The Power of Personal Experience

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This month's letter was intended to be a reflection on graduation season during a pandemic, but I confess that I find it difficult to think of much else beyond what has been happening over the last few days in my state. To have an issue besides COVID-19 dominate our thoughts and headlines is really quite telling.

I live about an hour south of Minneapolis which is still quite literally burning. It is the city in which George Floyd was murdered as a result of a knee to his neck that cut off his airway for eight minutes while onlookers filmed and shouted to let him breathe.

A new friend reached out recently to discuss how she was processing all of the above as her physical isolation due to the pandemic was compounded by being in a new city working in an area where she was the only Black woman.

She shared that after a sleepless night, she was grateful to have leadership of her organization acknowledge in a timely and sensitive manner what had happened. It was the first time in her career that she could remember this happening. 

Silence also makes a powerful impression. In a laundry list of all the things we are working hard to do as individuals and organizations, what is left unsaid, the absence that lives in the spaces is also very much noticeable.

I have stopped believing that people will respond, reach out or stand up without some prompting. Empathy exists and it is foundational to the work of pediatricians everywhere, but I have learned over the years that empathy without context and an understanding of history, sociology and current affairs from a wider perspective leaves children behind.

It doesn't mean that people don't care. They often do. But if we're being very honest, things that happen to other people never move us in quite the same way as if it happened to us personally. I don't know if that's human nature or human fault, but it's one of the only reasons I can think to explain why there isn't a more massive, concerted effort to change the structure of a system that does not equally prioritize the needs of our most vulnerable.

In communications, the internet and the advent of social media were supposed to be great equalizers. I've written and shared data in the past about how that doesn't necessarily result in a level playing field on its own, meaning we still have to check our biases and social structure to achieve equity in who and what is heard and amplified.

In the past few days, it's been interesting to observe how #MedTwitter has handled recent events, which I found were expressed most succinctly and powerfully here by two trainees:

  • From LaShyra Nolen, Harvard Medical School class president who pointed out that active allyship requires "relinquishing privilege" or risk contributing to the problem

  • From Dr. Colleen Farrell, internal medicine resident who pointed out the stark discrepancy in prioritization of discussion topics among two subgroups of medical professionals on twitter, neither of which involved COVID-19   

In the midst of a crisis, other crises don't disappear. They merely become less visible.

News cycles move on, but the problem remains built into the structure, just with less attention.

I think often of people who have been working on the issue of structural racism and violence. I can empathize with exhaustion that comes from pointing out for months, years, even decades, and still not being heard or taken seriously by the powers that be.  It is the frustration that comes from the futility of repeating oneself multiple times only to receive a response that still does not acknowledge the gap.

It means constantly having to make a choice about whether to point out inequities and risk ruffling feathers or quietly swallowing the umpteenth example of not being heard for the sake of diplomacy and maintaining relationships.

It is observing who is allowed to flout rules without consequence and who is not; who is allowed to express rage and frustration and who is expected to maintain a polite tone; who is excused for major wrongdoing and who is held accountable for minor transgressions.

How can we apply empathy to an issue that hard evidence shows is a crisis but that may not have voices at the table that decide what is and is not a priority? How do we as pediatricians and communicators change society, our profession and our own perspectives to push outside of our own paradigm?

I don't have answers to that, but I would like to end on a positive note that pulls together the passion and hard work of our trainees, desire for justice, the critical need for equity and diverse representation of voices.

In a week that has been tragic, infuriating and unbearably sad, I want to share and uplift the Health STEMencement project, which sought to celebrate graduates from a variety of health-related fields with speakers who are leaders from groups not often represented "on the platform" during commencement ceremonies. This project was entirely conceived of by students and grew to include official sponsors including APHA, ACP, AMWA, Time's Up Healthcare and more.

COCM's own Dr. Mona Hanna-Attisha is one of the featured commencement speakers. Dr. Rhonda Acholonu and I also contributed to this virtual ceremony, which can be viewed here.

A fellow COCM member told me recently that because of limited bandwidth, she had to remove "save the world" from her list of extracurriculars, but added "maybe one child at a time."

Thank you all for what you do every day to save the world.