How ICE's presence is affecting health care in Minnesota

(upbeat music) - Good morning, I'm Katherine Richard, Phillian for Angela Davis. You're listening to MPR News, we're glad you could join our show today. Over the past month, healthcare workers have reported that ICE agents have been entering hospitals with detained individuals, sometimes with the warrant, sometimes with that one, and they are frequently present during patient care. And since then, healthcare providers have noticed something alarming. Patients who are supposed to come in for checkups aren't showing up, appointments are being canceled at the last minute. People who need routine care are staying away because they are afraid. And when people put off treatment, or wait too long to go to the ER, conditions can get worse quickly, and emergencies become more likely. So this hour, we're talking about how ICE's presence is affecting access to healthcare in Minnesota, what providers are seeing on the ground, what it means for public health, and how clinics and hospitals are responding. We want you to join our conversation. Have you or someone you know delayed or avoided medical care because of fear around immigration enforcement? Are you a healthcare provider seeing this play out? What has been your experience? The phone lines are open, call us at 651-227-6000, or 800-242-2828. Now I want to introduce our guest, who's with me here in studio here in St. Paul. We have Dr. Jana Goertz, O'Brien. She is a pediatrician and adolescent medicine physician based in Minneapolis. She is the president elect of the Minnesota chapter of the American Academy of Pediatrics and an assistant professor in the department of pediatrics at the University of Minnesota. Thank you so much for being with us, Dr. Goertz. - Thank you for having me. - Okay, so you work directly with patients and families. What changes are you seeing right now about who is coming in? Well, we know that patients and families are fearful and we're talking about kids as young as seven or eight being afraid to come in. And we're talking about adolescents and young adults and their families just expressing that they're afraid to come to the hospital. The rates of no-shows are absolutely up. I, our own clinic has been calling our patients when they don't arrive for visits or they cancel visit for the last minute and frequently we're hearing, look, we've heard that ICE is around near your hospital, near your clinic. We are afraid and we, can we do this any other way? - We did a show yesterday about mutual aid, not just taking donations and delivering groceries, but people are also giving rides to folks who are worried about leaving their house for fear of being detained. Are you seeing health care providers take some novel approaches to how they might be helping people get to their appointments? - Yes, one beautiful thing that we've seen across this entire mess has been that folks are stepping up to protect their neighbors, to accompany them to appointments and health care professionals from all disciplines, nurses, doctors, midwives are going out into communities, are being flexible in the care they provide, providing virtual care, doing phone visits and doing everything we can to get patients the care they need wherever they are so that they can be safe. We care deeply about our patients and we're willing to be flexible to make sure that they get what they need. - How is telehealth fitting into this? And you've sort of experimented with that during the pandemic, right? - Yeah, I mean, I think one benefit of the pandemic is that we've really built an infrastructure that if I call a patient, like I did yesterday and said, hey, I missed your appointment, I was worried what's going on and follow up on a chronic condition or a mental health condition that they're like, could we do this on video? I don't really want to go into the hospital, it's not safe for me to leave right now and we're able to transition really quickly. So it's allowed us this infrastructure to be nimble and to meet patients and families where they are when it's safe. - Yeah, we have Robert and Minneapolis on the line, Robert, what do you want to share with us? - Yeah, thanks for taking my call. This is a great show. I'm happy to be here. I'm actually a medical interpreter. It had up in healthcare. I've been there for 28 years and I know your guest quite well, Jana. And yeah, I just wanted to give my perspective as an interpreter. This is a position that I have really felt highly appreciated and grateful to be able to help the communities of immigrants in the Twin Cities. They have enriched my lives in many, many different contexts over the last several decades. And I've always been thrilled to be of service. And this is such an atrocity that our patients can't even come in to get the care that they need. And I've been in appointments where I'm interpreting for a provider and they are like in tears. They're left without words because of the situation that these patients are in, a dad was deported. And a mom's just sitting there with her baby and we're just sitting there going like, okay, now what do we do? There's no source of income. There's no security. They're clearly, the occupation here is clearly making life far worse than if there's no improvement at all. And it's just frustrating to see that even the hospital isn't a safe haven for patients that's absolutely disgusting. Robert, I want to keep you on the line here for a second. May I ask what languages do you speak and help interpret? - I interpret in Spanish Portuguese and Italian. - Okay, can you share more about when, and did this really just start in the last few weeks because I live in Rochester, right? It's a medical community and it's become very apparent to me in the years that I've lived there that creating places for people who maybe don't