Is it a celebration?

I have been talking to my mother a bit more in the past few weeks.  She is such a joy to talk to, but our last call was a bit sad.  She told me that she is not watching the news.  She just can’t bear seeing the image of George Floyd’s death anymore.  She said,” I just can’t take watching as he calls for his mother, and they just killed him.” That is an unsettling image for anyone, but for an 82-year-old African American woman, it is too much.  She can only see her grandsons lying there.

I talked to her again because my cousin posted that his brother and niece were recovering.  We have a Family Reunion page.  I called her to find out if everyone was alright.  COVID-19 rates are increasing in Birmingham.  She called on the circle of sisters.  That starts with my aunt, who usually is always in the know.  Then the circle of cousins gets activated and resulted in the next call.  It is not COVID-19.

Family for us is so important.  It is a circle that keeps us grounded and secure.  It keeps me humble and inspired to keep pushing my limits.  I have always known that if I ever I fell, they are there to pick me up.  Fourth of July was a celebration in our family.  A cookout with my uncle operating the grill and producing the best ribs ever.

I am holding my breath as COVID-19 rates increase in the southern states.  My roots are there.  My mother, sisters, aunts, uncles, cousins, nephews, and friends.  As the two pandemics rage, I have so much at risk.

Two solutions are evident.  Wear your mask and practice social distance.  Address racism and bias to make us truly free. July 4 has to mark a day of reflection.  Then a pledge to address these issues for the true manifestation of our freedom.

“This Fourth of July is yours, not mine, You may rejoice, I must mourn.” July 5, 1852, Frederick Douglass

https://nmaahc.si.edu/blog-post/nations-story-what-slave-fourth-july

https://teachingamericanhistory.org/library/document/what-to-the-slave-is-the-fourth-of-july/

Happy Father’s Day

Father’s Day is a time to honor those men who love and support their families. Loving husbands and fathers make a difference during difficult times. I met my husband a few years after his divorce. After we started dating, I met his son and daughter when they were ages 7 and 8. I took the liberty of putting his daughter’s hair in a neater style. She was beautiful with the most expressive eyes. Black fathers have been the victim of stereotypes of being absent and uninvolved. My husband spent many days taking our son to the Pediatrician alone for shots. It was difficult for me to get away from my training and later the office. He did soccer games, tennis lessons, and all the homework. He was the Book Fair volunteer; he and another Dad would make sure the kids made smart book choices. He was the chaperone on the school trips; he made all the visits to the orthodontist for the brace: found the Barber for the haircuts, and scheduled the music lessons. He cooked all our meals and even did the laundry.

Now in this Pandemic, he has the patience to do our shopping and keep me calm. He has been the rock as I have been working from home: stepped up and made meals and just has been so supportive. I have spent hours on Zoom learning and meeting up with colleagues. He listens as I have my tirades and then makes me laugh.

Happy Father’s Day.

It’s the courage to raise a child that makes you a father. Barack Obama

 

We can never become complacent

Our lives begin to end the day we become silent about things that matter.  Martin Luther King, Jr.

“Our generation became too complacent and wealthy. We lost track of what we were marching for back in the 60s and 70s.” This statement was the refection of a white colleague. I graduated from HS in 1975 and finished medical school in 1983. It became very apparent to me that white males dominated medicine, and they dominated the leadership positions in academic medicine. I had planned to be a Urologist.

There were many obstacles to achieving this goal. General Surgery was a white male specialty, and when I interviewed, it was apparent. At one program, when I showed up on the interview date, they told me I had not been scheduled for an interview. I had a letter, but they said I had been rescheduled. I never received that letter. At another program, I witnessed the side conversation of “Have we ever had a colored woman in this program? No, wait a minute, one, but she was only here a year”. When I did get into a program, it was not easy. I had the skills and knowledge but not acceptance. When I applied to Urology programs, I was told that they only were accepting men into the program. Even now, in academic medicine, as of 2017, of the 15,671 US medical school surgical faculty, 123 (0.79%) were Black/AA women surgeons, with only 11 (0.54%) being tenured faculty.

