Vulnerable: Thoughts From An African-American Male Podiatric Physician

How is 2020 going for you all? Many would probably overlook the question and its answer prior to the start of the new year. However, in today’s climate, such a simple question can evoke a multitude of emotions. So please take a minute and really think about that question. The good news is that there is not any right or wrong answer.

Recently, I find myself overwhelmed by an array of emotions when it comes to the challenges our country is currently battling. The first of these challenges is COVID-19. It took a lot of self-interest and eight years of advanced education, countless study hours and examinations to obtain a full grasp of medical science, and obtain a Doctor of Podiatric Medicine degree. In the span of several weeks, the entire world received a crash course in infectious disease, virology, epidemiology and public health. Fear, confusion, anxiety and panic became the expressions of many around the globe. Processing such information in regard to the intricacies of a viral pandemic and actually trying to survive it became the art that every individual attempted to perfect. 

As a husband, father and podiatric physician, one of my main goals is always trying to identify the underlying issue within a conundrum. The underlying issue typically resolves what one sees at the surface of these struggles. COVID-19 is a disease that many battle but it has also brought on an increased public awareness of the underlying issues that are very apparent in the fields of medicine and public health. Racial disparities are an arduous challenge within the medical profession in many aspects, whether it is attaining access to health insurance for uninsured individuals or simply getting authorization for a patient’s medications. 

When specifically looking at the African-American community and COVID-19, the increased prevalence of COVID-19-related mortality within this group is formidable.^1-3  While I did not find this shocking, I did find it disappointing because African-American communities around cities in the United States have experienced increased financial and health disparities for decades at disproportionate rates. When a pandemic essentially rips off the metaphoric Band-Aid among one of the most vulnerable patient populations, it makes for a delicate and potentially catastrophic mindset. Eventually, vulnerability and mistrust toward public health services grow to exponential levels, leading to frustration.

However, racial inequality is unfortunately imbedded in a multitude of institutions around our nation. Recently, many have viewed the tragic video of George Floyd’s death at the hands of police officers. This tragedy has brought to light numerous other scenarios in which similar forms of treatment have occurred at the hands of those that the community look to for protection.

As a health-care professional, I would like to emphasize that aspect of trust. Police officers and health care professionals are in the same business of altruism and service. Our job is to protect and serve our nation’s citizens. In order for us to do our job efficiently and accurately, we must continuously educate ourselves to better answer the call of our communities. For instance, as physicians, we are required to take a patient's history including his or her demographic information. This is not solely for information collection purposes. It allows us to better understand what our patients may be predisposed to. Furthermore, it can often have a direct impact in terms of access such as neighborhood location, whether there is access to fresh produce or affordable fitness facilities in order to maintain a healthy lifestyle.⁴ Although these are tough conversations sometimes as a provider, it is often the reality, especially for those practicing in inner city or rural settings. However, we must be made aware of this because it is our duty to understand and serve our vulnerable patients. 

Optimistically, I believe that health-care professionals can improve in this capacity more rapidly and effectively in comparison to our law enforcement counterparts. It only takes a conversation with your patients of color to discuss such matters with them. It is not that those facing these adversities expect immediate or overnight change, but knowing that their health-care provider took time out of his or her day to listen to their concerns goes a long way. Even recently, being an African-American health-care provider, I have had patients stop to ask me about my own well-being due to being African-American during the COVID-19 pandemic and heightened concerns of police brutality toward individuals of color. 

In closing, just last week, I spoke with a geriatric patient who celebrated her 93^rd birthday this month. I asked her if she could give one piece of advice to those individuals that feel unheard, abused and oppressed, what would it be? She kindly replied that through her years of navigating life, she has realized that none of these challenges have a quick fix. Her remarks were that support, unity and patience is how America has solved a majority of its difficulties over her lifetime from World War II to September 11th. 

Though it may seem bleak for a majority of us at this present moment, it all starts with our individual actions toward one another. It could include running errands for the elderly in your community or checking in on a colleague you have not spoken to in a long period of time. We have to remember why we chose to become doctors, which is to simply impact every person around us in a positive way. As podiatric physicians, we all know that one shoe truly doesn’t fit all.

Dr. Johnson is currently a Podiatric Medicine and Surgery Clinical Research Fellow at University of Pennsylvania-Penn Presbyterian Medical Center in Philadelphia. In addition, he currently serves as the only podiatric physician committee member for The Alliance of Minority Physicians at Penn Medicine and The Children’s Hospital of Philadelphia.

(Views expressed in this blog are those of the author and do not necessarily represent those of the author’s employer, affiliated organizations, or Podiatry Today.)

Dr. Johnson dedicates this blog to his beloved grandfather U.S. Air Force veteran Joe Louis Williams, Sr. (1936-2020) 

References 

1. Reyes C, Husain N, Gutowski C, St Clair S, Pratt G. Chicago’s coronavirus disparity: black Chicagoans are dying at nearly six times the rate of white residents, data show. Chicago Tribune. Available at: https://www.chicagotribune.com/coronavirus/ct-coronavirus-chicago-coronavirus-deaths-demographics-lightfoot-20200406-77nlylhiavgjzb2wa4ckivh7mu-story.html . Published April 7, 2020. Accessed June 16, 2020.  

2. Deslatte M. Louisiana data: virus hits blacks, people with hypertension. US News World Report. Available at: https://www.usnews.com/news/best-states/louisiana/articles/2020-04-07/louisiana-data-virus-hits-blacks-people-with-hypertension . Published April 7, 2020. Accessed June 16, 2020.  

3. New York State Department of Health. COVID-19 fatalities. Available at:

https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n . Updated June 17, 2020. Accessed June 17, 2020. 

4. Hillengas A, Bettigole C, Wagner A, Lawman H. Neighborhood food retail in Philadelphia. City of Philadelphia Department of Public Healthy Division of Chronic Disease and Injury Prevention. Available at: https://www.phila.gov/media/20190923114738/GHP_FoodAccessRpt_Final_wDate.pdf . Updated September 2019. Accessed June 17, 2020.