terrifying because 

The consequences of holding power 

Are that your choices, small and large 

Even if you fail to make them 

Can hurt someone else 


I say this simply,  

As though it is simple 

But it is not 

Because I see so many people with 

Power refusing to 

Accept the consequences for their  



I can only assume they were unafraid 

When they got it 

Or maybe they never acknowledged they had it 

But I felt it one day, like a rope around my neck 

And I trembled 

With the knowledge of it 


There is a freedom in being a victim because at least 

You didn’t do the bad thing 

You couldn’t have done it 

You were powerless 

But I knew in that moment I would never really be the 

Victim again 

Instead I would be the perpetrator, or if I was lucky the rescuer 

Although that one can wear thin 


But I would always be something 


My mentor had been in Africa for a long time 

Maybe too long 

He saw it, saw me, saw my cowardice 

And he said, with 

Pitiless eyes 

Pick it up.  


Pick it up and put it on and  

Never forget 

That you have it. 


Be a shield. 


It was an order, and a  

World-weary confession 

Of the weight of it 



And I have never forgotten 

And now,  

You won’t either 


I’d graduated medical school and was studying at Stanford when I read a faded paper handout from a community organization. It was like a bomb exploded in my mind.  


“Privilege is commonly invisible to or taken for granted by people who have it. People in dominant groups often believe they have earned the privileges that they enjoy or that everyone could have access to these privileges if only they worked to earn them. In fact, privileges are unearned, and they are granted to people in the dominant groups whether they want those privileges or not, and regardless of their stated intent. 


I didn’t like the paragraph. It made me feel uncomfortable. I’d worked for my success, hadn’t I? How dare they invalidate my accomplishments. I’d always considered myself an underdog and suddenly I realized that I wasn’t anymore. Perhaps had never been. 


I’d always been able to see the things I was unfairly barred from. What I didn’t want to see, and what began to dawn with crystal clarity in my mind, were the things I’d unfairly been given entre to.  


The world is inequitable. All of us have inherited a history we didn’t create. We may perceive this clearly or be ignorant of it—willfully or through naivete. This poem is about how I learned to take responsibility for the power I had that I hadn’t earned.  


Doctors have disproportionate power in society. This power can be given to us whether we want it or not. Yes, we can be mindful of our claims upon it. We can decouple our personal identities from the power assigned to our role. We can mindfully empower our patients and other clinical staff. We can advocate for the disempowered and work to restore more balance in the future. But we should never forget to use the power that we have with restraint and compassion.  


To operate with privilege and power, and deny it, is to abdicate responsibility for the unasked-for weight of our actions.  










This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.