Questioning a Cherished Ritual
The class had a provocative discussion. Usually the majority holds a singular view. However, the discussion was unusually balanced, thoughtful and respectful.
How could we have known?
There were signs that the public health enforcement was very weak. One quick glance at the figures made sure of it. A walk (not a drive in your temperature controlled vehicle) down Elks Place revealed numerous businesses in violation of the city ordinance. One could infer a couple things: the health department is understaffed.
For the privileged who live in houses (and not multi-unit apartments) and drive cars (and not have to take public transportation), it may not have been noticed that the poor of New Orleans were living in great constraints. They did not have resources. The gulf between the middle class and the low income was noticeable. The ignorance of the privileged about how the have-not caste members struggled was hurtful and disappointing. Other signs portending disaster included: subprime quality of care, poor comprehension of cultural diversity in the United States, poor consumer protection, inadequate understanding of federal and state civil codes, delayed rolling out of Medicaid, inadequate infrastructure, lagging public policy. In order to prolong health inequality, it is essential to have individuals in power who proclaim that there is no problem and everything is fine, and also persecute those who challenge the gospel that "everything is fine." The ecosystem of New Orleans is an example of a perplexing irony: how is it possible to have a world-class medical school and a public health school and yet have the environment remain toxic, violating numerous health guidelines.
The revaluation of a cherished custom requires serious compassion and generosity. Outsiders may have found the university actions of revering the annual custom to be bewildering. TV monitors on the 4th floor next to the Tulane Physiology Department displayed shuttle schedules to get to the parades. The BMS Student Association emailed the same shuttle schedules. Resources were used to get gatherings that offered plastic beads with an amassed value, when compared to the North Korean won elevates the latter to the status of the Swiss franc. But the same resources were not used to help students to get to community service sites.
The federal government did not provide the warning about the Covid until after Mardi Gras. Governor Edwards did receive a briefing about the dangers of the Coronavirus in February, in time to cancel the annual celebration that generates tourist revenue. After the lockdown, news reported that Planned Parenthood clinics were threatened to shut down, even though they provide timely care for women.
True. However, the federal government is known to act slow. However, it is not allowed to interfere in the affairs of the state. The onus was on the Governor who is supposed to bolster the health department and ensure that the state is prepared for such emergencies. To echo Benjamin Franklin, "If you fail to plan, you are planning to fail! "
The tragedy of the Covid occurred long before Mardi Gras and the warning signs were there. Poor infrastructure was one of the many problems. All pediatric providers should warn the caretakers of children that this ceremony is not meant for children. It is not safe.
Furthermore, the lack of conformity to the guidelines provided by the Centers for Disease Control was one of the second warnings that no one should take the risk to attend Mardi Gras, especially if you are not a rich, white male.
Dr. M emphasized the importance of going outside and getting some sunshine. An alternative is to consume vitamin D supplements and use a manual treadmill. Going outside is not a safe option for Asian Americans who may confront aggressors of an uneducated populace scapegoating them for the Coronavirus. It is about as useful as talking down a patient in the ER who is presenting rotary nystagmus.
The first fatality in Louisiana was a tourist visiting from Ohio to attend Mardi Gras. His steps should have been traced so that individuals can know if they are possible asymptomatic carriers who continue to infect others unknowingly. But testing has been prioritized for those who show respiratory symptoms. Furthermore, the workers who had picked up the trash after Mardi Gras deserve more than sympathy. Those trash must have functioned as bioweapons, carrying remnants of the Covid virus. The working poor had no choice but to undertake risky, dangerous jobs. This was the same quandary that Dr. Alice Hamilton observed; she advocated for safer working conditions that formed the basis of OSHA.
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The benign title of the course is about how leaders in healthcare can be mindful of the factors outside of the exam room. Dr. M explained of his work and his demonstration of resilience and professionalism throughout what should not have been a controversy: the pursuit of safety for children. His opponents included the petroleum industry and also his employer. Dr. AK. explained the basics of chemical treatment used to treat water.
For those new to Tulane University, the university announcements on boil advisory notices can be bewildering. When those notices are received, you have to get bottled water, increasing your exposure to BPA.
After class, I watched the Nova episode on what happened at Flint, Michigan and the residents there were poisoned by lead, because those in power wanted to save money. The manifest function was a telling of how cutting corners on a vital part of epidemiology. The latent function was demonstrating what professionalism is about when pursuing justice. Even with truth on your side, your opponents will malign you. First, they dismiss the findings. Then, they demean your character. As mentioned in a previous post, historically, the (toxic) masses have been impatient and intent on persecution based on rumors and falsehoods. When a lone EPA official spoke up about the injustice of the improper handling of water, his colleagues and superiors refused to support him, inciting that the pursuit of justice can be a lonely affair that can test your equanimity. Unlike winning NIH grants, there is no glory for helping poor, vulnerable people. Speaking up is a disruptive activity and must be punished.
"Disruptive" “those are words that white people use to express our racial fears.” Chana Joffe-Walt
Dr. Sapolsky mentioned this quote used in the text for Endocrine Pharmacology. For progressive reformers who envision a better present and future, the slander used by those around you and worse, the apathy, can be frustrating and stressful.
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