AMA President Gerald E. Harmon, MD
In the inauguration address at the June 2021 Special Meeting of House of Delegates, Gerald E. Harmon, MD, discusses the challenges of the past year, his own journey in medicine and the AMA’s recently released plan to embed racial justice and advance health equity.
Acting worthy of ourselves
Good evening. Thank you, Russ, and Sue. Thank you both for your service over the past year, and the past many years. And many thanks to Speaker Bruce Scott and Vice Speaker Lisa Egbert for putting this meeting together.
It is a privilege to address you as president—only the third time a practicing physician from South Carolina has had that honor. The first was Dr. James Moultrie in 1851, and the second was Dr. Randy Smoak over 20 years ago.
This, then, is a rather uncommon occurrence.
Let me begin by expressing my gratitude to everyone assembled in this virtual inauguration—the second in a row for the AMA as we continue in the throes of a now-historic viral pandemic.
So many people have supported me along the way, and I cannot thank you enough. If we were in person, I would recognize you and ask you to stand, but tonight, I will have to call you out virtually:
First, my colleagues within the AMA itself—officers, trustees, administrative leaders, co-workers, and the House of Delegates: thank you;
Those at home in South Carolina who have supported me throughout my career, including my fellow physicians and co-workers at Tidelands Health and for many years at Waccamaw Family Medicine in Georgetown County: thank you all.
My military colleagues across the nation, many of whom are still in active service: bless all of you for everything you have done and continue to do to serve our country. You truly are my heroes and role models.
The leaders in my community and state who have taken on roles of public responsibility and who have supported the medical profession in so many ways: thank you.
The innumerable patients and the families who have given me so much more than I have given them. They have placed their lives and those of their family members sometimes quite literally in my hands. Their continued support of my service in organized medicine and the AMA has humbled me greatly.
And the most important of my supporters—and often the most under-recognized: my amazing family.
- My Mom Angelyne—who goes by the ‘Call Sign’ Buncie—raised my brother Randy, my sister Elizabeth, and me as an incredible single parent when our father was stricken with a fatal brain tumor at age 33. She is now nearing 91 years of age, but still lively and quick to give us pointed advice—thanks, Mom.
- My three children: Bevin, Kathy, Scooter and their families, and my eight grandchildren. All of them will recall that my military and medical duties resulted in missed graduations, missed proms, and missed family gatherings. And we all know that happens in doctor families. Love and appreciate you all.
- And finally, my ‘Enabler-in-Chief,’ who has made it possible for me to attend to those duties and supported the family in my absence: my wife and best friend of nearly five decades, Linda Harmon. There never will be enough words to express what you have meant and will always mean to me … and really, to all of us. Thank you, Linda.
You know, a couple of days from now—June 17th—will be the 246th anniversary of the Battle of Bunker Hill.
This was, of course, an early engagement in the Revolutionary War for freedom from oppressive control and taxation by the British.
Among the casualties to the Continental Army was its ranking officer, Major General Joseph Warren, a 34-year-old physician.
Three months before his death he gave a speech commemorating the Boston Massacre in which he exhorted his countrymen to preserve and defend liberty, which he described as “far dearer than life.”
He said, “On you depend the fortunes of America. You are to decide the important question, on which rest the happiness and liberty of millions yet unborn. Act worthy of yourselves.”
Act worthy of yourselves.
Ninety years and two days after Bunker Hill, June 19th, 1865 marks another crucial day in American history. On that day, just after the end of the Civil War, federal troops took control of the state of Texas and proclaimed all enslaved people free … an important step in extending the freedom fought for in the Revolutionary War to all people.
I went to high school in Texas, and we recognized that date as Juneteenth.
And so, as we acknowledge these historic anniversaries this week, I ask you to join me in reflecting on the words of Joseph Warren and ask … Are we acting worthy of ourselves in this moment? Of future generations?
This is a consequential time in American history, and in the history of medicine. We, too, are at war against seemingly formidable adversaries …
… the COVID-19 pandemic which has led to the deaths of millions worldwide, and hundreds of thousands here at home
… prolonged isolation and its effects on emotional and behavioral health
… political and racial tension and the immense battle to rid our health system—and society—of racism.
As we face these challenges, we must remember that our actions as physicians and as leaders, will have far-reaching consequences for our families, our patients and our communities, and will affect the lives and happiness of “millions yet unborn.”
Like many of you, I have experienced a roller-coaster of emotions over the past 18 months:
- The exhaustion of working 12-15-hour shifts alongside other front-line colleagues who were similarly physically and emotionally dragging;
- Attending seriously ill patients who were afraid to ask, “Will I survive?” because they were often fearful of what I might answer; and
- I specifically remember one senior patient with whom I spoke—behind a complex barrier of PPE—and when I reassured her that she was on track to recover from her Covid infection she grabbed my hand and—with tears in her eyes, said, “Dr. Harmon, you’re the first person to tell me that!”
Like you, I have seen the terrible outcomes of this devastating virus and have experienced the loneliness of being unable to gather with friends and colleagues—even for weddings or funerals.
