Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
We will recall when, during the summer of 2020, the moral and political duty to engage with the most momentous anti-racist movement since the 1960s reanimated a nation paralyzed by fear. By the fall, cataclysmic wildfires on the West Coast poisoned the air from San Francisco to New York City. Coronavirus, cultural upheaval and manifestations of climate change all bore down on us as we entered the most consequential and divisive national election in living memory.
His parents attended a parent-teacher conference with the hopes of encouraging his teachers to transfer him to the gifted track. After their inquiry, the principal explained, “It would be better for Chris to be in the remedial track, so he can see people who look like him.” This instance of racism would be the first of many for Chris, whose journey to medical school required him to rise above institutionalized racism and implicit biases.
I have become, in these last six months, a twisty little ouroboros. I eat my tail because it’s all I know, and I savor 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 health care 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.