what i know to be true:
I write this because I love myself and other black people so deeply. All the organizers I know work from this same place of deep care and love. I write this, because as someone who has an MPH and is in the process of completing an MD and PhD, this is what I have to offer to people who work in medicine and public health.
I support all forms of black protest. I believe we need to abolish all of our current systems.
Racism is a public health crisis, it is a medical crisis, it is a crisis crafted and maintained by all the systems of the state.
We will not “implicit bias”, “structural competence” or “health inequity” training ourselves out of this. We need to explicitly name and target colonialism, capitalism, racism, sexism, and other oppressions.
We need to eliminate barriers that keep us from implementing better and different modes of care. Talking about implicit bias, structural competency, health inequities and even anti-racism can take up a lot of time and energy and most of the times is a checkbox, to make people feel good about doing next to nothing to actually uproot structural violence in our society. They do not transform systems in and of themselves. People make up institutions and systems, and people must transform their behavior, allegiances, and values to change them. Across the country, many police departments , public health programs, and medical schools have adopted language around anti-racism, conducted numerous “anti-bias” or “anti-racism” trainings that only serve to quell white guilt. Instead of simply attending or teaching about anti-racism or bias, white people need to become activated and committed to equitable transformation.
Individual actors within Medical, Public Health and Education systems are complicit in upholding racism.
George Floyd’s initial autopsy report from the Minnesota Medical Examiner was an attempt by a physician to erase police brutality and structural racism as the cause of death. We have seen this happen over and over again with high profile black state sanctioned murders. This tactic is just one way medical knowledge and physicians “cultural authority” is marshaled in service of the state.
In my own research on late1930s and early 1940s maternal mortality reports, it is clear that autopsy reports and death certificates are more than symbolic. These documents are marshaled to “fix responsibility” for deaths-to absolve responsibility from the state, from physicians, from the healthcare system and to place blame of death on the patient.
Who and What is protected when we obscure the links between the root and systemic causes of death?
Physicians made these determinations and public health perpetuates them. However, we can unmake them.
The reality is society at large, physicians and public health practitioners know how racism compromises health on an epigenetic, endocrine and neurological level. We know that increased exposure to racism and other forms of discrimination are toxic. We know that experiencing housing insecurity is bad for health. We know that incarceration inflicts psychological trauma. We know that black people are dying from medical violence and neglect everyday. We know all we need to know.
But somehow as culture and practice, people are able to convince themselves that Black people should have less. They rationalize that there is some reason we should have worse health, lower life expectancy and use other medical equity language to obscure the truth.
Why are physicians and public health practitioners hesitant to stand up for the health and wellbeing of black people? This is genocide: “the deliberate killing of a large group of people, especially those of a particular ethnic group or nation.” We have so much data, so many studies, historiographies articles and books. We have all the evidence that IS black people’s lives. So what are you waiting for in order to radically change? What do you fear? What do you think you will lose? Is what you will lose not worth black life?
Capitalism and Respectability Politics do NOT work for the masses
You may see one or two black people make it to positions of power, but as a whole these systems do not work for entire families or communities. It definitely doesn’t work for black people as a whole. We need to get rid of this whole myth. Just because one or two black people become doctors, doesn't mean racism is magically eradicated in a place. We just get to experience the particular form of insidious racist violence of that institution, that turns into institutional gaslighting when these spaces co-opt rhetoric of diversity and inclusion.
The only way out, is through it. These systems must end and die.
For that to happen, physicians and public health practitioners must stop believing the lies these systems, workplaces, and institutions tell you. What myths have they fed you to keep you to keep working, striving, straining for the mythical securities they pretend exist at the end. Was it a title? Or a fellowship? Or an award? When did your MD buy your silence, What are you afraid of losing? Do you realize that you should probably have that thing in the first place? And your ability to live or thrive shouldn’t be based on blindly buying into capitalism and racism, and other forms of structural violence? How have these systems bought your silence and complicity?
In each of my educational experiences, in public health practice, medicine and higher ed, I have seen black people suffer violence, abuse, disrespect and dismissal at the hands of the same people writing letters proclaiming solidarity. I have been manhandled by a white woman who is the “diversity” dean at David Geffen School of Medicine. Administrators responsible for the joint program I am currently enrolled in have threatened to expel me for firing a racist advisor, who told me black women dying during childbirth was not a big enough issue for my dissertation, and said the N-word in his 300- student undergraduate lecture.
What has been so evident during this pandemic, is that our society is not designed from a place of care. It is designed to exploit. It is designed to extract all your energy and time and labor, and then blame you for what the stress does to your body. It does not provide time, space, or financial security necessary to care for our bodies nevertheless our minds. It does not give people time to care for their sick family members, to care for children, for their community. This society expects people to go to inhumane lengths to perform productivity even in the most unprecedented times. This is no way to live.
Healing requires genuine care and love. Just because you have an MD does not mean you are a healer. This is the time to use your body, resources, and knowledge in fugitive ways.
Providing true care means caring about our patient’s day to day lives while simultaneously the betraying and defying the systems that make their life stressful. There is so much possibility for radically different worlds if physicians and public health practitioners moved from a place that makes true care and love the priority. Use your being in this moment to stand for the abolition of prisons, the defunding of police, the eradicating of medical racism and stand and work against state sanctioned violence.
New worlds are possible. Black people have been and are currently creating them. Every single day I am inspired by black artists, black teachers, black healers, black parents and community who work in spite of violence and because of violence to create spaces black life and joy for ourselves and our futures.
Continue to send direct funds to bail out protesters and pay for legal fees etc.
Support long-term organizing:
Black Youth Project (BYP) https://secure.actblue.com/donate/byp100-1
Dignity and Power now Frontline Wellness Network in Fighting for Prison Abolition
KindredSpace LA in creating their new birth center for racial birth justice
Read work from:
Dr. Camara Phyllis Jones MD, MPH, PHD
Dr. Ruha Benjamin, PhD
Dr. Chandra Ford, PhD
Books:
Birthing Justice- Julia Chinyere Oparah and Alicia Bonaparte
Killing the Black Body- Dorothy Roberts
Fearing the Black Body — Sabrina Strings
Medical Apartheid- Harriet A. Washington
Medical Bondage- Deirdre Cooper Owens
Reproductive Injustice- Dana Ain Davis
Body and Soul- Alondra Nelson
No Mercy Here: Gender, Punishment and the Making of Jim Crow Modernity- Sarah Haley
Intimate Justice: The Black Female Body and the Body Politic- Shatema Threadcraft
Emergent Strategy- Adrienne Maree Brown
More Reading here, from my friend Antwann Simpkins:
venmo:@Ariel-hart-1
