JEAN LUD CADET, M.D.

HEALTHCARE AND MEDICINE IN 2022 AND FORWARD

— BY JEAN LUD CADET, M.D.

Since 1975 when I entered the College of Physicians and Surgeons at Columbia University in Manhattan, there have been discussions regarding shortages of Black physicians and scientists in the USA.

In every subsequent decade, there has been a report deploring the low number of Black science students, the low number of Black students in medical schools, and shortages of physicians in various subspecialties including surgery. These are important issues because lack of representation of Black physicians working in medical schools and research has been shown to impact the care of African Americans (AAs). Specifically, Black Americans are known to suffer from several medical, neurological, and psychiatric diseases. These include hypertension, diabetes mellitus, strokes, depression, anxiety, and shortened life spans. Moreover, there is increased maternal and infant mortality among AA populations, irrespective of class. Although these issues impact other underserved global communities as well, the present essay will focus mostly on members of the African Diaspora.

The shortages of physicians who take care of AA patients might be related to low numbers of AA students in STEM courses during their high school and college years. Enrolment in those classes can be improved by helping student to develop science-related identities through exposure to AA scientists and physicians. Indeed, the development of science identities will propel AA students to then pursue careers in science and medicine. It is important to note that, despite the problems that AA students have encountered, there are, nevertheless, enough Black college graduates that could serve to increase their numbers in medical schools.

The number of AA students in medical schools could be increased further by increasing the number of medical schools at HBCUs. Presently, there are only 4 historically Black medical schools in operation: Charles R. Drew (California), Howard (D.C.), Meharry (Tennessee), and Morehouse (Georgia). The opening of 6 additional medical schools in cities with a HBCU and large enough hospitals that provide care to a majority of Black patients would be very helpful to the care of AA patients in the USA. My personal choices are (1) Morgan State University in Baltimore, (2) Xavier University in New Orleans, (3) Florida A&M in Tallahassee, (4) Jackson State in Jackson, (5) Norfolk State in Norfolk, and (6) Southern University in Baton Rouge or South Carolina State in Orangeburg.

In the meantime, we all can try to have positive thoughts in the presence of very difficult times.

COVID-19 has ravaged the lives of many AAs who were already impacted by racism-induced stress disorder (RISD). I think that we can care for each other better by getting vaccinated, practicing physical distancing, and wearing masks.

I am very aware of the reasons why not to trust American medicine. However, the vaccines can help to alter the course of COVID-19 if you are infected. We owe a debt to our ancestors to do the right thing for future generations by protecting our health.

As I pointed above, these are some diseases that disproportionately influence the lives of AAs in the USA.

However, we can learn to take control of these diseases by seeking help from Black physicians and nurse practitioners who might be more empathetic when we are sick.

In the case of hypertension and diabetes mellitus, exercises and certain changes in diet can be very helpful in in controlling their longterm negative consequences that include strokes, peripheral neuropathy, and kidney ailments that are very disabling. It is therefore very important to take medications that are prescribed in addition to a regular exercise program.

Other diseases of interest include anxiety and depression. These are issues that can be dealt with by seeking well trained psychiatrists or psychologists who are familiar with issues that AA patients face on a regular basis. Going to your friends and pastors might not be enough because these diseases affect your brain and are not related to any ‘personal weakness’. The stigma associated with mental health is a powerful deterrent to seeking help but good care is available for those who seek it.

In conclusion, I am very hopeful that 2022 will bring better tidings for all of us. However, it is important for us to participate in maintaining our own health because, without our own personal physical and mental health, it is difficult to care for ourselves and our families.

Steps that include exercises, annual visits at your primary care, self-examination, and not delaying care if you are worried can all help to improve our health. I believe that we should all push our congress men and women to push for the opening of new medical schools at HBCUs so that we can have more AA physicians to go to. Finally, although the essay has focused mostly on issues that impact AAs, many of the same principles described apply to other communities that are underserved on the global stage.

ABOUT JEAN LUD CADET, M.D.

Jean Lud Cadet, M.D. was born in Cap Haitien, Haiti, in 1953. He attended the most prestigious Catholic High School in his hometown, The College Notre Dame du Perpetuel Secours. He left Haiti in 1970 and moved to Brooklyn New York. Subsequently, he attended medical school at the Columbia University College of Physicians and Surgeons in 1979. Dr. Cadet is a known neuroscientist internationally. Presently, he is a tenured senior investigator and Chief of the Molecular Neuropsychiatry Research Branch at the National Institute on Drug Abuse, a part of the National Institutes of Health. He is also a member of the Society of Haitian Neuroscientists and Black Psychiatrists of America, among other organizations. He has co-authored more than 500 papers, book chapters, and abstracts on various aspects of neuroscience. He was recently listed as one of the prominent 1000 Black scientists in the USA.