Adding to the suffering, the COVID pandemic has revealed enormous gaps in how we care for people and communities in America … demonstrated in the disproportionate impact of this pandemic on communities of color. . . and in the weaknesses of our under-funded and under-resourced Public Health infrastructure.
During such times of struggle and heartbreak, it is important for us to “remember our why.”
Why did we enter medicine? Why do we struggle against overwhelming administrative and regulatory burdens? Why are we risking our health and our families during this global pandemic?
I would submit that the education, the training, the years of experience and sacrifice we have gone through has prepared us for “such a time as this.”
This past year—and the year ahead—is WHY we—America’s physicians and the AMA—are here.
As Viktor Frankl—a Holocaust survivor—wrote, “Those who have a 'why' to live, can bear with almost any 'how'.”
We have heard for much of the last decade about ‘physician burnout’ and increasing dissatisfaction within our physician community. We understand why that happens, given the administrative hassles and the regulatory challenges we face, as well as a general lack of understanding and appreciation for other types of work that doctors do … academics, researchers, regulators, and administrators.
But in the past year we have seen a new appreciation for all of medicine.
Americans recognize how much they rely on their own personal doctors and other health care workers on the front lines …How much they depend on the researchers and scientists to develop treatments and vaccines …
the medical educators and teachers who mentor and train the vital physician workforce …
and the physicians in non-clinical jobs who deliver crucial health care resources in an emergency.
The AMA’s own surveys find that nearly 50 percent of doctors have experienced a ‘renewal of purpose’ among the tribulations of pandemic response. In a year defined by so much suffering and heartache, this is welcome news.
Colleagues, this past year has been extremely challenging, and we hope the worst of the pandemic is behind us.
Looking to the year ahead, we will need to “remember our why” to meet the very difficult, ongoing challenges we face in medicine:
- Recovering from the pandemic; vaccinating the nation;
- Removing obstacles to care;
- Ending our nation’s drug overdose epidemic;
- Improving outcomes for patients with chronic disease;
- Making technology work for the benefit of physicians and patients;
- Preparing future doctors to meet the needs of all people and our changing world;
- And, significantly, embedding the principles of equity and racial justice within the AMA and throughout our health system.
Just a few weeks ago, the AMA released a comprehensive strategic plan to guide us in our work to advance health equity and justice; and to improve the quality of care for people who have too long been marginalized.
Meaningful progress will not happen until we, as physicians, recognize how profoundly systemic racism influences the health of our patients, and until we commit to taking action within our own sphere of influence.
As a family physician in a diverse state, I have treated people from all backgrounds, and have seen the inequities up close … inequities that understandably lead to distrust.
A few months back, when rounding with our physician inpatient team, I was advised that the patient on the 3rd floor was a 70-year-old man with pneumonia who did not say much and was described as “difficult to communicate with.”
I went in to see him and found an older Black gentleman with a last name that was clearly local. I noted, he gave only one-word responses.
Rather than continuing to quiz him about his illness and his symptoms … in the traditional hospital model … I told him I had met and treated several folks with his surname. I asked where he lived and what he did for a living.
He replied, “mechanic.”
I asked, “What type of mechanic?”
“Jet engine” was his reply—(not a typical profession for Georgetown County by the way.) I told him I some experience with jet engines, and then he opened up a bit.
Turns out he had obtained a degree in aerospace and worked on jet propulsion engines for NASA at Langley Air Force Base where I had spent three years. He was, quite literally, a rocket scientist.
From there, we established a bond, and I was able to understand him, and address his health needs, with a more meaningful conversation.
We provide better care when we treat the patient and not the disease, and when we endeavor to overcome racial stereotypes in our communications.
Our equity plan, as well as our other strategic goals, is ambitious and far-reaching.
But as individual physicians, and as the nation’s largest association of physicians, we are uniquely gifted with the intellectual, physical, and emotional skills to respond to each of these challenges.
When we invest years of our lives—and ask our families to sacrifice—let’s remember it’s not about ‘us’ but rather about the gifts and talents we possess to care for humanity.
We do not have to be on the Board or elected to a position to lead—we lead just by being doctors every day in every category: researcher, administrator, regulator, teacher, bedside clinician, advocate.
The AMA can meet the health care challenges of this moment because our members are physicians acting worthy of themselves every day, in every venue. And in the process, we are moving medicine forward and positively affecting the lives of generations yet unborn.
Just a few weeks ago my wife Linda and I were at a softball game watching our granddaughters play. We were wearing our masks when a woman from the opposing stands came up carrying a toddler in her arms.
She approached cautiously and asked, “Aren’t you Dr. Harmon?” When I said ‘yes’ she said, “You won’t recognize me, but this is my grandbaby here and her Mom is coaching first base. You saved her mother’s life when she was born, and they are both here with me today because of your actions. Thank you again for being a doctor.”
Patient stories like this remind me of my “why.” They lift me up when I am down; give me the energy and enthusiasm to work on our ambitious agenda; and sustain me as a servant of the medical profession.
And so, I ask you, wherever you may find yourselves in this field … caring for patients, … doing the work of advocacy, of education, of research … or being a supportive family member to the physician you care about … remember your why … and pledge with me, as Doctor and Major General Joseph Warren said over two centuries ago—to Act Worthy of Ourselves and our calling.