Sitting up, sweating, chest rising with shallow breaths and minimal eye contact, there was my next patient, a 45-year-old male. He was flagged to have limited English proficiency. He was struggling to breathe as his oxygen saturations were hovering around 90% (barely acceptable) even while on oxygen. History leads us to the diagnosis in medicine, and when interviewing him in Spanish, he tells me he’s from Central America, works in construction with long days outside in the cold, doesn’t stop to eat lunch and also works a few hours at night in a restaurant near his residence. He had been feeling ill for four days, but he kept working and did not seek medical attention. He confided that he couldn’t afford to lose income as he supported his wife and two young children.
As with any other patient, I finished my exam, explained the plan and reassured him that with antibiotics and a few days of hospital care, he should be good enough to go home. He and his wife were relieved and expressed gratitude to our team with the limited English they could speak.
Credit: Contributed
Credit: Contributed
As I approach what I expect to be the halfway point of my career in medicine, I never would have imagined worrying about immigration authorities raiding hospitals to deport patients. Let me be clear: I have never been intimidated or antagonistic to legal authorities in the hospital. I’m accustomed to having armed security present in the hospital, and even local police if an incarcerated patient were admitted to the hospital or had a warrant out for his arrest. But the thought and images of U.S. Immigration and Customs Enforcement agents forcefully entering a hospital, probing for information and potentially apprehending patients is purely unfathomable. It’s simply something that should never happen in a hospital anywhere, let alone in our country.
I reflect a lot the infamous saying from medical training of “first, do no harm.” It’s simple enough, right? Our goal will always be to not medically harm a patient, which ranges from actual medical decision-making to communicating at the bedside. But even with the sincerest efforts in top-rated health systems, harm still occurs daily around the country in hospitals.
Recognizing the possibility that ICE could raid a hospital to detain a patient adds a threat and a risk of real harm to the patients and the staff. Most patients are not fully healed when being discharged from a hospital. The majority are still sick, but not sick enough to be confined to a hospital bed. Their recovery continues for days or weeks at home. To think that ICE would apprehend human beings in that position, subject them to deportation and ultimately impede their healing frankly seems inhumane.
The experience of ICE entering hospitals can equally harm staff. There are already a multitude of mundane and regulatory tasks and priorities that take the front-line staff — from doctors, nurses, therapists, social workers and more — from the patient’s bedside. Not only would they be trying to protect a patient from an ICE arrest, but they would now be following additional safety protocols, screening mechanisms and witnessing more suffering of their patients. This will intensify the stress and chaos of the fragile workforce, and psychologically traumatize them as they witness these events.
It is yet to be seen, but I can hypothesize that many who are undocumented will be cautious about seeking health care in hospitals as they will feel vulnerable and visible in the public eye, making them susceptible to ICE. This, in turn, is harm; it’s a risk to the individual’s health as well as potentially a community risk if they had a communicable disease.
Let’s get back to my patient with pneumonia. A few days later, he was better and eager to be discharged. He was still weak and coughing but no longer required supplemental oxygen. His wife looked at us with relief and smiles as her family was getting their husband and father back. He asked about returning to work and the costs of medications, anxious about bills while caring for his family. My team and I found generic medications that were cheaper and would treat his pneumonia as well as his newly diagnosed diabetes. We advised him on best strategies to sustain his recovery at home and when he could return to work. I recognized that when he discharged, his resources for health care would be minimal as he is uninsured and unable to get insurance. Did that make me feel good? No, but I knew we did our best, empowered him to take care of himself and advocated for him. That’s our job.
The metaphorical equation of caring for patients in hospitals and other health care settings these days is increasingly complex, with so many variables that it is almost impossible to successfully solve. We are now faced with the additional complex variable of ICE entering a hospital to apprehend a patient.
I plead for us to remember there are essential safe places in a community, and a brick-and-mortar hospital is one that needs to be immune from an ICE raid. When patients enter the doors of a hospital, it’s simple humanity to responsibly provide care, advocate and keep them safe on all levels, just like we did for my patient. That’s how we did things yesterday, how we do them today and how we’ll continue tomorrow.
Dhaval Desai is a physician in Atlanta.
About the Author
Keep Reading
The Latest
Featured
