Kartik Amarnath joins the Agents of Change in Environmental Justice podcast to discuss his work and advocacy in community determination and empowerment, and energy justice.
Amarnath—a policy specialist for PUSH Buffalo, a MD and MPH candidate at SUNY Downstate Health Sciences University, and current Agents of Change fellow—also talks about how his family’s past informs his present, his advocacy work on clean energy, and how oppression and injustice manifest in illness.
The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows, as well as others in the field. You can see all of the past episodes here.
Listen below to our discussion with Amarnath, and subscribe to the podcast at iTunes, Spotify, or Stitcher.
Transcript
Brian Bienkowski
I’m talking to Kartik Amarnath, a policy specialist for PUSH Buffalo and an MD and MPH candidate at SUNY Downstate, Health Sciences University. Kartik is a thinker, he has such an incredible mind. He talks about how his family’s past informs his present, his advocacy work on clean energy, and how oppression and injustice manifests in illness and how we can better think about this in the medical and public health fields. Enjoy.
All right, well I would like to welcome Kartik Amarnath to the podcast. Kartik, how are you.
Kartik Amarnath
I’m good Brian, thanks for having me.
Brian Bienkowski
And where are you, where are you coming at us from today?
Kartik Amarnath
I’m coming to you from East Flatbush in Brooklyn, New York.
Brian Bienkowski
Awesome, awesome. Very cool part of the city. Well thanks for joining us today. I am really happy to talk to you and I want to start, as I do with most people, going way back. And you’ve, you’ve described your identity as a transnational assemblage of histories migrations and struggles, which I just love the way you put that. I was wonder if you can fill us in on some of your family’s background and how this history helped shape your career path in public health and environmental justice.
Kartik Amarnath
Sure, yeah happy to do so. So, I guess I can start with where both my parents come from. My mother is Malaysian Indian, so her ancestors migrated to Malaysia from South India under the British Empire, and they were sent to Malaysia to work in the rubber plantations in, at the time the colony was called Malaya. And through that form of labor, my mother’s people, my mother’s community essentially supplied the world with cheap rubber, and that cheap rubber was essential for the automotive boom, the global automotive boom. So things like Fordism, the development of industrial cities like Detroit, automotive cities in the United States, the Federal Highway System—all of that was possible, economically, socially, politically because of the labor of this community. And where that community is now in Malaysia is, you know, they’re more or less experiencing the brunt of a highly racialized society. Malaysian society has a lot of contempt for Malaysian Indians. They were forcibly displaced from the rubber estates, as the rubber industry became more mechanized. And a lot of the rubber plantations were also converted to palm oil plantations. So, you know, Malaysian Indians experienced a great migration similar to the great migration that we found in the United States. The two great migrations from the South. So, a landless people who now really struggled to survive and face a lot of oppression and have been forgotten by their country of origin, many of which, you know, come from India, as well as some other South Asian nations. My father’s side. My father’s Sri Lankan Tamil, and I guess for those who don’t know, Sri Lanka is a country that experienced the longest protracted civil wars in modern history, and that was a civil war between the ethnic Tamil minority, a rebel force known as the Tamil Tigers were fighting on behalf of the ethnic Tamil minority, although not everyone in the Tamil community subscribed to their politics my family being one of them. Versus the Sinhalese Buddhist majority, and basically the fight was for an ethnic Tamil homeland in Tamil majority areas of the island as a response to the majoritarian practices of the post-colonial Sri Lankan government, which basically situated Buddhism as the primary religion and sort of evoked Sri Lanka as like the Sinhalese Buddhist homeland. So Tamils who are predominantly Hindu and Christian as well as other minority communities such as Sri Lankan Muslims were marginalized under that arrangement. The Sri Lankan Civil War is where modern suicide bombing was created. The Tamil Tigers sort of perfected and exported that method. Sri Lanka, even though it has a population similar to the size of metropolitan New York City at one time had one of the highest incidences of enforced disappearances, so people who forcibly were disappeared and never heard from again. And, you know, now, the war ended in a very violent means, there’s a Channel 4 documentary called “Sri Lanka’s Killing Fields” which shows leaked footage of what amounts to war crimes that were committed by all armed entities, all armed parties during the final days of the Civil War. The United Nations estimates that close to 80,000 civilians were killed, potentially more, according to other studies. And a lot of the root causes of the Civil War