The people in Baltimore’s poorest ZIP codes die twenty years before those in the richest. I went to a meeting on Friday to try and help the health of the poorest, at least in the ZIP codes nearest to Johns Hopkins Hospital. Federal funding is behind this, as well as considerable clinical and research expertise.

It was a great meeting with important goals and inspiring ideas. At the same time, I felt like we were all blinding ourselves to a problem. We were talking about engaging patients in their care – vital to be sure, and there are a lot of patients who don’t see their doctors, do real damage to themselves, and don’t participate in what others try and do for them. On the other hand, there is a mountain of mistrust between Baltimore and Hopkins. I felt like we were all trying to look over it, and there it was in the middle of the polished table. 

How do we get over that mountain? Are good intentions and practical deeds enough? Is working with the community enough? Is there a way to apologize and make amends without shooting ourselves in the foot?