The Importance of the Personal

Interview with Gina M. Solomon, MD MPH

I first got involved in advocacy work through PSR. When I was a college student I heard Helen Caldicott speak, around 1984. I was inspired by her as a pediatrician who was speaking out on public health and public policy issues. I thought it would be amazing to be like her someday. That was actually part of my decision to go to medical school. I got all excited, I called my parents after I heard Caldicott speak, and I said, I want to be like her someday. My father said: “Why do you think people listen to what she has to say?” Of course, he had an ulterior motive, because he was hoping I’d go to medical school. So I actually switched my focus in college and started on the path to go into medicine. So in some ways my interest in advocacy pre-dated my medical training.

I remember my first press conference on a cold winter day in Boston when a group of PSR physicians put on white coats and stood behind a banner. I felt kind of stupid standing in the street in downtown Boston with a few other docs and nurses in white coats and stethoscopes, freezing. Then we started the press conference. To my amazement, press actually showed up to hear what we had to say. We had a number of local TV and radio stations. I was so nervous but it was also really inspiring to realize that when there was a group of doctors who had something they wanted to speak out about, that there were people who would listen. We gathered a crowd, and got on the TV news that evening. That got me thinking, ok, it’s not actually that scary to stand up in public or in front of TV cameras. Then people actually hear what you have to say.

Have you had the experience of speaking with a legislator hostile to your cause?

I actually have found that if and when I’m speaking with skeptical legislators or their staff, for the most part they’re polite and willing to listen. I think it has to do in part with the fact that I’m a physician and a scientist. I try to be really clear about where I’m coming from. I see patients. I see first-hand the health effects of pollution. I teach students and I feel strongly that this issue affects everyone in this country. Even the folks who I thought would never in a million years vote my way will at least be polite, will listen, and I sometimes feel like I’ve gotten a little bit of traction. It’s happened recently with some fairly conservative Republican senators, Senator Crapo of Idaho, who as it turns out has a suspected brain cancer cluster in his state involving children. He is deeply concerned and feels the need to get to the bottom of this. He thinks there may be environmental links and that those need to be researched.

And Senator Boozman of Arkansas has also been interested. He is a health professional and a conservative Republican. He is very willing to listen and to discuss health issues, and environmental issues. So I’ve talked with both of them, and I feel like they’ve heard my piece. They listen, they engage. The important thing about health issues is that they affect everyone, so they can cross party lines. We should never give up on talking to legislators, even if many meetings don’t seem to generate results.

What is your role in meeting with a supportive legislator?

Usually my role is to answer questions or to help give them information to rebut arguments that they’re hearing from the other side. So often I hear: “We have lobbyists coming in here saying this, and I don’t know what to say to them. And, is there any truth to what they’re saying?” As a scientist I can either answer those questions or find somebody who can answer them. I give them credible, science-based information that will allow them to engage and respond to opponents.

One of the things I often do is go in with a group. I’ve been trying to bring students along, and residents, people who don’t have a lot of lobbying experience. It’s really fun to bring a medical student or resident or fellow along to - in my case - Sacramento. At first they just tag along, but after the first visit or two I’ll say, “Why don’t you talk about your perspective on this issue?” It’s so empowering to them to realize that they can walk into a legislator’s office and say “I’m a medical student at UCSF, and I’ve been learning about air pollution and respiratory disease, and I’ve been seeing patients with asthma, and I’m very concerned because I know that the science shows that air quality is critically important in asthma. We need to do more to protect our air quality and reduce pollution.” They start to develop their own voice. So I try to bring along interested students, and I try to prep them and empower them.

What is unique about the health professional as advocate and how can they highlight this when doing advocacy work?

Personal stories are incredibly important. I think that as scientists, health professionals tend to get caught up in the science and they are often nervous about being advocates because they feel they have to be familiar with every detail about the science. In fact that’s not what works in political advocacy. What works in political advocacy is first-person narrative, the story, the anecdote. In some ways as a scientist I find that sad. I wish that the science really mattered more, and that politicians would really listen to what scientists have to say about the scientific literature and what the data show. But in fact all of my experience has shown is that what they remember, what jumps out at them, is the story of a patient that you saw or your story of what you see in your clinic and how you feel that is relevant to some broader policy issue.

The better a storyteller you are, the better a political advocate you’ll be. It really doesn’t have to do with knowing the science inside and out. I’ll often have health professionals say to me, oh I can’t talk to anybody about this, I haven’t done a full literature review, I don’t know all the science on this, I haven’t published anything on this. All that anxiety is ill-placed because it’s not what’s needed. What’s needed is someone who knows enough of the science that they can say with confidence that a particular public health solution is needed, whatever the issue is, whether it’s on nuclear weapons or gun violence or an environmental health topic such as climate change or exposure to toxic chemicals. What’s needed is someone to say, “From my experience as a health professional, this needs to happen because it’s going to save lives, it’ll protect people.” If you can say that with confidence based on your understanding of the science, that’s pretty much all you need.

If health professionals speak from that personal experience and that strength of purpose then you can make a huge difference.

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