By Nathanael L. Holley
Sometimes, I have moments when I really want to get a COVID-19 vaccine. I say to myself, Nate, this is science, if you want to be a part of the solution and not the problem, you need to do this. Then there are other moments when I see CEOs and other corporate and government representatives speaking on the news, and I think, there’s no way I’m going to trust these people or anything they have to say about my health and wellbeing. I’ve spent my entire professional career working in healthcare communication and education, and yet this is the struggle I face internally when considering what to believe about the pandemic. At the end of the day, it comes down to trust—who has earned it, who has lost it. And this applies to multiple entities (government agencies, pharmaceutical corporations, hospitals and universities). The American healthcare system is by far the most expensive, complex, and hardest to navigate of any other healthcare system in the ‘Western world’, with very few exceptions. I’m writing this to help heal myself actually. I need to know that I’m not falling prey to some fringe, irrational, cultural idiosyncrasy. This is how I’m going to break this down.
Potential reasons for distrust include:
(1) Healthcare providers, regardless of their profession and ethics, have historically been motivated by profit due to financial incentives from insurance companies, pharmaceutical companies, hospital administration/hospital chains, etc. This causes a conflict of interest for patients who are already at risk of being lost in a healthcare system that is not overly fond of people with meager means.(2) Conflicts of interest are more apparent in the pharmaceutical industry because corporations lobby unabashedly and often exert direct influence over legislators and the public policy that they support or manage.
The history of healthcare discrimination in the US, simply cannot be ignored and neither can the more subtle disparities that have taken seed in the huge corporate mechanisms that manage and provide healthcare in the US. From insurance companies to the private practice down the street, medicine has now been inexorably linked to money. And anyone who has been paying attention knows that being poor or even just ‘perceived’ as having a low income (and thusly not a priority) anywhere on the planet puts you at risk of being underserved if not left out altogether.
This is the state of things. And this is why I’m still leery of the COVID-19 vaccine, even though the logical, rational part of my brain knows that it has to happen. In order to give myself even more of a pep talk about this subject, I decided to call a healthcare provider that I trusted and interview them on the subject. Her name is Calandra Bobbett and she’s a nurse. I interviewed her on my humble, yet very enthusiastically crafted, podcast, Knoemoore Art. It’s still up and you can listen to the whole exchange if you’d like, but here is the general gist of what she said.
She told me that her nursing school actually taught a lot about the history of bad practices in the US and countered that nastiness by instructing people to listen to their patients’ concerns, cultural beliefs, and personal histories. If a patient comes in and says they are a Jehovah’s Witness, the nurses know not to give them blood transfusions. They always offer up all the appropriate medical options and encourage patients to seriously consider their situation, but they never argue or try to coerce people into doing something that goes against their beliefs or just makes them uncomfortable. The choice is still the patient’s, and the will of the institution does not override that choice. In the end of the conversation, she gave me, and whoever else wants to listen, an incredibly wise and simple tip. Go to a doctor that knows you. Go to a small practice where you can regularly spend some time with the staff and get a full checkup done so that they know all your baseline measurements, values, etc. After a few visits, they will know what normal looks like for you and you can begin to build a real connection with them and their advice because you will know that they are looking at you as a real human being and an individual. I think that’s what most people of color want anyways when it comes to healthcare services. They want humanity. They want to be believed and they want the basic respect that should come with being a human. Nothing more, and nothing less.
But I think it will take time to get to that place for me. I just moved to a new city and I haven’t found a primary care provider yet. After my interview with Calandra, I built up the courage and ventured out of the house to get that shot, my first vaccine shot anyways. I still have one more to go. It’s that type of ‘baby steps’ engagement that will turn the tide for people of color. We need more people of color to become physicians, nurses, administrators, etc., We need more people of color to be recruited for clinical trials and more research dedicated to African American physiology. We must create space for more of the good interactions and much less of the bad ones and things will have to change. At least that’s my opinion, but feel free to go out and get a second one.
Nathanael L. Holley is a creative director and curates a podcast available at this link https://nateholley.com/podcast.