When clinicians are bullied at a school board meeting [PODCAST]

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“The first amendment protects your right to free speech. But it does not make you more right, more ethical, or more kind. And nor does it give one license to rewrite history as has been occurring since July 27th, adding insult to our experience. Let me break this down.

On one hand, three pediatric medical professionals and one student spoke eloquently and rationally about facts, guidelines, and personal experiences. On the other hand, grown adults belonging to ironically named groups claiming to “protect kids,” tried to intimidate, bully, and silence a child for exercising her first amendment right to free speech.

We now have a vaccine against COVID-19. And even though we (individually and as a medical profession) anticipate continued harassment by these groups, bringing their hateful rhetoric and actions to light is the only inoculation we have against bullying.”

Anusha Viswanathan is a pediatric infectious disease physician. Jennifer Bish is a pediatric nurse practitioner.

They share their stories and discuss the KevinMD article, “A pandemic of the bullies over others.”

This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. On today’s show we have Anusha Viswanathan and Jennifer Bish. Anusha is a pediatric infectious disease physician, and Jennifer is a pediatric nurse practitioner. Anusha wrote the article “A pandemic of the bullies over others.” Anusha and Jennifer, welcome to the show.

Anusha Viswanathan: Thank you for having us.

Kevin Pho: So we’ll get into your article and story in a little bit, but first off, I’m going to ask each of you a little bit about your story and journey to where you are today. Anusha, why don’t you go first?

Anusha Viswanathan: Yeah. So I’m a mom of two children, almost five and two. My background is pediatric infectious disease. I had a little bit of a circuitous way of getting to the infectious disease part. I took a couple of years between residency and fellowship where I worked abroad in Rwanda, so I had a little bit of global health background during that time, and that really sparked my interest in infectious disease. And then I came back and did my training.

Kevin Pho: So Anusha, as a pediatric infectious disease physician, what would you say are some of the biggest challenges over the past 18 months of the pandemic that you faced?

Anusha Viswanathan: The biggest challenge was sort of not understanding what exactly the impact of COVID was in children initially, and it took a little bit of time to discern how children were being impacted. And I think the other learning point for me was understanding that, you know, when adults around kids get significantly ill, that also has an impact on children. So there are a lot of things about COVID, both in terms of direct impact and indirect impact, that presented a lot of challenges.

And I think one of the things that really personally affected so many of us was the fact that children were out of school, and it seemed like schools were the first thing that sort of shut down. And I think there are lessons to be learned from that, that we should put forward as schools have reopened: sort of prioritizing the mental health and the education of children in a way that still keeps them safe. So those were some of the challenges that I thought really came through in the last 18 months.

Kevin Pho: And Jennifer, can you share your story and journey to where you are today?

Jennifer Bish: So I started out as a bone marrow oncology nurse, and I was a floor nurse for 12 years, so a lot of my background was working with these immunocompromised patients. And currently I work as a community primary care nurse practitioner in the same community I live in. I have three children, ages seven, five, and 11 months. And in the whole first year of the pandemic, or first 10 months of the pandemic, I was primarily home with my three children, navigating virtual school with my seven-year-old. So I can definitely echo Anusha’s thoughts on how the pandemic impacted children.

And I think that where I primarily am right now is trying to balance the idea of keeping kids in school but doing it in a safe way: not ignoring the fact that the pandemic is still occurring, but addressing it with mitigation, and focusing on the fact that mitigation is the primary way to keep kids in school, and that if we don’t take those mitigation measures, we’re putting our schools in danger of closing down again. And I would just love to get everybody on that same page and focusing on that same thing.

Kevin Pho: So we’re speaking toward the end of September now, and kids have been in school for a month, month and a half or so. So Jennifer, how are we doing so far, from what you’ve seen, both in your area and across the country?

Jennifer Bish: So I think that we got a heads-up. By the time Pennsylvania schools opened, we saw what happened in other parts of the country, and that those schools very quickly shut down when they didn’t have any mitigation in place, and we got a chance to learn from that. In particular, in our county, I think we struggle with a balance of incorporating mitigation and the thoughts of different parents in the community.

