The Right to Breathe

From the July 28, 2023 issue of the Transformational Times

The Right to Breathe

Michael N. Levas, MD, MS

A pediatric emergency medicine physician advocates for comprehensive and compassionate care in the broader context that health is more than biology – that it encompasses people’s lived experience, their trials, their strengths. As a leader of several diversity, equity, and inclusion initiatives at Medical College of Wisconsin, he also reflects on recent shifts he has observed in institutional culture, and reminds health care providers to be mindful of the social pressures that burden patients and colleagues...

“I can’t breathe.”

These were some of George Floyd’s final words, captured in a bystander video. Through this video, we as a nation also witnessed a dying man call out for his mother.

I often see youth who are scared, and some who feel like they are dying, as a pediatric emergency medicine physician who practices at Children’s Wisconsin. They say, “I can’t breathe” and they ask for their mothers. Watching the video of George Floyd, I felt powerless. But in the emergency room, there are situations where I can do something — I can help their difficulty breathing, we can find their mothers and get them to their bedside.

The risk of becoming numb to social injustices is real. It can lead to harmful health outcomes, even death. The continued traumas our nation experiences are seemingly endless.

Mobilization and hope

There has been a movement within MCW to increase advocacy addressing diversity, equity, and inclusion, including the development of DEI councils within residency programs and clinical departments.

For the first time since I was a medical student at MCW (many moons ago), I feel that it is okay to talk about biases, microaggressions, social determinants of health, and health equity.

In fact, health equity has become a theme of many clinical, educational, research and community efforts at MCW. More grand rounds across campus focus on racism’s impact on healthcare outcomes. Trainees are demanding health equity be woven into curricula. There is more acknowledgement that

health is much more than biology – that health encompasses people’s lived experience, their trials, their strengths.

Within the Department of Pediatrics, over 500 faculty and staff have participated in Implicit Bias Training. Other departments have requested this training, including Psychiatry and Behavioral Medicine, Anesthesiology, Physical Medicine & Rehab, the Admissions Committee, the Joint Fellowship Council, among others.

The Comprehensive Injury Center and Department of Pediatrics recently adopted policies recognizing MLK and Juneteenth as holidays by not scheduling recruitment, training, or lectures during those days.

Barriers are real

But two things are clear: inertia is real, and not everyone is happy with such activism. For every stride we make fighting for equity in health outcomes and health education, a counter narrative is threatened by change.

While we are deliberating about what efforts to implement or back as institutions, youth are dying from firearms, families are losing their homes, and transgender youth are losing faith in the healthcare community.

Some changes that need to be made do not require repeated meetings or committees to implement. Unfortunately, our current healthcare environment has become accustomed to that approach, driven by fear of retribution rather than focus on doing what is right.

“The time is always right to do the right thing,” is my favorite quote from Dr. Martin Luther King Jr. We cannot become numb to the trials that our patients face. We cannot ignore the social pressures that burden our patients and colleagues.

Despite continued barriers and bureaucracy, as health care professionals we must continue to model comprehensive and compassionate care. We need to have the courage to use our privilege as health care providers to speak out against social injustices and our expertise to show the evidence-based approaches that lead to less disparities.

Every living human has the right to breathe.

We need to breathe to stay alive.

We need to breathe life into policies that strive for health equity.

We need to help others to pause and breathe before they are threatened by ideas that lean towards justice.

We need to breathe for those who no longer can.

Dr. Michael N. Levas, MD, MS, is a professor of Pediatric Emergency Medicine, Vice Chair of Diversity, Equity, and Inclusion for the Department of Pediatrics, Medical Director of Project Ujima, Associate Director of the Comprehensive Injury Center, Faculty Advisor for the Latino Medical Student Association, and MCW Faculty Advisor for White Coats for Black Lives.