Protect and serve. Do no harm. These are covenants our public servants promise to us. Police officers and clinicians are both entrusted with attending to our health and safety. Both are failing. We must be able to trust clinicians and police with the intricate details of our living and dying. When they deliberately lapse in integrity, or are completely negligent of due diligence, they need to either be stripped of their roles, or reimagine their purpose and role in society. As a practicing physician, my perspective is that we perform these professional responsibilities with our intellects, physical faculties, and our hearts. When we violate our oaths, a sacred trust is violated. Legal remedies are partially restorative. But trust is a matter of the heart. Coldhearted. That’s the judgment that comes to mind with the image of ex-officer Derek Chauvin, one hand in his pocket, one eyebrow raised, forehead crinkled, a knee on the neck of the late George Floyd, eyes fixed straight into the camera of an innocent and courageous 17-year-old gal filming him murdering a helpless man. Unflinching. Unemotional. No anger. No fear. No agitation. No anxiety. Brutal. Psychopathic. Ice. Coldhearted. Two of the three other law enforcement officers present at the scene of the crime, Thomas Lane and J. Alexander Kueng, actually helped Chauvin pin George to the ground. The third, Tou Thao, bore witness to a cold-blooded murder without intervening. Coldhearted. That’s the impression that comes to mind with the mental image of 3 police officers, Jonathan Mattingly, Brett Hankison and Myles Cosgrove storming into the bedroom of Breonna Taylor in the middle of the night, shooting and killing her while she slept, putting a completely different spin on “dying in one’s sleep.” The cultures of law enforcement and our medical system are products of a larger cultural mentality of war, conquest, rank, and inequality. Even the hallowed work of healing is rife with combat terms like front lines, trenches, and battles against various diseases. The police force continues to demonstrate its perception of the public as the enemy. A battlefield fraught with tear gas, rubber bullets, tasers, paint bombs, and riot gear is no place to cultivate trust. Put your weapons down, police peoples. The chilling, ruthlessness reflected in these events requires the urgent counterbalance of fire. Literal and metaphorical. Such coldbloodedness requires a blazing fury, rebellion, and turmoil without which the system risks collapse. If the professionals we are counting on lean to the shady side of the canoe, the rest of us can’t sit quietly in the center of the craft, lest we all flip and sink. We are now shouting to the police, “We see you and the naked lack of integrity of too many amongst your ranks. We see the damaged hearts, sick minds, toxic culture, and twisted priorities in your troops.” Law enforcement needs to hold itself accountable, which it is failing to do. So the public must compel them. The current medical system is also merciless and inequitable. Health inequities obviously cleave along racial and socioeconomic lines. The excessive COVID-19 death rates among Blacks, Latinos, immigrants, and Native Americans fuel the anger we are currently burning. Although some measures are in place to keep clinicians accountable for mindfully attending to the health concerns of patients, our medical system fails in gross measure. The USA has some of the worst health metrics in the developed world, and medical errors cause the unintended deaths of 250,000 people every year in the USA. Clinicians build trust by connecting with patients in everyday ways. Preventive visits afford an opportunity to get to know each other when patients aren’t acutely ill. We stand with our patients as they navigate the curvilinear convoluted trajectory of life and death. Clinicians know that establishing trust and offering diligent medical care takes time. For-profit medicine and its collusion with the insurance industry has a stranglehold on the patient-clinician relationship by throttling the time allotted for medical care. That relationship is hindered as long as third parties payers continue as intermediaries. Our profession is responsible for offering the conditions that foster mutual trust. And the public ought to exact it from us. Many have been putting their minds and hearts to the issue of re-envisioning the role of law enforcement in creating public safety. For building trust, I point to a model offered by police forces in Kerala, community policing, which successfully forges meaningful, cooperative relationships between police and the communities they serve. Officers take time in daily rounds getting to know the people on their beat when there’s no crime happening. This is an approach, a philosophy, that envisions police as members of a community, rather than embodying a paternalistic “us against them” mindset. Community policing makes it harder for officers to break their promises to protect and serve the people they actually know, and even more difficult to intentionally kill them. Shattered social, political, and economic agreements pervade every aspect of our society, including the ways in which we have broken our commitments to support, protect, and nurture each other, our children, parents, women, men, spouses, teachers, healers, artists, workers, retirees, vets, elders, the poor, mentally ill, disabled, and disenfranchised. Even the very earth we stand on. We won’t stand for it anymore. We have created a culture based on the fragile and false paradigms of hierarchy, reward, punishment, achievement, and acquisition as measures of our worth. We have forgotten that every creature deserves love, respect, freedom and happiness for the simple fact of surviving our own birthing. Nothing more is required for the right to live life. It is time to re-create our world. This is just the tip of a very cold iceberg. One fact about ice is that even an iceberg can melt in the presence of fire. This ignition is an immediate invitation to participate as equals in the combustive transformation of our civilization into one of freedom, peace, health, and love. We must now engage in a massive cultural paradigm shift. We must consider how we all have to change in order for us to be free together, a mutual gift. We must honor the pledges we make with each other. It is possible to rebuild trust. Do no harm. Protect and serve. There is no try. Do or capsize. Jayshree Chander is an occupational medicine physician. Source
