Problems in Modern Medical System Embodied in Dallas Buyers Club

Human Immunodeficiency Virus and Acquired Immune Deficiency Syndromes (HIV/AIDS) refer to a series of conditions caused by the Human Immunodeficiency virus. (Sepkowitz KA, 2001) The origin of this disease is still undetermined. Although some medicines can alleviate the symptoms of patients and prolong their life span, there is still no medicine to cure this disease completely. This movie, Dallas Buyers Club, depicted the story of an AIDS patient in the mid-1980s of Dallas, Texas. This patient’s name is Ron Woodroof. Ron must fight against physical pain and strive to live longer. Meanwhile, he chose to smuggle drugs from Mexico by all means due to the tight restrictions in the USA. These drugs included peptide T and nutrition supplements, which proved to be effective. However, they were not approved by the FDA (Food and Drug Administration). He also distributed these drugs to other HIV patients to make money. Later, a Buyers Club based on membership was established by Ron. He named it “Dallas Buyers Club.” However, Ron was punished because of smuggling. Nonetheless, Ron achieved self-salvation in this process, and he was not philistine or arrogant anymore. In this paper, the author will explore how to establish a more friendly relationship between patients and doctors, correct the prejudice against HIV/AIDS patients, and reduce the discrimination against those people based on Dallas Buyers Club.

HIV/AIDS, retrieved from https://theconversation.com/four-big-insights-into-hiv-aids-that-provide-hope-of-finding-a-vaccine-86736

The most impressive and controversial topic in this movie should be the unhealthy relationship between patients and doctors. In this film, HIV/AIDS was torturing numerous patients. They need medicine urgently to soothe their pain. However, doctors must adhere to the instruction of the FDA. The only permitted drug of FDA was AZT (azidothymidine), which was proven to trigger a lot of severe side-effects later. In this case, patients must seek other methods to get effective medicine. Therefore, it seems that medical institutions should be blamed. Even if Ron had adopted many radical actions in the movie, including smuggling, establishing the Buyers Club, and conflicting with doctors, the audiences might find it difficult to hate him. On the contrary, he was almost a hero who dared to break the ruthless rules in the movie. However, this film had brought up a controversial problem: what caused the imbalanced relationship between patients and doctors?

Ron and Dr. Sevard, retrieved from Go into the Story

According to professor Koeck, multiple factors had undermined the relationship between patients and doctors (Koeck, 2014). First, the doctors are the representatives of the modern medical system. Compared with doctors, patients know much less about both medicine and the medical system itself (Koeck, 2014). Therefore, a wise choice for most patients should be adhering to doctors’ suggestions and prescriptions. However, the obedience of patients had empowered doctors and enforced doctors’ status. Once this relationship is broken, conflicts between patients and doctors seem to be inevitable. That explains why Ron was always arguing with Dr. Sevard in this movie, and the verbal violence can even evolve into physical abuse, too.

Second, the differences in health conditions between patients and doctors would further worsen the imbalanced relationship. In most cases, doctors are healthy and robust, while patients are feeble and fragile. As Davis stated, this comparison would engender “normality hegemony” and result in the abuse of power (Davis, 2017). To illustrate, “normality hegemony” means only healthy people can perform social tasks and feel superior in this way. In comparison, disabled people are not as competitive as so-called “normal people” and should be inferior in the stereotype. In some extreme cases, eugenicists even argue that we should eliminate people who are “inferior.” Nazi is precisely an example of “normality hegemony,” while people realize that eugenics was an excuse for the genocide of Fascist. Going back to the film, we can view Dr. Sevard had abused his power more than once and behaved as if he was more respectable than patients. To demonstrate, he even suggested Ron prepare for his funeral in one scenario. It is hard to believe that Dr. Sevard was genuinely concerned about Ron, and his words did hurt Ron. However, this scenario may keep happening in the modern medical system. This is such a poignant criticize.