speak English as their first language, making them feel safe in the healthcare setting is really important to making sure they're getting the care they need. And that was already a challenge to begin with, right? So have you seen this just very quickly get worse or was this a bit of a trickle since we've seen more ice enforcement in general around the nation? - Well, I mean, it's gotten over the last couple of weeks. I'd say the last two or three weeks is when we've seen just enormous increase in fear. And everybody that's in the appointment, they're like, the providers understand what's going on. They say, thank you for coming in. And the patients are always like, yeah, I almost didn't come. Even though I'm here to get routine vaccinations or my son broke his arm or whatever, we didn't want to come in because we're afraid that we're either going to get stopped. Either this hospital is in a safe place or we're going to get taken by ice when we step out of the hospital or when we're walking from the car into the clinic. The other day, I had to walk with a patient through a series of tunnels and, you know, a skyways and stuff to get to a different building just so, you know, the patient who was hospitalized with a brain injury after ice now assaulted him so that he could get back home safely. - So this is someone who was assaulted by ice there for treatment and there was a afraid of being detained again as they were leaving? Is that correct? - Yeah, he was in the ICU and actually he was, the ice was in his room. Until the hospital was successful in getting ice out. I don't remember exactly how it happened, but finally they left. And so then he had a chance to leave the hospital safely, but even at that point, just to avoid ice picking him up on the way out of the hospital. We had to go through this series. I mean, the amount of resources that are being used to avoid ice is absolutely absurd. We should just be like, take a care of patients. We should have to be like, I mean, this is completely Nazi, you know, it's like Germany in 1940s, right? Like going through underground tunnels to try to safely get out of the hospital so you can get back home without being sent back to a country that you haven't been in for 20 years. And that's like more ravaged because of the United States participation in Latin America. It's absolutely disgusting. And people are ignorant about the situation. - Robert, I can hear how frustrated and upset you are. And I wanna give Dr. Gwarts a chance to maybe share too. I mean, the situation he just described, is that something that you've encountered or are hearing from other colleagues who are working as healthcare providers right now? - Well, first of all, Robert, I'm so glad you called in. And I will say that I think all of us in healthcare right now are seeing this in every single visit. This is very real for families. They, I have had adolescents say to me, I literally feel like my friends and family are being hunted. They're staying home from school. They're staying home from clinic visits. They're missing much needed potentially life-saving care and avoiding that care because they are afraid, because our hospitals, which should be safe and our schools, that should be safe, are now places where they could legitimately be victims of violence, be detained, be separated from families, which is traumatic. And they are rightfully scared. And as you're hearing, I says both in the hospital and around the hospital. I was taken care of a newborn in the nursery with a family. And we, we're talking about this. This should be the happiest place in the hospital. Let's just be clear. This is the newborn nursery. So newborn healthy babies. And I'm there with families and they're in the room with an interpreter because they're a vital part of our team. And the mother, first of all, I said, which the grandmother said, could we do the follow-up visit at home? And I said, you know, we really need to have this in person. They need to be checked for a jaundice. We need to check on their weight. This is really important for the baby the next day. And the mother looked outside and said, let me get out of the way to like meeting ISIS outside. They could see them from the window of the hospital. And they said, there's no way we can come back here. Can we do this any other way? So yes, from babies to the elderly, people are afraid to come here. Is there another way to do these very critical visits, especially when it involves a fragile newborn baby? In some cases, there are. And again, I'm proud of our healthcare systems and our healthcare professionals for stepping up in the form of mutual aid, but also as systems to try and meet families where they're at. But there are some things that right now need to be done in a clinic or hospital setting or care that is needed at a higher level that patients are missing. I mean, I think a good example is that we've heard many reports of people laboring at home or not wanting to come in, which many people make that choice. But even people with medical complexity that need to be in a hospital to give birth who are afraid to come in to give birth. This is not how it should be. This is dangerous. - If you're just joining our conversation, we are talking about a trend that physicians are seeing, which is that people are delaying care. They're not going to their healthcare appointments because they're afraid of being detained by ICE. We want to know if you have experienced this personally, is someone in your family delaying care? Are you a healthcare provider watching this play out? We want to know your experience. The phone lines are open, call us at 651-227-6000 or 800-242-2828. You just mentioned a situation with a newborn and new mom. I want to share a conversation that I had with a physician assistant named William Alman yesterday in Rochester. He