The Observer Divide: What I Learned as a Cancer Patient and Systems Designer

Crossing Healthcare’s Divide

In the sterile environment of an imaging-guided biopsy room, I discovered the true meaning of being a bridge builder. As I lay there during my twelfth biopsy—what should have been a routine procedure turned into a nightmare—I confronted a harsh reality about our healthcare system. This experience could have made me feel bitter and led me to pursue legal action, as many suggested. Instead, it planted the seeds of transformation that reshaped my understanding of Dr. Martin Luther King Jr.’s enduring legacy.

The image of Dr. King crossing the Edmund Pettus Bridge in Selma stands as one of the most powerful symbols of the Civil Rights Movement. This bridge, where peaceful marchers encountered brutal violence, represents more than just a physical crossing. It embodies a profound choice: the decision to be a bridge rather than a barrier, to connect rather than divide, and to transform suffering into purpose.

Dr. King showed us that the most important bridges are built of compassion and courage. After experiencing a series of medical failings during my cancer journey, I was left with a haunting question: "What happens to those who cannot advocate for themselves? Would they have been able to overcome the barriers I faced?" This question became my "bridge moment," a catalyst that transformed me from a cancer patient into a healthcare innovator.

Dr. King understood that achieving progress requires more than just identifying problems; it necessitates building bridges across the divides that separate us. In healthcare, these divides are significant: they exist between providers and patients, between clinical research and bedside practice, and between world-class healthcare and the subpar care that many people experience. Drawing on my background in engineering and human-centered design, as well as my experience as a patient, I have chosen to develop solutions that improve care for others.

Defining the Observer Divide

Healthcare providers dedicate their lives to caring for patients; however, their extensive experience in delivering care can sometimes blind them to what it truly means to receive it. While they witness numerous journeys through the healthcare system, even the most seasoned providers experience healthcare from only one side of the hospital bed. Few have had to navigate the healthcare system while facing a life-threatening illness themselves. This separation between professional observation and personal experience creates a significant barrier to understanding the challenges that patients endure.

Receiving my cancer diagnosis through an impersonal email made it clear how advanced medical institutions can sometimes overlook the human being behind the medical record. This experience underscored how the clinical perspective can often miss profound human realities of illness. Just as observers watched marchers cross the Selma Bridge from a safe distance, healthcare providers can remain fundamentally separated from the lived experiences of patients navigating illness and the healthcare system.

The consequences of the observer divide are significant: nearly half of patients avoid seeking care due to negative experiences within the healthcare system. Just as Dr. King recognized that progress requires more than simply identifying problems, addressing this divide demands a fundamental transformation in how healthcare systems interact with the people they serve.

The Loss of Human Connection

At the heart of healthcare lies a vital element that the observer divide undermines: the human connection between providers and patients. When providers overlook this connection, it transforms what should be healing relationships into clinical transactions.

In their observer role, providers often reduce patient communication to a series of structured interactions, such as delivering diagnoses, explaining procedures, and prescribing medication. While conveying accurate clinical information is essential, this task-oriented approach overlooks the deeper human elements of care. The focus on "what" needs to be communicated overshadows the equally important "how" we communicate, leaving patients feeling processed, unseen, and dehumanized.

Dr. King recognized that genuine dialogue could only occur when people meet as equals. Similarly, meaningful healthcare requires providers to move away from a "dominant" role and engage with patients as equal partners in the healing process. The concept we often refer to as "shared decision-making" today misses this essential requirement for true partnership. To create healthcare interactions that genuinely support the healing process and achieve authentic shared decision-making, we must fundamentally shift from mere observation to active engagement and from clinical distance to meaningful human connection.

The Systemic Cost

Just as the civil rights movement gained momentum from personal stories rather than relying solely on statistics, effective healthcare reform should be grounded in robust data and a deep understanding of patients’ real-life experiences and challenges. To truly transform healthcare, we must create systems rooted in the tangible realities of the patient journey.

Yet, despite this important lesson from history, today's divide extends far beyond personal interactions and shapes the very foundation of our healthcare system. When healthcare providers and leaders design and evaluate systems based on their limited perspectives rather than incorporating patients' real-life experiences, they often prioritize superficial needs that may appear significant from an outside viewpoint but overlook what truly matters to patients.

When this narrow perspective influences healthcare policies, technologies, and metrics, the consequences can be severe. These advanced solutions and measurements, grounded in an observer's restricted understanding, tend to perpetuate the divide rather than bridge it, leading to unnecessarily complex and costly solutions that fail to effectively improve outcomes.

The Unequal Burden on Marginalized Communities

Historically and still today, those who design healthcare systems, create policies and hold decision-making power often come from positions of privilege. This privileged observer stance has become a significant source of marginalization in healthcare, where the gap between a provider’s observation and a patient’s reality can become a matter of survival for vulnerable communities. When individuals involved in designing and delivering healthcare occupy positions of relative advantage, their limited perspective often blinds them to the diverse needs, values, and circumstances of communities different from their own.

This creates a "double blindness" within the observer divide: providers neither fully understand the reality of patient experiences nor recognize how their perspectives are shaped by cultural assumptions. They may mistakenly view their experiences and assumptions as universal truths, leading to systems that work for people like themselves while inadvertently excluding others.

The outcome is a healthcare system that perpetuates disparities through privileged observers’ failure to recognize and respond to needs that differ from their own experiences. This blindness affects not just individual encounters but also becomes embedded in the very structures and processes of healthcare delivery, transforming what should be bridges to healing into systemic barriers that disproportionately impact vulnerable communities. Addressing this divide demands a fundamental shift in how we understand and deliver healthcare to marginalized patients.

Conclusion: Be the Bridge

When Dr. King stepped onto the Selma Bridge in 1965, he understood that crossing the physical structure was just part of the journey. The greater challenge was to bridge the divisions within human hearts and minds. Today, in healthcare, we face our own bridges to cross—bridges between observation and understanding, clinical excellence and the human experience, and the healthcare system we have versus the one we need.

My cancer journey presented me with a choice similar to the one Dr. King often described in his speeches: would I let my experience embitter me, or would I use it as a catalyst for change? The easier path would have been to retreat into anger over the dehumanizing treatment I received. The harder path—the path of the bridge builder—meant transforming that pain into purpose. This is the choice confronting everyone in healthcare today: to remain comfortable observers or to summon the courage to cross these divides and truly see the human beings who depend on us for care.

The modern-day courage required for healthcare transformation differs from the physical bravery shown on the Selma Bridge, but it shares the same essential quality: the willingness to step beyond our comfortable perspectives and risk genuine understanding. Dr. King taught us that the strongest bridges are not made of steel and concrete but of compassion and courage. When we choose to cross the divides that separate us—moving from observation to understanding, from clinical distance to human connection—we take meaningful steps toward creating a healthcare system that honors both the science of medicine and the humanity of healing.

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