Post-election, many of us in the medical field have become more aware of the somber sentiments expressed by the groups that were rhetorically and literally targeted throughout the election cycle. Many of us are women, immigrants, people of all faiths, people of color, refugees, disabled individuals and members of the LGBT community. We understand that policies and hateful rhetoric impact us, impact our colleagues, impact our families and impact our patients. We can see how the communities we serve have already started to be affected by this election.
I am heartbroken that this election has made many feel disenfranchised, scared and displaced, including many of my peers, colleagues, family members, friends and the communities that have shaped and supported me. I am heartbroken that there are people in this country who feel like their humanity is being ignored. I am heartbroken that one of our faculty members started to cry as she told her five year old daughter that “the girl hadn’t won.” We all know that this election was about much more than gender. I am heartbroken that the young men of color my classmates and I teach about cancer prevention are faced with messages that vilify their existence rather than nurture their potential. I am heartbroken thinking of my former intern who asked me if I thought it would be safe for her to continue to wear her hijab. I am heartbroken for the fifteen year old immigrant mother whose life was upended by rape and subsequent pregnancy. I am scared for her and her child’s immigration status and their access to appropriate support. These are not just statistics; nor are they stories to be told and forgotten. These are real people with whom we interact daily.
When you walk into your doctor’s office or the hospital, know that first and foremost we see your humanity. It is secondarily that we ask about your language of preference, your country of birth, your faith, your choice of partner and your family. We use these identifiers not to vilify or to pass judgment, but to discern how we can best serve you. We know that our views may differ from yours. We may disagree on many levels. But we also understand. We understand fear, frustration and setbacks. We empathize. We do not think that we are perfect and we try our hardest to preserve dignity, kindness, compassion and humility whenever we step in front of you.
Structural racism, oppression, violence and xenophobia disproportionately affect the physical, emotional and mental health of those that are the most vulnerable in our society. Changing the social determinants of our patients’ lives is one of the hardest and most frustrating aspect of our work. But let us not forget that we do hold a certain power and that we are in a position to advocate for social changes from a medical standpoint.
Activism starts locally and can make an immediate difference. At my medical institution, efforts to support women’s health groups, immigrant and refugee communities and the providers that directly work with vulnerable populations are underway. Collaborations with immigration lawyers and health policy experts help us to better support our patients. Medical schools and health systems have sent out policies and personal notes on the commitment of the institutions to health equity and protecting the dignity of all patients and providers. Some of these institutions are scheduling sessions with students to specifically explore the implications of the new government. Student led initiatives focused on de-escalation and peaceful protesting are being organized for the new year.
Part of advocating for our patients, colleague and our profession involves the overarching tenet that health care is a human right. Through direct advocacy, policy, patient care, service and research we need to uphold this tenet. Health care reform is a crucial part of this effort. The Affordable Care Act (ACA) is not without its flaws, but because of its implementation, the rate of uninsured individuals is at the lowest it has been in decades. As students, we need to be well versed in the nuts and bolts of health care policies so that we can advocate for the parts of the ACA that need to be upheld, such as the pre-existing conditions provision, and for those parts that need improvement, such as the consumer marketplace experience and rising costs.
To better serve our patients without bias, we need to invest in conducting qualitative and quantitative research on health care disparities. Working with interdisciplinary teams of public health centrists, anthropologists, and sociologists can help guide clinical and community practice. This is more urgently needed post-election because cross discipline research may allow us to directly tap into the communities we serve and include them as stakeholders in solving the challenging problems at hand.
It is imperative that we use our position of power to never accept anything that we could make better. Your silence is deafening and it is heartbreaking for our patients and our colleagues who are affected by the rhetoric amplified by the Trump presidency. Indifference is not an option, so let’s get to work.