“We denounce race-related violence and will speak out against discrimination”

I think it's a common misperception that working in geriatrics anesthetizes us to mortality. So many in the general public—and even among our colleagues in health care—assume that's “just what we do.”

I've been thinking a great deal about that misperception these last few weeks, not only because of COVID-19 but also because of the powerful protests unfolding across the United States in response to race-related violence and discrimination. Like many of you, I see the need for change—and, as a geriatrician, I hear reverberating through it the words of British poet Dylan Thomas:

Do not go gentle into that good night,

Old age should burn and rave at close of day;

Rage, rage against the dying of the light.^{1 (p. 2703)}

When read at face-value, Dylan's poem—like geriatrics, I suppose—seems a not-so-subtle allusion to death and dying. But I think there's far more there, and I think much of it speaks to what we are seeing, hearing, and feeling in America and across health care.

Too few in our country benefit fully from a good life, let alone “that good night” Thomas references. We see it in socioeconomic disparities that disadvantage communities of color. We see it in a lack of social supports and services for us all as we age. And now, we have seen it—violently and painfully—in very public displays that make race-related violence and discrimination something few can ignore…and none can deny.

“Old age should burn and rave at close of day.”^{1 (p. 2703)}

That should mean something for us personally, but it should also mean something for us professionally. And while anger and frustration have taken many forms these past few weeks and months, I think the most powerful examples are those that translate feelings into priorities…and action.

Earlier this summer, the AGS issued an updated position statement on discrimination, joining advocates across the country calling for justice and changes to policies that have allowed racism to persist in our society.²

As our CEO, Nancy E. Lundebjerg, MPA, explained: “In the U.S., the coronavirus pandemic alone has only exacerbated devastating impacts on Black and African American communities and many other racial and ethnic groups. Today's challenges not only expose racial inequities but also emphasize why action is critical, when many economic and social policies continue to jeopardize health and well-being for people of color.”^{3 (para. 2)}

The statement is available to all from the AGS website (https://www.americangeriatrics.org/where-we-stand), but I think portions of it bear repeating here…and, ideally, in your own work with colleagues, caregivers, and patients.

The AGS believes in a just society—one where all people are treated equally regardless of their age, ancestry, cultural background, disability, ethnic origin, gender, gender identity, immigration status, nationality, marital and/or familial status, primary language, race, religion, socioeconomic status, and/or sexual orientation.²

Through our advocacy, ethnogeriatrics work, and tools like our Doorway Thoughts series, we have long worked to address systemic bias in health care by highlighting how we, as geriatrics health professionals, can be better partners with our patients from different cultural, racial, and ethnic groups. But we can and must do more to address systemic racism in health care, given its impact on our patients and their families across their lifespans.

As a professional society, we are committed to embedding these priorities in our programs, policies, and procedures. They can't be aspirational; they need to be woven into the fabric of who we are—permanently.

As professionals within a professional society, many of us also may be looking for tools and resources to translate our own thoughts into action. While not exhaustive, I hope the list below (with case-sensitive shortened URLs) can help you forge a path toward your own advocacy:

• •AGS Guideline on Achieving High-Quality Multicultural Geriatric Care: http://ow.ly/s9Lu30qQeMt
• •AGS's Doorway Thoughts: Cross-Cultural Health Care for Older Adults: http://ow.ly/hTgf30qQeGT
• •FrameWorks Institute's Discussing Age with a Social Justice Narrative: http://ow.ly/H4Vd30qQeI8
• •Diverse Elders Coalition's Addressing Unmet Caregiver Needs in Diverse Communities: http://ow.ly/4STz30qQeIl
• •University of Wisconsin-Madison's Bias Reduction in Internal Medicine: https://brim.medicine.wisc.edu/
• •American Public Health Association's Racism and Health: http://ow.ly/uWdB30qQeJ6

“Old age should burn and rave at close of day.”^{1 (p. 2703)}

There are innumerable interpretations of Thomas’ words—our colleagues in literature departments can certainly attest to that! But today, I think they can and should convey the passion that is a driver for geriatrics just as it is a driver for generations of older Americans. Too many good nights have come and gone without making good on our commitment to a just society that treats all fairly. And that deserves more than outrage; it deserves action.