The man writhed in agony as he was brought to the hospital by ambulance in the middle of the night.
He was throwing up, complaining of severe pain in his chest and belly. He spoke mostly Spanish, so Dr. Alisheba Hurwitz was summoned.
She ticked off questions emergency room doctors often ask to quickly assess a patient’s condition. What’s going on, the Methodist Hospital physician asked in Spanish. How can I help you? Do you have any medical problems? Are you allergic to any medications? Do you smoke, take drugs?
Have you traveled outside of the U.S. in the last few weeks? It was a question doctors have routinely asked since the Ebola outbreak.
But upon hearing it, the man, still in excruciating pain, bolted upright:
“Tengo pasaporte!” he yelled repeatedly. “Tengo pasaporte!”
“He was terrified,” Hurwitz said, her voice cracking at the memory of the man screaming that he had a passport. “He’s actively vomiting, in distress, and I can’t tell if he’s having a heart attack or what’s going on, because he’s so terrified that I’m going to call immigration."
In the months leading up to President Trump’s election, his promised immigration crackdown front and center, Hurwitz noticed a troubling trend among her patients at the South Philadelphia hospital. Suddenly, they were hesitating to disclose their identities.
She tried to reassure them; doctors weren’t interested in turning them away or handing them over to authorities. She could no more deny them care than she could a U.S. citizen.
"We’ve already decided that some level of health care is a basic human right," she said.
But her patients' anxieties and fears only increased. And now here she was, desperately trying to convince a man that she only wanted to make him better whether he had papers or not. After she was able to stabilize him, he showed her pictures of his young children. He couldn't die, he told her. He was working as hard as he could for them. Everything he did, he did for them.
I wondered how she dealt with that, the emotions of the job that are only getting harder as more immigrants are targeted.
“I write letters,” she said, with a laugh.
She had taken to writing to Sen. Pat Toomey, who supports cutting funding to "sanctuary cities" and Trump's travel ban, and she did again after this latest incident. But this time she asked other colleagues to join her.
"We ask you to speak out actively against the current climate of immigrant persecution. Reject any executive orders that seek to establish a Muslim ban," the letter read. "Voice your disapproval of the plan to waste billions of dollars on a border wall. Defend sanctuary cities, instead of vilifying them. Speak up and speak out, for the health of all Pennsylvanians."
In hope of making the letter more personal, Hurwitz drove all over the city collecting 17 signatures of fellow physicians. With her two young children in tow, she pulled into ambulance bays, met doctors at the ends of their shifts.
“Someday I’m going to have to look my kids in the eye and tell them what I was doing when this was going on, and I have to be able to tell them honestly that I was doing everything I could,” she said.
For Hurwitz and the physicians who signed the letter, their concerns are as much personal as professional.
Hurwitz’ husband is Muslim.
Dr. Priya Mammen’s parents came to the U.S. from India.
Dr. Bon Ku is the son of Korean immigrants.
“Our family always felt safe when seeking medical care,” said Ku, who works at Thomas Jefferson University Hospital. “I never would have imagined a time when patients from other countries would be fearful when seeking care.”
This weekend, Ku is headed to SXSW, the annual music, film, and media festival in Texas, to work on a prototype of a symbol or phrase that doctors can wear or display to convey safety to vulnerable patients.
Hurwitz has taken to wearing a tiny pair of gold earrings in the shape of safety pins, a signal of solidarity with marginalized groups.
Even if they don't speak the same language, she hopes that they notice the earrings and realize that they are safe.