Friends, deal plainly with yourselves, and let the eternal light search you and try you, for this will deal plainly with you; it will rip you up, lay you open, and make all manifest that lodgeth within you ... Provoke one another to love ...
Margaret Fell, Epistle to convinced Friends, 1656
I have always known that it was of utmost importance to me that my professional life be congruent with my spiritual values. ln family medicine l have found daily that involves deep listening, caring for all patients equitably, and shaping my skills to be of service to a community. In conducting asylum, I have deepened by experience of bearing witness to suffering, and have seen the value of being heard. I experience trust as a gift, and I know that my trustworthiness is earned.
Fundamental to Quakerism is the belief in the presence of God’s spirit within each living being, and therefore in the equality and dignity of all humans. As such, Quakers have always found themselves involved in work against bias and inequity, and for the benefit of those who live at the margins. Involvement in prison reform and advocacy for the rights of inmates is one such example. At this historical juncture in our country, we are called more urgently than ever to protect and lift up ideals of social justice. We see the broad swath of work before us: combating the school-to-prison pipeline and mass incarceration, joining in efforts to slow climate change, advocating for the poor, supporting Black Lives Matter and other campaigns against racism, and on an individual level, responding with love in this climate of fear and blame. In 2017, the gathered body at the Annual Sessions of New England Yearly Meeting, in considering the importance of supporting refugees and undocumented immigrants, affirmed the following minute:
The theme of 2018 Sessions was “In fear and trembling, be bold in God’s service.” As I sat with the idea, I began to understand the statement as a call to action.
Quakers believe that the worlds we seek is here, now. Some would call it a “blessed community”; others call it the “Kingdom of God.” It is available to all of us because we all live in it, but requires that we all work to create it. Our task is to visualize the world as the just, kind, and loving place that we know and wish it to be, and then to take steps to make it a reality. Those steps require boldness and challenge, and certainly will require accepting change. The process will be uncomfortable, even messy, and we will likely stumble along the way.
The community must be inclusive of everyone, regardless of theology, background, race, gender identity, or financial status. It requires deep and committed listening, and a willingness to take risks together. It requires those of us with privilege to lay down our defensiveness, fragility and guilt as we educate ourselves on our own complicity in racism and other injustices. It requires us all to relinquish a sense of ownership in the outcome, and to participate in the process as a truly shared journey.
This is where the “fear and trembling” comes in. Radical action requires us to allow ourselves to be vulnerable. Letting go of privilege and security is scary. How much risk am I willing to take? As a parent, how can I risk without exposing my family? As a physician, how can I risk without compromising my job or my license? I ask myself: How radical am I willing to be? Conversely, if I am acting as my true self, how can I not be radical?
We will need support as we travel on this journey; only when people are supported can they open themselves to this process. How can I listen deeply to others? How can I show it, and build trust? We also need love. There are many examples around us of strident voices, advocating from a place of anger. But, rather than fueling segregation and fear, we need to build community and trust.
What does this mean to me as a Quaker physician? It means that “serving the community” is not just a matter of practicing clinical skills, but also advocating broadly and fearlessly. I means recognizing and calling out systemic injustices as they affect the community that we care for—that health equity cannot be achieved until societal inequities are resolved. More than systems work, it requires me to engage in personal reflection, to be vulnerable and be willing to change. It means accepting that I benefit from and play a role in perpetuating the inequalities on which our society is built. Once I have acknowledged this, I must then work to dismantle those inequities. The recent closure of Plumley Village Health Services  provided one such opportunity to speak out and speak clearly, to realign my work and my values—though it required making uncomfortable decisions and actions. What comes next?
If I am to act, when is the right moment? Is it now? What will push me to action?
Learn to live your life with all your heart and all your soul and all your mind and love all humankind as you would love yourself … We’ve got home down deep inside because in love we do reside …
(from a folksong)
 Plumley Village Health Services was a clinic integrating public health and primary care services for low-income residents of downtown Worcester. Run by the UMass Medical School, the clinic closed permanently in July 2018 as part of a cost-cutting measure.