still have not been addressed. The primary grievances of Tamils as well as other minority communities, and the radicalization of the Tamil community which led to armed violence and armed uprising, we see that radicalization, you know, and happening in parallel. Nowadays, in other communities, such as the Sri Lankan Muslim community and, you know, we saw those devastating Easter bombings, not too long ago. So the roots of the violence have not been addressed and the violence, formal armed conflict is only ceased because of, because of the indiscriminate killing and targeting of civilians and, you know, the war ended in a lot of violence, there was not some sort of like peace agreement reached. So, you know, the Civil War, as well as ethnic based oppression, they very much have an afterlife right now, and that reverberates in the diaspora. In my mom in my mom’s case, you know, there’s a reverberation in that diaspora too, and a lot of those issues that my parents faced and the countries that they came from, you know, manifested in sort of like our lives at home. You know, my family is afflicted with a lot of diseases that now we understand as directly correlated to experiences of trauma, and recognizing that those traumatic experiences are the product of oppression and structural violence. And, you know, systemic marginalization. That’s sort of what prompted me to look at health issues from a justice-oriented lens and a lens of inequity and injustice, and what to do about those realities. And yeah, that, that eventually led me to understand environmental justice as a concept. I was at an internship with the Centers for Disease Control and Prevention, the National Center for Environmental Health within the CDC, I was doing an epidemiological study on the living and working conditions of migrant farmworkers in South Georgia and came to understand that a primary modulator of health inequity is just how our society is arranged in relation to the environment that we utilize for resources, for sustenance, and how exposure to hazards and risks change based on how society is organized. So environmental justice became the primary entry point from which I wanted to understand public health issues, especially in an era of climate change, and public health issues, you know, according to justice and equity perspectives.
Brian Bienkowski
I can’t help but think about, so my family are, I came from Polish immigrants who were escaping what we believe to be Russian oppression in the eastern half of Poland, and they went to Detroit and worked in the auto plants. So when you were talking about Malaysia, I kept thinking that you and I have this link, or my, my grandparents were probably touching some of the parts, you know, made over in Malaysia. But thank you for that. I am wondering if, you seem to have such a firm understanding of your family history on both sides, was that something that was just talked about at home, or was it something that you kind of on your own decided to, I need to learn about this and figure out where I come from.
Kartik Amarnath
Yeah, it’s interesting, like, I mean, the short answer is no. And I think a lot of that has to do with trauma and, you know, my, my dad in particular, very rarely brought up the things that he experienced. And, you know, in my case being American, and having parents come from these parts of the world that aren’t really a part of American discourse, I guess. I think we struggle to find a language to articulate what the experiences were that my parents went through. And then pair that with sort of the stereotypes around South Asians, particularly Indian-presenting people in the United States, that of being a model minority. You know, the nuances of my parents’ experiences and my family’s experience at large, kind of get erased as we sort of got swallowed up into this model minority narrative. And then, you know, that kind of changed into, you know, post 9-11. And so, like, I sometimes tell people when I, when I was growing up, I grew up in different countries but the years I spent in the United States I was, I had to traverse between being seen as a nerd and a terrorist, and that was sort of like what I existed as in my skin. And so, I didn’t know who I was. I didn’t, I wasn’t able to articulate what I was experiencing, and, and I knew that what I was experiencing was different from what the world was telling me I was supposed to experience, which was an ascendant model minority sort of experience or like, you know, having affinity for like terrorism or whatever. And so yeah, a lot of it was, was me doing the groundwork myself to try and understand who it is that I am, and what I come from, like, what experiences brought me into being, you know. And, you know, my father for example escaped the Sri Lankan Civil War and went to Malaysia, so without the Sri Lankan Civil War I wouldn’t be alive today. So in a way, I am like the alchemy of a very serious, serious and significant tragedy that took place. What do I do with that reality? I have to take on that as a responsibility. And so that’s sort of like, where the pursuit of understanding where I come from, comes from, I guess. And yeah, it’s been, it’s been deeply rewarding and informs every area of my life and how I try to navigate it.
