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Physician, Activist — Does One Preclude the Other?

When do you leap into the unknown and venture into the uncomfortable? Is it after methodical deliberation or is it much more abrupt, emboldened by a critical decision? Perhaps it is a deep drive within you, one that propels you forward in a way in which you cannot look back.

I write as a daughter, a sister, a partner, a physician, a scientist, an activist and a voter. The interconnectivity of these roles is not always something celebrated. 

Science and medicine, for good reason, have a longstanding history of the preservation of objectivity. The core structure of a scientific experiment is reliably composed of a hypothesis, methods to test that hypothesis, analyses and a conclusion. A parallel structure exists in medicine, composed of the history of present illness, physical examination, diagnostic studies and differential diagnosis, culminating in an assessment and plan. These pillars frame our work, and our minds, in hopes of leading us to new discovery with sound methods. Through this lens then, one can understand why engaging in politics, social justice and mainstream media may be something that requires objectivity by those of us in medicine. 

The beauty of science is that it is not applicable to a specific motive; it is merely tried and tested fact. As doctors, with our origins rooted in science, we apply these principles when we engage in activism. To instill mutual trust and security with vulnerable patients, we do not want to be perceived as polarizing or controversial. We aim to build and preserve rapport to demonstrate that, for all patients and families, we will care for them as if they were our own family, no matter their views, circumstances or sacrifice.

However, our identities are not solely linked to our role as medical providers, but also with our families, friends and as members of our local and national communities.

In many ways today our world feels broken and tumultuous, with heartbreak always around the corner. We face a global crisis as a result of the novel coronavirus with over 200,000 dead nationally; more than one million globally. This is an ever-present reminder of how our time on Earth is fleeting. We feel the rumbling energy of national unrest with countless losses at the hands of the pandemic of racial injustice; a product of 400 years of inequality further exposed by COVID-19. Meanwhile, the simmering threats of climate change are boiling over and contributing to one catastrophe after another. Record breaking blazes in California make the skies orange and air toxic, overlaying a backdrop of pulmonary disease from COVID. Amazonian fires continue to create alarming deforestation rates. Hurricanes increase in activity and gain intensity at rates that exhaust even the method of classification. Cyclone Amphan off the Gulf of Bengal, the strongest storm on record, displaced large scale populations in India and Bangladesh, augmenting the struggle of social distancing in our health crisis.

This duality is our new reality. May one be bold enough to say that the climate crisis is the pandemic we have been idly watching establish itself, with gross negligence at the expense of our most vulnerable? Is the public truly just realizing the atrocity of large-scale inaction? While each headline pulls at us in different ways, perhaps it is not the oscillation of these sinusoidal waves but the complex interplay that is most impactful. The intersectionality of health disparities, racial injustice and climate change may be the most pressing reason for action.

And so, I find myself in a new pandemic world, fearful for our planet and human rights, with a drive like no other to demand change. I write my piece after the November election, when the American people and democracy have spoken. An election that resulted in the highest voter turnout in over a century. An election that brought forth new political engagement from the scientific community, illustrated by the Scientific American publishing its first ever Presidential endorsement and the New England Journal of Medicine condemning the current administration’s response to COVID-19. And while the American people have raised their voices through the power of their votes, this should serve as the first spark of an ongoing conversation.

It is at this moment that I write to call out to the medical community to take a stand. As physicians we must do no harm, meaning we cannot be complacent in our elections or communities. We must all be activists, channeling the energy for which we advocate for our patients in health care settings into the political and advocacy arena. We must embolden our communities and amplify the voices of grassroots movements, building upon the momentum of this historical moment. Just as we guide and support our patients to better their health, we must nurture our communities to better the health of our nation and the world. And if we can work to reverse the scales of discrimination and build a clean, green future, it will serve as an investment to avert future crises.

The Climate Lens: Physician Perspectives of the Climate Crisis

The Climate Lens aims to share narratives that illustrate the health impacts of climate change in a relatable way.

Image credit: The Day The Sun Didn’t Rise by Christopher Michel licensed under CC BY 2.0.

Shalini Shah, DO Shalini Shah, DO (2 Posts)

Attending Physician Guest Writer

Boston Children’s Hospital

Shalini Shah is a pediatric hospitalist at Boston Children’s Hospital in Boston, MA with special interests in environmental health and health equity. She completed her medical training at the University of New England College of Osteopathic Medicine and her residency in pediatrics at the University of Massachusetts.

The Climate Lens: Physician Perspectives of the Climate Crisis

The Climate Lens aims to share narratives that illustrate the health impacts of climate change in a relatable way.