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This morning I was alarmed to learn of first lady Melania Trump’s visit to Boston Medical Center. Like my nearby hospital, Cambridge Health Alliance, BMC opens its doors to everyone, including the most vulnerable in our population. New immigrants to Boston have a medical home in these hospitals because we provide not only care, but also comfort and community. Trump’s visit puts that all at risk.

Illness in this country is political. Access to care in this country is political. Access to insurance in this country is political. Access to government assistance is political. Melania Trump’s presence is political. 

The first lady’s visit is meant to be a nonpartisan event, but it falls in line with the lack of care and consideration this administration has given to the health and well-being of all immigrants, patients and medical professionals alike. From the travel bans that affected immigrant physicians and scientists to restrictions on asylum for refugees, the Trump administration is systematically barring people of color from everything our country is morally obligated to offer. The net effect cripples the health care workforce and discriminates against people who need the care. 

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BMC staffers protesting Trump’s visit worry that their work and their hospital will be painted with the same anti-immigrant brush, sparking fear in patients whose status is threatened. I see this every day in my work.

I’ve had very sick patients refuse care because they are worried about how it may impact their ability to become legal permanent residents. 

The public charge rule attempted to exclude immigrants from the safety net and government assistance programs they need to survive, including food and housing subsidies as well as certain Medicaid benefits. Even though federal judges have blocked the rule, the fact that this was in the air has had a chilling effect. I’ve had very sick patients refuse care because they are worried about how it may impact their ability to become legal permanent residents. 

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Melania Trump is trying to learn more about the impact of opioid abuse as part of her “Be Best” initiative, which focuses on “the major issues facing children today, with the goal of encouraging children to BE BEST in their individual paths, while also teaching them the importance of social, emotional, and physical health.” Her agenda at BMC included a stop to highlight the Cuddling Assists in Lowering Maternal and Infant Stress Program developed to treat babies born dependent on opioids

While this may seem like a good deed on the surface, it renders invisible the ways in which the Trump administration has been structurally cruel toward immigrant communities. I fear Melania Trump’s presence is antithetical to that Be Best mission, and her presence will jeopardize the social, emotional, and physical health of the type of families I serve. 

When working with patients, I often conduct a risk-benefit analysis by outlining the pros and cons of each treatment option, which includes a discussion of the risk of harm by receiving no treatment at all. How will I ease their very real concerns and offer care and comfort when a high-profile symbol of the Trump administration is knocking on the doors of our community hospitals? Why can’t Melania Trump learn about BMC’s substance use disorder programs and promote its methods from a safe distance? Wouldn’t that Be Best? She is here for only a few hours, but the legacy of her visit will last a long time. 

I stand in solidarity with the medical professionals at BMC non-violently protesting today’s visit. I urge BMC’s leadership to consider how this tacit endorsement not only harms our common patients, but also undercuts the hospital system’s employees who give everything to care for the most vulnerable members of our community. 

The risk-benefit is clear: You lose nothing and risk everything by having her visit.

  • Thank you for addressing this critical yet hidden health care problem. As a Registered Nurse, I have deep concerns about the future of our healthcare system in general. And the effects upon our most vulnerable citizens in particular. Those in power rarely comprehend the ways in which they subtly, and often unsuspectingly, have a detrimental impact on these vulnerable populations.

  • It seems to me that some readers missed the point and substance of the letter. When you think about what this physician was writing about you can understand the fear of those who are faced with getting health care, supplemental food stamps, etc. while they are trying to become citizens, this administration has repeated over and over that using these services could affect that. Comments are about not wanting to see “political” pieces in STAT well medical care is very political and especially in this administration – you cannot separate the two.

    • I respectfully disagree, the physician in this article could have discussed some of the followup ramifications in Nashville after Melania’s visit or any of the Kaiser family’s statistics on the Public charge Rule. If someone isn’t able to differentiate between facts and rhetoric than they aren’t trying very hard. I think the majority of readers who were dissatisfied with this article as I was understand her discussion, however “fear” and “concern” without any evidence sounds a lot like complaining that someone disagreed with you even worse you haven’t proven them wrong. For example, the publicity and name recognition could indirectly result in increased grant funding for that hospital but with articles like this I guess we’ll never know.

    • Dr. Dawson I agree that the author could have used peer reviewed publications or journal articles to support her beliefs. I read her article as an opinion piece, not an article that is fact checked. I believe she was writing about her concerns and her support of staff that felt like the visit wasn’t the best choice. I also don’t see concerns that she raised as “complaining”.

