While sitting at the Swearer Center Award ceremony at Brown this May 26th, watching my student Maddie Lorenzo accept her award for public service, I began to think about the young persons who were being celebrated at that event. I thought about their work, and the programs that they contributed to, and about what inner drive motivates these young people and their mentors contribute to public service. I thought about this as I watched the young people go accept their prizes with humility and grace – and heard more than one of them say – I did do not do this work to get this prize; I did this work because I believe in it.
Watching the happy proceedings, I began to think about the two types of people who get involved in work related to addressing health inequalities- the work that I am engaged in as a physician. These two types of people often end up at opposing ends of the engagement spectrum in terms of their contributions to ending health inequity, for reasons that are directly related to their own motivation for their engagement. One group is engaged in the struggle against health inequality because they live and breathe and identify with that struggle. They do this work to improve health for human bodies- because in that struggle, they see their own well-being -in other words, they see themselves as being part of that body for which they struggle.
The second group of people is engaged in work that addresses health inequalities for no other reason than it increases their own personal power. They do it for money, they do it for recognition, they do it to get grants, they get it to advance their academic careers, they do it so as to gain power over others – for any of a host of reasons – but the net effect is that their search for power and recognition ends up weakening the effort to address health inequity. Why? Like plants that compete for space in a field, obtaining power and preeminence comes at the cost of destroying other fragile seedlings. And for that reason, I call that second group of individuals health inequity weeds, and I say that they are dangerous to public health.
I challenge each of us to examine the reasons why they do this work. Is it for our selves, meaning is it for all of us, as part of the human whole? Or we do it for our self. Meaning that we do this work as a means of increasing our own power and status in the world. I would ask each of to begin our work every day by asking this question – why do I do this work.
Why is it worth asking this question? We need to ask it, because being the former type of person leads to sincere, constructive contributions that will lead to positive change and improve human health. The second reason for engaging in the struggle against health inequity will almost certainly lead to increased self importance, greater recognition, awards, and honors. Yet the success of weeds so often comes at the expense of other programs, and other individuals who are trying to contribute to the struggle. For that reason, the struggle for power has no place in the struggle against health inequity.
Not only is it important for us to ask that question of ourselves, but also, we must seek out and challenge the weeds. We must identify those individuals who do this type of work for personal gain. We must challenge them. If we are to create a fertile field, where all the programs can grow, and where our students, like young seedling starting out – can flourish, we need to seek out and challenge the weeds.
I have come across many weeds in my career in public health. They are attracted by money and prestige. The field of AIDS has many of them – and we have them right here at my own instiitution. We know who they are and we do nothing about it. We are afraid. We do not speak their names, and because we are silent, the destruction, the stifling, the eradication of young seedlings, young programs, and outspoken professors, continues.
For our students, for our programs, for our selves we need to identify the weeds in our fertile field, and we need to speak about the destructive work they do. More than any plaque or award that they can hang on their wall, the young students who were celebrated at the Swearer Center this May deserve this. Our gift to our students should be to protect them, and the next generation of seedlings from further harm by weeds in the field of public health.
Annie De Groot MD,
GAIA Scientific Director and Founder
The Warren Alpert Medical School of Brown University