The Palestinian physician, who I mentored as a medical student, while I worked in Nablus during my Fulbright thinks so.

A. is in Texas completing an externship, an 8-week experience with an internist, to gain experience in the US so he can apply for an Internal Medicine residency in here. Weekly we talk about his experiences in US health care and I have been sending him articles of interest about health policy and Texas from the New York Times.

A. has a unique perspective. His family moved from Palestine to Saudi Arabia during the second intifada, an 8-year period of unrest in the West Bank. His family returned to their home to Jenin so A. could attend college and medical school. Jenin is a hot spot, the location where the US journalist Shireen Abu Akleh was shot in 2022 and the recent IDF attack in July. His family lives in a nice neighborhood not far from the refugee camp where unrest (or attacks) usually occurs.

Long story support, A. has experience with war, injustice, and loss. He is shocked by the homelessness in Texas. In Palestine family take care of family. If family are unable, then the church, mosque, or community step up. Palestine may be poor but no one goes without the basics. He is shocked at the struggles Texas patients are having with the loss of COVID funding – access to the basics like prenatal medications. The recent op eds by Nicholas Kristoff outline the sad realities of US health care.

A few days ago he met a 30 year old patient whose friend was shot dead just before the patient came into the clinic, A. wrote me:

The last patient I saw today had a left leg amputation. She's on peritoneal dialysis, and she's only 44.

Within a month I've seen her twice. Once after a car accident and today after Mallory-Weiss tear.

She's not the only one though. By now I'm not surprised to learn a patient has some sort of amputation.

It's like I'm in a war zone, but the war is invisible.

I agree with A. The injustices are appalling and overwhelming, especially since during my career I have tried to add my voice to the political efforts to address them. Last Saturday, I saw a 42-year-old woman with knee pain. She needed decent shoes, not the flimsy flip flops she was wearing. She grew defensive when I asked her about her housing; I was wondering about stairs. “I’m not homeless she told me, not anymore.” But where could I send her to get her a decent pair of shoes that would support her flat feet? I could order x-rays, blood work, send her to physical therapy if she could get there, but what about supportive tie shoes?

So how do I/we respond?

We keep plugging away, moving forward and try to make a difference where we can. I am also heartened by the enthusiasm and energy of the new group of medical students I am teaching this Fall. Once upon a time, I was ready to tackle the challenges with the same faith and hope.

In solidarity. . .