This isn’t a story I ever thought I’d need to tell. But we’re living in a moment where everything has changed, and where saying nothing would make me complicit.
I resigned from my role as a civil surgeon. It wasn’t just about a job, and it wasn’t just about politics. It was an act of protection; personal, ethical, and professional.
For those unfamiliar, a civil surgeon is a physician authorized by the federal government to complete immigration medical exams (Form I-693) for people seeking permanent residency in the United States. Many of us in direct primary care take on this role to meet people at the margins of the system, and to help them safely enter it. For me, it was a way to offer trauma-informed care to immigrants navigating one of the most grueling bureaucratic processes in the U.S. legal system. I saw patients from all over the world. I listened. I learned. I witnessed firsthand how immigration is not “open borders.” It is already a punishing, expensive, unforgiving maze – one that weeds people out for the smallest mistakes. It is already brutal.
And now it’s being militarized.
Today, those same immigrant communities are being targeted in full daylight. Protesters – many of them citizens – are being assaulted, tear-gassed, and surveilled for exercising their First Amendment rights. Peaceful demonstrations that resemble parades – singing, dancing, even horseback riding – are being reclassified as threats. ICE agents and National Guard troops have been deployed without request by state or local leaders. They are showing up masked, unmarked, and unaccountable. Journalists are being turned away or detained. Federal buildings are closing their doors to Congress.
This is not democracy. This is regime behavior.
And I cannot in good conscience participate in a system that weaponizes the immigration process while stripping away its last shreds of decency, oversight, and truth. As a civil surgeon, your name is listed on a federal registry. Patients search for you there. Your business is tethered, however loosely, to a federal infrastructure that now feels less like a system of care and more like a list of names to be watched, tracked, or used.
So I removed mine.
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This was not a decision I made lightly. I have deeply valued the experience of being a civil surgeon. It allowed me to meet extraordinary people – future artists, researchers, parents, physicians, and community leaders. People who are already contributing to this country, and who simply wanted a safe, legal path forward. Some had never seen a U.S. doctor before. I made it a point to make their first experience a good one. I played music. I answered questions. I gave space for fear. I laughed with them. I shared what I could about direct primary care. And to my surprise, some of them took those ideas home. They wanted to recreate DPC in their own countries. That’s how change spreads. Quietly. One person at a time.
Being a civil surgeon wasn’t just a form of care. It was a form of connection. And in stepping away, I am mourning that. But I am also drawing a line. I will not serve a government that ignores the Constitution. I will not aid a federal registry when that registry may be used to harm the very people it claims to help. I will not stand by while peaceful protest is recast as criminal, and public health tools like masking are politicized to the point of collapse.
And I will not be silent.
This act (this resignation) is part of something larger. It is what I now call Medicine in a Moment. It is a practice of witnessing, of speaking, of choosing ethics over silence in real time. It is not a replacement for clinical care. It is an extension of it. It is medicine in the moment we are living through. And this moment demands that we stay awake, informed, grounded, and courageous, however we can.
To be clear, I am still a physician. I am still here. I am still fighting for my patients, my community, and this country.
But I will not participate in a system that has turned medical legitimacy into a weapon, and immigrant wellness into a bargaining chip.
I hope one day I’ll be able to return to that role in good conscience. I hope we all get to return to a country where decency is the norm, not the exception. Until then, I’ll keep practicing medicine in a moment. In this moment.
Because silence is not neutral.
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I cannot in good conscience participate in a system that weaponizes the immigration process while stripping away its last shreds of decency, oversight, and truth.