Stigmatization, retrieved from https://www.ombudsman.hr/en/stigmatization-can-lead-to-violation-of-rights-discrimination-and-impair-the-efforts-in-containing-the-epidemic/

One topic that incited a lot of discussions is the discrimination and stigmatization of HIV/AIDS revealed in this movie. As mentioned before, HIV/AIDS is infectious and had caused numerous deaths in the world. There is no treatment to eliminate HIV/AIDS nowadays, needless to say in the 1980s. Therefore, the best method to avoid it seemed to stay away from patients of HIV/AIDS. Plus, in the United States, homosexual and bisexual men are more likely to be infected with HIV (AIDS info, 2020). Moreover, researches have proved that drug abuse is associated with HIV/AIDS tightly (AIDS info, 2020). On the one hand, people who abuse drugs may share injectors with others, while HIV/AIDS can be transmitted via blood. On the other hand, drugs can destroy the immune system and reduce the ability to deal with infection (NIDA, 2012). Thus, HIV/AIDS had been connected to homosexuality, drug abuse, and death tightly. It was more like a stigma than a disease for patients. In this film, the audience can observe the process of stigmatization through the change of Ron. In the beginning, he cannot believe he could be infected with HIV since he was a proud rodeo and a proficient electrician. He even used “faggot” to insult HIV patients. However, when he was confirmed that he was infected, he became the one who was discriminated against. People around him began to avoid interaction with him, also used some malicious words to hurt him. He was even fired by his employer and evicted from his house. This situation is pathetic, but it also denoted the deep-rooted stereotype toward HIV in people’s minds at that time: HIV/AIDS was equal to death, and HIV patients were like a walking stigma.

Nonetheless, the definition of “stigmatization” might be vague and variable. One reasonable interpretation was come up by Goffman (1963). He maintained that stigmatization means to categorize a man different or deviate from the standard criteria. In some people’s eyes, those patients “deserve their illness” due to their sexual orientation, behavior, or something else. The evolution of this discrimination might even result in symbolic and physical violence in society. Consequently, inequality among people would become worse and worse. Reflecting on the film, Ron was treated with indifference and suspect. Unfortunately, seldom did people around him understand that Ron was a patient, and he needed to be empowered.

Ron and Rayon, retrieved from https://www.cinemablend.com/Dallas-Buyers-Club-6555.html

Another controversial topic in this film is LGBTQ rights. And Dallas Buyers Club has depicted a more vivid transsexual character in the mid-1980s, Rayon. One thing that needs to be pointed out is that Rayon is not a transgender person since he did not accept any operation, as revealed in this film. However, her mental, sexual identity is female. It is a regret that the director, Jared, had mistaken this point. In the time of Dallas Buyers Club, even a gay man would be despised by people around him, needless to say, a male who dresses like a female and wear brilliant make-up. However, Rayon still treated other people with kindness and took care of Ron when he was sick. This did change some people’s stereotypes about transsexual people or force society to reflect on namely “normal” sexual orientation.

Rayon in Suit, retrieved from https://www.tumblr.com/search/film%3A%20dallas%20buyers%20club

Further, Rayon’s existence had implicated the hostile treatment of families. Rayon’s father was a bank manager at the top of society, while Rayon was a powerless gay person fighting against HIV. When Rayon was facing her father, the latter could not reconcile with Rayon on her sexual identity. Sadly, Rayon did not make through it in the end. Nevertheless, the suffering of Rayon had helped Ron to achieve self-redemption. He switched from homophobia to accept homosexuality. Rayon had enriched the content of the whole film. Also, this character would be a great model to discuss the inequalities faced by the LGBTQ group in this society.

Now that there are so many problems in the medical system, are there any solutions? The answer is definite. First, to improve the treatment quality of patients, we need to change the complicated and fussy modern medical system (Bayer, 2009). There are several alternatives proved to be valid, according to Bayer. For example, the “three by five” method, which was developed by Dr. Kim in South Korea, had provided antiretroviral to three million patients. Another technique that worked well is “informed refusal,” created by De Cock. According to De Cock, this method would reduce the effect on those who are HIV/AIDS negative but pay more attention to HIV/AIDS positive patients. (Bayer, 2009) As Bayer mentioned in the paper, the ultimate goal of modifying the current medical system is reconciling the conflicts between the public health system and human rights. Admittedly, there are fewer and fewer cases of Dallas Buyers Club in the real world. However, further modification may benefit the patients even more.

