I have become, in these last 6 months, a twisty little ouroboros. I eat my tail because it’s all I know, and I savour my pain and confusion. I am always full and always empty and a little twitchy from all the coffee. We are one of the few medical schools in the country to push ahead early with in-person rotations during the pandemic.
Moreover, homelessness and COVID-19 both disproportionately burden marginalized populations — in particular, Black communities and Native Americans. When COVID-19 began spreading through the community, it came as no surprise that it would disproportionately impact those living in congregate homeless shelters. Overcrowded shelters, the inability to physically distance, and poor access to handwashing and hygiene facilities are coalescing for an unsafe environment that could accelerate disease transmission.
This unrest reached a high point in September, when nurse Dawn Wooten filed a formal complaint against Dr. Mahendra Amin, a Georgia physician working at an Immigration and Customs Enforcement (ICE) detention center, who she claims performed mass hysterectomies on detained immigrant women without consent. While the country reacted in shock, the reality is that coerced sterilization against communities of color is not new. The United States has a shameful history of exploiting Black and brown women’s bodies as part of a larger objective for population control rooted in white supremacy — and the medical field is partly to blame.
I wish it were different — / Dying patients, struggling hospitals, overworked healthcare workers, / topsy-turvy economies, politicized safety precautions, and the / uncertainty / of tomorrow.
Now, I am a fourth-year medical student standing at the foot of a tall ladder. The hierarchy of medicine requires that I follow some unwritten rules in order to climb. Throughout my training, I have gotten the sense that one of those rules is: avoid trouble, good or bad. Of course, now, doctors are beginning to find their voices through movements like White Coats for Black Lives. But as a young trainee, I sometimes feel the sentiment directed at James in 2018: shut up and doctor.
Rather than ask elderly poll workers to risk their health on Election Day, medical professionals and students can volunteer to work at polling locations. Health care professionals and students tend to be in a lower-risk population and are also well-versed in the public health practices critical to safely conducting an election during the pandemic.
It is not uncommon for transgender and gender non-binary individuals to be misgendered by health care providers or in the health care setting. This negatively affects their health and their relationship with their providers. Leaders in the field of transgender and non-binary health care recommend asking about a person’s pronouns and integrating pronoun introductions into the clinical setting.
You don’t have to sit in silence and painfully nod along with an attending’s racist, misogynistic lectures because you’re their medical student. You don’t need to pick the skin off your cuticles to stop yourself from replying. You don’t need to learn how to hide your grimaces behind your mask because you know you’ll have to listen to them attack your identity for the next several weeks.
So, what is planetary health? It refers to a burgeoning field focused on understanding the health impacts of human-caused disruptions of Earth’s natural systems, including climate change and environmental pollution. This also encompasses the immediate and downstream health threats from such disruptions, which have impacts on communities at the local level — Philadelphia is no exception.
As many urban academic medical centers have become the world’s leaders in research and patient care, their bordering neighborhoods have suffered through decades of disinvestment and economic blight. Medical students often receive their first years of training in hospitals that serve these disadvantaged populations. While the current focus on social determinants of health represents a rising cornerstone of medical education, what else do medical students need to know about inner city poverty?
Yes, unfortunately, I have become one of the 60,000 and rising daily cases in the nation. Yet, I am one of the lucky ones.
Medicine is a discipline that claims to be based on empirical and scientific truth about human nature. Instead, its knowledge and practice are often steeped in biases like racism. For example, medicine was used in the nineteenth century to justify slavery due to the “biologically inherent superiority” of White races.
Contributing Writer
John A. Burns School of Medicine
Maiya Smith is a third-year medical student at the John A. Burns School of Medicine in Honolulu, Hawaii class of 2022. In 2017, she graduated from Emory University with a Bachelor of Science in anthropology and human biology. She enjoys hiking with her dogs, surfing and macrame in her free time.
