Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election. Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality. What does the future hold? What will the consequences be for my gay, minority, and Muslim friends, family, and patients? How will this affect the vulnerable children that I care for every day?
As I began to process this information, my first reaction was that I wanted out. Sign me up for Canada! I hate cold weather, but I love Vancouver and maybe I could get on one of those HGTV shows that films there. I lost the desire to stay and fight for what is right, a premise on which I have built my personal life and professional career.
Fine America, you want him as your president? Then I can’t help you if you won’t help yourself. I am relatively unlikely to be personally affected by any of the social policies he has promised. I am wealthy. I don’t have children. I am unlikely to ever need an abortion. I am white. I am straight. But many who voted for him are likely to be affected by his promised social policies, which does continue to confuse me. So I figured fine, you made your bed, now lie in it.
But then I continued to watch cable news like a car crash I couldn’t take my eyes off and followed the tallying of the popular vote. That’s when it dawned on me. A majority of American voters did not vote for this man. In many states, the votes were decided by shockingly small margins and all of those who tried so hard to keep the president-elect from winning must now also suffer the consequences along with those who did vote for him. And many of this popular majority but electoral college minority are not as privileged as me.
So, just as pediatricians dedicate themselves to advocating for children who do not have representation in legislation, we must now as a profession dedicate ourselves more strongly than ever to protecting the health and well-being of those who are now scared for what the future holds. We must advocate for the interests of those who are now forced to live in a reality they did not choose, and, yes, we must also protect those who did vote for this and suffer the consequences anyway because this is what our profession requires of us.
So, how can we make a difference going forward? As we all know, the collective power of physicians to do good is substantial, so let’s channel our feelings into productivity together:
- Get involved in the legislative process. This election has taught us many things and one vital lesson is that exercising your right to vote is important, but it’s not enough. Phone bank, canvas, and hold rallies for candidates that represent the interests of your patients from the local to the national level. Sign petitions. Call or email your legislators on a regular basis. Run for office! I couldn’t be more proud of my former co-chief resident, Dr. Lisa Cannon, who just ran for State Representative in Rhode Island. This is an amazingly bold way to effect positive change for so many more than we are able to serve in our offices and hospitals each day. There are physicians in legislative power all the way up to the House and Senate, and I would argue that no one is more qualified to guide the uncertain future of health care policy than those in the trenches who understand how the system works firsthand.
- Donate your money. We are all in a position of economic privilege in this profession and should consider now channeling our charitable giving to organizations that can assist our patients in times of need and those that may be threatened in the new political climate. Donate to Planned Parenthood to show our OB/GYN colleagues that we stand with them and appreciate their valiant efforts in risking their lives every day to go to work and help others. Donate to the ACLU, your local food bank, or a political candidate who represents the needs of your patients.
- Rally your professional organization to represent patient interests. The American Academy of Pediatrics sets a superb example as a physician organization whose primary role is representing the needs of our patients. This is not to say that professional organizations are wrong to represent the interests of their physician members, as this is also essential for the success of health care in the United States. That being said, if you feel your specialty specific organization could improve their role as patient advocates, contact them and tell them so. There is so much power to be harnessed in these already established organizations that can be channeled to improve care and social policy for our patients.
- Do everything you can for every patient you treat. We should never forget that our role as physicians goes far beyond ordering labs and prescribing medication. When working in an outpatient pediatric office in North Philadelphia, I was constantly reminded of this fact. For many well visits, I exercised almost none of the knowledge I had gained in medical school, as the children were, like most, relatively healthy. However, really taking the time to talk to patients and their families both allowed me to help them with what they really needed and understand the issues that were affecting the community in which I practiced so I could then advocate for change.When children don’t have enough food to eat, families are scared of gun violence, or the educational system is allowing students to fall through the cracks, it is our obligation to speak up and to help on an individual basis. I was far prouder of my day at work when I helped a family to secure a place in a domestic violence shelter and escape danger at home than I was when I diagnosed and treated asthma. Not that both are not vital for us to do, but not everyone expects the former when they visit their doctor. However, we have the ability, and I would argue the obligation, to perform both of these duties for our patients. Let us all follow the example set by Dr. Mona Hanna-Attisha in Flint, Michigan who discovered the lead crisis that affected so many children and brought this catastrophe to light. She boldly refused to back down when attacked by critics and her efforts are responsible for saving countless additional children from the terrible effects of lead poisoning. We all have the opportunity to similarly affect our communities by acting confidently and without hesitation on opportunities for change.
It is sometimes easy to forget what a privilege it is to practice medicine. When our phones ring at 3 a.m. (again), our first thought is not that we are privileged to do our job. Each month when we pay back astronomical student loans, we do not feel privileged. But we are, for so many reasons. Having grown up in a middle class, nearly all-white New Jersey suburb, I had an amazing and happy childhood, but not one that was defined by diversity. This was even more true at the boarding school I attended for 6th to 12th grade, where there was far more ethnic diversity, but little socioeconomic diversity. College at a state university and medical school in the melting pot of Philadelphia offered great opportunities to get out and meet more people unlike myself, but of course, this population is also somewhat isolated. It was not until I really started practicing medicine that I had the opportunity to meet and connect with people from all walks of like, the biggest privilege of all in our profession. I have met residents from all over the globe and patients from all walks of life. I never would have the same insight into the effects of deep poverty had I not worked for four years in the poorest zip code in the US and heard from my patients first-hand about how this affects their lives.
Perhaps the greatest privilege I’ve had in my career was the ability to run a refugee clinic and meet families from the direst circumstances who continue to motivate me to affect change on a daily basis. We must never forget that this is the reason we chose this profession and that we possess great power to help all those in need. We are privileged to practice medicine despite the many flaws in our system and must utilize our position of privilege for the benefit of those we serve. I will not tell you not to despair or not to be hurt or angry, as I am all of these things as well. But never forget why you chose this career path and never underestimate your ability to make a difference.
Morgan Leafe is a pediatric hospitalist.
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