Doctors Facing Political Violence and Unrest in the US with Author Stephen Marche Part 2
Political Violence, Burnout, and the Doctor’s Dilemma: My Candid Conversation with Stephen Marche
Hello friends, colleagues, and fellow seekers of a balanced life in medicine—
This week on the Interesting MD podcast, I dove deep into a topic that’s been gnawing at the edges of our profession and society as a whole: political violence and how it’s creeping ever closer to the clinic doors. My guest was none other than Stephen Marche—podcaster, novelist, essayist, and a sharp observer of American political culture. This wasn’t your typical med school lecture or CME update; it was a raw, honest discussion about what it means to practice medicine in the chaotic social climate of today’s United States.
When Political Violence Is Not an Abstraction
For many years, the conversation around mass shootings, political violence, and social unrest was something happening “somewhere else.” But, as Stephen and I both explored, these dangers are becoming frighteningly real for physicians. Not long ago, we were hailed as heroes, with pots banging in gratitude and communities rallying around us. Now, that very same society is scorning and vilifying healthcare workers, accusing us of conspiracies, and, in extreme cases, targeting us simply for doing our jobs.
As Stephen put it, history is not subtle: first come the attacks on journalists, then security services, and then—inevitably—the medical profession. We’ve already seen the CDC being targeted, public health officials threatened, and clinics subjected to harassment. The next logical question is: when do day-to-day acts of violence spill over for doctors, nurses, and healthcare staff?
It Changed Me: Firsthand Witness to Violence
I’ll be honest with you, witnessing violence firsthand fundamentally changes how you live and work. I experienced a mass shooting at Mardi Gras—smoke rising from the barrel, terrifying confusion, shielding my young children. For years after, that trauma shaped how I viewed my life, my career, and my responsibility to my family.
For those who haven’t lived through it, it’s unimaginable. The breakdown of law and order, the normalization of danger—it is not an abstract “policy debate.” It's daily, visceral, and real. After years practicing in New Orleans post-Katrina, where carjackings and rampant shootings were commonplace, I knew I had to take my family somewhere safer. The certainty of worsening conditions finally outweighed the uncertainty of uprooting our lives.
Doctors Are on the Frontline—Whether We Like It or Not
The reality, as Marche reminds us, is that all figures of authority—and especially medical professionals—are on the list. Political authoritarians treat us as threats: either we’re painted as elitists, part of a conspiracy, or outright accused of malevolent intent. This isn’t just paranoia; it’s historical precedent. From Stalin’s purge of doctors to the more recent targeting of public health officials, medical professionals have always stood in the crosshairs once social order deteriorates.
So what do we do? How do we respond when government agents arrive in our hospital parking lots to arrest vulnerable patients? How do we balance our obligations as citizens, doctors, and parents when all seem to be in conflict?
There are no easy answers. As Marche said, “Hard decisions are coming for us all.” History asks a lot of doctors—sometimes more than we ever thought we signed up for.
Why I Left, and What We Gain By Moving
I chose to move my family to Canada, seeking the peace, safety, and rule of law that’s increasingly hard to find in parts of America. Canada isn’t perfect, and moving brought its own costs, anxiety, and uncertainty. But, as Stephen told me, “Living without the threat of violence—there is no replacement for that.” The rule of law is the ultimate luxury, and once it’s gone, it's nearly impossible to restore.
Many colleagues are thinking about similar moves. Small towns in Nova Scotia, Quebec, Toronto—these communities want doctors, and the stability is worth the tradeoffs. But wherever you go, you’re still resisting chaos and fighting for your values. That resistance just takes different forms.
We Need Real Policies—Not Just Political “Teams”
One point that stuck with me more than anything was the observation that American politics has entered a bizarre “post-policy phase.” Election coverage is no longer about what’s best for public health, education, or economic stability—it’s about cosmic slogans, anger, and performative conflict. The nitty-gritty of improving lives falls by the wayside. Until mass shootings and violence become more important to our politicians than fundraising or careerism, nothing will change. And that's tragic.
States are starting to chart their own rational policy paths, but until a real national reckoning occurs, instability will persist. If America’s leaders won’t act, the risks and the responsibilities fall to us—and it’s wearying.
What Should Doctors Do?
If you’re a practicing physician in America, these questions aren’t academic. They are urgent:
Are you prepared for the possibility of violence at work?
Do you know how you’d respond to government overreach, patient targeting, or societal breakdown?
Have you talked to your family, your colleagues, and your community about these realities?
Start those conversations now. Even if you think, “That would never happen here,” just remember: history doesn’t ask permission before arriving.
Final Thoughts: Finding Balance, Preventing Burnout, and Choosing Your Front Line
We’re all living through history—and for American doctors, the sense of living at the end of history, suddenly snapped back into conflict, is disorienting and painful. Finding peace, purpose, and safety is paramount, whether you remain in the U.S. or seek a new life elsewhere. As Stephen said, “There’s a front everywhere. Ultimately, everyone must choose one side or the other, and they’ll have to fight wherever they are.”
As always, my hope is for laughter, for better policies, and for safety for all medical professionals. But until that happens, we have to look after ourselves, our families, and our patients—and have candid, honest conversations about what’s coming.
Feel free to share your own stories and struggles in the comments, or reach out to me directly (rob@interestingmd.com). Let’s strengthen this community and support each other—wherever our “front line” may be.
Stay safe. Stay balanced. Stay interesting.
Dr. Rob Beck
Host, Interesting MD
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