Before he was another Black man shot by police, Jacob Blake could have been my patient. In Waterbury, Connecticut, where I practice as an internist, his shooting has left me to consider the health effects of the exposure of violence on his sons, who watched in horror from the back seat of the car as their father was shot eight times in the back by a white officer of the law.
As a physician, the effects of systemic racism on my Black patients: the historic effects of enslavement, Jim Crow laws, redlining, and police brutality are not always appreciated in my daily interactions, but the physical pain of personal traumas are what often brings people to my medical attention, and what can leave lasting negative effects on my patients and their families. I am reminded of the many patients I have taken care of over the years who have been victims of or witnesses to violence. One of dozens of examples is a patient I will call David. He was a 28-year-old man that had recently moved to Connecticut from Florida to find work and be near family. When I asked how he spent his days, he told me, “Ms. I hustle. I provide for my son. I find a way to get by.” He was lying in the hospital bed where I was taking care of him – a urinary catheter draining his urine, staples along his right thigh where a bullet had entered, destroyed his bladder, and lodged in his abdomen. He had survived. He returned to the hospital this time two weeks later, admitted to my service because he could not tolerate the pain, did not have anywhere else to go, and was devastated knowing he would need to urinate into a bag attached to his leg for now, possibly forever.
In this country, we know that communities of color disproportionately experience the negative health outcomes of disease. And I wonder if exposure to the trauma and violence of these Black mothers and fathers leave the children of those like Jacob Blake and my patient David, at higher risk for death themselves. Adolescents who have been victims of or witnesses to violence have higher rates of depression and substance use disorder. We are now learning that these young people are also at increased risk for cardiovascular complications like hypertension and systemic inflammation. The effects on health of being a victim to violence, and trauma in general, are just beginning to be understood.
The medical profession must add to the list of work that needs to be done to address the injustices our Black patients suffer: the need for more research on the effects of exposure to racism fueled violence and trauma, and the best defenses against the deadly health outcomes that may result. Jacob Blake’s sons and my patient David’s son will continue to bear the burden of violence throughout their lives. In this divided time, I hope we can agree that the need to protect our children and our future from these consequences is not political.
Angi Kang is an internal medicine physician.
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