Healthy Living

Making America Fear -- A Psychiatrist Worries For His Patients Under A Trump Administration

Lost in the political debates are the human stories of real people that rely upon the quality of care their providers offer.

As I meet with a patient, I always keep two words in mind, “be curious.” Be curious about not only our differences, but also our similarities, for curiosity breeds respect and can bring about healing. From my clinical experience, I fear that the recently elected President Trump and his newly appointed political regime lack the capacity to acknowledge the differences and find the similarities that our nation needs in order to heal.

As a Resident in Psychiatry at the Cambridge Health Alliance, a community hospital affiliated with Harvard Medical School in Cambridge, Massachusetts, patients seek treatment from me for mental anguish: anxiety, depression, psychosis or suicidal thoughts. Almost all of my patients, both diverse and incredibly vulnerable, rely on public health insurance expanded by the Affordable Care Act.

It has now been three months since Trump was elected President, and in the span of one month in office, the world witnesses a new political regime that is wantonly changing policy without regard to consequences.

Simultaneously, in the last few weeks, I have personally witnessed patients express fears of persecution. A man who identifies as gay, fears the rights he fought for in the 80s and 90s will be stripped away from him by a Vice President who has voted in favor of gay conversion therapy and who would allow a business to discriminate based on a customer’s sexual orientation.

I have witnessed a patient fear she may no longer have access to comprehensive reproductive health care. Most forms of birth control are covered under the ACA, but with the advent of the Trump Administration’s implementation of the Mexico City Rule (a ruling that defunds organizations providing abortion services in foreign countries), she fears her rights will be next.

I have witnessed Muslim patients fear for their family’s safety. One man worries of his family’s possible deportation if funding is no longer granted to sanctuary cities. He feels they would be more vulnerable to federal prosecution and racial profiling. Another woman, a U.S. citizen, fears the most recent New Executive Order, that implements an immigration and travel ban against individuals in seven Muslim majority countries, only reinforces anti-Muslim sentiments and hysteria towards those already here, even when the ban remains blocked.

“Where is the current administration’s acknowledgement of my patients’ differences and its willingness to find my patients’ similarities alongside other American citizens?”

Patients suffering from long-standing addiction in a region of the country overwhelmed by deaths attributed directly to opiate overdoses are worried their access to life-saving opioid-maintenance programs is threatened. In addition, those with histories of trauma have been provoked to have intense concerns about their own safety and access to care.

I care for patients too mentally ill to have the capacity to understand the scope of their own illness. These patients are protected under the Affordable Care Act with its intention to provide care for those with preexisting conditions. These patients’ families worry that without the ACA, this protection will be gone.

One after the other, patients come to me expressing how fearful they are about the possibility they may no longer have health insurance.

Will LGBT rights be stripped away? Will abortion be outlawed? Will families be torn apart? The policies enacted and repealed within the last few weeks have instilled confusion and fear among my patients.

While the Administration engages in making “America Great,” I feel they are engaged in making “America Fear.” My patients cannot rely on the freedoms they thought made America great. They so desperately want to remain visible, be acknowledged and feel welcomed. Yet, they are fearful for simply being themselves.

Where is the current administration’s acknowledgement of my patients’ differences and its willingness to find my patients’ similarities alongside other American citizens? How can they heal?

I will not stand still. While we learn how to treat disease in medical school, physicians have an obligation to care for all people and advocate for them. A group of physicians, social workers, psychologists, and other health care professionals at Cambridge Health Alliance have organized together to create the Social Justice Coalition whose mission is simple: “Honor the intrinsic and indisputable worth of all people. Promote equity across all domains. Improve the social, cultural, economic, environmental, and political health of the communities we serve.” We believe that every member of our country has a right to affordable health care and this is why a chorus of physician organizations, including my union, the Committee of Interns and Residents, are opposing the repeal of the ACA.

Lost in the political debates are the human stories of real people that rely upon the quality of care their providers offer. Whether you are a health care provider or the President of the United States, we have a shared responsibility to maintain and improve the ACA, so that we don’t threaten the health and financial security of American families and our communities.