Brian Bienkowski
So you mentioned, starting to gain understanding and appreciation for environmental justice as kind of central to your work, and before you returned to medical school you were the energy planner of the New York City Environmental Justice Alliance. I was wondering if you could talk a little bit about the disproportionate health burdens caused by our current energy system and how you all were trying to address that, and perhaps any victories you all had.
Kartik Amarnath
Yeah sure. So the energy system, how we understand it, you know, commonly, is just turn on the lights or you turn on the fan or, you know your appliances, what have you. But what it takes in order to do so, there are a lot of injustice laden within the entirety of the energy supply chain. Right, from production to distribution to consumption. When it comes to production, for example, more than two thirds of African Americans live within a 30 mile radius of a coal-fired power plant, or an oil or natural gas refinery, according to the NAACP. And a 30 mile radius is sort of the, the radius in which the most pronounced negative health outcomes from out of stack missions are experienced. So epidemiologically speaking, that would help to explain why African Americans have lower rates of smoking, but higher rates of lung cancer. It’s not the only reason, but it’s a huge contributor at the very least. So that’s, that’s on the production side of things. And just one small example. And then on the consumption side of things, you know, I think there are very robust conversations going on around the housing crisis and gentrification, and how legacies of redlining and segregation in cities have produced sort of the unsustainable conditions that we have right now in relation to housing. And energy plays a huge role in housing insecurity and housing injustice. So on the consumption side of things a disproportionate amount of a household’s income that goes towards energy expenditures falls on low income communities, communities of color. And the reason why more income from these households is devoted to paying their utility bills, largely has to do with the fact that the housing stock that most communities of color and low-income communities across the country live in, you know, are not…The housing stock is relatively old, it’s not well-maintained and a lot of that just has to do with, again, histories of redlining and segregation and plan shrinkage, you know. And parts of the country in places like Buffalo where I’m working currently, or I’m working with an organization based in Buffalo, a lot of the housing stock there, they describe it as walls made of Swiss cheese, for all intents and purposes, when it comes to the weather and just like, climate control. And because of that you got to pay more into, you know, keeping the heater running or keeping the air conditioner on during increasingly frequent and more pronounced extreme weather events like heat waves. So, you know what, what that amounts to is a situation where families have to make the decision between keeping the lights on and keeping the heat on, or bringing food to the table, you know. And and this challenge of how to make that choice is sort of an ongoing chronic situation of crisis that is really going unaddressed. And we even find inequities in the solutions, right? So, like, as renewable energy is becoming more affordable as the solar market for example is expanding. We don’t see that translating into the nascent renewable energy industry trying to undo any of the racial inequities that we found in the traditional energy economy. So there’s gross underrepresentation when it comes to, when it comes to hiring people of color, hiring women to sustainable jobs, well-paying jobs, jobs with leadership in the solar industry, for example.
A lot of the energy bureaucrats at state level energy agencies and authorities, you know, are not people of color and don’t have a racial analysis on how the solutions need to facilitate a transition to a renewable and regenerative economy that is fundamentally just. So, yeah, we have a catch-22 where the traditional energy economy was harming historically oppressed communities and much the same way as every other sector of the economy does. And then, as we are trying to push for solutions with a huge amount of backlash obviously coming from vested political interest in maintaining the traditional energy economy, there isn’t enough of a racial analysis or a justice-oriented praxis there as well. And yeah, both need to happen. In terms of victories, I mean, I think this happened soon after I left the New York City Environmental Justice Alliance, or NEJA for short. But, New York State passed what is considered one of the most aspirational forms of climate legislation in the country if not the world. It’s called the Climate Leadership and Community Protection Act. And basically what this legislation, what this legislation puts forth is, you know, sort of the basis for a transition to a regenerative economy by demanding an aggressive cap on emissions across all sectors of the economy, and then ensuring that revenues generated from that cap and the transition to a renewable energy economy, those revenues are reinvested strategically to address historic harms committed by the energy industry as well as other polluting industries. So, investment in frontline communities and frontline workers as well. So that’s really exciting and I don’t know if I had a direct contribution in the passing of that. Like I wasn’t in there lobbying, but at the very least, I can say that you know I was in meetings with, you know, the Cuomo administration and officials at the various energy authorities and agencies and departments at the state level, as well as at the city level in New York City. And we really were unapologetic in, in bringing forth the language of a just transition, and what that looks like, and how the energy system is implicated in injustices related to historic realities like redlining, and, and, you know, bankability and how there’s segregation around the ability to get a loan, and how that relates to the energy system. And so we, you know, we were just bringing forth the racial and social justice analysis and environmental justice analysis where there, into spaces that were devoid of one for a long time. And I think that opened up the possibility for legislation like the CLCPA to get passed and now there’s going to be a lot of work to make sure that implementation of such an aspirational policy is true to form.
