Physician Resolve On Display as the Immigration Conversation Continues

JUNE 20, 2018
Thomas Castles
When Attorney General Jeff Sessions ordered federal prosecutors to implement a “zero-tolerance policy” for illegal immigration at the US-Mexico border, the Trump Administration drew the kind of mixed support and condemnation you’d expect from such a move. But when Americans began to realize that the policy had consequences that included migrant shelters full of parent-less children, the conversation changed tone.

Polls suggest that separating children of immigrants from their parents at the Mexican border is highly unpopular, except among Republicans. First Lady Melania Trump and former first ladies Michelle Obama, Laura Bush, Hillary Clinton, and Rosalynn Carter have all united in opposition to the practice. But few groups have been as vocal – and few have brought more powerful evidence and potent anecdotes to the table – as physicians.
doctors and immigration
I’m inspired by the fact that physicians are taking time out of their often busy schedules to analyze current political maneuvers, and that they are committing themselves to reshaping future ones. I recently wrote (and truly believe) that meaningful pathways toward curbing gun violence must include the steadfast commitment and expert consultation of physicians. In light of the recent conversation around immigration and the intimate link between familial connections and health, it’s appropriate to take that statement a bit further.

Replace “gun violence” with many of today’s most pressing challenges – immigration woes, human trafficking, racism, the opioid epidemic, the school-to-prison pipeline, all-too-high suicide rates, etc. – and I’ll continue to stand by the statement. If we want to gain ground and make progress in these areas, physicians must be involved. And as the debate around immigration and familial separation has risen in fervor, they have been.

About 2 weeks after a Fox & friends Twitter poll questioned whether the American Medical Association (AMA) should “get so political” about gun violence (71% of voters agreed that yes, they should) the AMA entered the immigration conversation by spotlighting the long-lasting negative health effects that often result when children are separated from their primary caregivers. Physicians across the spectrum of specialties echoed that sentiment, often drawing support from the literature. It’s not hard to find data bolstering the idea that separating children from their primary caregivers can have long-term negative health effects.

In an interview with MD Magazine at Psych Congress last year in New Orleans, Vladimir Maletic, MD, clinical professor of psychiatry at USC, highlighted studies showing that early life adversity is a significant prognosticator of future occurrences of major depressive disorder, addiction, and several other conditions. “Individuals who have suffered more than 2 adverse early life events had double the rates of depression, but interestingly enough, they also had double the rates of inflammation…they had double the rates of metabolic disorders, and they had double the risk of developing 2 or more chronic medical illnesses,” he said. In addition to psychiatric conditions, physicians have raised concerns about increased risk for communicable diseases among children in high-density shelters. Data suggest that jail- and prison-like environments present an important infection-control challenge for infectious disease practitioners and epidemiologists. During incarceration, inmates are at an increased risk for the acquisition of blood-borne pathogens, sexually transmitted diseases, methicillin-resistant Staphylococcus aureus infection, and infection with airborne organisms, such as M. tuberculosis, influenza virus, and varicella-zoster virus. Pediatricians have been especially active on Twitter in response to the news that new immigration policies have resulted in more than 2300 children being separated from their parents at the southern US border. Many have rallied behind American Academy of Pediatrics President Dr Colleen Kraft, who shared the story of her visit to a Texas facility for migrant children separated from their families on June 18. Kraft said she was not allowed to “comfort or hold a crying child. And we all knew that this child was crying because she wanted her mother.” Other pediatricians lamented the simple fact that such a drastic situation could arise in the first place. What impresses me most about these physicians – the ones vying for change, whatever their opinions may be – is their resolve. Many doctors chose medicine as their life’s calling because they wanted to change people’s lives for the better. Many more quickly find out that it often is not glamorous work. As one physician wrote on Reddit under the user name mrmao, “You’re overworked, underappreciated, spend most of your time doing paperwork, and fighting upstream in a broken system.”

The funny thing about that? It’s exactly the kind of chip-on-the-shoulder attitude needed to spur real change. When you pair deep-seeded ambition to help others with unwavering resolve, amazing things can happen – and physicians are making them happen every day. Editor’s note: This is a column written by Tom Castles, associate director of editorial. His analysis reflects his views, not necessarily those of the magazine.

Related Coverage >>>
Copyright© MD Magazine 2006-2018 Intellisphere, LLC. All Rights Reserved.