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Last Reviewed on June 19, 2019, by eNotes Editorial. Word Count: 231

No Apparent Distress by Rachel Pearson, MD is the story of Pearson's gradual and horrified realization that many impoverished people do not get the medical treatment they need. Pearson's tale starts as she begins medical school at the University of Texas in Galveston (U.T.M.B.), right after Hurricane Ike hit in 2008. Pearson worked in various clinics in and around Galveston, and she began to notice that she and her fellow students were working to help diagnose patients that never received treatment. At one point, Pearson wondered if U.T.M.B. officials viewed the patients as little more than a collective training ground for medical students. Pearson notes that patients like these have not simply fallen through the cracks—this lack of care is the result of a deliberate decision. The president of her university later states that the school has no intention of treating people who don't have the financial means to pay for their care. The number of people in this position will only grow, contends Pearson, as the state of Texas neglects to increase Medicaid benefits under Obamacare (or the Affordable Care Act). Pearson also discusses the lack of safety nets in general for the poor and the ever-growing disparity between the very rich and the very poor. Finally, Pearson examines depression and burnout in herself and in her med school colleagues, a surprisingly common occurrence.

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