I decided to go into Family Medicine and then academic family medicine. For me, this was not a path to wealth but one of service. It became quite evident that even when I was negotiating contracts, that I was not aware of all the information that my white colleagues had. They had the advantage of inside information. It is no accident that even now, African Americans make up only 3.6 % of US medical school faculty as of 2018 AAMC data. Fed up with the politics of an academic medical school position, I left my position. My department chair told me I could come back if I met three criteria; increased scholarship, gain national recognition, and meet the institutional promotion requirements. I had to figure out how to do this because it was the criteria for all institutions. I had barely met these. For URM physicians and especially African Americans, it is hard because we spend most of our time in the patient care and community service areas, and we must learn to turn this into scholarly projects that meet criteria for promotion and tenure.

My path was different and often met with roadblocks that prevented movement into leadership positions that could lead to higher pay and recognition. After completing my FM residency, I was not offered a position in any of the practices. I was naïve to think that as an African American couple, the community would embrace us. We met racism in the small town we moved to and then again, when I entered academic medicine, not from the institution but patients. A smart African American husband is not readily accepted into many places, even if his wife is the new African American female physician. The assumption was that we would find friends in the African American community. We lived in a non-African American neighborhood for the school system, and this set us apart and often meant not being in places where the leaders were gathering and having your ideas used by others to promote themselves. I realized that some of my colleagues had generational wealth and privilege.

Unfortunately, many White leaders lose sight of how to create an organization that has a diverse workforce because it is a matter of self-preservation for many. It would help if you practiced conscious inclusion and equity-mindedness, which could lead to having URM colleagues that are “fully integrated, fully engaged, and fully empowered.” However, out of fear or ignorance, they dismiss us and the knowledge and skills we have acquired from the best institutions in the country. I have never lost sight of my goal and what was needed but met opposition from the White males and females in the room. My ideas and contributions dismissed.

I often wish I had the privilege of complacency, but this will never happen because I am the mother of two African Ameican males and an African American female. I mentor several URM faculty in many areas of the country.  I spend countless minutes fielding texts and calls from those who need support as they navigate racist environments. They are a constant reminder that I must continue to speak up when I get the opportunity too. I cannot forget them.

It happened to all of us

“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

No need to be angry?

“[If] a man does not have a job or an income, he has neither life nor liberty nor the possibility for the pursuit of happiness. He merely exists.” Martin Luther King Jr., A Knock at Midnight

I have been angry for several weeks; I cannot bear to hear stupid comments anymore. The news media asking someone to predict what the fall may look like is one of these questions and the comments that follow.   I had a beautiful day. I finished all my patient visits and completed my notes and then had dinner.  I went to bed early for a change, but I had the most vivid dream. I dreamt I was screaming.  My husband, my son, and the world all trying to calm me down, but I kept screaming.  I finally stopped, rolled over, and said, “I am sorry.”  My husband moved over and went to sleep. I realized that this was a dream.  The difference between sanity and insanity is not to scream out loud, but if you do, you make sure no one hears you.  I woke up and felt a weight was lifted. I am not sure why I was screaming.  Maybe it has to do with all we have lost, the lives lost, loss of insurance due to job loss, and all those people not wearing masks.  It may be because of the white men carrying guns on the steps of statehouses or the vicious killing of another black woman’s son.

Perhaps I have watched too many White House Coronavirus Task Force Briefings or listened to too many people complaining about having to teach their children or being bored.  My sister and her husband, with a joint effort, helped my 11-year-old nephew complete all his assignments for the school year.  She was immensely proud of their work.  Maybe I am anxious about him returning to school in the fall. Perhaps I am anxious about the fall and the prediction of a “second wave.” As we reopen our offices, I am concerned about not having enough PPE.

I have become a fan of the governors of New York and New Jersey.  They do not hesitate to express their true feelings.  I especially like that they represent what I am feeling. “That is stupid” or “don’t be a knucklehead” and “that is just insensitive and reckless.”   I especially like “That shows a total disregard for others.”  I am concerned about all those people who may become infected and about the lives that will be lost.  I am concerned about those rushing to return to houses of worship.

I am worried about trying to provide an excellent educational experience to my residents.  I have scoured the internet to compile resources for them.  I realize that the root cause of my anger is my fear.  My fear is caused by my concern of not being prepared, not being able to take care of my patients, family, or friends.

“Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
― Martin Luther King, Jr.

