A look at the roster of patient names filling the floor-to-ceiling dry-erase board in the COVID-19 hospital intensive care unit where I practice reveals an unsettling pattern:
More than half are of Hispanic origin, and the lion’s share of the remaining names belong to African American individuals.
And this is just the tip of the iceberg. Sadly, daily discussions with the patients’ loved ones reveal an even deeper disparity, marked by tearful stories of multiple family members hospitalized or deceased due to complications from the virus. Indeed, there have been entire families admitted to the hospital at the same time due to COVID-19.
When asked about potential exposures, most cite living with family members with essential jobs who have had to continue working during the pandemic, despite their desire to keep themselves and their families safe.
These heart-wrenching accounts paint a grim picture of the burden disproportionately borne by communities of color, their lives placed on the line to keep society running and capital flowing.
Moreover, the deaths these patients suffer are generally not what we think of as “good deaths” — a term commonly used by medical providers to describe a peaceful, pain-free passing. Instead, they all too often occur amidst a flurry of invasive interventions — emergent bronchoscopy (a procedure where a flexible camera is used to clear blood clots or globs of mucus from the airway), CPR (which contrary to its depictions in popular culture is nothing short of barbaric and entails chest compressions forceful enough to break ribs), and sometimes extracorporeal membrane oxygenation (a treatment modality that uses tubes slightly smaller than a garden hose placed in the vessels of the neck and groin to bypass the heart and/or lungs).
It may sound horrific, and indeed it often is. But we do all of this in order to keep people alive and breathing, regardless of race, creed or any other identifying label, valuing the sanctity of life above all else.
To that end, the recent events surrounding the death of George Floyd, a black man who died when a white Minneapolis police officer kneeled for more than eight minutes on his neck, left me simultaneously baffled and enraged. Thoughts of Eric Gardner, another black man who similarly died by asphyxiation at the hands of a New York police officer in 2014 — as he pleaded, “I can’t breathe” — rushed through my head.
It left me with the same sense of moral outrage that I had felt when looking at the patient names on the board in the COVID ICU. Yet another person of color – perhaps better stated, yet another human being with loved ones, ambitions and what ought to be inalienable human rights, who just so happened to have darker skin pigmentation – was made to suffer the type of horrible death rarely forced upon whites.
Of course, American history is replete with examples of systematized racial injustice. Arguably, the miasma of institutionalized racism has plagued the United States since its very inception, born of the original sin of slavery and perpetuated by a brutal, white, paternalistic power structure which has, for generations, maintained a near-absolute reluctance to meaningfully account for the countless transgressions committed (both historic and current).
However, under the draconian policies of the Trump administration, which has been overtly hostile to various minority groups (lest we forget the reported 2,654 immigrant children cruelly separated from their families after crossing into the U.S. to seek asylum), the air in modern-day America has become particularly stifling for people of color.
In this age of unfettered greed, hyper-capitalism and ubiquitous disinformation, as a collective we seem to have been lulled into an apathetic disregard for the lives and wellbeing of the poorest and most vulnerable among us, so much so that our elected officials have instructed us to value economic gain over the sanctity of human life without so much as a modicum of shame.
This is wrong and indefensible, and it must be vigorously rejected.
George Floyd was allegedly pursued, subdued and murdered on a report that he had attempted to use a counterfeit $20 bill. The incongruity between the supposed crime and irreversible punishment is infuriating, but it is not surprising. Nor is it surprising that peoples’ anger had to boil over and capital be physically destroyed before the offending officer was held to account for his despicable and heinous actions.
Floyd’s death is the ugly manifestation of what happens when human life is devalued in the name of capital. And the current upheaval taking place in cities across the country ought to be seen by our politicians as a clear repudiation of the lack of accountability and flawed calculus that continues to devalue the lives of people of color in this country.
For ages, physicians have taken a symbolic oath to do no harm to our patients, and we are held to a high standard of accountability in those unfortunate cases in which harm occurs. Perhaps we ought to demand the same level of accountability from our police officers who, like physicians, possess the power to cause grave and irreversible harm to those they are sworn to protect.
Such changes won’t be easy, but they are moral and just. And perhaps most importantly, they are a long overdue first step in helping our fellow Americans breathe easier again.
Dr. Justin Anthony Fiala is a chief pulmonary/critical care fellow in the Division of Pulmonary and Critical Care Medicine at Northwestern University’s Feinberg School of Medicine.
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