Brian Bienkowski
One of the common themes with this Agents of Change program is, people often talk about this disconnect between, kind of, mostly academic researchers and the communities they’re researching. And I’m wondering, you know, you were working here on the ground in tandem with communities. I’m wondering what you learned that maybe you wouldn’t have learned just by attending university.
Kartik Amarnath
Wow, that’s such an interesting question. There’s so much to say there and I don’t know how to start. You know, I guess. I mean, I don’t want to dismiss academia at large. I mean, the people who I would argue, without sounding melodramatic, but, the people who, like, saved my life and really, gave, helped me orient what it is my purpose is, and just how to be in the world were scholars, academics, my mentors, my mentors in college. But you know, I guess what’s, what’s really important to consider in terms of academia and scholarship is that… I don’t know, in order to do, in order to do scholarship that has a public impact, you really have to like go against the grain in a lot of ways. I mean, I’m not in academia, but from my understanding, like, the necessity to get published, and you know the insecurity around tenure, and just the fact that that is becoming less and less of a viable option for a lot of academics. You know, things like community based participatory research where you consult with the very communities that you’re working with and doing research about, during every phase of the research process—that, unfortunately, I would imagine, becomes a secondary thing for a lot of people. Whereas for us, you know, the New York City Environmental Justice Alliance, the Board of Directors, so it’s an alliance of grassroots organizations throughout New York City, four boroughs of the five, sorry Staten Island. Four of the five boroughs, grassroots organizations that come from those boroughs, that are serving the most environmentally overburdened communities. And the Board of Directors of the Alliance are the very members of the Alliance, you know. So, there, there is no hierarchy of leadership in the same way that you would see like in a corporate office or even in a university. The people who determine the direction of the Alliance, where resources are allocated, what sorts of, what public officials do we work with versus what public officials do we post protest outside of the office of—sometimes it’s the same public official, depending on the issue. You know all of the decisions that are made for the organization are informed by the very communities that they serve. And that priority, which is very much an existential question for the Alliance and for organizations similar to that alliance, that kind of priority is not integrated into the DNA of how a university is run, you know. Or how, how a think tank or a research center or a laboratory operates. And I think it would do well for that sort of orientation to be more of a prominent feature in the universities that we see in the United States and abroad. Yeah, I hope that answers your question.
Brian Bienkowski
Yeah, for sure. And I’ve been asking everybody this question, and it’s just as big and broad, if not more so, and that is what is the defining moment or an event that shaped your identity.