I am fearful that there will be a poor turnout for the November elections, and we get a repeat of the last four years.  I am scared that ignorance, xenophobia, and racism will win.   I am afraid those who proclaim to be religious will continue to spread hatred and evil and promote conspiracy theories over the facts of Science. I have not had that dream again.  I hope it is because I have come to terms with this mess, we are in.  I can work hard to change the things that are within my power to change but I must accept what is out of my control. Anger has it root in fear. Letting go of the fear frees you from anger. 

“Science investigates; religion interprets. Science gives man knowledge, which is power; religion gives man wisdom, which is control. Science deals mainly with facts; religion deals mainly with values. The two are not rivals.”
― Martin Luther King, Jr

Cleaning your home during a Pandemic: No Lysol or Bleach

Just before the Pandemic hit, I was so busy in the office that I did not get the opportunity to do any shopping for household cleaning products. My husband went out, and none of the products we use were available. So right now, I am living in a house without Lysol or Bleach, and I think we are okay. We went through almost all our Clorox wipes. I have been putting paper towels in the leftover liquid and extending my supply. We do have alcohol, but of course, I never mix products.  I could not find cotton swabs for over 3 weeks, so I had to cut them in half to clean my face. We did find Unscented Tide Pods. We do have a good supply of hand wipes. When I do go to my local ShopRite or Target, they are none of these products on the shelf. So, I have just resolved myself to using what I have. I tried one product, but the smell was a bit irritating, so I spray and step out and wipe later.

At work, I wash my hands so much they are shriveled. I use hand lotion after the soap and water. I spend most of So far, we are doing fine. The house is reasonably clean. I have not created any Chlorine gas fumes, and we have not had to go to the ER. The most important part of trying to prevent COVID-19 is handwashing, social distancing, and wearing a mask in public places. We have ordered food but are incredibly careful where we order from. I am a bit about where I eat, and that is a longstanding problem. I think it is from growing up in the south. I do love to eat out and enjoy a great restaurant.

Now, I am concerned. I am running out of my Swiffer Wet and Dry Mops. So, now, I must figure out my next steps. I read one article that said cleaning products may not be available until August. I know we are in the middle of a pandemic, and I hope we speed up access to cleaning products.

I do want to remind people to never mix cleaning products. Bleach and vinegar should never be mixed. Also, never mix alcohol and bleach. The effectiveness of cleaning products is not enhanced by combining them together but can generate dangerous gases and skin irritants. Drinking Bleach or Lysol does not kill COVID-19, so do not buy extra.

You just need to wash your hands, practice social distancing, and wear a mask.

 

Don’t give away your power

“You have the power to heal your life, and you need to know that. We think so often that we are helpless, but we’re not. We always have the power of our minds…Claim and consciously use your power.” Louise Hay

It took some time before I understood what my grandmother meant by “never let them drive you crazy.” For a long time, I thought she was reminding me of my late father’s mental illness and that I should be vigilant of my own mental health. However, I soon realized what she meant was to stay authentic to your core beliefs. Don’t let them make you lose control and make unwise decisions. That would be giving your power away.

I have always been an active daydreamer. I could get lost in my head or in a good book for hours. One of my heroes was Harriet Tubman. I imagined myself walking through the woods and streams, freeing the slaves, and bringing them to the promised land. I always thought that Harriet had magical powers. I read books about Kings and Queens of Africa and saw myself as the African Queen leading my people to victory against invading forces. I was powerful and in control, and I never lost a battle.

I began to think that as I went through high school and college that there was some magical force helping me navigate the rough waters. Getting through medical school for me was the greatest gift. I never gave up my power.

Right now, COVID-19 is wielding its mighty sword through our community, and I am getting texts from friends of loved ones lost. I feel powerless, so I want to put on my regal garb and fight and get fighting. I want to be Harriet Tubman leading my people to good health and keep them safe. I want to be that African Queen wielding my sword against this invader. If only I could. I know it is not that easy.

Some real true and hard facts. If you are obese or have hypertension, diabetes, or sleep apnea, you are at risk of dying from this disease. We need to regain control. If your Blood pressure is not controlled, you need to get it under control. No excuses. Most African Americans should be on at least two medicines if not three to four to control high blood pressure. If you are obese, let’s get kicking. No, I mean kicking up your legs by marching in place 10 minutes twice a day. It works and you don’t need to go outside. Exercise can reduce your blood pressure and blood sugar. You can use this time to gain control and get your power back. It won’t be easy but you have to start somewhere.   If you need a new doctor, practices are offering virtual visits. Get one now.