  • It’s embarrassing that this was published in STAT and more so embarrassing that it was written by a physician. Protesting Melania Trump will do nothing productive for the health and care of patients in the US. The government pays for majority of BUMC funding, its entire residency program, and many opioid preventative programs. Employees of BUMC should have shown more respective to an individual who does not write any policy herself, but serves as a bystander in politics

  • I’m not a Trump fan, but even less a fan of cancel culture. Dr. Okwerekwu, please grow up.

  • 👎🏿 I’m surprised and disappointed that this atrociously biased piece even made it into STAT. Please keep extreme politics out of this otherwise fine newsletter.

  • STAT: .You do a good job in some areas. Articles by professional medical writers, like Sharon Begley, reflect real research done to inform. The results have been startling. Your magazine should be “above” the dreary Shame Talking Points of your personal political party. This article is straight from Pelosi’s “Burn and Smear Campaign Tactics.” (for tactics, see below)
    Those who fear for their hospitalized illegal alien patients should ponder why they risked “near death” crossing deserts to get here?? How incredibly fortunate they are to be getting any free health care, formerly unobtainable by many penniless legal immigrants, including my grandparents. Then consider those flatly turned away from the US to face certain death. (Vietnam Boat People, Jewish Holocaust refugees on the M.S. St. Louis, etc.)
    Working in AZ Federal Prison, I evaluated Mexican women, recruited by the gangs to mule, who successfully arranged to be arrested at the US border. The success was theirs because they believed they were safer behind US bars than they were in their own country.
    Perhaps the author, a psychiatry resident is too young to discern truth-telling from indoctrination. She should have at least been helped by editors to create a plausible, if biased article.

    Also, perhaps Stat magazine and even the young author believe this country is so horrible and the medical professionals, your readers, so monstrous, that there is no place for dialog.
    Then let me suggest:
    Go to another country and become an illegal alien. Go with no passport, money, and a health issue. Can you get past the borders? Are people offering you food? Are you able to get health care, even become a hospitalized patient?
    For physicians in this country who are getting a salary to give out free health care…..you are not the generous one. Let’s have a little humility and reality here. We are all paying for this. Tactics: https://www.facebook.com/profile.php?id=100002422159140)
    Peggy Finston MD

    • I don’t believe that the author of this piece believes that this country is so horrible, they are writing about what they see that affects their patients. In this country we can question and still love this country, and not be told to go somewhere else because we have a difference of opinion. You write of humility and reality and you talk about partisan politics and STAT should be above it. You brought up Nancy Pelosi, you said that the readers and medical professionals are so monstrous that you can’t have a dialog – I disagree and I hope we continue to have a dialog that embraces humility.

  • Bravo. Great column. As a BMC alum and after 40 years practicing family medicine I am sad to have been exposed to the racial discrimination and financial exploitation that distorts the capacities of our medical care system. The Republican’s basic attitude toward health policy has only been magnified and epitomized by the Trump Administration. It is basically arrogant, selfish, racist, discriminatory and neglectful. Melania’s concerns are only window dressing

  • Excellent! And as in The Handmaid’s Tale – Don’t let the b—— get you down!

  • This article could have used an editor with sounder judgement. I don’t read STAT for political hit pieces by woke writers, and this drivel should have never made it past an editor’s desk.

  • As usual, privilege blinds people to the fragility of vulnerable people and ensures their greater suffering. Thank you for speaking out in advocacy for your/our patients! Your honoring of the sacred calling of healers and the oaths we take to protect and serve the needs of the sick to receive care and the well to remain in health is inspiring and commendable. To those who would criticize you, I say that we hope you are never without the ardent defense of your human rights and wellness! We will stand up for you and everyone else in need as is our duty and privilege. Humanity First!

    • I find this writer’s opinion ungracious and unfair to the First Lady. From what curdled political worldview does she see this high-level support of an important child heath initiative as being a ‘threat’ to the health of patients at her hospital? Further, it is deceptive to use the term ‘immigrant’ to make her argument about administration policies toward illegal immigrants, for which this administration has widespread support among the American people, whether she likes it or not. The title of this piece is accurate, for unintended reasons: as long as individuals like the author are incapable of overcoming their political bias in anodyne events like this, then it is true that “nothing is nonpartisan”.

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