is from Ecuador. Originally, he has been serving immigrant communities as a provider for decades in Rochester. He was telling me about a situation that just played out in the last week or so where there was a woman who gave birth at home and how he and he actually just retired from a healthcare clinic in Rochester literally in the last few days. But he knows that providers were trying to go to her to do some of those follow-up visits. And he also talked to me about the barriers that many immigrants face when it comes to just getting healthcare safely. So I want to play a clip of that. They are fearful. They are in a different country with different language. They are on minimal wage. They have to work two jobs to maintain their homes. So they always have a little bit of anxiety, a little bit of depression. There's big concentrations of people and they don't know what is going to happen in that uncertainty. Make you sick because what happened is you don't know because language and then you are being looked for. It's like they get afraid to leave the house because they have transportation issues. Sometimes they have to say, oh, four of us go to BCN. So they have to make appointments for four of them in one car and to come in BCN. So it's really difficult for them. So they have opted especially after the first really killing of an American citizen, you know, that completely drop. Actually we close for a week and other clinics in the area have done the same because what happened is, you know, now even the staff is concerned of what could happen to them. - So Dr. Gourds, I mean, there's a lot to talk about there, but I was hoping you could just first react to, you know, this idea that, like the stress of not being able to leave your home for some basic care, like sort of compounds itself, right? You know, what do you hear that resonates with your experience? - Well, that certainly resonates with what I'm seeing here in the Twin Cities and I just wanna thank you for bringing in the perspective that this is not just a Minneapolis or St. Paul specific issue. This is also occurring in Rochester, in St. Cloud, - Mankato. - Mankato, Wilmer, like all over. So I think the idea that this is just an urban phenomenon is really not true to the reality of the situation, which is that we are occupied as a state. And then in terms of people avoiding care and being fearful, I was just talking with young people, several different young people yesterday who are doing all of the grocery shopping for their entire family, who are hiding at home, who are, again, expressing that they are being hunted because they're afraid to go out. So yes, this healthcare piece is one part of it and that amplifies things, especially when people are sick at home, especially when people are needing to weigh this risk of, do I get the healthcare I need? Do I get evaluated against the risk of, do I go outside and potentially risk being detained, separated from my family and the trauma of a violent interaction with an occupying force here in our state? - Yeah, and the other thing that William said there that struck me was that providers of color or people who might have been born and trained in a different country are now working here are also afraid to go out and practice too, especially if they're working at a clinic that is serving a lot of these populations. Is that something you've seen? - Oh, absolutely. So first of all, our healthcare workforce is remarkably diverse and we benefit from having Somali nurses and Somali healthcare assistants and Somali doctors and lead PNA health care nurses and doctors and interpreters from all backgrounds and walks of life and from many different countries. And our workforce is also worried about being targeted on their way to and from the workplace and especially when I says present physically in hospitals, what I'm hearing from colleagues of color is it's not safe for me to be on that unit. I mean, it is not safe for me to be nearby. I mean, we've had nurses, healthcare assistants and physicians say they were squinting and looking awfully closely at my ID to figure out who I am. So again, people are worried about being detained while they're actively serving communities, while they're providing healthcare. And again, these are the same healthcare workers that took care of the victims of anunciation. These are the same healthcare workers who showed up every single day during the COVID pandemic. So these are healthcare workers who are contributing immensely to our workforce and we need them as a healthcare workforce to be there. That representation is essential and yet they are rightfully fearful to walk in and out of clinics and hospitals right now. - We've got a lot of good calls coming in. I wanna go next to Nate and Western Wisconsin. Nate, what are you seeing? - I'm a family doctor over here in Western Wisconsin and have seen a lot of things that are similar to what I'm hearing you guys talk about on the radio. I get to run down babies in the nursery, which again, like you said, should be one of the happiest places in the hospital, but we've had to discharge patients at 230 in the morning 'cause they feel better about going home during that time instead of during the day. And I'm in clinic. I've seen a number of patients not come. Just to echo some of the things that you had said about the whole healthcare team, one of our translators is Ecuadorian American woman. And she has done just an amazing job of trying to coordinate care and figure out who needs what when and how to get them to care that they need, even if they don't come into the clinic. But it is hard. There's a lot of people who are not getting seen when they should be. - And you're in Wisconsin, right? So this is not Minnesota, but it sounds like there's been a bit of a ripple effect into your state around the fear around