Why am I writing?

Who I am

• My name is Mike Sportiello.
• I'm a physician-scientist serving the people of Atlanta, Georgia.
• I obtained my MD-PhD in Rochester, NY.
• I like to run outside.
• You can contact me at [email protected]

Where I'm coming from

I became a physician to help people free themselves of the barriers that weigh their life down. For some, the barrier is the inability to feel the wind through their hair biking down a hill without having an asthma attack. Others wish they could focus better on the books that they're reading. Others need help keeping their HIV viral load down to avoid opportunistic infections.

Physicians are lucky that our profession operates in the material and the idealogical. Patients come to us often explicitly stating their values. This is often followed by a material ask. Some extend a political analysis on their own.

Value statement

I want to be a good partner to my wife, and she says it's harder to breathe after I come in from a smoke. My brother recently got diagnosed with cancer too, and I can't believe it took all of this to get me to try to really quit smoking.

Material ask

I need help quitting, maybe a prescription or something.

Political analysis

It shouldn't be legal to do what those tobacco companies did to me, making a profit off of an addiction to something that gives me cancer. I can't believe I put money in those people's pockets.

It's this iterative practice with patients, going back and forth with them on how we can help and supplying some of our own political analysis, that I so enjoy, because it's often this more than the supplying of medication that they remember and that makes them feel most humanized and individualized. Practicing medicine is, in many ways, not so different from opening up one's kitchen: it's not the flavors people remember when they get up from your table, but often how you treated them as guests in your home, how you made them feel. I think the best medicine I've practiced, and the best I've made patients feel, have involved explicit political conversations. When I worked at the syringe access program in Rochester, I wasn't perscribing any medications at all, but we were cooking them food and dressing their injection wounds. We were giving them access to a toilet and a social worker, not to mention sterile needles and naloxone. I've discussed the culpability of big pharma, perscribers, a broken safety net, a broken policing system, a corrupt mayor, and more explictly with these patients week in and week out. I've also discussed a more positive politics, a politics of patients who came to bring extra food and warm clothes to their roommates who couldn't make it down in time to share, or for extra naloxone, something with essentially no street value, to bring to areas of high concentrations of drug use. I wish every health care space in which I operate could be as explictly political as those patients in Rochester made it.

I'm also a scientist. I earned my PhD studying memory T cells, a part of our immune system that prevents future infections after an initial infection. In addition, I've studied the role of social factors in the success of infection treatment. I'm a scientist because I believe it's learning more about our world and health care systems that allows us remove the barriers patients experience. There are those who say science is apolitical. Just like medicine, this couldn't be further from the truth. Just like the decision to treat a person dying from HIV or to let them die, something explicitly argued over early on in the HIV pandemic, the decision to spend research dollars on HIV or not continues to be argued.