Dr. Jack Ludmir, A Champion for Health Access for All
Dr. Ludmir is AL DÍA’s Health archetype for its 2020 Hispanic Heritage Awards.
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Summarizing Jack Ludmir's professional career is almost impossible. Not so much for his years of training and education, but the countless anecdotes and experiences in each episode of his life.
In our more than one hour conversation, Ludmir tried to summarize his profession as "high-risk obstetrician,” but between laughs, he realized there are many stories around this title and they are much more important than what comes on his CV.
Although born in Philadelphia, Ludmir grew up in Peru from the age of four until he was 18, and he feels as comfortable speaking Spanish as he would English. His mind moves at such a speed that he intersperses the answers to questions with questions about who is interviewing him, marking unexpected turns in a common thread that tells of an admirable life.
In the late 1960s, Peru, like much of Latin America, experienced a political crisis linked to the coup d'état of General Juan Velazco Alvarado. And by the early 1970s, the press was gagged, and students were protesting in university courtyards.
A young Ludmir made his debut at only 16 years old at a private medical university when the country’s instability prompted him to continue his education thousands of miles away in the United States.
Although many would believe he was following his father’s footsteps — an obstetrician graduate from the University of Pennsylvania and trained at Jefferson — Ludmir wanted to make his own way.
"Since I was five years old, I would watch my father work in a public hospital from 1636 that he had set up for women and children," he recalls. "I watched the rounds, and I was influenced to follow in the footsteps of the specialty.”
However, "I didn't want to be 'daddy's boy,'" he said.
Taking advantage of the fact that he was born in the U.S., Jack earned credits that transferred him to the University of Pennsylvania. The hardest part of coming stateside was the beginning – and that's a lot to say in a story like Dr. Ludmir's.
Upon arriving in Philadelphia, he remembers the most challenging part was opening his mouth.
"I had a name that is obviously not Hispanic, and they thought I was totally gringo. But I was always afraid to open my mouth and be asked again, 'Where are you from?’” he said.
Ludmir was a gringo who had a very strong Hispanic accent.
"Let me tell you, that was not easy," he assured, but with a smile, he said that "over the years that has changed.”
"That's my strength, instead of being my weakness.”
The second stumbling block was separating himself from his father’s image, a doctor recognized both in Peru and in the rest of Latin America for his excellence and career. To do this, he had to overcome the demands of a very competitive university whose environment, on the contrary, was depressing.
"It was the year ‘75 when the Vietnam War ended, and everyone became super individualistic, and the fight 'for the people' was over," he recalled. "Being at a snob university like UPenn didn't have [the atmosphere] that I was used to [in Peru].”
Thanks to a summer session he had in Louisville, he met the first African American in his life. "Altazo, huge," Ludmir remembered of his first American friend.
"While there are brown people in Peru, and there is discrimination, it wasn't the same tension that there is in this country, obviously," he said of his experience after meeting one of his best friends and, through him, the reality of a country that existed far from the Ivy League classrooms.
His friend took him to where Muhammad Ali was born and it opened his eyes, teaching him about segregation, which had ended just a few years before.
Back at UPenn, another of his best friends was "a Black guy from St. Louis," who was studying Spanish and was openly gay, which was unusual for the time.
"It was this friendship that taught me to see other facets of the country, just like another friend from Texas whose parents were undocumented," he recalled.
He then learned about the diversity of color and civil realities that are juxtaposed in a single society like in the U.S.
After a couple of years, the young Ludmir was accepted to several medical schools in Philly, finally choosing Temple. Their facilities were in a neighborhood of color, and they offered medical care to vulnerable populations, including the second-largest group of the Puerto Rican diaspora in the nation.
"There I realized how the color of your skin puts you in different categories," he said.
From Temple, he was accepted to do his training and residency at the University of Pennsylvania Hospital, while spending summers in Peru working at his father's hospital.
"I obviously had a much more advanced surgical skill than any of the other residents," he recalled, "but I liked the complicated stuff.”
