Two pandemics

The world we live in is being dramatically shaped by the COVID-19 pandemic. There is new information coming out every day, new policy changes, and more people sick and dying from the disease. As a student of medicine and simply as a human, it has been overwhelming to try to keep up, to help. I am by no means an infectious disease or public health expert and so I have tried to leave the education to much smarter people than me. But I will say, please continue to take it seriously, stay safe, and care for those around you.

A good resource that is updated daily is the American College of Physicians COVID-19 resource guide.

Additionally, please check out the recent piece from the American College of Physician leadership entitled The Collision of COVID-19 and the U.S. Health System. A particularly meaningful quote from this article is:

‘This pandemic has ripped the seams of the U.S. health care system wide open, thrusting front and center our health care inequities and injustices.’

It is time to make a change.

Please note that I have held volunteer positions in the American College of Physicians, including Chair of the Council of Student Members, but on this site I speak for myself and myself only.

The second pandemic has been going on much longer. It is racism. Racism is a barrier to health equity and is a public health crisis. There are many different types of racism (definitions from the Alberta Civil Liberties Research Centre):

  • Individual racism: “An individual’s racist assumptions, beliefs or behaviours and is ‘a form of racial discrimination that stems from conscious and unconscious, personal prejudice'”. This is learned from /connected to our culture/history and can be expressed in many ways (definitions adapted from @DaniBeck on twitter – link to thread):
    • Micro-assaults: Explicit expressions meant to hurt others (example: wearing confederate flag clothing or saying “go back to where you came from”).
    • Micro-insults: Insensitive communication that is demeaning (example: an employee asking a colleague of color how they got their job, implying they may have landed it through affirmative action).
    • Micro-invalidation: Ignoring the psychological thoughts, feelings, or experiential reality of a person of color (example: asking “Where are you really from?” after someone has already answered the question)
  • Systemic racism: “Includes the policies and practices entrenched in established institutions, which result in the exclusion or promotion of designated groups.” Subsets of this are:
    • Institutional racism: “Racial discrimination that derives from individuals carrying out the dictates of others who are prejudiced or of a prejudiced society.”
    • Structural racism: “Inequalities rooted in the system-wide operation of a society that excludes substantial numbers of members of particular groups from significant participation in major social institutions.”

As a person of European descent, I cannot begin to understand the pain that my Black and other non-White community members experience. However, I can continue to listen and learn how to be a better ally and use my platform to amplify their voices. I plan to develop a FAQ page that can serve as a FREE, comprehensive resource for those aspiring to go to medical school and/or graduate school and within this page, I plan to link to as many relevant non-White perspectives as I can (if you have any particular questions that you want answered, please use the contact page or reach out on Twitter).

I also always welcome guest posts from students about their personal experience in any aspect of MD/PhD training (though I understand that writing for free for a little med school blog is not the most bang for your buck). If you’re interested, again, please use the contact page or reach out on Twitter.

In the meantime, you can find a list of some of the voices that I am listening to in this Twitter thread.

I will end with two quotes from the book White Fragility: Why It’s So Hard for White People to Talk About Racism by Robin DiAngelo that I hope my fellow White allies take to heart:

‘I believe that white progressives cause the most daily damage to people of color. I define a white progressive as any white person who thinks he or she is not racist, or is less racist, or in the “choir”, or already “gets it.” White progressives can be the most difficult for people of color because, to the degree that we think we have arrived, we will put our energy into making sure that others see us as having arrived. None of our energy will go into what we need to be doing for the rest of our lives: engaging in ongoing self-awareness, continuing education, relationship building, and actual antiracist practice. White progressives do indeed uphold and perpetuate racism, but our defensiveness and certitude make it virtually impossible to explain to us how we do so.’

‘If, however, I understand racism as a system into which I was socialized, I can receive feedback on my problematic racial patterns as a helpful way to support my learning and growth. One of the greatest social fears for a white person is being told that something that we have said or done is racially problematic. Yet when someone lets us know that we have just done such a thing, rather than respond with gratitude and relief (after all, now that we are informed, we won’t do it again), we often respond with anger and denial. Such moments can be experienced as something valuable, even if temporarily painful, only after we accept that racism is unavoidable and that it is impossible to completely escape having developed problematic racial assumptions and behaviors.’


Almost Docs: What it’s like to advocate for healthcare

This was originally published on (which doesn’t exist anymore???) in August 2017. I’m sharing it here again to help others know how they can get involved in healthcare advocacy.

Make your voice heard.

With the ongoing healthcare debate, we are told again and again how valuable our voices are as docs and almost docs. But how?

One way is to call your representatives. Another is to visit them.

A number of medical organizations coordinate annual advocacy days on Capitol Hill for their members to attend. The benefit of meeting in person with Congressional representatives and their staff is that it can help us put a face on the healthcare workforce and establish ourselves as experts in the care of patients. It can create lasting relationships with these representatives that gives us the power to speak for our patients.

This year was my third time attending one of these advocacy days held by the American College of Physicians. Yet, I can still remember the uncertainty I felt as I arrived at Washington, DC as a first-year student. Who am I to speak on what ails our healthcare system? What if I don’t know the exact policies?

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Illinois medical students and residents excited to learn how to be better advocates.

Luckily, the first day was designed to get me up to speed. I received outlines for each issue we were advocating for, including current related bills we should ask our representatives to support. I listened to policy experts speak about the issues and how to best speak about them. I watched example discussions with representatives, so that I had some idea of how things would go.

I also joined a team. We were sorted by location so that we would meet together with our local representatives. Our team was comprised of medical students, residents, and attendings from downstate Illinois, including some with previous experience advocating in DC. The meetings the next day were already scheduled, and we planned who was speaking and what topics would be covered at each meeting. As a medical student, I would speak on an issue most relevant to me – funding for graduate medical education.

The next day we headed to Capitol Hill. I found myself in a Senator’s office, speaking with his healthcare staff member. I told him my concerns for matching and emphasized the growing need for more physicians. Then, with a quick look at my notes, I asked that the Senator supports S.577, the Resident Physician Shortage Act, to increase the number of residency positions.

As we left the meeting, my group of advocates took a picture to share of our experience, and I later followed up with an email. After a few more similar meetings, my involvement in our advocacy day was formally ended. However, it does not have to be and will not be the end of my advocacy.

If you ever get a chance to speak with your representatives on healthcare, I highly recommend it!

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The US Capitol.

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