The Most Important Questions We Won’t Answer For You

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My fellow pediatrician and friend Nia Heard-Garris and I wrote a piece on medium about how White Supremacy and anti-Blackness show up in medicine and how to start the conversation.

Check it out here and let me know what you think!

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Viral Violence and the Challenge for Public Safety

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As the screens we carry narrow our proximity to random and targeted acts of violence, many parents and families are rightfully questioning the impact viral violence has on shared perceptions of public safety and child health.

In pediatrics, we have long considered the link between media, violence and health.

We know kids who watch fake violence in movies or play violent characters in video games show signs of increased aggression. But what happens when the violence kids watch is real? Or when the cameraperson is only a teenager?

Today, youth can easily capture and consume real violence, in real-time, as a part of their daily routines – from snapping school violence, live streaming police violence, recording sexual violence, or sharing images of political violence. This is the new normal* and it’s more complex than the simple relationship between simulated exposures and aggression.

A child watching real violence from their cell phone now understands something tangible about the world; and a kid who records or shares violent imagery online can contribute to others understanding of the world. That elevation of the voices and experiences of youth can be extremely valuable. Indeed, in terms of activist’s movements like Black Lives Matter, the perspective of youth, magnified by social media, has become a national catalyst for police reform, criminal justice reform, and racial equity.

Yet, perpetual exposure to viral violence takes its toll – often manifest in feelings of victimization, grief, fear, intimidation, anger and sadness. And kids and teenagers may be most vulnerable to this kind of trauma because they are still developing the emotional and intellectual maturity to process troubling events. What is more, they rely on trusted adult figures to provide safe spaces in their life.

As we face these harrowing challenges, consider two thoughts:

1. While it’s okay to be protective, thoughtful and proactive regarding how youth experience and contribute to violent images online, we, as parents, caregivers, or providers, cannot simply turn a blind eye. While distressing, some images of violence advance our collective understanding, compassion, and empathy for the suffering that exists outside the walls of our private communities or our segregated social groups, and the privileges those spaces confer. In this way, confronting the visual of violence with a particular effort to center the interpretation of the events around the marginalized populations disproportionately affected, is the first step towards collective healing. And that healing begins with rigorous and vigilant public exploration of the ways systemic racism, sexism, Islamophobia, homophobia, xenophobia and intolerance threaten public safety.

2. As we live-stream our lives, we open windows to the neighborhoods we live in, the spaces where our kids learn and play, and the ways we perceive and are perceived in the world. When we don’t like what we see on the other side of that window, it can be easy to hide discomfort or insecurity with blame or shame or to create narratives that distort the humanity we witness. But each time one of us resists the opportunity to understand the burdens or experiences of another, we all move further from the co-existence necessary to bring peace.

*This is a piece I wrote with my friend and colleague, Dr. Wendy Sue Swanson, that was published in the July 2016 Pediatrics. It is available for free online for the first week of publication.

2015: A Year in Review

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As many of us begin the time-honored tradition of celebrating what lies ahead, I want to briefly look back and review a year that has meant so much to me. In true New Year’s Eve fashion, I thought a countdown would do the trick.

4. One Degree

For the past year and a half, I’ve coordinated a partnership between our regional American Academy of Pediatrics and One Degree, a SF-based tech non-profit. One Degree and their incredible staff are the brains behind an ambitious project to not just digitize social service referrals, but to do so in a way that strengthens the capacity of the safety net to understand and respond to social needs. By maintaining a platform that is freely available to the public, in English and Spanish, One Degree is also endeavoring to transform referral agencies, from gatekeepers whose staffing capacity determines access to bridges that open access to resource information. They also launched an affordable housing portal this year!

Together, in 2016, we are embarking on a multi-site clinical pilot, to test the feasibility and usability of One Degree’s technology in diverse clinical settings in the Bay Area. We are partnering with a mobile asthma clinic, a clinic for homeless families, a teen clinic, a primary care pediatric clinic, and a free clinic with a large immigrant population. With a team of faculty, providers, and research assistants we hope to refine this technology for use in the clinical setting and broaden the ways healthcare providers address social determinants of health. Here’s a picture of our fearless team!

3. Mentoring

This year, I was fortunate to meet Christine Chen, an inspiring undergraduate student at Stanford University who founded DiverseCity, a website where students “will find the stories advice, and reflections from a diverse range of inspirational people, to show [them] that no matter where [they] come from, or what [their] background, [they] can do incredible things.”

Through Christine’s work, I can hopefully encourage students and trainees to use their voice to make a space at the table for those of us with unconventional interests or underrepresented backgrounds.

To check out Christine’s feature on me, click here and to check out her blog post on Medium, click here. Here are the videos she made:

2. Teaching

In 2015, I had the opportunity to teach 1st and 2nd year Stanford medical students as well residents! When I was a medical student, I was eager to learn about the connections between health and inequality, but early in my education, I found few outlets for my curiosity. Since becoming an attending, introducing medical students to these topics has been a dream of mine. Through the work of students Jessica Steinberg and Brandon Turner, I got to participate in the development and execution of a seminar entitled “Clinical Excellence and Best Practices: Delivering Healthcare to Changing Populations.” This experience was a highlight of the year and something I won’t forget. Here’s my 1st class!

1. Police and Child Health

I, like many who share black skin, have watched, witnessed, black bodies killed without reason or hope for just retribution, by the very agents charged with our protection. And every time, it affects me. Like others, I know the actions of officers in Oakland, Ferguson, New York, Cleveland, Baltimore, Charleston, Chicago, and San Francisco upset more than sensibilities and implicate more than the random carelessness of a select few. It shakes my personal sense of safety and unearths an uncomfortable, non-random reality about being black in America.

But unlike many, whose fear for black lives is more personal than philosophical, I also know the physiology. I know that witnessing violence has important health implications and the impact of police encounters may not be limited to the transience of bruises. For survivors, far more may suffer incarceration, a sustained trauma that separates families, disrupts social networks, and generates new barriers to economic security. I know what is happening to black lives matters, but it isn’t simply an ethical supposition, it’s a biological one.

So I’ve been writing about it, first for my blog, then KQED radio and now Pediatrics (this piece is coming soon!). And I’ve been coordinating a local group of public health leaders, community advocates, and funders to help our public health infrastructure capture and address the health impact of police violence and other harmful police exposures.

More than any work I’ve done this year, this has been the most personal. Addressing social determinants of health is why I became a doctor but elevating the needs and priorities of communities of color within society’s trusted institutions is my life’s work. I feel overwhelming grateful and humbled to begin that work here and now.

Looking back, I never could have guessed the things that happened in 2015 (some that took me away from my blog for months at a time!). Though I hit the highlights here, know it was a year marked by challenges just as much as it was marked by opportunities – lost grants, extended paper revisions, and growing professional relationships. But I made it! I embraced the things that wake me up in the morning and light me up inside and I can’t wait to do it again in 2016.

Happy New Year blog family!