Narrative Medicine, retrieved from https://www.aamc.org/news-insights/narrative-medicine-every-patient-has-story

As for the care of HIV/AIDS patients, narrative medicine would be a useful instruction. As Charon maintained, the modern educational system would teach students to diagnose and operate in medical school. However, those students would not be taught how to treat patients with humanity (Charon, 2006). Also, the medical system further reinforced the imbalanced relationship between patients and doctors (Koeck, 2014). Thus, the ignorance and indifference suffered by patients in Dallas Buyers Club might exist widely in the world. While narrative medicine requires a doctor to collaborate with patients, help patients to reflect the disease, and validate their statements. Also, a doctor must be a great listener, according to narrative medicine. In some cases, doctors may even need to tell stories to patients. It may sound incredible for the first time. However, Charon had argued that this method would help the doctor to cultivate empathy and make patients feel respected (Charon, 2006).

Photo by Hush Naidoo on Unsplash

As mentioned before, HIV/AIDS is still highly risky for homosexual and bisexual males, as well as who are addicted to drugs (AIDS info, 2020). Therefore, it is always associated with stereotypes to some extent in ordinary people’s minds. The stereotype might evolve into insult shown in Dallas Buyers Club and even hurt the patients further. Carol Thomas’s work would be instructive for this phenomenon. First, the LGBTQ group is also regular people. HIV/AIDS are human beings, too. Even some trivial actions may help those patients a lot. For example, a more comprehensive understanding of diagnosis, some considerate small gestures to make them feel respected, and more subjective treatment rather than objective judgment (Thomas, 2000). The most important thing to remember is everybody deserves respect. Plus, the narrative medicine introduced before may also be an excellent supplement to the treatment of LGBTQ people. Take Eve, a female doctor in Dallas Buyers Club, for example. She was the colleague of Dr. Sevard. However, she earned respect from HIV/AIDS patients, including Rayon, the transsexual person. The reason is she was willing to listen to them carefully and show her empathy, instead of purely finishing a routine and giving proscriptions like Dr. Sevard.

To conclude, based on the real-life of an HIV/AIDS patient, Dallas Buyers Club had introduced some problems existing in the real world, including abuse of power, stigmatization of HIV, and stereotype toward LGBTQ people. The imbalanced power in the modern medical system had obstructed the relationship between patients and doctors. Also, HIV/AIDS is always associated with LGBTQ groups and drug usage, which formed a stereotype that “those patients deserve this disease.” Moreover, the widespread indifference and lack of empathy had hurt the dignity and feelings of the patients even further. However, several methods might be effective for the modern medical system. First, the “three by five” method and “informed refusal” method might be helpful to reconcile the conflict between the public health system and patients. Then, the narrative medicine would be beneficial to maintain a balanced relationship between patients and doctors. Plus, people must realize that both LGBTQ people and HIV/AIDS patients are ordinary people. They deserve the respect of society. Although HIV/AIDS patients cannot be eliminated thoroughly, it is not invincible.

References:

Koeck, C. “Imbalance of Power between Patients and Doctors.” BMJ, vol. 349, no. Dec15 10, 2014, p. 7485., DOI:10.1136/bmj. g7485.

HIV and Gay and Bisexual Men, March 23, 2020, AIDS INFO. Retrieved from: [https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/25/81/hiv-and-gay-and-bisexual-men]

NIDA. (2012, July 1). HIV/AIDS. Retrieved from: https://www.drugabuse.gov/publications/research-reports/hivaids on 2020, April 7

Davis, Lennard J, editor. “Introduction: Disability, Normalcy, and Power.” The Disability

Studies Reader. 5th ed., 5th ed., Routledge, 2017.

Parker, Richard, and Peter Aggleton. “HIV and AIDS-related stigma and discriminations: a conceptual framework and implications for action.” Social science & medicine 57.1 (2003): 13–24.

Ford, Akkadia. “The Dallas Buyers Club: who’s buying it?” Transgender Studies Quarterly 4.1 (2017): 135–140.

Bayer, Ronald, and Claire Edington. “HIV testing, human rights, and global AIDS policy:

exceptionalism and its discontents.” Journal of Health Politics, Policy and Law 34.3 (2009): 301–323.

Thomas, C. (2000) “Medicine, Gender, and Disability: Disabled Women’s Health Care Encounters.” Health Care for Women International, vol. 22, no. 3, 2001, pp. 245–262.

Charon, Rita. Narrative Medicine: Honoring the Stories of Illness. Oxford University Press, 2006.

Undergraduate student / Research assistant/ Always curious / Opinions are mine