Doctors and other health care practitioners inhabit a unique spot in our politically sensitive world. On the one hand, they care for people, whose concerns and troubles animate the fiercest policy debates. On the other, their neutrality and professionalism are the bedrocks of health care.
Medical case study: structural racism
The stories in this newsletter show medicine at its best - engaged with the troubles of society but leading the way in fixing them.
"An Israeli shot me. An Israeli healed me."
Yousef Bashir is from the Gaza Strip. The Israeli army, he says, used his family's house as a command centre for five years beginning in 2000. A soldier shot him in the back in 2004 - when he was 15.
The experience left him hating Israeli soldiers. [subscription may be required]
In this he differed from his father, who he says viewed the Israeli soldiers with more tolerance. His father refused to leave the family home but taught his son to "never to feel hostility toward the soldiers. They were the children of Abraham, as were we Palestinians."
Bashir's attitude to Israelis changed in the Israeli hospital where he was treated.
"For years, I had lived in fear of Israeli soldiers. Now I was surrounded by Israeli doctors, and yet they were doing all they could to save my life. My favorite nurse was Seema, a Jewish woman from Iraq who fed me, cleaned me, gave me my medicine and, most important, made me smile. An Israeli soldier had tried to kill me, but now Israelis were trying to heal me."
The ensuing year of physical therapy taught him to walk again. He eventually returned home - and found his perspective had changed.
"The soldiers were still there," he writes, "but I could look them straight in the eye. They were now the ones who looked away. Their guns no longer frightened me, and I could see them as my father saw them: scared young men."
Bashir eventually emigrated to the U.S., where he has shared his story in public speeches. His story is an optimistic one for Israel and the region - and demonstrates the value of keeping politics out of the practice of medicine. Health care practitioners can change hearts and minds just by doing their job.
"The Israeli army apologized to me," Bashir writes, "and the soldier who shot me was suspended. I often wonder what has happened to him since, why he did it and what he now thinks about the whole thing. I wish we could talk. I would tell him that I want to do my part to make peace between our peoples more possible, the way my father taught me. I would tell him that I have forgiven him."
Structural racism has risen on the public agenda. Now the New England Journal of Medicine has published a case study assessing its effects on health outcomes.
Published late last month, the article focuses on the experience of a 60-year-old black woman from Chicago's South Side. It claims that she and other black women living in neighbourhoods of "concentrated disadvantage" lack the same access to care enjoyed by white women.
The article, which is summarized in the Medical Xpress, is part of a larger series of structural racism, highlighting the "importance of social concepts and social context in clinical medicine."
The woman in the case study was originally told by a general surgeon that she would need to undergo a mastectomy. It was only after intervention by an on-site navigator from the nonprofit Metropolitan Chicago Breast Cancer Task Force that she was spared the surgery, and offered less agressive treatment.
The task force claims that the black/white mortality disparity has decreased by 20 percent since the group was established over 10 years ago.
To help physicians, the case study offers three ways they can replicate the successes of the task force in their own practice. See a synopsis of the case study.
Made-in-Israel fix for opioid crisis?
As the opioid crisis continues to take lives, an Israeli treatment received the go-ahead to help turn the tide of overdoses.
The Food and Drug Administration approved the first generic nasal spray version of Narcan, which reverses opioid overdoses. The nasal spray, which is already available in Canada, is produced by Israeli pharma giant Teva Pharmaceutical.
Almost 50,000 Americans died of opioid overdoses in 2017.