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Why politics has a place in medicine

Ariana Witkin, MD
Health Policy
October 26, 2020
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I am a pediatrician.

I live and work in a liberal city in a liberal state. As you may expect, of late, politics has been a hot topic of discussion at the hospital in which I work.

From the massive change in practice and policy-driven by the coronavirus pandemic to the sweeping change in immigration protections for families and children, politics has infiltrated medicine and my daily care of children throughout the Trump presidency.

Recently, we were asked by my department to tone down the political talk at work. At first, I was displeased, but added this request to the growing list of bureaucratic annoyances, of which anyone who works in health care is acutely accustom.

Tonight, watching the final 2020 presidential debate, I am actively reallocating this request from annoyance to unacceptable.

As I sit on my couch, weeping, listening to the president of the United States say that the 545 innocent, immigrant children who were separated from their asylum-seeking parents at the border and whom are still separated, are “well taken care of,” I am infuriated. I am heartbroken.

I am turning on my baby monitor to make sure my own child is still in her crib.

Taken alone, the president’s statement is stunning. It is reminiscent of Nazi-era propaganda meant to hide the atrocities and crimes against humanity being committed in concentration camps. In the context of the president’s entire remarks, at best, it is inhumane. Not once did the president apologize or express an ounce of sadness for the intergenerational trauma this policy has propagated. Not once did he say that his administration is working tirelessly to reunite these children with their parents.

The request to cease political discussions at my hospital was put forth in an effort to relieve the discomfort of my right-leaning colleagues, but it raises the fundamental question: Does politics have a place in medicine?

In the context of tonight’s debate and the politicization of vulnerable children, the answer is unequivocally yes.

Prior to completing medical training, each and every physician takes the Hippocratic Oath. While this oath is oft modified by individual institutions from its original text to reflect contemporary events and practice, the core tenants of the oath remain the same.

Practice with humility.

Believe in science and evidence-based medicine.

Provide care with empathy and without discrimination on any basis.

Recognize that your patients do not exist in a vacuum; they are the products of the society, structures, and environment in which they live.

Be a steward of public health.

Remain curious and never stop learning.

When there is a national leader, such as is the case right now, that openly and proudly stands in opposition to these principles, the discussion of politics in medicine is not only admissible, it is a mandate, even when doing so means making our colleagues uncomfortable.

In addition to being a pediatrician, I am Jewish and the granddaughter of a sole Holocaust survivor. My grandfather’s family perished in Auschwitz, a concentration camp in Poland. My grandfather alone escaped, skiing through the night, to his safety and ultimate survival.

The request from my hospital, the presidential debate, and the seeming dismissal of parentless children reminds me of a quote from Elie Wiesel, a Nobel Prize-winning writer, and Holocaust survivor.

“What hurts the victim most is not the cruelty of the oppressor, but the silence of the bystander.”

I will not tone it down.

I will not be silent.

I believe a medical institution that is dedicated to the well-being of all people would not ask me to do otherwise.

Ariana Witkin is a pediatrician.

Image credit: Shutterstock.com 

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