I know in our particular school system, we’ve now been open since the last week in August, and I think we’re still learning. So our district right now has some mitigation in place, including masks. They’re mandatory masks, but we are struggling to get other mitigation put through, like, in my particular school district, mitigations such as quarantine. And that varies in our area, both from district to district and county to county, for Pennsylvania.

Kevin Pho: All right, let’s transition into the KevinMD article titled “A pandemic of the bullies over others.” Anusha, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Anusha Viswanathan: Actually, the whole thing came about pretty organically. The background is that another doc reached out to area medical providers, Jennifer and I among them, saying that the district COVID plan would be in discussion at a school board meeting, and would other medical people come to sort of provide input? And eventually, our voices were being entirely drowned out in these school board meetings, and we thought maybe we could have a press conference, where we could have more control of the dialogue. We could talk without interruption, and that would be a better way to sort of get our message as area medical providers into the community. And our message was basically, “Hey, COVID is real. COVID mitigation strategies work, and they work to keep kids in school.”

And I think I approached this in a pretty naive way. So in the article, I initially talked about going up to this makeshift podium that we had and, like, changing my case numbers, the incidence of COVID, as I was walking up to it, just to make sure I was totally up to date, because I really thought if I articulated facts well, that would seize the day, so to speak. But what I didn’t account for was these, I guess they would call themselves counterprotesters, who arrived that day in a much bigger group. They were organized. They were ready to disrupt.

And I think they disrupted in such a dehumanizing way that it was so shocking. I don’t think I was prepared for that at all. I wasn’t prepared to be called a murderer, a child abuser. I definitely wasn’t prepared to be called an illegal alien. I wasn’t prepared to hear, with the Black man who was holding the microphone for me because I was really shaky at that point, you know, the crowd chanting “I can’t breathe” at him, very, very clearly, pointedly at him. And I wasn’t prepared for how they heckled the high school student who spoke beautifully and eloquently. And I think that was probably the worst moment.

And I think that was the impetus for my article, because as the event was occurring, and as they were screaming about everything but what we were talking about, essentially just these attacks on our personhood, as soon as that was happening, the crowd was live streaming and changing the dialogue almost immediately, to portray themselves as being bullied. And it was such an untruth of that event.

And I think, you know, right after that event, there was a lot of chatter in the community: “Well, there are two sides to everything. People on both sides have strong opinions.” And that did not feel like what that was about. It did not feel like a two-sides argument. It did not feel like two points of view with validity on each side. It was an attack. And I think that was what I wanted to communicate, as the person experiencing that moment.

Kevin Pho: So Anusha, paint us a picture of what that room was like. How many counterprotesters were there, and how big, approximately, was the total audience, so we can get a better idea of what it looked like?

Anusha Viswanathan: Yeah, we actually held it outside. It was in front of the school board administrative offices, so we did try to make it as COVID-safe as possible. We actually just, like, invited press to know this was happening. So I think one of the lessons that we learned was, in a community, nothing is a secret. Somehow word got out. I would say it felt like we were outnumbered at least two to one.

There was a small group of us on the podium. There were four speakers. There were activists from the community. There was one peacekeeper, which is essentially a community activist who’s there to sort of defuse the situation. So there weren’t very many of us, because honestly, we were not expecting anyone to come, or even if we were. I think initially we actually offered to share space and time, in that we’ll finish talking and then you can actually have the microphone that we brought and talk to the press as well. But that was not the intent.

I think one of the things that happened very quickly was that we were surrounded, both in front with the crowd and behind as well. So it felt like they were encircling us, and I think that was sort of the first way in which it felt almost physical, in the sort of threatening nature of it.

Kevin Pho: Jennifer, you were also at that event. Please share your story from that event.

Jennifer Bish: I guess I spoke right before Anusha, after Dr. Mahmoud. And I guess I saw what was occurring with Dr. Mahmoud, and it wasn’t at all what we were expecting. I had very similar thoughts to Anusha, that we would be able to present these facts and, you know, dispel some disinformation, in particular trying to dispel some disinformation about health hazards of masks, and that masks work. And I think that I went into it thinking, “Oh, I think people just need more information, and then we could all get on the same page.” And I watched what occurred and watched people heckling.

