Vulnerable: Thoughts From An African- American Male Podiatric Physician

How is 2020 going for you? In today’s climate, this simple question evokes a multitude of emotions. 

Recently, I find myself overwhelmed when it comes to the challenges our country currently battles, the first being COVID-19. In the span of several weeks, the entire world received a crash course in infectious disease, virology, epidemiology and public health. Processing the intricacies of surviving a viral pandemic became the art every individual attempted to perfect. 

As a husband, father and podiatric physician, I try to identify the underlying issue within a conundrum. COVID-19 is not just a disease but has brought on increased public awareness of underlying issues in the medicine and public health. Racial disparities are an arduous challenge within the medical profession, whether it is access to health insurance or simply getting authorization for a patient’s medications. 

When specifically looking at the African- American community and COVID-19, the increased prevalence of mortality within this group is formidable.^1-3 While I did not find this shocking, it was disappointing because African-American communities around cities in the United States have long experienced disproportionate rates of financial and health disparities. When a pandemic rips off the metaphoric Band-Aid in one of the most vulnerable patient populations, it makes for a delicate and potentially catastrophic mindset. Eventually, vulnerability and mistrust toward public health services exponentially grow and lead to frustration. 

Unfortunately, racial inequality is imbedded in a multitude of our nation’s institutions. Many viewed the tragic video of George Floyd’s death at the hands of police officers. This tragedy brought to light numerous other scenarios in which similar forms of treatment occurred at the hands of those whom the community look to for protection. 

As a health-care professional, I want to emphasize that trust. Police officers and health-care professionals are in the same business of altruism and service. Our job is to protect and serve our nation’s citizens. In order to do our job efficiently and accurately, we must continuously educate ourselves to better answer the call of our communities. 

For instance, as physicians, we are required to take a patient’s history, including demographics. In addition to collecting information, it allows us to better understand what our patients may be predisposed to. Furthermore, it can also have a direct impact in terms of access. For example, does the patient live in a neighborhood with access to fresh produce or affordable fitness facilities in order to maintain a healthy lifestyle?⁴ Though these are tough conversations, this is often the reality for providers practicing in inner city or rural settings. However, we must be aware of this as it is our duty to understand and serve our vulnerable patients. 

Optimistically, I believe that health-care professionals can improve in this capacity more rapidly and effectively than our law enforcement counterparts. It only takes a conversation with your patients of color to discuss such matters. Those facing these adversities do not expect immediate or overnight change, but knowing their health-care provider took time to listen to their concerns goes a long way. Recently, patients have stopped to ask me about my own well-being due to being African-American during the COVID-19 pandemic and heightened concerns of police brutality toward individuals of color. 

In closing, I recently asked a 93-year-old patient to share one piece of advice for individuals that feel unheard, abused and oppressed. She kindly replied that while navigating life, she realized no challenge has a quick fix. Instead, support, unity and patience is how America solved many difficulties over her lifetime, from World War II to September 11th. 

Though it may seem bleak for many right now, it all starts with our individual actions toward one another. It could include running errands for the elderly or checking in on a colleague you have not spoken to in a long while. We have to remember why we chose to become doctors, which is to simply impact every person around us in a positive way. As podiatric physicians, we all know that one shoe truly doesn’t fit all.  

Dr. Johnson is a Podiatric Medicine and Surgery Clinical Research Fellow at the University of Pennsylvania-Penn Presbyterian Medical Center in Philadelphia. He currently is the only podiatric physician committee member for The Alliance of Minority Physicians at Penn Medicine and The Children’s Hospital of Philadelphia. Dr. Johnson dedicates this column to his beloved grandfather, U.S. Air Force veteran Joe Louis Williams, Sr. (1936-2020). 

Editor’s note: This column has been adapted from a previously published DPM Blog for Podiatry Today. 

1. Reyes C, Husain N, Gutowski C, St Clair S, Pratt G. Chicago’s coronavirus disparity: black Chicagoans are dying at nearly six times the rate of white residents, data show. Chicago Tribune. Available at: https://www.chicagotribune.com/coronavirus/ ct-coronavirus-chicago-coronavirus-deaths-demographics-lightfoot-20200406-77nlylhiavgjzb2wa4ckivh7mu-story.html . Published April 7, 2020. Accessed June 16, 2020. 

2. Deslatte M. Louisiana data: virus hits blacks, people with hypertension. US News World Report. Available at: https://www.usnews.com/ news/best-states/louisiana/articles/2020-04-07/ louisiana-data-virus-hits-blacks-people-with-hypertension . Published April 7, 2020. Accessed June 16, 2020. 

3. New York State Department of Health. COVID-19 fatalities. Available at: https:// covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID- 19Tracker-Fatalities?%3Aembed=yes&%3Atoo lbar=no&%3Atabs=n . Updated June 17, 2020. Accessed June 17, 2020. 

4. Hillengas A, Bettigole C, Wagner A, Lawman H. Neighborhood food retail in Philadelphia. City of Philadelphia Department of Public Healthy Division of Chronic Disease and Injury Prevention. Available at: https://www.phila.gov/media/20190923114738/GHP_FoodAccessRpt_ Final_wDate.pdf . Updated September 2019. Accessed June 17, 2020.