Medicine, Politics, and Helping Others Theme Analysis

At the time of their motorbike trip across South America, Ernesto and Alberto are studying to become doctors in Buenos Aires, a wealthy city in which the average middle class citizen has access to sophisticated medical care and training. However, their journey through remote parts of the continent reveals to them that modern medicine is rare or nonexistent for many of their countrymen. Witnessing the disparities in medical care across South America teaches Ernesto and Alberto the promises and limitations of modern science. Even small improvements in medical care for the impoverished can dramatically improve people’s quality of life, and Ernesto is proud when he can provide care to those he meets. But individual efforts alone cannot fix unequal access to care; only a change in the political system that undervalues poor people can ensure equal treatment for all. The benefits of modern science, he concludes, will remain limited and unequally shared if the society’s underlying political system is unjust. Thus, Ernesto’s compassion for the circumstances of those he meets leads him, at first, to give medical care to the poor, but then to turn his attention to politics. 

Initially, Ernesto and Alberto believe that modern science alone can solve the public health problems they frequently encounter. The two men often meet people so lacking in basic medical services that even though Ernesto and Alberto aren’t fully qualified doctors, they are able to provide tangible help. For example, patients in the underserved leper colonies they tour are ostracized by the local communities because of superstitions surrounding the disease and misconceptions about the risk of transmission. Because the two men have a scientific understanding of the disease, they are able to give a “psychological lift” to the patients by shaking their hands “as we would shake anybody’s,” by playing football with them, and treating them as people with dignity rather than outcasts. Ernesto also views the doctors who work in the leper colonies as role models, remarking on the sophisticated research they do with few resources and admiring their commitment to a field that mainstream society does not value. This admiration marks a change in the two men’s personal behavior. At the beginning, Ernesto professes himself already “jaded” with the medical profession he’s preparing for, and uses his status as a medical student chiefly as a tool by which he and Alberto can quickly obtain respect, assistance, and free drinks from unsuspecting townspeople who believe they are real doctors. However, as he begins to understand how desperately rural communities need medical care and how much even a half-trained doctor can help, he begins to truly grow into the role he adopted as a farce, seeking out doctors wherever he travels and providing care to people who need it along the way. In this part of the memoir, Ernesto’s focus on the things doctors can achieve makes it seem like the efforts of educated and well-intentioned individuals can be a solution to the social crisis of unequal healthcare.

However, eventually Ernesto realizes that it is impossible for individuals to provide sufficient healthcare, especially to the poor, without the backing of adequate social services. In the leper colonies, Ernesto notes the that due to the neglect of government and local communities, patients live in “disastrous” conditions and the facilities are bug-ridden lack surgical equipment. Conditions like these prevent doctors from providing more than the most basic care. In another instance, Ernesto attempts to treat a poor woman’s asthma and realizes how little he can actually do to help her. While Ernesto also suffers from asthma, he can buy inhalers which allow him to go about life unimpeded. Since this woman has no access to innovations like these, he can only provide a stopgap by giving her some asthma pills he knows she’ll be unable to replace.

Ernesto argues that if health care is unequally distributed, it works to heighten class disparities rather than reducing them. As a member of the middle class, Ernesto doesn’t let asthma prevent him from attaining an education, making a living, or even going on vacation. However, this treatable ailment derails the poor woman’s entire life. By preventing her from working as a waitress, asthma drastically decreases her economic status. In her hardscrabble community, this affects her social position and even basic family relationships. Her inability to contribute makes her “a purely negative factor in the struggle for life and, consequently, a source of bitterness for the healthy members of the community.” Although they deal with the same illness, this woman faces a set of dire consequences Ernesto has never had to consider.

By the end of the memoir, Ernesto comes to understand that poor healthcare is part of a broader crisis of a political system which both fosters and depends on inequality. Modern science cannot provide real benefits to the poor without radical change in the government. Ernesto makes more and more explicit connections between individual medical cases and political injustice in general. For example, the chapter about the asthmatic woman begins as an explicitly medical episode but ends with Ernesto realizing the broader “injustice” of the political system and commenting on the “profound tragedy circumscribing the life of the proletariat the world over.” The leper colonies also showcase this revelation. Because lepers are a particularly powerless and despised group, society (and the ruling class that decides how social resources are allocated) explicitly denies them social services and ostracizes them, just as it implicitly does the proletariat. Contrary to Ernesto’s initial impression, even the most well-intentioned individuals with the best scientific training cannot ameliorate the plight of these people. Only wider social change can accomplish that.

Ernesto’s experiences as a medical student and faux-expert on leprosy both inspire him to serve those less fortunate than him and change the way in which he intends to do so. While he begins the trip taking his access to the benefits of modern science for granted and regarding the medical profession as a vehicle for personal advancement, Ernesto comes to realize the importance of his profession in extending access to science beyond the upper and middle classes. However, he also realizes that working toward this goal as a doctor is not enough. Alberto is seriously considering a job as a leprologist by the end of the book, but Ernesto declares himself ready to be “immolated in the genuine revolution,” committing himself to much more drastic action. His experiences with medical care on the road ultimately galvanize Ernesto’s shift away from the bourgeois world of his youth, towards radical activism. Rather than doing good works as a doctor, he will become a revolutionary.