the concerns around fear, yeah. - Yeah, about 20 miles across the border. - Okay. - And are you serving patients who actually live in Minnesota and are coming to Wisconsin or is it really just sort of the ripple effect of fear? - I think it's more just the ripple effect, mostly just the ripple effect. We haven't had any immigration enforcement in our facility yet, but certainly across the street. So we've had patients not a lot of leave when they're ready to go. - Thank you so much, Nate. I wanna go next to Carrie and the South Metro. Carrie, what do you wanna share with us? - I am a home care nurse that I've been seeing patients for quite a few years in home and just how the environment has changed there. So where I have multiple patients who are scared to go to the appointments that they need to go to skipping appointments because they are scared to leave their home. And just how things have changed. Lots of kids at home, not going to school because they're scared to leave their home. And just, it's really difficult. I'm being the eyes and ears of patients, but I can only do so much. My license only allows me to do so much. There's things that need to be done in the clinic and they're too scared to go there. - So Carrie, when you say people are skipping appointments, can you give us a sense of how the scope and scale? Are we talking about just routine? My kids go for their annual checkup every year. Usually nothing's terribly wrong. Or are you talking about care that to manage chronic conditions or stuff that if you get behind on it, you could really catch up with you at some point. - There is, I mean, a lot of what I do is wound care. And I need providers orders to follow and if they're not able to physically see a provider. Or some of the wound care that needs to be done in the clinic that I'm not able to do in the home isn't being done, which puts patients at risk for infection and worsening illness. And it's not only that, they can't get the food. But I mean, I'm being told by patients that they can't even get groceries delivered right now because the delivery services are so overwhelmed because there's so many people not leaving home. - Carrie, thank you so much for sharing your perspective. Dr. Gorets, can you say more about that compounding effective delaying care? Like what conditions are you most concerned about right now? - So first of all, we're in the peak of flu season and we are experiencing a lot of respiratory illnesses. I'm getting calls from parents saying, should I bring my baby in? They seem like they're having trouble breathing. But I really don't want to risk going to the hospital. Are there things that we can do at home? I am really fearful about those. I think for people who are pregnant, making sure they get the prenatal care that they need and that they are getting into healthcare facilities. When they need to, I'm really worried about that for sure. And then I think we're seeing just delays and people coming in for things that sometimes are benign like belly aches, but then coming in with a rupture appendix, meaning a burst appendix that could have been-- - It escalates real quickly. - It escalates really quickly. And we see that with wounds and with wound care too, as you're hearing from our home health nurses. I mean, if we wait when there's a small infection, then by the time they get in, they're extremely sick, needing hospitalization, sometimes needing ICU level care. So this delaying care for both chronic conditions, but also for acute conditions is really dangerous. We are not making America healthier again with this ice enforcement. - We have Bob and St. Paul on the line, Bob. What do you wanna share with us? - I'm a retired case manager working in the mental health system for 25 years. And I just wanna say to all my buddies out there still working, keep it up, do what you can do. The follow-on problem we're having is gonna have as people that are trying to deal with mental health issues, paranoia, voices, depression, everything. That's enough just every day for them to try to cope with therapy, medications, that kind of thing. And then you add this reality on top of it. I get concerned for myself. A black away from where I live is a Hispanic preschool and day care immersion thing. That's been targeted by ice. - So Bob, it sounds like you're concerned about the, you know, compounding effects of people who are both experiencing mental illness and not getting their regular treatment, but also maybe creating depression anxiety because they are experiencing this or worried about leaving their home. Dr. Gowards, you're nodding your head vigorously here. - Yes, I am. So the mental health ramifications of what we're seeing here are acute and severe. I'm already seeing adolescents that are at home that cannot come in with severe, severely worsening mental health concern. Sometimes showing me cuts on the video camera, but not willing to come in because they are afraid, I'm talking about cuts on their arms. - Yes, so they're self-injury and self-harm, suicide risk. And I think again, this is something we're seeing growing because what's happening in our community is traumatic and scary. And then I'm really worried about the long term mental health effects of this. I don't know. I think this is going to be intergenerational that we are recovering from the trauma of this engagement with ICE and this occupation. - We're gonna have to take a quick break for news here in just a few minutes, but before we do that, I want you to call in, join our conversation. Are you a health care provider seeing this play out in your clinic? What's been your experience? Please call us at 651-227-6000 or 800-242-2828. Before we take a break for news, I want to take another call from Josh and Elco, new market. Josh, what do you want to share? - Yeah, no, I mean, so maybe a slight