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Nathan Chomilo is dressed in light blue scrubs, seeing children this Saturday morning for their routine checkups.
As he examines Zuri Fritz, whose parents have brought her to Park Nicollet’s Brooklyn Center clinic for her four-month checkup, Chomilo leans on the patient room bed with his left hand on his hip. Baby Fritz is drooling.
“They start exploring the world through their mouth at this age,” Chomilo says, sharing a laugh with the girl’s parents, Precious and Nathan Fritz.
This is a typical morning shift for Dr. Chomilo, who has been a practicing pediatrician and internal medicine doctor for seven years.
Toward the end of the visit, Fritz’s father asks Chomilo when his daughter may be eligible for a COVID-19 vaccine.
“You’re pretty involved in that, right?” he asks Chomilo. “I saw you on TV.”
Chomilo indeed made the news the week before by helping promote a vaccine event held at the Urban League Twin Cities parking lot in North Minneapolis. He frequently shows up in local media, usually speaking about one of his great passions, health equity. Most recently, that’s been in his role as the state’s COVID-19 vaccine equity director, which he took in March.
It’s not Chomilo’s only professional role with the state. Just before the pandemic, the Minnesota Department of Human Services tapped Chomilo to be medical director for the state’s Medicaid program.
Those responsibilities limit him to being at the doctor’s office every other Saturday. This morning, he’s a pediatrician with a casual and easygoing demeanor. When looking for their daughter’s pediatrician, both Precious and Nathan Fritz heard of Chomilo through a friend whose child he also sees. One thing both were seeking for their daughter, who is biracial, was a doctor of color.
Precious, who is Black, said she’s had experiences in the doctor’s office where she felt her voice wasn’t heard.
“I just want her to be represented,” she said of her daughter.
Both parents say that Chomilo pays attention to the details. Holly Davis and David Policard agree. Chomilo is the pediatrician for their 1-year-old son, Xavier, who is also biracial. Last fall, Holly and David were weighing the risks and benefits of a family trip to Haiti, where David is originally from, during the height of the pandemic so their son could meet his grandmother for the first time. Chomilo, whose own parents are originally from Cameroon, helped them navigate their decision to ultimately visit Haiti for one week last November.
“We didn’t get a, ‘Oh my God, why are you traveling with him? Why are you going out of the country?’” David said.
Holly added: “He understands that we have family elsewhere.”
From X-Men to the doctor’s office
Chomilo describes his personality as goofy and nerdy.
During his summers growing up in the Twin Cities suburbs, Chomilo recalls spending whole days at the library reading comic books. He liked Justice League, Black Panther, and in particular X-Men, the superhero story about mutant humans who are looked down on by society.
“They were different, they were treated differently, and they had these amazing superpowers,” he said. “And this idea of, ‘What’s the best way to justify your existence in society? Helping or taking power?’”
Chomilo, 38, said that his personality led him to both becoming a doctor and choosing to treat kids. Before becoming a doctor, he worked with kids as a camp counselor and a soccer coach.
He also has a serious side. Over the past few years, Chomilo has emerged as one of the state’s most prominent and outspoken public voices on health equity.
That social justice activism and focus on policy led him to his two prominent roles in state government. Though he’s the first doctor in the family, Chomilo comes from a long line of health professionals. His father, recently retired, worked as a pharmacist. His mother worked as a nurse.
Although his mother was born in Cameroon, her family is Norwegian; her own mother moved to the West African country to do missionary work for the Lutheran Church. His father, who was born and raised in Cameroon, followed in his aunt’s footsteps by moving to Minnesota. Though they were both from Cameroon, Chomilo’s parents first met at the University of Minnesota.
Chomilo describes his interest in social justice and health equity as a gradual journey. Growing up in the affluent, predominantly white suburb of Eden Prairie, Chomilo said he initially bought into the idea of meritocracy.
“My dad coming from Cameroon, working hard and getting to where he is was like, well, you work hard and you get your just rewards,” he said.
During his first few years in medical school at the University of Minnesota, Chomilo saw firsthand examples of how social conditions determine health. Much of this came during a three-month medical rotation at the university’s Broadway Family Medicine Clinic in North Minneapolis, where many of the patients come from underserved communities.
“I was learning about all of these cutting-edge developments in medicine,” he said. “But literally miles away, there were folks who couldn’t get access to their basic diabetes care, or their hypertension care, or their mental health care. There was a disconnect there. To keep pushing medicine to develop all these new things, but not figure out how to make sure everyone has the same access to all of that just didn’t seem right.”
One event, however, really changed him: the 2016 police killing of Philando Castile. Speaking about it five years later, Chomilo still tears up.
He remembers shopping in a Target when he first found out and watched the cell phone video of Castile’s death. Several things about it resonated with Chomilo. The child in the back seat of the car who witnessed a police officer kill his mother’s boyfriend. The fact that it happened one mile away from where Chomilo asked his father-in-law for his wife’s hand in marriage. The fact that Castile was close to the same age as Chomilo, and also Black.
“That one did it for me,” Chomilo said. “It was just, I have to be able to do more.”
Castile’s killing led to a lot of self-reflection, he said, and a lot of self-education about how racism influences medicine.
Ending race-based medicine
One place where Chomilo successfully merged his social activism with his profession is at the American Academy of Pediatrics. With others, he got the professional association to commit to stop publishing medical articles using race-based medicine. Race-based medicine, Chomilo explained, uses a person’s race to determine their treatment.
A modern example of race-based medicine, Chomilo said, is kidney function tests. A doctor determines a patient’s kidney function with a blood test. If that patient is Black, doctors are instructed to put in an equation that adds to that patient’s kidney function score. This equation was based on an assumption that Black people have higher muscle mass than white people.
Such assumptions are wrong for two reasons, Chomilo explained. First, because race is a social and political construct, not a biological one. And second, because doctors have no professional mechanism to determine a patient’s race.
Another way Chomilo brings his equity work into the patient’s room is during the 3-year-old checkup. That’s when he brings up racial identity.
Children around this age start forming their own identities and start noticing people may be treated differently because of their skin color or gender, he usually tells parents toward the end of the checkup. Messages children get from the books they read and the movies and TV shows they watch influence their understanding of identity. So do the things parents tell their children on the subject.
“I really encourage parents to be intentional and think about what messages they may be sending, on purpose or not,” Chomilo said.
Chomilo said he’s constantly tweaking and refining how he approaches the subject in the patient room as he learns more. His patients, he said, are noticing.