We have a democratic government that we elect. We pay taxes and are entitled to be helped by that same government. We should not have to beg our elected officials for the basic needs. So, as I watched my colleagues in tears and asking for the materials they needed to care for sick patients, I realized that we have the power to make changes. It only takes one simple act. We have the power of being a team. That means working together. One way is voting. If our elected senators, representatives, and our president put us in the position of begging for what we have paid taxes to support, then we must regain our power and use the power of our ballot.

Governors who refused to authorize shelter in place orders are not protecting us; they’re protecting their interest. Ministers who entice their members to go to church despite the known fact that this puts them at risk for COVID-19 are not true men of God. My grandmother always pointed to that fact. She was critical of the ministers who she felt were in it for the money.

We have the right to speak up. We need to demand protection, adequately equipped hospitals, and to be respected by those we elect. Remember, we elect them not to serve their interest or that of a party or a president but the people from the states that they represent.

Let’s regain our Power.

Self-reverence, self-knowledge, self-control; these three alone lead life to sovereign power.  Alfred Lord Tennyson

Another nice mess!!

 

If you are  a Laurel and Hardy fan, then you totally get the meaning of “another  nice mess you’ve gotten us (me) into.” Each movie was a series of antics that started with one innocent act that led to a series of escalating events that culminated in a total collapse of a building, a car crash a train derailment. Each one funnier than the other, but this is no laughing matter. The Oxford English Dictionary shows that back in the fourteenth and fifteenth centuries, as English was coming into its own, nice meant “stupid” or “foolish.” (From the Baltimore Sun) 

What a “nice mess” a series of lapses has caused. Once again, innocent people will unfortunately die, and a significant number will be African American. I heard the comment it was because we have so many comorbidities, and that is true. Another real problem is that so many of us do not have the privilege to work from home. We are on the frontlines, even in healthcare. We are the Certified nursing assistants for home care agencies, in nursing homes, in assisted livings and group homes. We are working on the front lines in every area of the hospital, from foodservice to cleaning services, and more. So, when we finally succumb to COVID-19, it will be due to our inability to shelter in place because we are deemed essential personnel. African-Americans comprise a large percent of transit workers, sanitation engineers, new Amazon hires, and working in Supermarkets. Walmart is a significant employer of people of color.

So, let’s not be silent. We must make sure that we are recognized as those unsung heroes that are once again keeping this country running. The blame game will paint us as overweight and sick, but there are many healthy people also dying from this disease. The problem is a lack of access to good primary care and low paying essential jobs that put us in harm’s way. We will see this play out in the rural and urban areas across the country. This disease will spread because of the lack of response by local officials in rural areas in the south and Midwest and by even the ignorance of church officials who are still having church services. We need a two-prong approach from healthcare. To protect ourselves, we need to protect our vulnerable populations that are held hostage to a system that is stacked against them.

Let’s fight to get the statistics out there so that once again, we do not have false information. No, this is not a conspiracy, and the numbers are not being inflated.

“I agree that income disparity is the great issue of our time. It is even broader and more difficult than the civil rights issues of the 1960s. The ’99 percent’ is not just a slogan. The disparity in income has left the middle class with lowered, not rising, income, and the poor unable to reach the middle class.”

Eleanor Holmes Norton

 

Empty Wagons

When we were kids, my grandmother had a saying for everything. One of the ones that seems apropos for this moment is one of my favorites. “an empty wagon makes a lot of noise”. It was always accompanied by “think before you open your mouth” or “don’t speak out of turn.” It took me a long time to grasp the meaning of these idioms. Empty wagons are “people who know very little to nothing on a subject often talk the most on the said subject,” and it also means that” people tend to talk a lot about nothing pretending all of that nothing is something.”

So, I spent all my life not wanting to be an “empty wagon” or someone who “speaks out of turn.” So, with all that’s happening, there are so many empty wagons. I especially am upset over the late orders to shelter in place by many governors putting many at risk. Who makes statements like “we really don’t know how this disease is spread’. 

I spent the past week working in the hospital. It became very apparent how easily COVID-19 can be transmitted. Also, sheltering in place is only valid if people follow the rules. I wear the N-95 mask all day at work, but to protect people when I am outside the hospital, I use a homemade mask to get around town. There are online DIY instructions for making masks, or you could just cover your face with a scarf.

My advice is to shelter in place and wear a mask.

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