twist on what you're talking about a little bit too. And the home health nurse kind of touched on it, but we have a lot of individuals living in group homes or receiving PCA or in-home services. And our staff are, many are terrified to go to work, similar to those going into the hospitals and clinics. And one of our biggest fears is, you know, if these staff are working with an individual one-on-one or maybe on the overnight single staff, what happens to those vulnerable adults or those individuals needing those supports in critical services if ICE were to show up, detain that only person there with them, without any regard to the critical services that they are providing at the time. And I think it's a real concern that we have. - Right, so staffing being an issue and not being able to provide those services, Dr. Gorets, what do you make of that? - Yeah, absolutely. I think we're seeing ICE enforcement and unprecedented places. I mean, we're seeing it in schools. We're seeing it in group homes. We're seeing it in healthcare. We're seeing it around social services agencies. I want to note that these were historically protected places. They were considered safe or sensitive spaces by our federal government until January of last year when they rescinded that order, that protection. - That's a good point. So these were previously places where everyone agreed. We should not be doing enforcement in healthcare and social services agencies in schools. And yet, what I hear over and over again, as you just heard, around social services agencies and around group homes, but also from schools, they don't even feel comfortable sending their kids outside to recess, not because of the bitter cold, but because they're worried their school age children will be detained or their teachers won't be. And that is unacceptable. That is an assault on the workforce that is out there caring for people in our communities. - Okay, so we've sort of, the word COVID, the word pandemic has come up a few times already in this conversation, Dr. Gourds. But it's hard to look at this trend that you've noticed without thinking about the much broader impact COVID had on people not getting care, delaying care. What do we know about that experience that might inform or help us understand what this could look like a few weeks to months from now for patients? - Yeah, so I think what we're laying the ground more for and what we saw during COVID is that people missed out on vital, potentially life-saving healthcare, missed out on care for their chronic conditions, and also were traumatized by the experience of being forced to stay at home and by fear and going outside. The problem is that now we're seeing this immense fear of going outside perpetrated by our own federal government. So they're not only concerned about going inside and catching a virus or an illness and they're missing that care, they're also experiencing the traumatic event of being hunted or the risk of having a family member detained. So in some ways, we're responding in similar ways to what we did in the pandemic. We're meeting people in community. We're doing video visits. We're helping with virtual care when we can. We're getting medications delivered. We're doing that. But what we didn't have to deal with during COVID is our patients and families. And again, these are immigrant families, but also anyone who is a black or brown person being fearful of going outside due to the risk of a violent assault by a federal agent. And that's unacceptable and heartbreaking. We have Jean and Bloomington who's been waiting patiently. Jean, what do you want to share with us? Yeah, I just want to say that, you know, I'm absolutely doing care for a family member. She has cognitive and some movement issues that we want to try to see if we can make them better. You know, it's hard enough logistically to get her places and figure things out when we're there and just on a good day, you know? And so I am staying away because I don't want that added stress or fear or worry of trying to get her out of a situation safely if something happens to somebody else, you know? So, Jean, I just want to be clear. It sounds like you are not personally worried about being detained or your family member, but you are concerned about encounters that would add to the stress of, yeah, okay. Yeah, I'm white. She is light skinned, but Puerto Rican. She's absolutely a U.S. citizen. And I am just heartbroken that I have to say that in America, you know, but that's a consideration. I have to add, you're thinking about safety. But yeah, we're absolutely delaying that because that would be at HCMC downtown. And we know there have been incidents at HCMC while documented incidents over the last few weeks. Jean, thank you so much for sharing your concerns with us. I think Jean's comment raises a question for me, Dr. Gourds, and hopefully you can help us better understand this. But what protections do patients actually have in medical settings here? Well, first of all, I want to acknowledge that this is heartbreaking. And if you are not listening to these and feeling enraged, then I think we all need to open our eyes. I mean, this is, again, U.S. citizens avoiding care. What was the question you asked? Sure. I was hoping you could detail what protections patients actually have in a healthcare setting. Yes, so in a healthcare setting, first of all, patients have a right to privacy. So we know that when federal agents are potentially at the bedside with somebody they've brought in or detained, it's been difficult to get them to leave the bedside, even for sensitive cares or sensitive conversations or baths. They've also been shackling or restraining people at the bedside, people who are not flight risks, who have no criminal histories, who are not raising concern or suspicion for safety, who are being