Kartik Amarnath
Defining moment and event that shaped my identity. There are many, and it’s hard to pinpoint one above others. But I guess I will say, you know, I’ll bring it back full circle and just talk about my family. So, a time in my life that really still means a lot to me today was springtime of 2009. I was graduating from high school. And around that time when I’m, you know, gonna be moving out of my parents house pretty soon and enter into this new chapter of life, and adulthood. My grandfather was rapidly declining from Alzheimer’s disease. At the same time he was losing his vision and hearing. So he was losing his sensory experience, as well as his sense of reality, you know, his cognition. Around that same time, so that was my mother’s father, the Malaysian side of my family. Around that same time was the end of the Sri Lankan Civil War, the Sri Lankan Civil War officially ended in May of 2009. And just learning about those two experiences, I mean, living through those two experiences from a distance. You know, I don’t want to claim like, I was in harm’s way or I bore the brunt of what people went through, but those two things happening around the same time and the inability for my mother and her family to express the pain and trauma of seeing the decline of my grandfather and the helplessness around that, and then the helplessness of the Tamil community, the Tamil diaspora, who were desperately protesting around the world and occupying highways and, and no one, no government was really responding and in a meaningful way. That sort of dual, dual experience of helplessness is where it really planted the seed for me to be, to try to harness who I am, my identity, my background, unapologetically, in a way that is of service to others who might share elements of similar experiences. You know, my grandfather’s declin could have been prevented, had he had equitable access to health care, or maybe came from a community that wasn’t exposed to the types of hazards that his community was exposed to environmentally, politically, socially. And, you know, we have the indiscriminate massacre of civilians and some would even call genocide, in the case of Sri Lanka. We have ethnic cleansing happening around the world right now, you know, and, and just those experiences and how they impacted me. How, like, the reality of mortality of a family member, and then the reality of like a social kind of death and cultural kind of death, that came with, you know, the indiscriminate massacre of Tamil civilians and the fragmentation of the Tamil community in Sri Lanka and beyond. Yeah, that is just what has made me who I am today, which is someone who tries to unapologetically fight against sort of this social death of like who I am and who my people are and where we come from. And that doesn’t necessarily, necessarily mean like I preserve our experiences and identities, but just, like, that’s important to me. But more important is that I, that I bear witness with compassion for people who may not necessarily look like me or communities who may not come from the same part of the world or, or ethnic background or religious background, but who have experienced oppression or harm in one way or another, just humbly and compassionately bear witness, and, and find a common human spirit in those people, and in those populations. And how do I hope to do that, through a justice-oriented practice of public health.
Brian Bienkowski
Take those experiences at 18 and turn it into what I would consider a positive, says something to your level of maturity, because at 18 that can go one of two ways, or one of many ways, I would say. When you’re experiencing trauma or loss at an age like that, I just know myself, I wouldn’t have been able to process things and come out the other side with such a kind of clear and positive view of how to turn that around. And now you’ve taken a position at PUSH Buffalo and pardon me, if I’m, if it’s, if it’s not PUSH, if I’m saying that wrong. But can you tell me a little bit about it and it’s, it’s kind of how, it’s trying to integrate both climate adaptation with economic equity.
Kartik Amarnath
Yeah, absolutely. So I decided to take a leave of absence from medical school and the medical field in general just given the circumstances of the pandemic and challenges around learning medicine over Zoom. So I put that career path on hold for the time being, and now I’m working at PUSH buffalo as their policy specialist. And PUSH stands for People United for Sustainable Housing. And PUSH Buffalo started off as an affordable housing organization and they’ve, you know, from their advocacy around affordable housing development on the west side of Buffalo, in a very diverse historically marginalized and neglected part of Buffalo, especially in the postindustrial era, the organization has really transformed into one that, you know, the locus was, was affordable housing. But in addressing affordable housing, you have to, they came to realize that you have to address things like climate resiliency, economic justice and injustice, language justice, disability justice, gender-based issues, policing. So, it translated from, you know, starting with affordable housing to really trying to develop community, develop opportunities for community autonomy and self-determination. So with that in mind, PUSH Buffalo established what’s called the Green Development Zone, which is sort of like a semi-autonomous space in Buffalo that’s only growing, where, where they’re really trying to develop a localized economy that can address, that can address historic harms, while facilitating a just transition into a local regenerative economy. So they’re trying to develop community owned energy systems, for example. They’re trying to integrate democracy into the workplace through worker self-directed enterprises through cooperatives. And all of this with a lens on race, class, gender, the environment, indigeneity. And where I fit into that is as policy specialist, my responsibility is to look at opportunities and challenges in the policy realm at all levels of governance, so city, county, regional, state, federal—look at, sort of suss out what the