7 minute read
Personal Perspectives on Diversity, Equality, and Inclusion
Dr. Alam graduated from Howard University College of Medicine and aspires to become an emergency medicine physician and to bring healing, address inequities, and reduce disparities in underserved communities.
“I recently graduated from Howard University College of
Mustafa Alam, MD Medicine and took the opportunity of doing academic research in Mount Sinai Hospital in New York City. As 2020 progressed, the city would also become the center of the worldwide pandemic of COVID-19.
“Many people can share personal stories of how COVID-19 has impacted their lives. It has been a challenging period for many hospitals, communities, and individuals. It is still a battle being fought. One result we have seen is the disproportionate number of patients that were infected and the mortality from this virus towards people of color.
“In the midst of this worldwide pandemic of COVID-19, the world also witnessed the tragic murders of Ahmaud Arbery, Breonna Taylor, and George Floyd. The videos of their deaths are haunting; watching lives taken so unjustly was jarring to see. In many cities protests and marches demanded justice for these individuals. The images and events reminded people of the public health crisis which has affected our nation for many years: Racism.
“If we anatomically look at racism, it seems to be ingrained in different aspects of our society. It is seen in the health disparities we may come across with the medical care of our patients. It is seen in the socioeconomic disparities of the population in the communities we serve. It is felt when we see injustice from our legal system and/or law enforcement officials in the treatment of people of color.
“Emergency medicine is a specialty that can address this health crisis in a unique way. I was happy to see emergency medicine physicians taking the lead in addressing this issue. For myself, emergency medicine, is my chosen medical specialty. I want to become an emergency medicine physician and practice in underserved communities. As the first doctor in my family and a person of color, I also have been a victim of racism. Racism causes a pain you would not wish upon any other human being. It wounds and hurts with each infliction. When I think about racism, I want to do my best to address it and to end it. Many underserved communities have families and individuals who have been victims of racism or of systemic racism within their communities.
I would love to advocate for emergency medicine residency programs to make this year's class of residents the most diverse class ever. If you come across a person of color that has faced setbacks, please give that applicant a chance. That opportunity will offer an inspirational story for that doctor to share with their families, mentors, and communities — communities that see someone who looks just like them and would be pleased to have a doctor of color serving them. More importantly, it will give these doctors the opportunity to provide hope, relief, and healing to communities with an urgent need.
“It is an emergency that people of color are facing injustice and racism. It is an emergency that we cannot ignore. Racism is rampant. We need to have an effective curriculum that addresses diversity issues in programs and hospitals; for example, simulation exercises that address conditions a patient from an underserved community encounters or how to approach a patient that is a victim of racism.
“Racism is a public health crisis, and we need to start now to address it. If we work hard to make changes and face this crisis together, with time we shall overcome it. It starts by changing ourselves and how we feel about each other. If we work together toward this cause, I envision a time where we will embrace our differences, when the values of equality, justice, and love will reign, and where a world will heal from the wounds and suffering caused by years of racism.
“We can start now, with our residency programs and ensure that the next generation of residents will be leaders in their communities in battling this public health crisis. May this specialty continue to inspire everyone to make a difference and to be in the front lines no matter which crisis comes through the ED.”
M. Aaron Vrolijk is a fourth-year medical student at the University of Colorado Anschutz applying to emergency medicine. His recent projects include curriculum aiming to reduce bias in medicine, interventions to improve communication with LGBTQ+ patients, and investigating the unique added stressors minoritized medical students face.
M. Aaron Vrolijk “There are two patients from my emergency medicine acting internship this year who keep recurring in my thoughts. Both are Black men. The first patient was a young man who came in after cutting his hand on glass while working a temporary job. As I sutured his hand, he thanked me profusely and apologized when I nicked a vessel causing his hand to bleed. I kept reassuring him that he was okay, he did nothing wrong, I had made the mistake, and I was there to take care of him. I wanted him to see that he deserved to be treated like this in all parts of his life and that it was not his fault that we live in a racist system. Throughout his visit he was telling medical personnel that “all lives matter.” When he told me this, it broke my heart. I was worried he didn’t see that his life was as important as everyone else’s. Not knowing how to respond, I said, “I went to the vigil for Elijah McClain.” My patient lowered his head and described the Elijah he remembered and how they knew one another.
“I saw the second patient, a Black man in his 30’s, on the last shift of my rotation. He was there for excruciating back pain and possible cauda equina following a laminectomy at another hospital. Neurosurgery was consulted after an MRI confirmed nerve impingement. Despite his pain, he was hesitant to get more pain medication. He tearfully told me that he had gone to several emergency departments before surgery with back pain. At one he had been labeled “pain medication-seeking” in his chart. Finally, he found someone who offered him a treatment— surgery—in another city. He started crying, telling me that I didn’t need to talk to him or to listen... but I did. He felt cared for, heard, and like his health problems were being addressed at our hospital for one of the first times.
“As a future emergency physician (fingers crossed for this match season), I am realizing the enormous responsibility we wield beyond direct lifesaving measures. We can change a patient’s life with a keystroke by marking them as a “poor historian” or “pain med seeking” (both characterizations I have only seen attributed to Black patients). We are part of a system that inappropriately dosed Elijah McClain with ketamine. But this health crisis is the result of a racist system that results from racism in medical training, housing inequality, K-12 education disparities, the prison industrial complex, and many others. The list feels endless. The publications detailing the racist underpinnings of America are well documented. How many books and studies need to be published solidly demonstrating America’s racist system? How many more studies do we need on health outcomes and treatments that differ based on a patient’s reported race? When will it be enough for medical schools to hire a professional to remove the numerous ways medicine continues to use race as a risk factor instead of the socioeconomic inequalities that have been perpetuated due to racism?
“I think about how much these interactions continue to affect me as a white man and can’t imagine how they affect my Black colleagues and friends. Medical school and residency are hard enough without seeing the effects of discrimination evident in patients or their own experiences with racism while navigating already difficult rotations. The numerous documented extra challenges minoritized medical students, residents, and faculty face make me think an instrumental step in dismantling racism (and, thus, the subsequent health crisis) is aggressively refiguring medicine to support minoritized members regardless of their health profession. The emergency department—with its interdisciplinary team, diverse patient population, commitment to medical training, and influence on patient care—is a fertile place to restructure patient care, support minoritized medical personnel, and remove racial underpinnings in medical education. Individually, we must make a decision to be open to listening, changing, and declaring that we’re tired of lives being stunted and lost based on the color of a person's skin.”
