Remembering Newtown

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In the wake of the tragedies at Sandy Hook Elementary, it seemed America had finally lost its taste for the spoils of gunfire. Despite what gun lobbyists would have us believe, animals aren’t the only victims of loaded weapons. Guns kill kids. And while the events at Sandy Hook were horrific, only 1-2% of youth homicides occur at school.

The truth is, kids are dying in our neighborhoods.

And just when we finally seemed ready to have a responsible discussion about rights in this country, namely the right to protect ourselves from the tyranny of guns, we wait. We wait for our federal and state legislatures to grasp that the sanctity of the 2nd Amendment can never be placed above the sanctity of precious American lives.

What gives? What other lethal weapons are so protected in this country? Cars require registration and training to operate. Unsafe chemicals require warnings (and if they are particularly toxic their manufacture, distribution, and use are regulated by the government). Cigarettes cannot be sold to minors, are heavily taxed, and many states now prohibit their use in public spaces. New York even considered banning soda because it may kill someone in the future, from complications of diabetes and heart disease (which have been linked to high sugar intake).

In America, it seems, we have no problem placing limits on things we deem a threat to public safety and public health. And yet, we wait on expansive federal and state gun control. And more importantly, while we wait, polls show our collective conscience is losing sight of the urgency of the issue.

Homicide is the 2nd leading cause of death for young people aged 15-24; and if you happen to be an African-American male, it is the number ONE cause of death. In 2010, 13 kids a day were victims of homicide and more than 80% of them were killed by a firearm. And in the 3 and 1/2 months following Sandy Hook, more than 2,200 lives were lost to gun violence (a number akin to a Newtown every single day since the mass shooting).

The data is clear. People are dying and we have a system that protects gun ownership at the expense of our lives.

Tomorrow, December 14, marks the one year anniversary of the tragedies that took place in Newtown, Connecticut. Despite our nation’s horror and resolve to protect our children from further tragedies, woefully little has been done to prevent it from happening again. To see just how little, check out this New York Times chart. According to their data, it is estimated that 1500 gun laws have been introduced in various states since the massacre and of those, only 109 have become law. Of those 109 new gun laws, 70 loosen gun restrictions, making it easier for individuals to register, conceal, and use firearms in various states across the country. Some of those laws even made it easier to carry concealed firearms at churches, public parks, and schools!

This is outrageous.

It is truly shameful that as we mourned the loss of those precious 26 lives, we at once made it easier for a similar tragedy to occur.

As a pediatrician and child health advocate, I continue to stand with President Barack Obama and the American Academy of Pediatrics in demanding sensible gun reform.

If America doesn’t have a crisis of consciousness over the incredible inaction that has surrounded the death of our children, I am not sure what it will take. I pray that more children don’t fall victim to firearms before we make some changes. It is time to put our children first and prevent further injury and death by taking the responsible steps towards sensible gun reform.

* This article is adapted from a piece I wrote following the tragedy at Sandy Hook Elementary. To read the full piece, click here.

* To check out what the American Academy of Pediatrics is doing to respond to gun violence, click here.

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The Way

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But somehow I wonder if

Despite their silent exterior

Away from the purview of others

In a darkness all their own

They endure the painful pruning of transition

Of transformation

Old is new

And new is you

And butterflies bleed too.

There are those among us who are treading on unmarked ground, fresh soil devoid of the comfort of patterned steps heralding the way. We are straying from tradition and daring to redefine the boundaries of our professions as we venture in new directions. It is not just that we don’t fit the mould, but that in some ways, we reject the idea of moulds all together.

For me, social justice medicine is the new direction. It is the practice of clinical medicine in a thoughtful way that creates and sustains health equity. It requires community engagement, civic participation, political advocacy, apt use of new media and technology, and interdisciplinary collaboration with local organizations and community leaders. It is essential to build a more just, equal, and free society and so far, it doesn’t really exist.

6 months ago, at the end of my pediatric residency, I took a position as a community pediatrician and have been eagerly piecing together a career in the practice of social justice medicine ever since. Sometimes, in moments of uncertainty, when my mind is quiet enough to admit my fears, I find myself in the throes of a great transition, worried I have no idea what I’m doing or where I’m going.