policy landscape is and where opportunities are for policy shifts that could help make real these aspirations for community self-determination on the ground along things like energy, green infrastructure, water equity, and new economy, so cooperative development, equitable workforce development, and local hiring, that sort of thing. So, right now, this is week three on the job. So still very fresh, but it’s already been so exciting just meeting with different stakeholders and folks involved at various areas of and points of intervention. Just understanding how, unfortunately, we continue, especially at the policy level to put these various topics or issues of energy, stormwater management, infrastructure management around water, public health, into these silos, and in doing so, really provide a significant barrier to actualizing a just transition. And a just transition requires a more systemic based approach, you know. So the nuts and bolts of that, it’s kind of like, you have a pot of money that’s devoted to workforce development around solar, right. Like, how do you ensure that that pot of money is spent in a way that provides sustainable jobs. Number one, sustainable jobs for people who are historically marginalized in the renewable energy sector, sustainable jobs for people who were historically burdened by the fossil fuel based energy sector, and jobs for people who are, you know, at the forefront of struggles around affordable housing, energy burden displacement from gentrification. Like, we really need to look holistically, so the both the challenge and the exciting aspect of my job is sort of interjecting in these siloed spaces to try and introduce a more systemic understanding, and try to find where initiatives and movement in the policy area, in policy areas along different issues actually have significant overlap. And, and we can work together to translate into more opportunities for community self-determination, and community ownership of assets in Buffalo. And, you know, PUSH is really at the forefront of these questions like, nationally, they’re a part of a few regional and national coalitions. So what happens at PUSH often, you know, often knowledge is shared from PUSH with other partners so it could have some really positive repercussions, especially in this new era we’re in, with the new administration. Yeah, it can have repercussions beyond Buffalo, and all of that is just really exciting, and I’m really grateful to you know, be a part of those efforts.
Brian Bienkowski
I don’t know how to phrase this question exactly, but when you mentioned your work there—I have one of those brains where, if someone says there is a housing problem I want to go build a house. And then I want to move on to the next problem. And I have a full understanding of the systemic nature of these things, but I just have one of those brains that’s like, cross one thing off at a time. And I’m wondering if you, like, how do you go about kind of untangling all of the disparate systemic issues? And then kind of, your next step is maybe going to policymakers, I’m assuming, or groups, and then bringing them back together and saying hey, we have this big ball, how can we address this, you know, holistically or with certain legislation that touches on a bunch of these. How do you, how do you approach that work because it would, it would just blow my brain up.
Kartik Amarnath
Yeah. And I guess, you know, speaking with you, given the purpose and vision of Agents of Change, I can be blunt about, you know, how like a systemic based analysis is needed and, and all of that. But how it translates into these spaces is not necessarily putting forth like, you’re doing this wrong because it’s limited and doesn’t have a systems based approach. But it’s more like, it’s more of a finesse I suppose. Like, here we have a pot of money in, you know, the Department of Health and here we have a regulation that’s changing with the New York Power Authority, and these two things actually speak to each other, and that informs, that therefore must inform PUSH Buffalo’s advocacy in both of these respective spaces. And it’s not necessarily like the withholding of information or lying by omission. Like we’re not being open about how, how these, the movement and these two supposedly separate arenas have systemic implications, but it’s recognizing that the viability of introducing, like, demanding that everybody think in a systems-based way, that’s a much longer battle to be had, I suppose. And I think, you know, in New York we have the luxury of a policy, a comprehensive, at least an attempt at a more comprehensive vision for climate action through the CLCPA that was recently passed, and because of that we’re able to now speak more openly about the systemic realities of the climate crisis and climate change. But, you know, your question also leads to like an intellectual question, right? Like, how is it that we’re supposed to approach these fundamentally systemic problems given the realities of like, the siloed nature of our disciplines and our professions, you know. And something’s got to give. And so, you know, a part of what I hope could be an intellectual project for me, you know, as part of PUSH but beyond that—any endeavors I have moving forward will be to develop new types of methodologies and disciplinary forms of understanding and theoretical frameworks that do justice to the systemic implications of the questions that we have at hand, you know. Like how can we, how can public health practitioners approach health outcomes from a structural perspective. I think that’s where there’s so much room for innovation, and there’s a lot of excitement there, and there’s a lot to be done in that world. And I guess, you know, what’s, what’s very much needed is to integrate justice, equity, structural analysis into the very DNA of how different disciplines and professions operate. And that’s, that’s a call for every sector every discipline every profession, not just public health, not just folks in the energy sector or what have you, everywhere. So that’s the project, and everyone needs to be a part of doing that. And hopefully we find more of that moving forward.
