This election and its results have illuminated a dark underbelly of American society: President-elect Donald Trump’s campaign may have drawn in voters who felt forgotten, but it also fed on racism, misogyny, homophobia, anti-Semitism, and Islamophobia. In the days since his election, reports of hate crimes and harassment have surfaced, often citing “Trump’s America.”
Understandably, many Americans are struggling with a renewed sense of desperation and a heightened fear of physical assault, verbal violence, and worsening legalized discrimination. It shouldn’t be surprising that the National Suicide Prevention Lifeline saw a spike in calls on election night, with 95 percent of callers linking their despair to the election. Trans Lifeline, a hotline for transgender people, received a whopping 350 calls the day after the election from people in crisis, according to a statement from the organization. And Crisis Text Line, a text message–based crisis resource, saw its volume double in the 24 hours after the election.
The nauseating anger and deep sadness these statistics imbue multiplies as I realize how many of my patients are vulnerable to the prejudices expressed during this election. My colleagues, too—being a doctor does not protect you from feeling persecuted for your race, your gender, your sexual orientation, your religion.
Yet together, doctors have the resources and knowledge to enact change and serve as a resource for others. These are privileges we must not take for granted, particularly now. Doctors already aren’t as civically engaged as we could be; our voter turnout rate, for one thing, tends to be even lower than that of the general population. It’s not that I advocate for doctors’ involvement because I think it could have swayed the election in either direction—doctors are pretty neatly divided down the middle. Rather, our dismal participation should give us pause.
If anything, we need to get more involved. Health care reform is perhaps the most obvious issue calling for physician advocacy. It’s not clear what will happen to many patients’ health insurance over the next few years, but doctors must be involved in this conversation. After all, physicians have on-the-ground experience with the health care system and its shortcomings. We hold diverse views about the best way to fix health care, and we must offer them up.
The election has split the nation in two, and we are obligated to use our voices to advocate for our patients and their well-being, regardless of our political sway. Last week, my colleagues and I struggled together through the machinations of life on the wards, trying to stay focused on our patients’ diagnoses and plans but distracted by concerns about the fate of our nation and its people. In the aftermath of this election, we must recommit ourselves to our obligation to our patients—and that includes both the people who have been targeted during this election and those who feel they were neglected before it.
The reality is that the results of this election may threaten many of our patients’ health. More than ever, I fear my patients will avoid medical care because they worry they’ll be treated poorly because of their skin color, religion, disability, sexual orientation, or gender identity. I worry that disenfranchisement will intensify, keeping already marginalized people from accessing the care they need. People of color and the poor already face worse outcomes and poorer access to medical care than wealthier people and whites and are more likely to report bad communication with their health care providers. Nonfluent English speakers’ chronic conditions, such as asthma, are managed poorly, and they suffer more harmful events in the hospital. And LGBT adults have worse outcomes and access to care than straight Americans do. The hate crimes we are witnessing make me worry that these disparities may deepen. That’s why we must help our patients feel safe in the hospital, clinic, and beyond, and why if we witness hatred, we must be clear we don’t tolerate it.
At federal, state, and community levels, we need to advocate for access to the crucial resources that play an immense role in our well-being; these include mental health and addiction counseling, healthy food, clean water, a habitable planet, stable and affordable housing, and safe outdoor spaces. Simply put, no medicine can overcome the deleterious effects the absence of these systems poses. And because the policies and public programs behind these resources may change drastically, we must do all we can to shape policy on our patients’ behalf and help them fill in the gaps.
Finally, we must recognize that our patients’ and colleagues’ sadness and frustration both culminated in this election and will be worsened by it. Many Americans are suffering, some so greatly that they need medical assistance. We must offer emotional support to those who are struggling and direct them to mental health and safe haven resources if they need it.
There are lives depending on us to speak up. Let’s get to work.