restrained, which we also know is extremely harmful and something that patients have a right to not be restrained and left they absolutely need to be. These are mostly civil patients who are there under civil offenses, not criminal offenses. And there is no reason for anyone to be shackled. I do want to share a quick story that I heard from a family yesterday that they gave me permission to share, which is that this is a young adult who's in nursing school, actually, not here in Minneapolis, but up in St. Cloud. And her family shared that she and a friend were stopped at 1.30 in the morning, just going to get some food, stopped by ICE agents. And they said, I bet your family won't be willing to send your birth certificate at 1.30 in the morning, because their school ID apparently wasn't enough. And their driver's license apparently wasn't enough. Thankfully, my patient's mother, their family, was able to provide birth certificate and notification. But the friend that she was with was detained and brought to an ER because she began to hyperventilate and needed acute care. Apparently, she was shackled to the bedside in the ER and ICE was in the emergency department with her. And again, this was not in the Twin Cities. It's up in St. Cloud that this is occurring. And it is creating a very unsafe environment for people and also for staff. And she ended up, again, she was here with legal status on a student visa. That is allowed. Yeah, not OK. Yeah, OK. So we have someone who's just saying there a physician in the Twin Cities on the line who wants to share-- what do you want to talk to us about today? Are you there? Hi. Hi. Is this a physician in the Twin Cities? I understand you didn't want to give your name. Oh, yes. Hi. I just had a few questions. And you guys were just talking a little bit about it. But I have taken care of patients who are in custody before. And generally, if they are an actual prisoner, they will be shackled. But we can ask the officers to leave the room and we get them a chair outside of the room to sit. And so I think it would be very reasonable for us to demand that I sit outside of the room, especially for examination and personal care and that sort of thing, but really for the entirety of the visit because they have no reason to have facts up to hip up. And then also, what are these specific rules for ICE in a hospital? Like, what could I, as a provider do, as I see ICE, like looking around or walking around, can I call someone or get them out of there? OK, thank you so much. Dr. Gowert's, what advice do you have here? Yeah, so first of all, I wanted to say that and acknowledge that the hospital systems are doing are with variable consistency. Or working to establish policies that align with the legal protections that patients and families have when it comes to ICE being in hospitals. So we're seeing kind of hospitals putting out policies of how to interact with ICE when they're in hospital settings, bringing in someone detained, and also how to interact if they come in and say that they want to detain somebody, meaning they need a judicial warrant for that in those cases. So a warrant signed by a judge, not an administrative warrant, if they're coming in, and they really, again, should not be allowed to enforce in hospital settings at all. Let's just be clear. So legally, I think every hospital system and clinic has a different set of policies. I personally, and I know many organizations are calling for the hospital's institutions to step up and clarify their policies so that this physician and many others know exactly what to do when ICE is present. ICE is not the same as other law enforcement, so it's important that we have specific policies for immigration enforcement officers and when they are present. And yes, you can ask them to leave the room just like we would anybody else, especially for sensitive care is when we're talking about health care. And then one other piece that I really want to mention is that folks who are in civil custody should be allowed to call families, to call their lawyers, and to have a visitation as they should. So those are things that should be integrated into hospital policies as well. - So I want to stay on a couple of things you just said. You're saying there's a lack of consistency in policies across hospital settings in Minnesota. Is that because this is a bit unprecedented? I mean, not necessarily something you plan for. - Yeah, this is absolutely unprecedented. And I think we're seeing hospitals kind of trying to scramble and figure out, okay, where are their differences between other people we've routinely cared for over many decades in custody versus folks brought in maybe by an ICE officer that doesn't have any sign papers saying that this person is actually somebody who could be legally detained with a person who hasn't had the right to do process. These are not people, so oftentimes people are being detained like the student I was talking about up north without appropriate due process and their legal rights are being infringed upon in hospital settings. - Yeah, okay, we have Laura and Minneapolis on the line. Laura, what do you want to share? - Hi, thank you so much for having me. My name is Laura, I'm a certified child life specialist. My job is really psychosocial support for pediatric patients. I'm community based, so I work throughout the entire state of Minnesota. And I just wanna say thank you so much for speaking as a pediatric doctor, but I just wanna talk a little bit about the capacity that healthcare workers are at right now. We have already attempted to still recover from COVID, still recovered from the enunciation shooting. And for all the trauma that children and families are seeing, I just, I really, I'm really, really concerned about healthcare workers and their capacity that being able to support families