I had one shift where I saw about 84 patients.
The first 21 days, we had to work consecutively without an off day.
These are 12, 13-hour shifts.
You know, I did seven days in a row of 12-hour shifts in an ICU that's
all Covid patients.
That's definitely a huge shift from my usual world of gastroenterology.
So I was the first faculty doing that Covid week.
All of our patients ended up being Covid-19 positive.
Some of those patients ended up passing away, unfortunately, but
we had to keep on moving.
I've been working as a primary care doctor over the last four years now.
This is certainly the wildest thing any of us has seen.
Typically, we see very diverse racially and socioeconomically patient
population. And it was interesting because I mentioned to our staff a few weeks
ago, I said, "Do you notice that more of our patients coming in, they look like
us?" And everyone said, "Oh, absolutely."
Historically, African Americans and other minorities, such as Hispanics, have
disproportionate numbers of hypertension, diabetes, high cholesterol.
These things are hard and challenging to manage on their own.
They also weaken the immune system, weaken the ability to heal.
Unfortunately, those diseases tend to track with structural and systemic factors
around the country, and those include lower income, lower rates of employment,
lower rates of access to insurance.
When you put a crisis on top of a crisis, these communities are going to do the
most poorly.
The patients that I noticed that didn't do too well, they were actually the
patients who are obese, who had a BMI, a body mass index, greater than 30, 35.
Those were the patients that we saw who needed the ventilators.
They needed machines to help them breathe.
Diabetes is unfortunately 60% more common in African Americans than in our
white counterparts.
The risk of diabetes is higher due to issues around diet, due to issues
around treatment of other chronic conditions that worsen diabetes, such as
obesity. You know, really getting through to people of color, especially
elders, in regard to their diet is definitely challenging.
You know, they grew up eating the scraps of food, you know, the
portions of food high in salt and high in fat.
I know from growing up in Detroit in a low-income
family that when you have to feed your family, buying fresh fruits and
vegetables is not necessarily affordable.
And so, if you're turning to the calorie-dense foods, you'll get your family
fed. Unfortunately, what comes with that, though, is obesity and diabetes
and high blood pressure.
Food deserts really influence the way people eat.
If you don't have access to the green vegetables or the healthy fruits,
unfortunately, you're going to be more likely to buy the chips, the soda, the
processed foods and increase one's rates of diabetes.
We started seeing more black and brown patients over the last few weeks, and
some of them were essential workers, they didn't have the luxury of working
from home. And we saw less white patients or patients that could work remotely
from home. It was, as I said, incredibly striking.
Right now we know that there are still states, for example, that did not expand
Medicaid to be able to ensure that the lowest income Americans, who
unfortunately in our society tend to be from black and brown backgrounds, have
access to insurance.
We know there are about 27 million uninsured in the country right now, and a
much higher proportion of those individuals are black and Hispanic.
We've had a number of patients come in to our urgent care at the front desk and
asking if you know, how much they will have to pay, how much do they have for
the visit, how much they have to pay if they were to get testing.
So these are real concerns and absolutely a barrier, especially for people who
are undocumented and who don't have insurance.
Many people don't know how to advocate their health because maybe they've not
had the resources or they're not comfortable going to the doctor.
So, yes, you see that they'll show up when things are so bad, you know,
they're knocking on death's door for lack of better words.
Workforce diversity, we know, is one of the solutions to addressing
racial health care disparities.
And the fact is that, especially among physicians and nurses and other
healthcare professionals, our numbers are quite low when you compare our
numbers in the U.S.
population. So if you were to ask me, you know, overall, is it
diverse here in terms of the physician population, I'd say to
a degree. In terms of diverse, in terms of a large number of
underrepresented minorities?
I would say no. Me, I'm the first African American
advanced endoscopy fellow here, period, you know?
And it's... you know, I started this fellowship in 2019.
We're in 2020 now and to say that I'm the first African American advanced
endoscopy fellow here is really mind-blowing.
Yale does an excellent job of really trying to recruit minorities.
It's just, you know, it's a slow process.
You know, when you're in the healthcare setting, it's already a scary and trying
time to begin with.
When you don't see anyone that looks like you, that can be even more
concerning. And so I've definitely seen that time and time again where patients
are just so excited to see another black doctor.
And actually, you know, they will go out of their way to to find a black
doctor. When you go into the room and then you say, you know, "I'm Dr.
Campbell," you just see a lot of times their face just lights up with this
pride and it's like, "Wow, I'm just really happy to see you here as a
physician." I think it makes all the difference when you can see someone who
looks like you.
You know, the patients are just, as you can imagine, more receptive to what
you're saying. I feel that there's even a sense of ease or
calm that might not be there otherwise.
Growing up, it was quite normal for me to see loved ones
and family and friends dying in their '40s and '50s and thinking that
that was normal. As I got older and went off to college and so
forth, I came to realize that, no, that's not normal.
Those are disparities and they're avoidable.
People who have been doing this work, we knew that these disparities existed,
and we knew that this pandemic would only worsen or even just expose these
inequities. And so what I'm hoping is that, you know, that this
horrible, terrible time, this basically nightmare that we're in, actually
something good comes out of it.
And that good would be for public health officials, for government officials to
really think about how we can prevent this from happening in the future.