This blog has been in the making for a month. I moved, settled into an apartment, completed pre-employment requirements, and learned my new neighborhood. I know, you’ve missed me. At least I hope you have. This post serves as the official start of this journey; matching into a pandemic, though probably not the pandemic we immediately think about. Tomorrow and Tuesday will be my department orientation and Wednesday is…well, the day. First patients. First rounds. First orders.
COVID-19 continues to ravage its way through the population of this country and the international community. While in New York people are catching their collective breaths and trying to wrap their heads around a new normal, total U.S. cases are skyrocketing. You don’t need me to repeat these facts. They’re waiting for you on the news daily. Wash your hands. Wear your mask. Stay socially distant. I know how tired you are, but pace yourself. Remember this is a marathon, not a sprint.
This post, however, started a month ago as a reflection on activism and its role in healthcare. June is Pride for the LGBTQ+ community- a time to reflect on where the community has been, to plan and work for where we have left to go, and to celebrate our best and truest selves. In full disclosure, I am a member of this community and this month brings a host of emotions alongside it. But this is not a foray into my personal inclusion in the community, but rather my professional one.
Larry Kramer died earlier this month. For those of you who don’t know him, Mr. Kramer was a playwright and AIDS activist, a huge voice for those who live with HIV and AIDS. I encourage you to read about him, learn of his activism, read and see the recorded productions of his plays, particularly The Normal Heart. But what caught my eye, and first spurred this post, was a New York Times article about Mr. Kramer’s friendship with Dr. Anthony Fauci.
You see, this isn’t Dr. Fauci’s first rodeo with an infectious disease; when people say he’s been doing this for 40 years, they mean that literally. With the passing of Mr. Kramer, Dr. Fauci was asked to reflect on his relationship with the man over 40 years of the AIDS epidemic. Dr. Fauci spoke of how Mr. Kramer never let him off easy, would push for more action, more resources, more acknowledgement of the virus decimating a generation. Yet the two were friends, often sharing dinners and developing a close relationship around the same struggle of getting society to understand what was happening.
It emphasized that medicine will always be intertwined with activism. If you intend to treat a disease, you look for the root causes of the disease. So often, those causes are not biological. Broadly, we define them as the social determinants of health; they can play out in innumerable ways. Your closest doctor could be half a day’s travel away, requiring a day off work and possible loss of pay for an appointment. You could be trying to manage diabetes with a healthy diet, yet all too often fast food is economically more affordable than fresh fruits and vegetables. This is all assuming you have a job that provides health insurance or the accessible money to see a doctor and pay for medications.
If we as a profession want to promote total health and wellness of our patients and our communities, we had better get to raising our voices.
All of this became even more urgent as the month progressed. And honestly, this is where my words fail me a little. I have been trying for weeks to write this part, doing my own reading and research prompted by the protests against police brutality and in support of Black Lives Matter. Previously in this blog, I’ve spoken of my father who is a retired police officer and the pride I have in his service to my hometown; that hasn’t changed. What has become so painfully obvious is how the system is stacked against portions of our population. And it’s not broken; it was built that way.
On top of this, what has become so painfully obvious is how little I know. This week, I will start practicing medicine where the majority of my patients will be people of color, speaking different languages, facing inequalities like those social determinants of health. And I don’t know nearly enough to promote their total health and wellness. Thankfully, I’ve always been a fan of libraries, books, and learning. Thankfully, I have friends, colleagues, and family- including my dad- willing to talk through things. So as I continue to learn medicine, I’ll be learning the history I never did before, the socioeconomics I never did before, and the activism I never did before.
After all, we need it now more than ever. This month, we’ve seen the current administration reverse protections that prevented healthcare insurers and providers from discriminating against transgender people. We’ve seen people step up and amplify the voices of communities silenced for a long time. The communities of our most vulnerable populations- facing health inequalities, economic inequalities, justice inequalities- being talked about now more than before. For as Gandhi said, “The true measure of any society can be found in how it treats its most vulnerable members.”
Happy Pride…the work continues.