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I Can’t Breathe

Isolated from the people and places I love

by a virus that preys

on the most vulnerable of us

I watched the sun set in front of my building

on the families and young people waving signs

as police dressed for war

surrounded them

as clouds of tear gas

filled the sky.

Later, my neighbor with asthma, who lives on the 11th floor

told me how she needed her inhaler to breathe that night

though she wasn’t sure if it was from the fumes

or the fear.

The department’s silence is suffocating

when I try to tell them,

full of old white men

who tell me my facts are wrong

that they have no responsibility for these things

that they shouldn’t be judged.

This doesn’t concern them

because they are objective and scientific.

they are busy

and this is not particularly important.

“I’m drowning”

my patient tells me.

How her panic attacks are getting worse

how she sits in the shower, ten times a day

how she’s so scared, she throws up when she eats.

I try to think

of how to tell her

the department no longer takes public insurance

while she is telling me

how the walls close in on her

how she can’t breathe

and I wonder if she sees

that neither can I.

Poet’s Statement

This poem narrates three distinct but related events, drawing upon experiences from June 2020. In addition to reflecting on emotions shared by many during this period, my hope is that readers will critically examine the following topics:

  • The role of academic psychiatry departments as leaders in recognizing the trauma of racism and advancing structural equity within academic institutions

  • The role of academic psychiatry departments in advocating for equitable systems of care in the communities they serve

  • The experience of residents in these systems, who often work with the most vulnerable patients, and have limited or no ability to affect health system policies

  • That the multifaceted contributions of structural inequalities contribute to worse health outcomes for patients and physicians alike, with trainees being especially vulnerable

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Correspondence to Eric Rafla-Yuan.

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Rafla-Yuan, E. I Can’t Breathe. Acad Psychiatry 45, 128 (2021).

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