Brian Bienkowski
So let’s take that to one specific sector. So you’ve had, you have an interest and you’ve had some training in medical school. And I’m wondering what are some of the aspects of health institutions and the healthcare sector writ large that you hope to change or better when it comes to promoting community health where do you see some opportunities there.
Kartik Amarnath
Um, I see a lot. And I’ve written about this a little bit. But basically, you know, who we see, I’ll just sort of like lay out a scenario of who we see in the clinic. Right. If we see someone with COPD or something like that, like, how can we understand the physiology, and the physiological realities of our patients in a way that links those realities with the structural realities that led to the health outcomes that we’re seeing. So, if someone has, if someone from a particular community has lung cancer, for example, a patient of yours. That lung cancer, didn’t necessarily manifest in a vacuum, it wasn’t just some sort of genetic accident and that’s it. The process of, of, of cancer coming about has very much to do with like where that person lives and what sorts of resources that person has access to, and a variety of environmental factors that are determined by the structures and systems we live within. So as a result of that, healthcare practitioners especially clinicians, doctors, nurses, physician assistants and beyond, have a front row seat to sort of, insults of the system. Because, you see those insults as they manifest physiologically in the patients that you serve. You know, and a lot of that is not necessarily talked about or, if it is, it’s not done so in a very robust way. Unless, oftentimes, like a clinician will have a degree in something else that provides them with, with, you know, methodologies, in which, and a theoretical framework in which to understand injustice in a robust way as would, you know, frontline activists, or organizations serving frontline communities do, and can participate in envisioning systemic instructional solutions. But a lot of, for the most part, structural competency is not taught very well in in medical school and, I’d imagine, other ancillary, you know, clinical professions. And that, that just really needs to change. For example, we have this new and exciting paradigm known as One Health, right, where, where basically, it’s trying to put forth transformations in medical and health professions and disciplines, such that we recognize human health is fundamentally interlinked with the health of environments, non-human species, the material environment, etc. So, you know, integrating ecosystem science with medical science with genomics, and that sort of thing. And that’s all really exciting, it shows how humans are fundamentally linked to non-human entities and actors in the world, and inspires that we see our connection with others. But a lot of those connections are transformed and transmuted and modulated based on systems, social systems, economic, political, ecological systems that favors certain people, certain actors over others. And, and that favorability, that discrepancy, and who benefits and who gets harmed, those are questions of injustice. So, you know, some scholars—one who I really admire his name’s Robert Wallace, they argue for a structural One Health approach where we understand how ecosystems are organized and how that results in health outcomes and disparities in health outcomes. But also recognizing that the question of how the questions around the organization of those ecosystems in those societies, those are questions of injustice, and justice and structures. Another example would be Nancy Krieger, at Harvard University who talks about eco-social health and eco-social theory, where, you know, she argues that bodies need to be understood in like, in a way in which we recognize health outcomes as embodiments of injustice, you know, and historic oppression. And that’s just such a rich way of getting to the root of the problem, you know, and is not talked about explicitly in the health care sector and that’s, I don’t know, that’s, that’s really disappointing. It didn’t always work that way, and it doesn’t have to continue to work that way.
Brian Bienkowski
Well Kartik, this has been really illuminating, I’ve really enjoyed this conversation. And I just get the sense that you’re a voracious reader. I have no way of knowing that, but I feel like you are. And so my last question is what is the last book you read for fun.
Kartik Amarnath
For fun. I read “When Breath Becomes Air” by Paul Kalanithi. He was a neurosurgeon, neuroscientist who passed away right before he completed his residency from terminal lung cancer and he was writing a memoir about just what it means to live a meaningful life. And the main takeaway I took from that is that medicine, medical field, any field that is of service to others, human and non-human, that, that’s not a profession, it’s a calling. So, that, that really stuck with me.
Brian Bienkowski
Awesome, well Kartik thanks so much for your time today.
Kartik Amarnath
Thank you, really appreciate the conversation.