Years ago, for a writing class assignment, I began a list to tell a story. My list was modeled after Sei Shonogun’s list “Hateful Things” from her tenth-century classic The Pillow Book. She listed everything she hated about being a lady-in-waiting to the Japanese empress circa 966-1017. I listed everything I hated about working as a family physician in community health centers. I shared my list with friends in primary care, who laughed, said “nailed it!” and encouraged me to share it with others.

I thought “Hmmm….if I publish this, I might get fired,” and stayed silent for years. Then I dusted it off, updated it for the time of COVID, and added explicit acknowledgment of the racism underlying so much of what makes working as a community physician hateful. A decade further into my career, I added a list of tolerable things–the human interactions and the deep meaning of our work that makes working as a community physician so rewarding. Recently, On Hateful Things was published in PULSE, an online literary magazine fostering health care advocacy, with voices from the heart of medicine.

For many years now, I have been silent. Now is not the time to be silent. Silencing ourselves allows oppressive power structures to thrive. Today is the time to use every ounce of our strength and bravery to create the world as we want it to be for tomorrow. Now is the time to talk clearly of our past and our future, to transcend the hateful things–racism, authoritarianism, schisms in the communities we are all a part of–to bring a more tolerable world to life.