continuously 'cause this will continue to happen. And we will be recovering from this for generations. - Yeah, I mean, Laura, you make such a good point, right? As a journalist, it's really easy to kinda get tied up in the moment of what is happening, but you've put some context around how the healthcare system has been pressed and pulled over the course of many years now here in Minnesota. I mean, and I mean, that can be a deterrent for people who are considering a career in the medical field. - I mean, healthcare workers, like many of us, we're all humans, we're also parents, and we're also care deeply about our patients and families. I have never seen so many healthcare workers step out of rooms and just burst into tears as I have in these last few weeks. And I think it speaks to the fact that folks are at capacity and we are fearful for our patients and for the families and for our own children. I mean, this, and this is an unacceptable level of violence and cruelty that we are seeing, and we're hearing these stories firsthand, and a lot of our patients and families are suffering immeasurably, and I think we go into healthcare professions because we care deeply about the patients and families we're serving, and we see young people who are, I saw one yesterday, a college student who is amazing and has been working through a lot of different things, healthcare and medical and mental health complexity, and was in college, was thriving, and has now gone completely virtually in college and is caretaking for her entire extended family. - Because she is worried about being detained by us. - Yes, so she is, she has legal status and her family has legal status. I've seen native youth who are afraid to leave their homes. I mean, these are Native American young people. So yes, we are, as a healthcare profession, are worried and fearful and we're seeing immeasurable harm and suffering at the hands of our own federal government in a country where we're supposed to be able to speak freely and assemble peacefully and have a right to do process and are protected from illegal search and seizure. And yet, our patients and families are suffering black and brown patients, especially immeasurably. - Yeah, we have Donna and Minneapolis on the line, Donna, what do you wanna share? - I just first and foremost wanna say it's mostly about the patient, I work at Hadam & Health Care. Sorry, is this just so emotional? - It's okay, it's supposed the patient's not getting care but it's also affecting our system as a whole. People not coming into appointments is, you know, affecting our financial situation which is dire as well. And again, I wanna emphasize that not, you know, it's mostly about the patient, right? It's been to them on the phone not wanting to come in and scared but also this is ice and the federal government is affecting how we move forward financially and we are in, it's a dire time for health care. - Yeah, I mean, I think I just have to nod to the news this week that Hadam & Health Care has said that finances are in dire straits, that is another headline that cropped up this week. But Donna's call raises a bigger point for me, Dr. Gortz, which is what are the long term big picture effects on the healthcare system when trends like this continue? - Well, first of all, black and brown communities have had a long legacy of rightful mistrust of healthcare systems rooted in our own harms that we have caused. So this is not a new thing that there would be mistrust in the healthcare system specifically. What we're seeing though, especially over the last month with Operation Metro Surge is a growing mistrust in amplified mistrust is what I should say in our federal governments, in local governments and our hospitals. And I think rebuilding that trust and overcoming that trauma is likely something that is going to be, something we are working to build and recover for decades. So I think the traumatic impact in the harms of mistrust in our healthcare system are only going to be amplifying things over the next generations. - For the very populations that have been challenging to build that trust width to begin with. - Yeah, exactly. And they, to be clear, I think people are like, well, should we, some have asked or like, we should encourage people to still go in. And I'm like, I'm really worried about that. I mean, there are reports even yesterday, a patient was said, you know, they were right outside of the hospital as I was walking into clinic or they just grabbing people as they come out. And I'm like, this is scary. I mean, I, it is, we're seeing immigration enforcement in and around our clinics and hospitals. Of course, they mistrust them. Of course, they don't want to go in. And I think our hospital systems need to stand up and say outright that we are not okay with ice patrolling in and around our hospitals. - Is there an effort to get the, you know, the Minnesota Hospital Association to make such a statement if they have, I missed it, but I mean, it's, you know, like politically speaking, what, what, what, would that carry weight? - I think the Hospital Association has been speaking out and has been working on this. I can't speak to, speak on their behalf directly, but I know that the hospitals are thinking about this and trying to figure out how to navigate. It's a complex time for hospitals as well. And I think they understandably are concerned about a retribution from our federal government too. And they do rely on, many of our hospitals do rely on federal funding, which puts them in a really difficult position. - Which we've seen, you know, federal funding has been used repeatedly, you know, university. - Yeah, right, yeah, exactly. - So I think they are rightfully fearful, but I also think they're working really hard across institutions and I hope to see more of this. Coming out and