I only realized that I was an optimist on November 9. Crushing disbelief is cliche, and yet — as I walked home, hot-cheeked, through rain and yolk-colored streetlights just after midnight, past a dive bar where neighbors tallied states and feverishly refreshed fivethirtyeight — I felt trampled.
Gun violence as a public health issue is not a new phenomenon. In 2014 alone, there were 81,034 injuries and 33,599 deaths due to gun violence in the United States,which equate to 222 Americans injured, and 92 killed, by firearms every day.
Major sporting events like the Olympics and the Super Bowl are often surrounded with excitement and drama. This year’s Olympics in Brazil is buzzing with talk of the Zika virus. The Super Bowl was fraught with drama surrounding Beyoncé’s half-time performance. It seems like everyone has something to say about these topics. But, one thing spectators don’t talk about is an unseen drama that often surrounds major sporting events: sex trafficking.
In December of 2014, one week after the non-indictment of Michael Brown, in-Training published an article entitled “A Lack of Care: Why Medical Students Should Focus on Ferguson.” In it, Jennifer Tsai argued that the systemic racism rampant in our law enforcement and criminal justice systems also permeates our health care system, affecting both access to care for black patients and the quality of care black patients receive. Lamenting that the medical community was largely absent from the Ferguson controversy, she cited startling statistics of disparities in health and health care as part of her call to action. In light of the events last week in Louisiana, Minnesota, and Texas, it’s time to revisit this message.
I walk down Summit Avenue in St. Paul, Minnesota this evening, and it is packed with people. People grieving, people chatting, people holding one another, people holding banners and people giving speeches. July 7, 2016: a black man named Philandro Castile had been killed barely twenty-four hours ago by a police officer.
As I write this article, 49 people have been confirmed dead after a mass shooting at a popular nightclub in Orlando, FL, with an additional 53 reported injured. In recent times, similar shootings have occurred with frightening regularity. In 2015 alone, we can recount San Bernadino, California; Colorado Springs, Colorado; Roseburg, Oregon; Chattanooga, Tennessee; and Charleston, North Carolina. People are being killed in unprecedented numbers, yet we have a poor understanding of the disease that is taking their lives. Gun violence is now a concerning public health issue and it begs the question: where are the patient advocates?
Among my professor’s stories from Lima, the chicken dinner story haunts me most. It features two students from his time as a middle school teacher in one of Lima’s most dangerous outskirt neighborhoods. A young teacher working at a Fe y Alegria school in North Lima, my professor, Kyle, had promised to take them anywhere they desired for dinner in exchange for exam success. The students requested chicken, standard Peruvian celebratory fare.
Though they make up 5.6 percent of the US population, discussions about Asian-American health appear to be few and far between. According to the Asian-American Health Initiative, a variety of medical and public health scourges disproportionately affect the Asian-American community. Some of these disparities entail disease incidence, while others describe a paucity of certain preventive health measures being delivered to this group.
During our many years of medical training, we study complex physiological processes running the gamut from acute sepsis to the equally devastating progression of chronic diseases. We spend countless hours in lectures and on the wards, attempting to gain exposure to proper medical management of bread-and-butter medical problems as well as more obscure diseases which may only affect a handful of patients annually. However, most medical schools neglect to teach one crucial area of expertise — training in advocacy skills to address social determinants of health.
Gun violence is a public health crisis. On your average day in America, 297 people are victims of gun violence. They are shot in murders, assaults, suicide attempts and completions and police interventions. 89 of these victims died — seven of which were children. In the first 90 days of 2016, there have been 57 mass shootings. Your average American is now equally as likely to die via firearms as in a car crash.
In March 2016, six medical students at Harvard Medical School launched #endstep2cs, an initiative aimed to garner support for the termination of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) that is currently administered to medical students prior to graduation. This past week, we talked with Christopher Henderson, one of the organization founders, and Dr. Peter Katsufrakis, the senior vice president for assessment programs at the National Board of Medical Examiners (NBME), to discuss the faults and merits of both the CS exam and the student-led initiative to end it.
Almost every morning, one of our physiology lecturers asks a question. Usually, it’s a question to which most of my 200 classmates would know the answer. Every day, the professor asks their question, often losing their rhythm in the twenty seconds it takes to shake an answer out of us. The silence lingers until finally they get a response, often whispered like an embarrassing secret by someone sitting near the front. The timid self-consciousness on display in this small ritual is a major part of the socialization that happens in medical school.