Greetings! Amid a week of serial funerals for those brutally murdered in Buffalo, the carnage in a house of worship in Laguna Woods, and shock from the children and teachers killed in Uvalde, it feels inadequate to offer words on a page. It is hard to comprehend that routine daily activities like grocery shopping, worshiping, and going to school can result in death. As an African American I continually struggle to understand the hatred cultivated for others, solely based on race—particularly when this hatred is used as justification for murder. As a physician and mother of three school age children it is unfathomable that as of 2020 fire-arm related deaths are the top cause of mortality for children and adolescents in the US.
With a heavy heart, I add my condolences and prayers to those sent from across our nation and indeed the world to the families and communities of Buffalo grieving the loss of their ten loved ones; to the families, congregation and communities of Laguna Woods who lost a worshiper and saw numerous others wounded; and to the parents, families and communities who grieve for the 19 students and 2 teachers murdered in Uvalde. As family physicians we strive to optimize the health of our patients and communities through the provision of quality holistic care. This care is key to the health of our patients. To be truly holistic, we must also acknowledge that what occurs in the exam room is only a part of what impacts health. Social determinants such as racism, gun violence and the explicit discrimination directed at African Americans and other marginalized groups in our nation far too often pose a more immediate threat to health and mortality than many of the conditions we treat within exam rooms.
As we grapple with gun violence and racism, we are also faced with the impending reality that the highest court of our nation may overturn nearly fifty years of legal precedent protecting a woman’s reproductive rights. Rights that allow a woman to decide how she will proceed with one of the most personal and significant choices she may make in her life. The potential change in law could compromise the patient-physician relationship and potentially put both at risk.
Racism. Gun violence. Reproductive health. Each of these issues is layered with a myriad of complex health considerations and related questions that we are challenged to confront—to push ourselves and our leaders not to be passive bystanders in the midst of these ongoing health crises. We must not remain unmoved until pain or tragedy arrives at our own doorsteps. Our words and conversations are important, but more so are our actions. The AAFP will continue to: consider racism a public health crisis and advocate for policies that opposes all forms of institutional racism; support primary prevention strategies to reduce injuries and deaths associated with gun ownership and violence; and explicitly support a woman’s access to comprehensive reproductive health services. As family physicians we have the ability to bring about meaningful change for each one of these issues and to improve health.
During his recent keynote address at the University of Maryland School of Medicine graduation, US Surgeon General Dr. Vivek Murthy comments included the following advice for the graduates, “All of you are joining a sacred family of healers, healers for who generations have stepped up to face the great challenges of their time . . .Healers who sought to shape society not only with the power of their knowledge but also with the strength of their values . . . Choose to get out of your lane . . .” Dr. Murthy’s advice rings as true for seasoned physicians as it does for those who are beginning in their careers. As healers we have the ability to extend our voices and our knowledge outside of the exam room to help shape society and health for the betterment of all.
The mission of the Maryland Academy of Family Physicians is to support and promote Maryland Family Physicians in order to improve the health of our State’s patients, families and communities.
Shana Ntiri, MD, MPH, FAAFP