Narrative Inquiry in Bioethics

I hope that future physicians read my story and become inspired about not only what kind of setting they would like to practice in, but what kind of physician they would like to be. My name is Joseph Asaro, and I am a board certified General Surgeon in Kingstree, SC, which is one of the poorest communities in the country. In Williamsburg County, the majority of the population are African American and on welfare. Being the only general surgeon in the area gives me great pride in taking care of this tremendous community need. My work includes general surgery cases, including Appendectomies, Cholecystectomies, Bowel Resections, Mastectomies, Ventral, Umbilical, and Inguinal Hernia Repairs, Mass Excisions, etc. I am also the wound care director for the hospital, and I have dedicated time in the wound care center for acute and chronic wounds, including surgical, venous stasis, diabetic, and pressure wounds.

I attended medical school in Dominica at Ross University, where the population is also quite poor. While the island was beautiful and often referred to as “the nature island,” I spent very little time [End Page 90] exploring the island and 99% of my time studying. I was determined to learn as much as I could to one day have the opportunity to become the best physician I could be. Anatomy was by far my favorite area and loved spending time in the lab and teaching other students while learning at the same time. We did our pre-clinicals in the community, which was made up of predominantly African American patients who lived quite poor but were some of the nicest and most appreciative people you will ever meet. They were so happy and grateful for your time and that you were willing to help them. Learning in this poor environment would eventually shape me as a physician as well as a person.

All of my basic science courses were done on the island, and I completed my clinical rotations in New York where I have many relatives, so I was able to stay close to family and rotate through many different hospitals in the area. My general surgery rotation was also in a poor community in Queens, NY at a hospital called Mary Immaculate, which has since closed. There I watched the surgeons perform many different procedures, take care of the sickest patients both surgically and medically, and be relied upon for many different areas of medicine. That is when I knew my destiny was to be a surgeon. The patient population was similar to what I experienced on the island.

I went on to complete my general surgery residency in Buffalo, NY. There, I had a great variety of cases and patient population from the cancer center downtown (Roswell Park), the trauma center in a poor community (ECMC), the VA hospital close to the medical school, and a suburban hospital where we saw bread and butter general surgery. I chose not to specialize because of the great variety of cases general surgeons see. My five years there were the most influential of my life as I not only learned so much mentally and technically in my field, but I met my wife, who was an ICU nurse in the trauma hospital.

I chose to take my first job in Charleston, SC shortly after getting married because of the location and the experience of the other surgeons already in the practice. The practice was owned by a corporation and was located in North Charleston, SC where there was an abundance of general surgeons. The patient population between this hospital and the hospital I work at now is quite different. In a non-rural community, the patients almost all expect fast and good care, while in a rural setting the patients are much more appreciative and thankful for your time and good care, similar to what I experienced while in rural settings in medical school and residency. The corporate scene was more like an assembly line, numbers first setting, although I did learn quite a bit for the 3 years I practiced there, both skill-wise and business-wise.

I started having children (3^rd on the...