I am MLK

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Unprovoked and un-prosecuted police brutality that preys upon people of color.

Separate and unequal education systems that consistently fail poor children of color.

Segregated housing that concentrates poverty and consequently, crime, in communities of color.

A discriminatory wage gap for women and people of color that bolsters growing wealth inequality.

And preventable patterns of disease that plague poor communities of color.

The contemporary threats to equality in American life are disturbingly similar to the injustices that emboldened leaders of the Civil Rights Movement more than 50 years ago. But while the issues that define our time are unsettlingly familiar, the opportunities to act are profoundly different.

With the advent of social media, ordinary individuals now have unprecedented access to both publish and consume publicly curated news. This step to democratize information creates a space for enduring public discourse and a real-time portal into the many faces of racism, sexism, classism, and cultural ethnocentrism that endanger our most basic American values.

The legacy of the Civil Rights Movement freed us from the tyranny of these “isms” at the ballot box, in the classroom, in our neighborhoods, in our work places, and in the public spaces of American life. In so doing, the acts of thousands of courageous Americans set a new precedence for our nation to reaffirm its commitment to liberty and justice.

Today that commitment is under attack. And although the challenges we face are formidable, our responsibility is great. So who will rise to the challenge? Who among us is willing to take the protests and the hash-tags into the daily routines of our lives where the insidious acts of racism, sexism, classism, and cultural ethnocentrism threaten the values we hold most dear? Who will fight for equality today?

Dr. Martin Luther King Jr. was an exemplary American who challenged us to rise to the height of our humanity. But we cannot wait for another visionary to bring us to the mountaintop.

The urgency of justice demands we act now, one institution, one industry, one community, one person, one step at a time.

If you are a teacher or school administrator, challenge the “zero-tolerance” policies that forge the school-to-prison pipeline, disproportionately shunting students of color and students with disabilities, as early as preschool, into the criminal justice system for routine school infractions.

If you are a local government official, question the redistricting policies that dilute the voting power of minorities and overturn voting registration policies that may prevent the elderly, the poor, or people of color from exercising their constitutional rights.

If you are a housing developer or real estate speculator, invest in mixed-income housing that enable people, regardless of race and class, to share the public benefits of education, parks, and recreation that flourish in proportion to local tax appropriations.

If you are an environmental advocate, lobby to protect poor communities of color from the industrial pollution that threatens their air,soil, and water quality and ultimately jeopardizes their health.

If you are a police officer, challenge “stop and frisk” policies that disproportionately target Black and Latino individuals and confront the biased assumptions that may lead you to suspect persons of color or treat them with excessive force.

If you are an writer, publisher, producer, or actor, demand that our films and books offer a genuine look into the lives of all Americans. This requires equal representation on the written page, behind the camera, and in front of it, to reflect the diversity of the American experience.

If you are a student, consider if women are disproportionately subject to sexual violence on your campus, and stand in solidarity with the victims in demanding that your faculty and administration protect young women and their bodies.

If you are a business administrator or owner, critically look at your workforce, from the leadership to the average employee to the staff and ensure that the process by which you recruit, hire, and compensate employees reflects equity in opportunities for women and people of color.

If you are a physician, confront your implicit bias and how your differential treatment of patients by race, gender, or class may contribute to deadly health disparities.

As Dr. King sagely foretold, “injustice anywhere is a threat to justice everywhere.” The racism exacted with the lethal precision to take the life of Eric Garner is just as pernicious as the sexism that ostracizes and threatens the lives of victims of sexual assault on our college campuses. It is time to connect the dots between all forms of oppression in American life and work towards justice.

The modern movement for equality will be powered by the daily diligence of the masses, not the brilliance of one leader. We all must summon the courage to go to into our work place, our classroom, our community, and our home, and engineer justice, create equality.

As we remember, with pride and gratitude, the life of Dr. King, let us not rely on his memory to ensure our liberty and justice. Without his living example, let us be his voice for change.

I am MLK.

This week, join @schumerj and I, as we tweet out our commitment to change our workplace, community, or social networks using the hash-tag #IamMLK and let’s build a coalition of leaders for justice. Also look for an upcoming 2-part piece on racism in the American health care system and what we can do about it. In solidarity, Rhea MD

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Dying While Black

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Each year, as our nation reflects on the life and legacy of Dr. Martin Luther King Jr., I look for contemporary signs of change, examples of how we as a society have evolved in our understanding of race and how and where African-Americans have folded deeper into the American story and been embraced by the country they’ve called home for centuries.

This year, I didn’t have to look any further than my own backyard. Last week, the Sun Reporter, a Bay Area weekly that runs local and national news involving African-Americans, featured a story on Jahi McMath. Jahi was a 13-year-old African-American girl whose untimely death, following a tonsillectomy, lead to weeks of contentious debate between her family, her medical providers, and the national media regarding her diagnosis of brain death. Being a local pediatrician* I was well-aware of the story. But what struck me when reading this particular piece, was the way the periodical characterized the family’s mistrust of the medical system.

