Common Sense

EM Physicians Treat All

Issue: September/October 2019

Author: David A. Farcy, MD FAAEM FCCM
President, AAEM


“We're not here to judge
We are here to love
There's no room for hate
We are just one human race
We must rise above
We are here to love
There's no time to waste anymore
Here to Love.”

-Lenny Kravitz

Since my last message, I had the opportunity to represent the Academy in Hawaii for the National Medical Association Meeting and then in the latter part of August, went into full action with Hurricane Dorian’s projected path predicted to make landfall in Florida. After activation and preparation, on Friday, August 30th at 11:00pm ET, Dorian turned and during a period of almost 48 hours, devastated Abaco and caused severe damage to the Grand Bahamas, our neighbor country separated by only a 30-45 minute flight or boat ride. No federal mandate came through, but Miami and Miami Beach could not stand and watch our Bahamian brothers and sisters and do nothing. Thus, several teams were mobilized and deployed. As we all know, the initial hours are crucial to the outcome of a disaster. No words can describe what my team found once we were on the ground in Abaco: the shredded town with death lingering around us.

But this presidential message is not a piece on disaster management, nor on disaster response, but rather a piece on a much more important topic. My presidency has been about challenging our members to join, realizing the important fact that sitting around and not participating brings no positive change. My presidency has also been about inclusion based on merit, speaking out on public health issues, and the promotion of racial, ethnic, and gender equality. As leaders in medicine, we have both a duty and a responsibility to educate our patients and their families, not only about medical issues, but about social issues as well. We have a duty to mentor students, residents, and younger faculty, putting them in touch with their unconscious bias, implicit bias, and explicit but unacknowledged bias. When we see bias at play, we must stand up and point it out, not just turn our back and pretend it did not happen. We must stand up and speak up, when we see gender discrimination, racial discrimination, ethnic discrimination, and health disparity. 

If “racism” is to end in America, we must all assume responsibility for ameliorating our unconscious biases and realizing the need to talk about this topic. Racism is part of American history, and frankly it is our legacy, but we have overcome hate through the courageous actions of individuals who stand up and say “NO MORE.” As an immigrant myself, I could never understand racism, but today more than ever disparity, discrimination, and racism continue to proliferate and to deteriorate the values of this country. Our leaders do not condemn it, but instead promote racism, ethnic discrimination, and the worst forms of intolerance perpetrated without basis in any evidence whatsoever. What can we do? It is not enough to say the words “racism” or “racist” and claim we reject it! We must fight it with every fiber of our being. Hate is a powerful force and we cannot defeat it with timidity, weakness, or even with strongly worded letters like those that have been thrown around on social media posts. Social media might be a place to talk and share positive stories, but we are becoming numb to posts. We are so overwhelmed that it has become almost impossible to have a debate in which any issue is genuinely brought to light.

Since the founding of our country, people of color have been fighting HATE and BIGOTRY, fighting for EQUALITY and JUSTICE, and regardless of our color, regardless of our gender, regardless of our religions, and regardless of our sexual orientation, WE ALL HAVE A RESPONSIBILITY as human beings, as doctors, and as educators to join the fight. YES, this is a fight! In this fight, we must acknowledge this as a systemic problem, now more than ever is the time that we must be vocal, involved, and engaged. We must teach our young that social injustice must be fought through peaceful demonstration instead of rioting and looting, by getting involved, engaged, and donating to the cause; time if you can and dollars if you cannot. Our team raced against time to fight for a young Bahamian boy handed to us by the Coast Guard, lifeless, and cold, with the Coast Guard screaming “we just lost him.” Just like all of us in the emergency department, we did not look at the color of his skin, nor his insurance status, but at the fact that he was the sickest patient we had and we came together for a very difficult resuscitation knowing the odds were stacked against him; we gave him the best possible chance.

Historically, individuals whose names were not known to the general public one day said “no more” and they changed the course of history, being remembered as leaders, champions, and visionaries who stood up in peaceful ways to protest against racism and oppression. History remembers Rosa Parks as the mother of the freedom movement, and the Reverend Martin Luther King as the man who dreamed that “injustice anywhere is a threat to justice everywhere.”

We all have a responsibility to stand up against HATE. We all must speak up against racial bigotry, intolerance, discrimination, and injustice and not let our unconscious bias or any other bias deter us from speaking up. This is not about politics or about what side of the aisle you sit on; rather this is about our duty as physicians to uphold life and promote life without regard for race, gender, or ethnicity. This is what I saw our fellow emergency physicians and other health care workers fighting for in the Bahamas. Every day in our emergency department stateside we provide care to millions of patients, pretending at times that we have no biases, but our action sometimes would point otherwise. We must learn that it is acceptable for someone to point out our unconscious bias without getting emotionally activated. Take a step back and make a conscious decision to change. I am the first one to admit that change is difficult, but small baby steps toward change will speak louder than any empty words. 

“People learn to hate and if they can learn to hate, they can be taught to love, for love comes more naturally to human heart than its opposite.”

-Nelson Mandela


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