As an emergency room doctor and state legislator, Jon Santiago spends a lot of time thinking about how public policy intersects with the public’s urgent needs.
That thinking has taken on a newly personal dimension in the age of coronavirus. Suddenly, he finds himself treating the very people that government is racing to save.
Santiago, a first-term representative from the South End, is a doctor at Boston Medical Center — already the city’s busiest emergency room, at the epicenter of the homeless population and “Methadone Mile.” Now, the challenges are mounting daily.
“The emergency room at BMC is always intense,” Santiago said last week. “It’s always filled with the poorest of the poor and the most vulnerable communities. It’s not that all the heart attacks and shootings just stop.”
But in his weekend shifts, he’s already seeing a change in the people he is treating, a preview of what’s coming soon.
“How do you tell a homeless person to socially distance?” he asked. “So here I am working [last] Sunday night and homeless people were coming in with fevers, and chills and coughs. Could be COVID-19, or could be something else. They can’t go back to the shelter. So even after COVID-19 was ruled out, they have to be admitted, taking up beds.”
Santiago, 37, was elected to the State House in 2018. He unseated Byron Rushing, a Beacon Hill stalwart since the early 1980s.
Santiago’s passion for medicine had always been intertwined with a strong interest in public policy. He says he became interested in medicine as an adolescent in Roxbury, when an uncle was infected with HIV, and struggled to receive appropriate care. He didn’t just decide he wanted to be a doctor; he wanted to be a doctor at Boston Medical Center, specifically. He wanted to treat poor people.
“That got me interested in the intersection between poverty and medicine,” he said of his uncle’s illness. “From the beginning, I saw that discordance.”
When he was a teenager, his family moved to rural Texas, partly to get away from mounting street violence in Boston. After college he joined the Peace Corps and worked in Central America. He attended medical school at Yale, then became a resident at BMC, and has stayed.
To balance his two roles, when the Legislature is in session many of his emergency room shifts are on the weekends.
As far as Beacon Hill is concerned, Santiago said, the House has been an eager partner to Governor Charlie Baker in trying to address the pandemic. But he bemoans the lack of leadership that has left the United States scrambling to respond. States and municipalities have been left by Washington to fend for themselves.
But he sees a medical community that is mobilized for this unprecedented challenge.
“What has been amazing for me to see is how engaged and ready for the fight the medical community has been,” Santiago said. “And just the commitment to patient care from new doctors who just started their training, to nurses working long hours and making sacrifices to work with their colleagues.”
But, obviously, this is a fight that is only beginning.
“If it gets unleashed, not only will you have morbidity and mortality, you’re going to have something very hard to control,” Santiago said. “We have to mobilize for a sustained and long campaign. We know what we’re up against. What China did will be very hard to do in America or Western Europe.”
It’s entirely possible that the coronavirus epidemic will fall heavily on the people on BMC’s doorstep — many of them people with pre-existing conditions — who will find it hard to socially distance, who will be, as ever, in great need. The people where Jon Santiago’s passions meet.
“This is going to require bold, robust policymaking,” Santiago said. “The Legislature is up to the challenge, and I’m excited to work in that capacity, just as I’m excited to put on my scrubs and work with the next patient.”