As faculty in the Hennepin Healthcare Family Medicine residency training program, I have the great fortune to work in the most diverse program at the most diverse hospital in the most diverse city in my 5 state region. Here in Minneapolis towards the end of May, we were gradually approaching COVID peak. Our governor had shut down the state in March. Regional collaborative teams had organized all the hospitals; we had built our hospital bed and PPE capacity to the point where even though we were still on the uphill part of the curve, state leaders felt comfortable making small adjustments opening up and we felt prepared for the climbing numbers. We were growing used to the increasing frequency of sirens heard intermittently through the day and night, and the slow but steady climb of daily deaths. Then, on Memorial Day, George Floyd was killed. That murder laid bare the inequalities that we know exist but do not always get fully exposed.

The next day, protests began – multicultural, passionate and non-violent until it reached the police station where protestors and police clashed with tear gas, riot gear, rubber bullets and hurled objects. The mayor publicly wondered the next morning why the 4 officers had not been arrested. Anyone else, not a cop, would have been arrested based just on the video.

The second night things got much more intense and that continued through the week. Suddenly the ominous sound of sirens became not “one more COVID patient” but police and firetrucks, as well as ambulances.  We were watching our beloved city burn. Twitter videos were shared of white people, dressed all in black, faces obscured, systematically breaking out windows and handing out gas bombs. Who were they? Was this planned, intentional, organized? Cars with no license plates drove around, clearly casing our neighborhoods. Multiple pharmacies were broken into across the metro area including three of our own community clinics, one of which I work at.

In my neighborhood, a Walgreens and a Holiday convenience store had been broken into and vandalized – less than 2 blocks from my condo. I heard helicopters and sirens all night but  yet, I felt safe. I was not in the war zone, but just a bit outside, though close enough that my building took the precaution of placing the garbage bins in the garage so we wouldn’t have any bin fires, and close enough that every storefront on the main street behind my condo had been boarded up as if in precaution for hurricane season (in Minnesota??) but yet, safe. I did not have a conflagration of multiple burning buildings on my block. I did not wake up to a street full of broken glass, just two stores on different blocks. I was not kept awake all night worrying that my house might go up in flames from the arson of other buildings.

On the fifth night, we suddenly did not hear any sirens for several hours. There were helicopters all night, but an eerie lapse of sirens despite ongoing unrest. It was surreal and almost a relief when they kicked in again around midnight with the arrival of the National Guard. Our governor stated in the paper that much of the violence was outside agitators; the St Paul mayor said all the people arrested in St Paul Thursday night were from out of state. This turned out to be only partly true; we have our own agitators here, too                                                                                                *

Who has suffered most? Our poorer neighborhoods, our small, immigrant-owned businesses and minority-owned shops, along with the neighborhood Target, all the grocery stores and pharmacies, two post offices and a clinic.  Already hit harder by the pandemic, those neighborhoods suffered the most damage by the reaction to police brutality, and in the very places they live. George Floyd’s neighbors now have to travel across several neighborhoods to get food, shampoo, baby diapers and fill a prescription

This was the most extreme experience of social injustice I have ever lived through up close. I had fear, but not nearly the fear of those in the hotspot poorer neighborhoods. But now, suddenly, I shared with those communities a fear of the police. I became afraid that if I call I may be responsible for someone’s death or injury. If something happens, who can I call and trust that the response will be appropriate? One of my African American residents reflected that sentiment; she says growing up black you never call the police. It’s not safe.

And we still have the pandemic. The large gatherings may fan the flames of the virus. Concerns have been raised that tear gas does this too. Does stress change the body’s immune response? If you have lived through multiple nights of terror, are you more likely to respond with that overwhelming inflammation that is killing otherwise healthy people with COVID? It remains to be seen.                                                                                            *

A deeper deployment of the National Guard brought relative quiet at night that weekend. On day 7, I visited ground zero with my brother, loaded up with first aid items and brooms. The devastation was unbelievable. It truly looked like bombs had been dropped. Buildings were reduced to their burnt out shells or piles of rubble. Anarchist graffiti was written on several burned buildings. We joined a crew that was emptying a former print factory building so it could be torn down. That part was heartening: a multicultural multiracial clean-up effort. I donated my first aid items to the back of a pickup truck where a first aid sign was posted. Turned out they were a motorcycle club who used to be EMTs. Go figure.

That evening I joined a Zoom call hosted by one of residents, ostensibly to discuss joining together for an effort to help the community. Instead, it ended up being a group therapy. Our residents were in deep pain and I could see the PTSD on their faces. They are the most diverse group in our entire hospital and they bring with them the scars of past and present micro and macro aggressions. They are wounded, trying to carry on in the midst of isolation due to COVID and, for some of them, fear for their own safety in their homes. The intensity of the pain was nothing I have ever experienced. The tremendous horror of the death of George Floyd, intermingled with the explosive community reaction, the fear for their own safety, the fear that the reaction was bigger than unruly protestors but appeared to involve highly organized people who arrived here just to instill terror. All this was too much to handle in a world where we are asked to isolate.  We were trying to work in a “Doctors without Borders” situation without training, psychological support or tactical knowledge.

The atmosphere became calmer but there were lingering weapons. A few fuel-filled bottles were found in yards in several neighborhoods. I learned that people of color were receiving letters threatening arson if they continued to keep protesting. One of our residents shared a photo of the note pinned to her friend’s door – yellow lined paper with red marker printing: “we know where you live”. She said he took it to the authorities. But then I thought – which authorities?                                                                                            *

My final observation is one of hope. So many amazing and unprecedented events have happened here in Minnesota.  Within my residency program, on Wednesday – day 10, core conferences was scheduled to be a forum for the seniors to present their research projects. Instead, the senior class took over the agenda and led a 3 hour conversation about race over Zoom. The majority of the residents as well as the majority of faculty were on that call. We cried, we told stories, we gave messages of understanding and care, we looked at tough racial issues within our program and our hospital system. Everyone was encouraged to speak, and those who had not spoken earlier did so at the end. Most importantly, we listened. We gave space for people to share their stories and grief. And it helped us heal a little. Together, we worked on the social determinants of health in real time and for each other.

-Susan Hasti, MD, Community of Practice Member

Dr. Susan Hasti is faculty in the Hennepin Healthcare Family Medicine residency training program.

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