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.
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.
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.