{"id":46433,"date":"2020-01-13T17:19:15","date_gmt":"2020-01-13T16:19:15","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46433"},"modified":"2020-01-20T14:49:26","modified_gmt":"2020-01-20T13:49:26","slug":"karen-e-lasser-a-doctors-protest-in-the-era-of-twitter","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/01\/13\/karen-e-lasser-a-doctors-protest-in-the-era-of-twitter\/","title":{"rendered":"Karen E Lasser: A doctor\u2019s protest in the era of twitter"},"content":{"rendered":"

Karen Lasser reflects on what she learnt from a protest to Melania Trump’s visit to Boston Medical Center\u00a0<\/span><\/p>\n

It was a crisp autumn New England day, and I left my desk in my research office at Boston Medical Center and walked through the empty side streets of Boston\u2019s South End in search of a cup of coffee.\u00a0 As I was returning to my office, I caught a glimpse of dozens of protesters standing in front of the hospital. About an hour earlier, I had been looking out the large picture windows of our Section of General Medicine\u2019s lunch room as I microwaved my meal. Massachusetts Avenue, a major thoroughfare in the city, had been blocked off in preparation for Melania Trump\u2019s visit to Boston Medical Center. The public had been told that Ms. Trump was coming to tour the hospital and learn about our cuddling program to nurture babies born with neonatal abstinence syndrome. Motorcades of black SUVs and police vehicles whirred by, and police shooed away the homeless and opioid-addicted denizens of the neighborhood in preparation for the First Lady\u2019s visit.<\/span><\/p>\n

I was struck by the sight of my colleagues protesting, and took out my phone, snapped a picture, and posted it on Facebook and Twitter. On Twitter I wrote \u201cProtesting Melania Trump\u2019s visit to Boston Medical Center @The_BMC.<\/a>\u201d\u00a0 I didn\u2019t give my tweet much thought\u2014this is just what I did, it seemed like an important event to document. In retrospect my tweet is ambiguous-was I protesting too? I then joined and chatted with the protesters. Colleagues held signs saying things like \u201cwho is going to cuddle the babies in the ICE detention centers?\u201d and \u201cOur BMC cares for <\/span>all<\/span><\/i> patients.\u201d\u00a0 I hadn\u2019t planned to attend the protest and thus didn\u2019t have a sign to carry. It was oddly quiet; there were no chants of protest, perhaps this had been agreed upon ahead of time?\u00a0\u00a0<\/span><\/p>\n

The day before, there had been a heated discussion among the doctors, nurse practitioners, and social workers in our primary care suite about the upcoming visit. I felt that it was reasonable for the hospital to host the visit, but at the same time I was somehow troubled by it. I didn\u2019t recall any visits from the First Lady when I was an intern at this hospital in the mid 1990s, caring for African-American women with HIV and addiction to crack cocaine. Finding it challenging to have an in-depth political discussion in the midst of a busy primary care session, I didn\u2019t fully engage in the discussion.<\/span><\/p>\n

Several hours after attending the protest and posting a photo on Twitter, I received an e-mail from my social work colleague that my name and tweet had been mentioned in coverage of the protest by Newsweek.com: \u201cBMC primary care doctor and health disparities researcher Karen Lasser, also a professor of medicine and public health and daughter of immigrants, according to her Twitter profile, shared a photo of the demonstration.\u201d My tweets usually consist of a retweeted New York Times article, and garner at most a handful of \u201clikes.\u201d I had inadvertently stumbled into the Twitter major-leagues.\u00a0 As I write this essay, my Tweet has been retweeted 48 times, there are 241 comments, and 221 likes.\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

I have received hate mail in the past, as some of my research has been critical of the tobacco, pharmaceutical, and insurance industries\u2019 role in healthcare. The comments on my tweet about Melania Trump\u2019s visit, including some posted by internet \u201ctrolls,\u201d are a barrage of hate. A number of the comments raise the inflammatory concern that \u201cleft-wing doctors\u201d will provide inferior care to Republican patients. In my nearly 25 years practising medicine, only one patient I\u2019ve cared for wore a pin indicating she was a Republican. Politics has always stayed out of the exam room. I recall wincing at a large tattoo on the chest of a patient\u2014not necessarily a Republican\u2014that read \u201cwhite power.\u201d He was seeing me to receive treatment for his hepatitis C infection and for his opioid use disorder. Research has actually shown that chronic use of prescription opioid drugs was correlated with support for the Republican candidate in the 2016 US presidential election. [<\/span>1]\u00a0<\/span><\/p>\n

Another recurrent theme in the responses to my tweet was that doctors should be taking care of their patients instead of protesting. This comment made me recall the National Rifle Association\u2019s message to “anti-gun” doctors that they “stay in their lane” after they had published papers about firearm injuries and deaths and issued recommendations to reduce gun violence. [<\/span>2]<\/span> Just as emergency department physicians and surgeons who care for patients with gunshot wounds have been speaking out about gun control, physicians who care for immigrant patients feel compelled to speak out.\u00a0 Most of my patients are immigrants from the Dominican Republic, and other Central and South American countries. While my patients have not discussed with me the effect of immigration policies on their lives (perhaps an effect of living in the \u201csanctuary state\u201d of Massachusetts), my colleagues across the US have raised serious concerns. They have observed that immigrants are avoiding medical visits and withdrawing from public benefit programs out of fear of possible deportation, in response to increasingly aggressive immigration enforcement. [<\/span>3] <\/span>\u00a0<\/span><\/p>\n

What had my encounter with the protest at Boston Medical Center taught me? It seems, that in these times when there are assaults on human rights and so much hate, it\u2019s important that doctors use their voices judiciously, so as not to lose credibility. I realized I had some ambivalence about protesting. Had it been President Trump visiting I <\/span>would<\/span><\/i> have protested, and not just on Twitter. But is Melania Trump culpable for her husband\u2019s words and actions? No one can know the interior workings of another\u2019s marriage.<\/span><\/p>\n

As I was driving with my 12 year old daughter, the American singer-songwriter Taylor Swift spoke to me from the radio:<\/span><\/p>\n

\u201cSay it in the street that\u2019s a knockout.<\/span><\/p>\n

But you say it in a Tweet that\u2019s a cop-out.\u201d\u00a0 <\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

\"\"<\/a>Karen E. Lasser<\/strong> is a primary care physician and Professor of Medicine and Public Health at Boston University Schools of Medicine and Public Health<\/span><\/em><\/p>\n

Competing interests<\/strong>: None declared<\/em><\/p>\n

Twitter<\/strong>: @lasser_karen<\/a><\/span><\/p>\n

 <\/p>\n

References:<\/b><\/p>\n

    \n
  1. Goodwin JS, Kuo Y, Brown D, Juurlink D, Raji M. Association of Chronic Opioid Use With Presidential Voting Patterns in US Counties in 2016. JAMA Netw Open. 2018;1(2):e180450. doi:https:\/\/doi.org\/10.1001\/jamanetworkopen.2018.0450<\/span><\/li>\n
  2. https:\/\/annals.org\/aim\/fullarticle\/2709820\/reducing-firearm-injuries-deaths-united-states-position-paper-from-american<\/span><\/a><\/li>\n
  3. https:\/\/www.urban.org\/sites\/default\/files\/publication\/100754\/safety_net_access_in_the_context_of_the_public_charge_rule_1.pdf<\/a>\u00a0<\/span><\/li>\n<\/ol>\n

    \u00a0<\/span><\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Karen Lasser reflects on what she learnt from a protest to Melania Trump’s visit to Boston Medical Center\u00a0 […]<\/p>\n

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