Chief Complaint: Stage IV Systemic Racism
History of Present Illness:
The USA is a North American Country with a 250+ year history of Institutionalized Racism. Multiple prior exacerbations include: slavery, annihilation/dispossession/forced assimilation/reservation marginalization of native peoples, the Chinese Exclusion Act, internment camps during WWII, lynch mobs, assassinations, anti-miscegenation statutes, the Tuskegee Syphilis Experiment, segregation, destruction of the thriving African-American Rondo Community in Saint Paul by Interstate 94, for-profit prisons, and the corrupt political system. (Please note, this is not an exhaustive list.)
The country presents today with a recent escalation in symptoms, manifesting in the shooting deaths of two black men by police officers. Mr. Alton Sterling died in Baton Rouge, LA, on 7/5/16. Mr. Philando Castile died in Falcon Heights, MN, during a routine traffic stop on 7/7/16. The shootings triggered an autoimmune response, with a sniper attack on Dallas police officers, resulting in five deaths and numerous serious injuries.
These recent symptoms have caused significant widespread distress, with frank emotional trauma, copious anger, and serious economic and logistical interruption. The US wonders if any new treatment modalities are available and also seeks immediate amelioration of pain.
Prior treatment attempts utilized forced de-segregation, affirmative action, the Black Panther movement, anti-discrimination laws, the Black Lives Matter movement, “need-blind” admissions, and internet campaigns.
Objective: Vital signs unstable with notable pressure buildup in various organ systems. Areas of deeper skin pigmentation across the country continue to be associated with poverty, incarceration, and lack of educational and employment opportunity. Brief focused physical exam demonstrates ongoing increased concentration of people in the region of the Governor’s Mansion on Summit Avenue in Minnesota, as well as smaller vigil-type clusters at the sites of recent shootings. The overnight blockage of both directions of I-94 in Saint Paul on 7/9/16 has resolved.
Comprehensive imaging again reveals stage IV disease, with widespread metastasis via hematogenous and lymphatic spread to all major organ systems, including but not limited to: education, employment, housing, politics, nutrition, military, law enforcement, social services, prison system, and healthcare.
Assessment:
The United States presents with ongoing Malignant Stage IV Systemic Racism intercalated within all major organ systems in the country. Today’s visit was prompted by a recent escalation in symptoms resulting in death, distress, and trauma. The country seeks information about curative procedures, therapeutic trials, and pain relief options.
Plan:
With Stage IV involvement, the patient will require an intensive multidisciplinary approach utilizing numerous specialists. Curation is a lofty goal and perhaps unattainable. However, hope is not lost as we know that even the placebo effect (If-You-Can’t-Say-Anything-Nice-Shut-Your-Trap) results in statistically significant improvement in symptoms.
Specific therapeutic suggestions include:
1) Surgery: We know from past treatment attempts that violent radical surgical approaches result in a high level of collateral damage. We will instead proceed with tumor debulking, where pockets of Racism are identified publically and provided high-dose education and legal poultices when necessary. Systematic dissection of all involved systems is necessary. Anticipate the need for significant reforms in education, housing, law enforcement, the prison system, healthcare, and etc.
2) Adjuvant Chemotherapy: We will begin a therapeutic trial of the new chemo cocktail fICE (facilitated Interaction, Compassion, Empathy). This combination works most potently at the cellular level, person-to-person. Common side effects of this novel chemotherapy include new friendships, relief, joy, and heightened understanding. During chemotherapy, people with less melanocytic activity are advised to close their mouths, open their ears, and bear witness.
3) Radiation: Plan to utilize two different modalities including HDR brachytherapy and EBR therapy. The specific radioactive energy type is LOVE, the most potent energy available at the time of this publication. As we know from lab studies, Racist cells die in the presence of LOVE.
A) High Dose Rate Brachytherapy: Love will be implanted directly into tumor-filled, Racist areas. Dr. Martin Luther King Jr. experimented with the direct implantation of love, with good result.
B) External Beam Radiation: We recommend full-body, daily, high-dose radiation with LOVE. Contrary to other radiation agents, there is no limit to the total Gy dose of LOVE that can be delivered. In fact, we continue to see an encouraging dose-response relationship even at extremely high doses. No negative side effects have been reported in the literature.
4) Close follow-up at regular intervals and prn to evaluate progress.