le 10
janvier 2015
Wielding pens. Waving swords. Stopping
traffic.
I’ve believed that for a long time, not
just in the old adage that “the pen is mightier than the sword.” As a writer
and a doctor, one of my greatest hopes and exultations in earning my MD was the
power and respect the degree bestows, for better or for worse, deserved or not,
to be a spoken/outspoken advocate, and to be published for it.
I use writer in the sense of “someone for
whom the act of writing is not an option; someone for whom writing is as necessary
to existence as is oxygen.” I use doctor in the sense of not just the
traditional physician and caretaker for a body and a person, but in the Latin
derivation of “doceo, docere – to teach.”
Almost every sentence and every paragraph
here starts with I. There is, too, now, “Je suis Charlie/ I am Charlie,” for
what it’s worth, for belief in and disbelief against the recent attacks in
Paris of freedom of speech.
I have recently felt ill, paralyzed,
galvanized by moment and by turn by the deaths of Ebola, inequalities in Africa
and health systems in Africa, prejudice, hatred, and fear of those of African
descent living in the United States, focus on a few individuals sick in a
country where they can be taken care of versus thousands upon thousands in
countries whose fragile infrastructures are being destroyed; by injustices
perpetrated by institutional racism across the country and most poignantly,
most close to home in New York, a system in which I, physicians in general,
anyone in a hierarchical position of power is complicit, where I weakly, as a
primary care physician, offer flu shots and preventative measures to my
patients who, in the South Bronx, are more likely to go to prison than to
college, who could be stopped and frisked on the basis of nothing, who fear and
are injustly feared on a daily basis.
There is the public health.
There is fear, worry, and helplessness
because my friends in Africa have a higher chance of dying because, well, they
have a higher chance of dying, and in two and a half years I went to
exponentially more funerals, including those of children, than I have ever
attended in the United States.
There is anger, outrage, need for telling
when one of my patients almost died because of his insurance company and the
lack of single payer health care, the lack of a generalized belief in health
care as a human right in this country (article in progress, submission of said
article to be done). He’s the first
patient I asked if I could write a story about, a patient I know well, and he
wanted me to publicize his story, to let others know, to try to help this not
happen to anyone else. It was one of the best medical visits we’ve ever had.
I often end up watching the news, being
part of the world, in patients’ rooms. We talk about it. It’s where I’m near
TVs. In the intensive care units, these patients might be comatose, sedated,
intubated, and as I try to remember and still speak to them as people, I become
more part of the world.
I watched the events in Paris, some of,
unfold in such a room. The patient was maybe-dying; a patient we’d had arrive
last week in a similar condition did die. Because the hospital does not have
the capacity it should for patients of this acuity of illness, because systems
and overcrowding and a Bronx that has one of the highest burdens of illness of
anywhere I’ve worked, he had not received an adequate level of care for the two
days since his heart stopped and was restarted. I know little more about him
that what the scant notes told me. I know he immigrated at some point, I know
he mostly speaks Spanish, and I can imagine that due to a paucity of
translators (though the phones are available everywhere), minimal time, and
sometimes a lack of value placed on communication with patients and families in
languages that they fully understand, he had likely not received the highest
level of care or explanation of his condition. He apparently has a primary care
doctor, that’s somewhat lucky. He was able to have a procedure to open the
clogged vessels in his heart, that’s lucky too --- though it shouldn’t be.
So I was standing behind the head of his
bed, increasing his level of sedation as he started to resist us placing a line
in the largest vein in his neck, to give him the medications he needed to
increase his blood pressure to the point of getting sufficient oxygen to his
brain and to the rest of his body. It’s not just because Paris is partly home
(true), or because I was there two months ago (also true), or because so many
people I care about so much are there (true), but I felt more sick and focused
on this, the fear minimally of death compared to the fear and horror of
violence against writing and writers, than by the pain I was inflicting on a human
being for “his own good,” necessity, for his illness that was contributed to by
societal inequalities.
All of the above would be silent, unknown,
if they could not be written of. There is TV now, internet, social media and
the Arab spring, There is the movie held from theaters for political threats.
But first, foremost, and still (yes, a picture may be worth a thousand words),
there are writers, there are pens, there is finding the exact expression of
something that is not for and by one but that is for and by a collective.
Plato banned poets from the Republic. They
were too dangerous.
It’s not just that they were writers and
artists. It’s that an editorial board meeting was targeted (and what, more than
that, proves the power of words?) In France, political satire is an integral
part of the culture. The political cartoonists were, are famous, before their
violent deaths for writing. Not every country would hold a national day of
mourning for writers. In few countries are major streets and squares, and so,
so many other public and critical things, named for writers and philosophers.
Writers are venerated. Artists are venerated. There are TV shows, many, solely
of political cartoons and sketches. There are more newspapers than this one.
Growing up in the United States, spending much but far too little time in my
native country, in my first language, even I knew their names.
With everything wrong and injust and
indignifying and terrifying and almost to be believed in the world (what else
makes the news?), the largest piece of meaning, what I personally (and everyone
is making this personal. Freedom of speech, freedom of expression is not just a
societal but a personal human right granted to every individual – or should
be—Je suis Charlie, I am Charlie) want to make a major part of my life is to
write about it. There is arrogance in that too, in the need and want for
publication. But it is tapping into a collective conscience, conscious and
unconscious, Poetry is, anyway. Many of the writers in Paris wrote under
assumed names, partly because that, too, in political satire there, is part of
the culture. They were still known as people. Any attack on writers is not just
an attack on writers but on everyone with a mouth, a tongue, a hand, an ear.
In Cameroon, I know people afraid to speak
of politics in taxi cabs. On presidential election day in 2007, my friends didn’t
want me to leave my house for fear of what I would see and what could,
potentially, happen to me. The same year, I spent six months trying to master
the bureaucracy of the French embassy in order to register to vote as a citizen
abroad, I traveled (four times) one hundred miles in fourteen hours in order to
vote. In the United States, I have campaigned in every presidential election
since 2000. And I have been grateful for the accident of birth that gave me two
passports in two countries that honor, that promote the right to speak and
write freely. This shouldn’t happen in my first, my native country and language
or in the country I am also from and where I’ve spent most of my life.
There is nothing left to say, there is
nothing left to write but to speak. And to write.
Keep writing! I would love to read more on your thoughts about America, freedom, health care and life in general.
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