And I think that the two things that struck me immediately, but I don’t think I could process it until after: The first thing was that usually, in any other time other than right now in 2021, I think health care providers getting up and providing information would have been met with respect and with courtesy for what we were saying, even if people disagreed with what we were saying. And it was almost like each thing that was said, the audience had a rehearsed counter thing to say when that keyword was said by us. So that was very surprising to me, and I was newer to dealing with our district at that point.

The next thing that was really surprising to me was, having been in pediatrics forever, I always encourage my patients to advocate for themselves and speak for themselves. And so when the student speaker got up, I think we all were fearful before she even started speaking, to the point that, you know, while the adults had spoken, we had people holding signs behind us and pushing against us and heckling us. And we wanted to at least make that student feel more protected, so we asked if we could stand directly behind her, so that nobody was touching or pressing against her while she spoke. And she specifically asked the audience for people to recognize that she was a student, and that all these measures are for students, and to please just not yell over her. And people immediately began yelling at her.

And as she spoke, people were yelling things about being an illegal alien. She spoke about having grandparents die in India, and people actually screamed at her, “Good.” And watching her, this very well-spoken, very educated, smart young lady, who has spoken at other events so eloquently and without any fear or hesitation, start shaking was just really, really hard, as someone who’s taking care of patients my whole life, but also, like, as a mom. And this is someone’s child standing there shaking.

And I think the worst part of it was actually something that occurred after, because we, you know, all went into the school board meeting, and we all spoke at the school board meeting after. And the student was standing there drinking water, and all of a sudden she got very nervous, and she asked me, “Do you know who that person is? You know who that person is?” And she was pointing at somebody, and I actually didn’t know. I now know who the person was, but at the time I didn’t. At the time, I only knew that that was somebody that had been, like, standing with us, kind of on our side, during the press conference. And she had said, “Well, she gave me water.” And now, I guess, she all of a sudden worried that somebody gave her water that had something in it.

And I think it traumatized me as a mom, because just the idea of thinking that my kids are in this district, and, you know, hopefully would be as eloquent, want to stand up for themselves and stand up for science just the way she was doing, but then being made to feel that way, was really hard to walk away from and really hard to come back from.

Kevin Pho: Anusha, what were the repercussions from this event? What happened after?

Anusha Viswanathan: What happened after was most of us, in terms of the medical people who were there and the sort of pro-mask people that were there, went immediately into a school board meeting. And actually, what shocked me, Jen, was how quickly the crowd of counterprotesters, or however they would label themselves, really changed their tone in front of the school board. You know, these meetings are very heated, but it was, like I said, almost like a rewriting of history. As soon as they walked in, they were so upset at how they were bullied outside, and they were communicating this to the school board. It was so startling, and I was just processing it. I didn’t know what to do with that. So it was almost like they turned it on and then turned it off, and then they went into the school board meeting and presented an entirely rewritten version of events that just happened.

And the interesting part, though, was they were well aware that they were being recorded on video, and TV crews were there. That’s how emboldened they felt at that moment, that they could do this without any impunity, essentially without any repercussions. And it still sort of feels that way.

But I think, at least for me personally, that was my moment of really pushing me into civic engagement, in a way that maybe, you know, like in college you’re engaged and you’re doing all this, and then life happens and kids happen, and it’s so easy to sort of step back and just make your world really small, and your family unit is your world. And it’s still that way. But I think for a lot of us, that moment triggered in us this idea of, if we are going to want this to change, there’s no one else other than us. And I have to say, I think that was one of the most rewarding parts of what happened: meeting, you know, Jen, and really a lot of women, really mothers in the community, who felt similarly and who had a similar feeling, like, we thought someone would take care of this for us while we raised our families, and then saying, “No, it’s us. We take care of this for us.”

Kevin Pho: Jennifer, there were press crews, television cameras, presumably newspaper reporters were there as well. So when this event played out in your local public, what was the public’s response to these counterprotesters?