Historically, there has been “bad blood” between some African-Americans and the US health care system. In many cases, that tension can be directly linked to documented cases of exploitation and deceit. Like, for example, when the US Public Health Service purposely withheld treatment from African-American men infected with syphilis, allowing them to suffer and sometimes die, to study the effects of untreated disease from 1932-1972.

Or take the case of the Henrietta Lacks, the African-American woman from whom the world’s oldest and most commonly used line of human cells (HeLa cells) were obtained in 1951. Despite being the substrate for some of the greatest advances in medical research, biological science, and pharmaceutical development, neither she nor her family received any financial compensation or recognition. Her cells were obtained without her consent, manipulated and sold without her family’s knowledge, and her genome and her family’s medical records were made public without their approval. In August of 2013, less than a year ago, the National Institutes of Health finally publicly acknowledged Henrietta Lacks’ contribution to science, agreed to protect her family’s private medical information, and allowed her family to be privy to future research utilizing her cells.

Given these egregious missteps in US history, you might not be surprised to know that some African-Americans actually believe the US government introduced crack into their neighborhoods or created AIDS to kill them. The woefully unsuccessful, and I would argue, recklessly enforced, War on Drugs aside, some black folks just don’t trust the core institutions that are created to serve the public good, and chief among them may be our health care system.

In the case of Jahi McMath, I have to wonder if feelings of distrust ran deep and strained the relationship between Jahi’s family and her medical providers, as they sought to find a common ground to discuss an incredibly difficult and distressing reality – a young girl is dead. Add to that discussion the general public’s confusion regarding the medical definition of death and the media-bolstered accusations that everyone, from the family and their lawyer to the hospital and its personnel, mismanaged the situation, and it is easy to see how the private bond between the medical system and the community it serves can fray and break.

Underlying this all has been the hurtful allegation that the hospital wanted to discontinue Jahi’s life support to save money or that the family’s limited resources affected their ability to advocate for her care. The obvious comparison here is the Terri Schiavo case, in which a 26-year-old woman was kept on life support at the insistence (and in part through the financial support) of her parents for 15 years. Although, I must say, that case was very different because the ultimate diagnosis was a coma-like condition called persistent vegetative state where the brain continues to function, albeit at a significant deficit, and in Jahi’s case her brain was determined to no longer be functioning at all.

Ultimately, it seems, despite being cared for at a hospital that local doctors like myself revere as a leader in practicing in and for, communities of color, a disconnect remained. To me, it suggests that perhaps it was the family’s distrust of the system to adequately care for Jahi and the complicated medical language surrounding the diagnosis of death that created an impasse. That impasse gave way to an unnecessarily long period of suffering for Jahi and her family and it must be prevented in the future.

But how? And why is this so important? There are two lessons here.

First, it is just as important now as it has ever been, to elevate the national dialogue about race as we continue to seek to understand each other as human beings.

Second, and most importantly, part of that understanding is rooted in communication and in every area where we miss an opportunity to effectively communicate with each other, we risk alienating people from the very institutions on which our communities rely, including medicine, education, and justice.

It is on this note that the media completely missed the point. Part of our national evolution to understand race involves recognizing and acknowledging the nuanced ways it remains relevant in our lives. One of those ways is in the way we communicate across cultures.

Effective cross-cultural communication (and one can argue that any communication outside one’s area of expertise is cross-cultural), requires identifying the contextual clues – the values, knowledge, and historical roots that contribute to how individuals interpret information and make important decisions. This is key to understanding any human behavior from basic lifestyle choices to the painstaking and charged decisions involved in end of life care.

In America, there is a history there that makes dying while black a particularly contentious issue, one fraught with fear of mistreatment and maligned intention, and one that must be addressed openly, honestly, and with compassion. Whenever we are able, those of us in positions of institutional power, must acknowledge and uphold the dignity of all human life as we practice across centuries of experience and knowledge. If we can do this for the most marginalized, then we have some hope of healing the scars of our past and addressing the ongoing struggles of our present.

I write this post in loving memory of Jahi McMath and Dr. Martin Luther King Jr, beloved members of the African-American community who died challenging all of us to learn to understand each other better.

*Disclaimer: Although I am a pediatrician in the Bay Area I was never involved in Jahi McMath’s medical care and this piece is not intended to discuss any details of her clinical course or treatment. In addition, this post is not meant to speculate on the feelings of the McMath family or the intentions of the medical providers who rendered her care but rather to stimulate a larger discussion about the ways race may remain relevant in each of our lives and how we can confront that reality in a meaningful way.

Update: Thank you to everyone who read, commented on, and shared this post. Given the significant interest it garnered, it was published in the San Francisco Chronicle on Sunday, February 2nd! Check it out here!