“There comes a time when one must take a position that is neither safe nor politic nor popular, but he must take it because his conscience tells him it is right.“

Dr. Martin Luther King

I woke up this morning and found while doing my morning mindfulness training that my left eye was twitching.  I had not experienced this in a long time.  The last time was when I was studying for my Family Medicine Recertification.  I was studying and looking at my computer and phone to answer practice test questions.  Since the COVID-19 Pandemic, I have been working from home doing virtual visits and participating in Zoom, Skype, and Facetime meetings.  I think I just have brain fatigue.  I have had too much screen time.  I have also been participating in web-based conferences and discussions dealing with the Pandemic.  I feel I am an expert in COVID and especially racial and ethical issues surrounding this disease.

Now comes the murder of George Floyd. The painful reminder of all the other killings in the past (lynching and police violence). The image of Mr. Floyd has shaken my mind.  I witnessed the moment of death now etched into my mind.  As a physician during the week that I was treating patients on the COVID floor, I had to suppress the urge to rush in and treat my patients before donning my Personal Protective Equipment (PPE).  As I watched him die, I wanted to jump through the screen and save him.  I know what those bystanders were feeling. In the hospital, if a patient is a Do-Not-Resuscitate, then we just must stand-by and allow them to die with dignity.  During this Pandemic, it was often without their family present or by using an iPad.  Mr. Floyd had people (4 police officers) who ignored his cry for help and those too afraid to rush in for fear of they would be shot by one of those police officers. That is too tragic to fathom.  My heart was broken.  I went to work, and I just lost it in a meeting.  I have not had that happen in years.  The next day I apologized.  I realized that I had seen a man die, and the conversation we were having was too trivial, but it was not their fault.  My nurse, who has known me for 18 years, just said, “I knew there was something wrong because I have never known you to behave that way.”

So, I am reacting to what I have always known and have worked to overcome.  The structural and institutional racism in our society kills people.  In Medicine, it is making our patients sicker because we do not have the diversity in our workforce to address the social and structural determinants of health. The Centers of Disease Control and Prevention (CDC) defines these as: “The complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world.”. 

We need to address these issues by dismantling the racist systems that prevent underrepresented in medicine students (African American, Latinx, Native Americans) from ever entering or completing their medical training.  It is not hard for those of us who work in this area to know the next steps, but it will take the willingness of those in power to force a change.  The steps are the same and must happen with policing in America.  How is it that a White male who guns down innocent people in a church gets treated to lunch when finally captured and a Black male killed over a $20 bill? There is no acceptable justification, and the video evidence is there for us to watch repeatedly.  The tragedy now unfolds as we learn that Mr. Floyd, victimized by a tainted officer, who, unfortunately, derailed his career opportunities when he was so young. This injustice has happened to too many, and we must review all these incidents and make amends. Too many locked out of career opportunities, especially in Medicine.

As one of my colleagues put it, you must watch that video and see the horror that we see as we watch our husband, partner, brother, uncle, friend, and fellow human murdered.  As another colleague texted just before she lost it in a meeting, “This is not watercooler talk. A man was killed.”

Mr. Floyd’s death happened to all of us.  Institutional and structural racism harms all of us, but it kills African-Americans and Native Americans, and we must dismantle it in every corner of our society.

“It is from numberless diverse acts of courage and belief that human history is shaped. Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring, those ripples build a current that can sweep down the mightiest walls of oppression and resistance.”

 Robert F. Kennedy