saying, okay, here are our limits and here are the protections that our patients and families have when they're in a hospital setting. - Yeah. Okay, and we're gonna go next to Anika in St. Paul, Anika, what do you wanna share? - Hi, I was just saying as a member of AA, when we had our COVID epidemic, people just stopped going to meetings and getting, that's our care that we need and there's a whole bunch of different support networks throughout, it's not just AA. But when people miss out on those meetings, there's relapses, there's hospitalizations, there's a fix the whole family, it's just the whole community suffers if we aren't able to be in our community and better help that we need. - Yeah, and Anika, are you not going to meetings right now or are you just worried about other folks you typically see at meetings deciding not to go? - I am going to meetings, but about half of the people that I usually see and interact with are not going to meetings, so that it's a lot like, we're reaching out, making phone calls, trying to figure out how to do online stuff for them. - Yeah. - But yeah, 'cause I'm white, so I have that privilege of not being totally scared, but that's not what it is for my community. - And that isolation could cause a relapse is yeah. - Isolation is the absolute worst. - Yeah, folks in recovery. - Yeah, go ahead Dr. Gourds, yeah. - Yeah, for folks in recovery, I am also very concerned, I mean, I work with a lot of young people who use substances and who in the setting of this traumatic event, and severe worsening mental health, I think many people are, I am fearful that many people are turning to substances and like we heard, are losing the supports that they have in their groups and their communities. So they're isolated, and they're also enduring extreme dress from a mental health perspective. So this is a really dangerous and toxic combination. - We are gonna take one more call here. I'm gonna go with Judy in Minneapolis. Judy, what do you wanna share? - Hi, my Afghan friend who's been here four years, studied here and became a phlebotomist at a suburban hospital. And two Saturdays ago, she found herself needing to hide in the bathroom because ice was in the hospital. And as an Afghan woman, she feared for her own safety. So you have staff, fearful of doing their job because ice was in the hospital. And when I asked her, as I picked her up from work because she doesn't wanna drive home, what ice wanted in the hospital, if they were looking for employees or if they were looking for patients, she said her concern is that they were asking for patient information. And she was concerned that her hospital was giving some and her union is protesting that. But you have a woman who's absolutely driven to become a productive American citizen, afraid to do her work that she has trained to do since she got here and hiding in bathrooms when she's a phlebotomist. - Thank you, Judy. Thank you for sharing that. I mean, Dr. Gwarts lets get back to what we were talking about earlier, which is that it's not just the patients, it can be staff members too who are fearful. - Yeah, that's just another prime example of how ice enforcement here in Minnesota is crushing the American dream, which is again collectively immigrants and refugees coming here for safety for peace, for liberty and justice for all, and then hiding in a bathroom because their own federal government is looking to violate laws and potentially cause harm. So yeah, this is heartbreaking and again, we're hearing story after story of this occurring. And I do hope that our hospital systems are protecting the rights of patients. That would be a huge violation of federal law if they were to share personal health information and protect to tell the information of patients, right? - Okay, so we have just a little bit of time left. I'm wondering if you have advice for people who might be listening, who are afraid to go access their health care or in community with someone who might be facing that conundrum right now. What advice do you have because you said earlier, yeah, I get why they would be scared. I'm worried for them too, but at the same time, we've been talking a lot about how dangerous it can get if you're not. So what might people people thinking about right now? Well, first of all, I want to send the message that your healthcare professionals are here and we're working for you and we are going to do everything we can to get you the care you need. As I almost keep out of service. We're not leaving. We're not going anywhere. We're here for you. And if you call your healthcare office, you do not have to share information about your legal status. You do not have to share information about your particular situation. But if you say, "Hey, I would prefer to do this at home." Or is there any other way I can get care? We are working hard as a healthcare profession to meet people where they are. I also encourage folks to reach out to their local mutual aid and neighborhood and hyper-local neighborhood organizations to help get the care they need to. Okay, our time is up for today. I want to thank our guest, Dr. Janna Gourts, O'Brien, as a pediatrician and adolescent medicine physician based in Minneapolis. Thank you so much for being with us today. Thank you for having me. And I also want to tell you about a special programming note for tonight. At eight o'clock tonight, I will be taking your calls and talking with former high school government teacher Sharon McMahon. An attorney Dylan White about federal immigration actions in Minnesota and what this moment means for the law and the country. We hope you'll join that conversation. I'll talk to you then. (upbeat music) Thanks for listening to a recording of my live radio show on MPR News. A reminder that if you want to catch my show in real time, tune in and call in weekdays at 9 a.m.