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Protect and Serve. Do No Harm. These are covenants our public servants promise to us. Police officers and clinicians are both entrusted with attending to our health and safety. Both are failing.

We must be able to trust clinicians and police with the intricate details of our living and dying.

When they deliberately lapse in integrity, or are completely negligent of due diligence, they need to either be stripped of their roles, or re-imagine their purpose and role in society.

As a practicing physician, my perspective is that we perform these professional responsibilities with our intellects, physical faculties, and our hearts. When we violate our oaths, a sacred trust is violated. Legal remedies are partially restorative. But trust is a matter of the heart.

Coldhearted. That’s the judgment that comes to mind with the image of ex-officer Derek Chauvin, one hand in his pocket, one eyebrow raised, forehead crinkled, a knee on the neck of the late George Floyd, eyes fixed straight into the camera of an innocent and courageous 17 year old gal filming him murdering a helpless man. Unflinching. Unemotional. No anger. No fear. No agitation. No anxiety. Brutal. Psychopathic. Ice.

Coldhearted. Two of the three other law enforcement officers present at the scene of the crime, Thomas Lane and J. Alexander Kueng, actually helped Chauvin pin George to the ground. The third, Tou Thao, bore witness to a cold blooded murder without intervening.

Coldhearted. That’s the impression that comes to mind with the mental image of 3 police officers, Jonathan Mattingly, Brett Hankison and Myles Cosgrove storming into the bedroom of Breonna Taylor in the middle of the night, shooting and killing her while she slept, putting a completely different spin on “dying in one’s sleep.”

The cultures of law enforcement and our medical system are products of a larger cultural mentality of war, conquest, rank, and inequality. Even the hallowed work of healing is rife with combat terms like front lines, trenches, and battles against various diseases. The police force continues to demonstrate its perception of the public as the enemy. A battlefield is no place to cultivate trust. Tear gas, rubber bullets, tasers, paint bombs, and riot gear do not engender confidence.

The chilling, ruthlessness reflected in recent events requires the urgent counterbalance of fire.

Such coldbloodedness requires a blazing fury, rebellion, and turmoil without which the system risks collapse. If the professionals we are counting on lean to the shady side of the canoe, the rest can’t sit quietly in the center, lest we all flip and sink.

We have been shouting to the police, “We see you and the naked lack of integrity of too many among your ranks. We see the damaged hearts, sick minds, toxic culture, and twisted priorities in your troops.” Law enforcement needs to hold itself accountable, which it is failing to do. So the public has to compel them.

The current medical system is also merciless and inequitable. Health inequities obviously cleave along racial and socioeconomic lines. The excessive COVID-19 death rates among Blacks, Latinos, immigrants, and Native Americans fuel the anger we are currently burning.

Although some measures are in place to keep clinicians accountable for mindfully attending to the health concerns of patients, our medical system fails in gross measure. The USA has some of the worst health metrics in the developed world, and medical errors cause the unintended deaths of 250,000 people every year in the USA.

Clinicians build trust by connecting with patients in everyday ways. Preventive visits afford an opportunity to get to know each other when patients aren’t acutely ill. We stand with our patients as they navigate the curvilinear convoluted trajectory of life and death. Clinicians know that establishing trust and offering diligent medical care takes time.

The financial dependence of medical care on insurers has placed a stranglehold on the patient-clinician relationship by throttling the time allotted for medical care. That relationship is hindered as long as third parties payers continue as intermediaries, whether they are administered by government, private, or non-profit entities.

The medical profession is responsible for offering circumstances that foster mutual trust.

The public ought to exact these conditions from us too by insisting we abolish a medical care system that requires or allows insurance to meddle in medicine. Consider how the clinician-patient relationship would change with direct patient care offered by salaried clinicians and staff who are supported by society to take care of everyone regardless of ability to pay. No billing anyone for services, not even the government.

Many have been putting their minds and hearts to the issue of re-envisioning the role of law enforcement in creating public safety. Since a version of this piece was published in KevinMD, I have learned more about the history and culture of policing. I have revised my perspective and agree that the law enforcement system is too broken for repair. We don’t repair things we should or could: socks with holes, malfunctioning blenders and cameras, strained relationships, and more. We live in a throwaway culture, and yet we have been trying for decades to darn the rents in the integrity of our police force. Forget it. Throw out the whole concept. Defund and dismantle the current law enforcement system.

Shattered social, political, and economic agreements currently pervade every aspect of our society, including the ways in which we have broken our commitments to support, protect, and nurture each other, our children, parents, women, men, spouses, teachers, healers, artists, workers, retirees, vets, elders, the poor, mentally ill, disabled, and disenfranchised. Even the very earth we stand on. We can’t stand it anymore.

We have created a culture based on the fragile and false paradigms of hierarchy, reward, punishment, achievement, and acquisition as measures of our worth.

We have forgotten that every creature deserves love, respect, freedom and happiness for the simple fact of surviving our own birthing. Nothing more is required for the right to live life.

Starting afresh would, however, require re-imagining how we serve, protect, and do no harm to each other as neighbors, friends, lovers, colleagues, business partners, customers, and family members. We would have to recognize our accountability to each other and take full responsibility for our integrity, honor our commitments, and respect for our world. That would require an overhaul of the nature of our connection with our communities.

It is time to re-create our world. The brutality we are witnessing is just the tip of a very cold iceberg. One fact about ice is that even an iceberg can melt in the presence of fire, the fire of revolution, and love. We must now engage in a massive cultural metamorphosis. We must honor the pledges we make with each other. We must consider how we all have to change in order for us to be free together, a mutual gift. This ignition is an immediate invitation to participate as equals in the combustive transformation of our civilization into one of freedom, peace, health, and love.

It is possible to rebuild trust. Do no harm. Protect and serve. There is no try. Do or capsize.

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