What Inspires Me!

John I. Takayama, M.D., M.P.H.

  I’m on a crowded flight back from the AAP ALF (Annual Leadership Forum) Meeting in Chicago and feeling both exhausted and exhilarated. Since January, most of the news has been about people being worried, scared or disappointed. I’m coming home motivated and empowered and here are the reasons why.

  Just last week, I facilitated a small group discussion. Medical students at UCSF, during their Health and Society block, conducted an exercise to apply theories of distributive justice to the current efforts to repeal the ACA (Affordable Care Act). Without any ethicists amongst us, we could figure out that both ACA and AHCA (American Health Care Act) represented versions of egalitarianism. The AHCA espouses strict egalitarianism. The new tax credit proposal recommends that all members of society, regardless of their income, receive the same subsidy. The ACA embraces John Rawls’ difference principle, which allows for diversion from strict egalitarianism, to provide the greatest benefit to the least advantaged members of society. The lesson for me was the possibility and realization of thoughtful discourse without threatening rhetoric.

  While debating and voting to determine which ALF resolutions submitted by members would muster approval, we heard several personal testimonials related to one resolution, Building Access to Legal Representation for Children and Families Seeking Safe Haven. The current federal government efforts to deport undocumented residents have spread fear and uncertainty. One colleague reminded us of Executive Order 9066 that resulted in the mass incarceration of more than 110,000 Japanese Americans 75 years ago; another provided an emotional account of what it means in 2017 to have a family member who immigrated from a Muslim majority country. These raised the specter of a government not always being correct, that while intent may possibly be reasonable (protecting jobs, protecting society), the methods harmful; and recalled the fundamental proposition that all people, regardless of religion or nationality, deserves equal protection.

  I was also inspired, as many in the audience, by examples of efforts to welcome refugees to the U.S. In the session, Promoting Diversity and Inclusion: What Pediatricians and Youth Can Do, Dr. Andrea Green described the Pediatric Immigrant Clinic of the Children’s Hospital at the University of Vermont, which serves refugees, fleeing violence from countries such as Somalia and Sudan and more recently Burma and Bhutan. This clinic without walls, extending into the larger community of Burlington, galvanized community groups to support and advocate.  Rhadika, a senior at Burlington High School, recounted how her family escaped into Nepal and eventually to Vermont to resettle, and how much she and her family were moved by the welcome in Burlington. Together with her classmates, she has developed “All Are Welcome,” a nonprofit to distribute the welcome to everyone.


  As the ALF Meeting hurtled towards conclusion, despite sleep in my eyes (having to wake up at 3:00 am PST for breakfast), I felt proud to be a member of the AAP, to be colleagues of a special group of people, to realize that when we advocate for children and their families, the AAP is ready to advocate on behalf of us. The four-part national strategy delineated by Mark Del Monte, Director of the AAP Department of Federal Affairs, forever a deliverer of inspiration, seemed at once both appropriate and feasible: engage chapters, build coalitions, mobilize members and speak out for child health.