Detained!!!

By Robin Canada, MD, Penn Medicine, and Jane Abernethy, MD, MBE, Johns Hopkins Medicine 

A patient, still recovering from a recent stroke, stepped outside his home one quiet morning headed to work. He expected an ordinary day. Within moments, he and two family members were pulled into an SUV by four masked, plainclothes men. There was no warrant. No explanation. Just fear and confusion. 

His wife, witnessing the abduction, had the presence of mind to film the encounter and immediately messaged a staff member from his doctor’s office. The men were agents from Immigration and Customs Enforcement (ICE). And the clock had started ticking. 

As healthcare professionals, we’re trained to recognize medical emergencies. But when our patients are detained, the emergency extends beyond the hospital—into legal systems, consulates, and courtrooms. In this case, his medical team acted quickly, writing a letter of medical necessity that detailed the patient’s urgent need for blood pressure medication, blood thinners, and cardiology follow-up to prevent a second stroke. That letter was shared with legal partners and the patient’s home country’s consulate. 

Guided by trusted advocates, the family secured a vetted private attorney and raised funds for bond through a GoFundMe campaign. After two weeks in detention, the patient was released with an ankle monitor. He’s now back home, awaiting an asylum hearing, and continuing his medical care. 

Not all patients are as fortunate. Many remain in detention without access to medical care or the legal support needed to seek release. But even when success feels unlikely, taking action affirms our values and gives our patients the best possible chance for safety and care. This story and others like it underscore how essential it is to be prepared before a crisis unfolds. Healthcare does not operate in isolation; it’s deeply intertwined with legal and social systems that can either uphold or undermine our patients’ well-being. When immigration enforcement threatens access to essential care, our ethical and professional duties—to respect persons and prevent harm—demand that we respond. In these moments, we’re called to serve not only as clinicians, but as stewards of our patients’ dignity, safety, and fundamental rights. 

As this landscape continues to shift, it’s more important than ever for clinicians to collaborate, share strategies, and learn from one another. Building collective knowledge about what works will strengthen our ability to respond effectively and humanely when our patients are placed at risk. 

Here are a few things we’ve learned: 

1. Build medical-legal partnerships before emergencies happen.

Connect with trusted immigration legal organizations in your area. Know which ones offer emergency after-hours support. Proactively ask for direct contact numbers to use in time-sensitive situations. 

2. Be aware of predatory legal practices.

Work with legal partners to identify reputable immigration attorneys. Providing families with a vetted list is crucial when they’re vulnerable and desperate for help.

3. Engage consulates.

Establish a relationship with your local consulate’s office. In this case, the consulate delivered the medical letter of necessity to ICE—an intervention that helped secure the patient’s release.

4. Act immediately.

A letter of medical necessity should be written and sent the same day a patient is detained. Include the patient’s diagnosis, risks of interrupted treatment, and necessary follow-up care. For some patients, it may make sense to provide them with this letter to carry with them.

5. Educate patients and colleagues.

Support “Know Your Rights” workshops. Distribute Know Your Rights Red Cards and resources about what to do if a loved one is detained. Create space for peer learning by sharing effective advocacy strategies across clinical teams and institutions.

This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.