It’s why Ludmir explored research on the impact of synthetic hormones on pregnant women during the 1950s and ‘60s, developed new forms of treatment for women with a cervix that dilated prematurely during pregnancy, and looked into the use of ultrasound for pathology evaluation.
Thanks to that research, Ludmir was recruited to Boston in 1992. While still very young, his academic advancement was unprecedented.
As a researcher, he became director of obstetrics and high-risk medicine at one of Harvard's hospitals, and one of the youngest people to ever be promoted to the position.
Six years later, he would return to Pennsylvania when he was offered to be the head of the largest obstetric service in the country, which Ludmir would radically transform.
"One of my mottos was 'we treat everyone the same, no matter who they are or their ability to pay,'" he said. "It was a little shocking, but it was my rule. I was very strict about that, and I started approaching poor people.”
From health centers in displaced areas to close neighborhoods, the young doctor's program promised to take care of everyone, without distinction.
At the turn of the millennium, Philadelphia-area obstetric services began closing one by one for medicolegal issues. In the meantime, Ludmir's service continued, and he traveled to all corners of Latin America with his research projects, gradually becoming a champion for health access rights.
"I went to all the public hospitals to see how they treated the poor, especially women," he said.
"I would embarrass anyone, and I didn't care if it was the president, the minister of health or whatever," Ludmir said of his anger at seeing patients being abused. "What hurt me the most was when my own colleagues said, 'It's okay, these are poor people, this woman doesn't know anything.’”
However, Ludmir repeated his motto as if it were a mantra: "Dignity and respect, no matter who you are.”
After years of advocating for everyone’s rights in Latin America, Ludmir began to see an increase in the rate of Hispanic patients coming to his Philadelphia hospital in labor without any prenatal care.
"Being in Philadelphia, in the richest country in the world... that surprised me," he said.
Along with a colleague who had experience with immigrant populations, Ludmir realized that they were Mexican immigrant families with work permits in the mushroom fields outside the city that had the right to work, but not the right to health care.
"I started digging and realized that I didn't have to go to any country to help because there were people here who needed access to health care," Ludmir said. "Because in this state, in the state of Pennsylvania, if you are undocumented, you don't have access to health care, and especially if you are pregnant, you don't have access to health care.”
He realized how a child born on American soil had a completely different circumstance in the kind of health care she or he received than the care the mother deserved from institutions.
That experience would mark the rest of his professional career, which has since been devoted to serving the region’s immigrant communities.
In an allegory to his work, Ludmir decided to co-found the non-profit association, Puentes de Salud, where they provide women with the prenatal care and attention they need, again, without any distinction.
Hand in hand with his wife who, according to Ludmir, "is who runs everything," and after a sabbatical working in Colombia during the Zika virus epidemic, the doctor decided he no longer wanted to be a department head, but to work with his boots on the ground, where he could really make a difference.
"I've become very sensitive to minorities, to immigrants, to refugees," he confessed.
Since then, he has opened other clinics, faced rejection because of his commitment to the immigrant community, and a pandemic that is hitting the most vulnerable areas, while politics is playing out in the rest of the country.
However, his commitment is stoic.
"I can tell you that I have perhaps the largest private practice in Philadelphia of women who don't pay a cent, and who have access to us 24 hours a day, seven days a week," said Ludmir.
Together with the Jefferson Latina Women's Clinic and the Philadelphia Initiative for Collaborative Health Equity, Ludmir makes Hispanic Heritage Month an everyday occurrence.
"For me, it makes no difference," he said. "I live this 24/7, I'm connected to the world, to values, to cultures, and I know the difference between people who come from different countries.”
"For me, the fact of the heritage that one carries as a Hispanic, is not that all are the same because every place is different, every place in Latin America has its own idiosyncrasy, and its own way of seeing the world, and obviously the social and cultural level of each one gives it a different perspective," he concluded. "For me, Hispanic Heritage Month means the daily recognition, not just once a month, daily, that the Hispanic community has many manifestations, that people come from different towns and different social strata, and for me, it is that respect for those differences and that richness of being different that you can put under that umbrella.”