In medical school, I took a class called Let Your Life Speak. It was based on a vocational guide by the same title, and it helped medical students identify our gifts and consider potential careers. In the book, author Parker J. Palmer presents the idea of “way” or the path on which each of us walk toward our purpose. I’ve been looking for my “way” since college and as my blog header articulates, it is an ongoing journey. Recently, I found some clarity.

In any hierarchical assent, “way” seems to form in front of you, with each opportunity striding towards the next. But the truth is, that “way” was already there, worn by the feet of others, and ending at a predetermined destination. Sometimes paths are created as “way” closes behind you. When opportunity doesn’t knock, it quietly closes the door, making new, unseen paths available.

To stretch the confines of what it means to be a doctor, I have to stretch my understanding of how to get there. In doing so, it has become clear that “way” is not linear and does not have directionality. It is the iterative process of curiosity, experiment, discovery, and failure that builds the experiences necessary to create an unconventional career. Although the cyclical process of preparation, pruning, and readiness may be difficult, the product will be beautiful and uniquely yours.

But somehow I wonder if

Despite their silent exterior

Away from the purview of others

In a darkness all their own

They endure the painful pruning of transition

Of transformation

Old is new

And new is you

And butterflies bleed too.

Hunger Matters

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I thought that point was obvious. But apparently, there remains some debate because on November 1, 2013, the federal government effectively cut 5 billion dollars from the most powerful anti-hunger program in our country – food stamps (or SNAP as it is now called, which stands for Supplemental Nutrition and Assistance Program).

Here’s the quick history on the issue: During the recession, unemployment rates spiked. As family incomes fell, more families were at once eligible for food stamps and in need of extra money to put food on the table at the end of the month. To account for this increased need, the federal government issued a “stimulus package,” technically called the 2009 American Recovery and Reinvestment Act. The Act did a number of things, one of which was to boost food stamp benefits. That boost expired on November 1.

The problem is, usage of the program (read: hunger) remains at an all-time high. And, the program works.

So let’s break that 5 billion dollar cut down to real numbers. For a family of 4, it means they will lose $36 dollars per month to cover their food costs. That is equivalent to losing 21 meals per month OR if you try to stretch the money out, having about $1.40 per person per meal, each month.

$1.40.

To put that number in perspective, in case $1.40 seems reasonable to you, the USDA has actually calculated how much it costs to eat on a super tight budget. They call that estimated value the Thrifty Food Plan. According to this bare-bones estimation, the cheapest, nutritious meal in America costs at least $1.70-$2.50 (the exact value depends on age and gender). For millions of American families, that gap between $1.40 and $1.70 will be the difference between being fed and going hungry in 2014.

In medicine, we refer to “being fed” as food security, or access to sufficient, safe, and nutritious food to maintain a healthy life. It is estimated that 1 in 6 Americans are food insecure. In 2012, that was about 49 million people. As of November 8, 2013, SNAP provided food for more than 47 million people, nearly half of whom were children.

Imagine I said 1 in 6 people have swine flu or the plague or a terrible form of cancer. There would be outrage. Frankly, we’d call it an epidemic, a real problem that someone has to stop! And yet, when nearly 20% of Americans do not have enough food on their table, there is debate about what should be done.

The answer is simple, #saveSNAP.

In 2011, it was estimated that SNAP fed 1 in 4 children in the US. Children need healthy food to build bones, grow their brain, and control their behavior. Try hurdling the achievement gap without breakfast. The challenge is obvious. People need food to live and succeed. As a society, we simply cannot tackle the major problems ahead of us if we fail to provide for the most basic needs of our country.

In the coming months, I will re-address this issue as the House and the Senate consider bills that would eliminate food stamp benefits for millions of Americans.

In the meantime, check out what pediatricians, community advocates, and I are working on to tackle hunger in the Bay Area.

I Missed You!

Hello blog world!

I took a sabbatical from writing while I studied for my pediatric boards, which I officially took this October (yay!). While I was away, I stayed busy with my clinical work and a few projects that I am eager to share with y’all. I also wrote a few pieces for other outlets that I will hopefully be able to post here once they are published.

So I just wanted to let you know that I’m back and I missed you! Writing for this blog is one of the highlights of my week and I can’t wait to resume our conversations on race, politics, technology, culture, and medicine. As always, if you have comments to share or topics you’d like me to write about, hit me up in the comment section!

Stay tuned for a piece on hunger this week!

Xoxo,

Rhea