LGBT in America: What have we (not) done?

As I round on patients in the hospital each morning, I wear a small but conspicuous rainbow-colored pin on the lapel of my white coat. The pin is the Caduceus, the most well know symbol for medicine in society today (two serpents wrapped around a winged staff), while its colors represent the well recognized “gay pride flag.” Why do I wear this on my white coat, and is it really appropriate? After all, shouldn’t I keep any personal agenda of mine outside the clinic walls as I take care of patients? After all, who am I, a lowly scientist and junior clinician in the hospital, to mix politics or my feelings on human rights, with my work?

Nobel Laureate AV Hill, famous for his contributions to our current understanding of muscle metabolism, published a piece in the premier scientific journal Nature in 1933, speaking out against the persecution of the Jews just after the Nazis came to power, long before we knew what would come with the discrimination against the Jews: “Freedom itself is again at stake…100,000 in concentration camps, often for no cause beyond independence of thought or speech, something over 1,000 scholars and scientific workers have been dismissed…” He goes on to urge other scientists to speak out and be activists about this early discrimination against Jews in Germany. It will give you a cold chill to then read the reply from Prof J. Stark in an issue of Nature soon after that, where he replies that Germany is merely attempting to “curtail the unjustifiable great influence exercised by the Jews” and explains that such prominent scientists (e.g. Einstein) have “voluntarily given up their posts” while those in concentration camps are there “because they have been guilty of high treason…” Of course, we now know what would come from these early anti-Semitic movements, and history helps us easily side with the correct view on the issue. While current discriminations do not begin to approach the travesty of the holocaust, it helps to remember that the holocaust began as simple discrimination against a group of people.

One need not look far back in our own country’s history to see embarrassing examples of blatant abuse and bigotry toward other humans. It was once commonplace for Americans to own slaves; even after their emancipation, gaining equal rights with white citizens continues to be a long, hard fought battle. Likewise, women were not allowed to vote, much less contribute in most positions outside the home until relatively recently. Even today, they may struggle with being paid less for equal work in the workplace.

Luckily, these “norms” of society have been gradually changing as one, then two, then more people stand up and speak out against them. Today, with history on our side to offer important perspective, it is easy to criticize our ancestors and their seemingly tremendous ignorance. Yet what do we do today that future generations may judge us by? In one of our major historical guffaws, we now discriminate against people based on sexual preferences they have. Sadly, this is something we will all one day have to answer to our grandchildren: Imagine the questions: Grandpa, did homosexuals break the law? Were they hurting someone? What if someone decides that liking chocolate ice cream is bad – will I think be denied rights because of what I prefer in my personal life?

All questions of nature vs nurture aside, the simple fact remains that we have discriminated against a large population of people for a long time for no crime or disruption. Fortunately, this great country has a rich history of at the very least trying desperately to correct our grave discriminations of the past (e.g. affirmative action, title IX in sports). Sadly, these stopgap solutions are often delivered too little, too late, and with many problems. In the current situation, the solution could be simple – grant all people regardless of sexual preference equal rights. This includes the right to choose a partner one loves and marry that partner should one choose. Individual religions would still be free to define marriage as they see fit.

AV Hill used his prominent position in society to speak out against discrimination of a group of people; imagine if he had been better heard. In medicine, too often lesbian, gay, bisexual, and transgender (LGBT) individuals are given poor care by clinicians with little understanding or empathy for who they are. While my simple gesture of wearing this lapel pin might not change anything, my hope is that when my LGBT patients see this, they know they have a provider who respects and cares for them, and feels they deserve equal rights and standing in society. If respecting all people’s rights is ever considered inappropriate or unprofessional in the clinic, then I’d rather take off the white coat and walk away before I take off this pin. I hope you too will find your small way of supporting those we continue to discriminate against in society.

(Finally, while I welcome replies, I would caution that going on record as supporting discrimination of any people is often viewed unkindly by future, more informed generations. As you might have guessed, Prof Stark eventually was arrested and served time in prison after WWII.)

Normal Burns - Ice??

I am not sure I am going to keep doing this, but I figure I might as well list a few posts of "common injuries" advice, since I get to learn this stuff, question it, and practice it everyday now...

When you burn yourself in the kitchen when touching a hot pot or pan, most people put ice on it - DO NOT DO THIS. Simply run cool water over it and then monitor it over the next day (severe blistering, turning black, etc may be concern for more severe injury and need for medical attention). Putting ice on a superficial burn only causes vasoconstriction to underlying dermis and causes the injury to worsen.

Please feel free to respond to this blog with questions for me to answer!

Recumbant Bikes in Hosp Rooms

Why is there no exercise equipment in the hospital?

Why aren't there trainers or assistants to get my patients moving? (PT evaluates and often cannot see them that much - they need trainer like people)

Why do we leave these people lying in bed all day? Who thinks this is at all a good idea, particularly after surgery, where you risk collapse of alveoli in lungs and clots in the legs from just sitting. Instead, why not have recumbent bikes next to each bed? They can strap in and just pedal. I am going to ask for a grant to do this study I think, but from who?