Jennifer Bish: So it’s funny. I guess somebody loaded it onto Facebook Live, and I couldn’t watch it. I don’t think I’ve watched it at all. I’ve watched little parts of it since then, but I just couldn’t go back to that place. But my husband scrolled through and read all the comments, and, you know, it’s funny, he said overall most of the comments were related to the behavior being awful, and that what was being yelled was disinformation. And, you know, I’m sure Anusha and everybody else involved had similar situations, with people reaching out to us, being like, “I saw you on the news. Are you OK?”

But I don’t know. I guess the community’s reception to it was kind of similar to what occurred at the press conference, but just in more proportional numbers, where we weren’t outnumbered. There was, you know, maybe 60 percent of people saying, “No, no, we need to get on this, and we need to be proactive about the science side,” and a majority of people saying that what occurred was inappropriate.

Anusha Viswanathan: Yeah, and to add to that, I think that there was a difference in the written coverage of the event compared to, say, the television coverage. So there were camera crews, and they presented what happened on the 11 o’clock news. And, you know, maybe I’m too close to the situation, but it really felt like the two-sides argument was what was put forth: heated emotions in a two-sided, you know, fight for masks or anti-masks. It just distilled it in that way in the television news that happened right that night. And I think for me that was another reason I felt like the narrative was so wrong, and that was one of the reasons I wrote my piece and published it in a bunch of local places, in the Philly Inquirer.

But I think it felt to me like a point had been missed, which was, you may have views about, you know, when masks should be required, at what incidence rate, or things of that nature, we could speak about. But when you call me an illegal alien for talking about health and safety, there’s just nothing I can say to that. There’s no argument that actually speaks to the fact. And I think that was sort of lost in the immediate press coverage.

And I think also what was lost a little bit is not just that we were parents, that we were actually medical people, talking both as parents but also as medical professionals. So it wasn’t just two sets of parents, you know, having two opposing views. It was more, you know, there were people who had some degree of expertise talking, in addition to being parents. And that felt, you know, unfair as well, I think, or just not balanced, I would say.

And I think a lot of the community maybe thought that it was sort of a one-off, like it happened, but perhaps aren’t aware that it happened before that moment and has been happening since. And I think that’s, for me at least, the biggest thing that I want to communicate to my community: Wake up, and take note of what’s happening in your local school district. And I don’t think that got captured either. But this conversation is moving, but it’s slow.

Kevin Pho: We’re talking to Anusha Viswanathan and Jennifer Bish. Anusha is a pediatric infectious disease physician, Jennifer is a pediatric nurse practitioner, and they’re talking about the KevinMD article “A pandemic of the bullies over others.” Anusha and Jennifer, I’m going to ask each of you for your take-home messages to the KevinMD audience. So Jennifer, why don’t you go first?

Jennifer Bish: So I think that my primary take-home message is that there’s so much disinformation out there that we definitely just need to work as a health care community to continue to try to get out the message that this disinformation’s out there, and combating it and giving it with facts. And sometimes it’s so tiring, and sometimes we feel like nobody’s hearing us, and maybe it’s just easier to give up or not have the conversation. But we do need to continue to have that conversation, and we need to, you know, stay true to the fact that while everybody has a place at the table, and everybody has the right to their opinions, sometimes opinions need to be weighed against facts. And while we give everybody a voice, we need to make sure that we stay with facts and not just allow the disinformation to take over.

Kevin Pho: Anusha, what’s your take-home message to the KevinMD audience?

Anusha Viswanathan: I think as medical professionals, we are in sort of a spot where we have, at least about COVID, a voice. We can use our experience, our expertise, our medical knowledge. But I think it can’t stop there. I think that what I’ve taken from this is civic engagement is key, and that means stepping in even after COVID and staying engaged, because this isn’t just about the physical health of our children. And Jen and I are both in pediatrics, and we know that children are impacted in a myriad of ways, and this is about the physical, emotional, and mental health of our children, which is tied so closely to the school community. These are key years. And if we don’t have civic engagement, and we just have a sense of complacency, then we’re done. And that’s what I am learning and have learned so far.

Kevin Pho: Anusha and Jennifer, thank you so much for sharing your stories, and thanks again for being on the show.

Anusha Viswanathan: Thank you, Kevin.

Jennifer Bish: Thank you for having us.

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