January 21, 2019

It was 1963. On the steps of the Lincoln Memorial, 250,000 marchers stood. They were there to address economic and civil rights, and to demand an end racism. "I have a dream," Dr. King began.

It's 2019 and although the United States looks very different than it did in 1963, we must ask how far we have come. We see corporate-funded prisons disproportionately incarcerate people of color. Inner city schools lack fundamental services. Barriers to jobs and housing still abound. There are sociocultural determinants of health. Poor health outcomes can often be predicted by zip codes. I share this not to bum you out, but to encourage you to think about what needs to be done to re-envision Dr. King's (and our) dream.

Cynically you could say that with the deterioration of public discourse and communication in the Twittersphere, there is no place for dreaming. You could say that we are embroiled in a rude, shout-fest. But I disagree. Smashing, breaking and destroying things may have a momentary, primal release, but sentient people of good heart are constructors, builders. They ask, "How can we make things better?"

Health is about preventing poor outcomes but also finding solutions to bad situations—an asthma attack, a fracture. Physicians are problem solvers.

So what is needed to re-envision Dr. King's dream? Cultural humility is an important first step. Learn the strengths of various communities, including those who may not be as privileged as your own. Another step it to commit to advocacy. Join a group that is doing work you care about, educate yourself and become engaged. Even becoming more aware of the issues at hand can help.

We need a new dream since Dr. King's only got us so far. What can you come up with?

Ana Núñez, MD
Associate Dean for Diversity, Equity & Inclusion; Professor of Medicine