Explore This IssueJuly 2020
At some point along this journey I made the choice to speak softly. Self-preservation required that I get to the finish line and avoid as many hurdles as possible. Yet, with each success, the line seemed to move farther way. Sometimes I find myself alone in the infinite and often unpaid and undervalued work of equity and inclusion. I remind myself that helping transform the narrative of race-based medicine in clinical practice is an issue bigger than me. I coach and mentor students and trainees traditionally underrepresented in medicine. I advocate for change. Pushing through my own experiences of implicit and explicit racism, I resist the impulse to surrender. A sense of urgency keeps me moving forward. My persistent presence in academic medicine is activism. I am proud of being a physician leader practicing anti-racism and working toward social justice.
Discussing these concepts is often framed as “difficult.” Recently, I was moved by Dr. Rebekah Fenton, who questioned that narrative when she noted that “Calling our [Black Americans] life experiences difficult implies that treating us as humans is overwhelming or burdensome” (@RFentonMD (Dr. Rebekah Fenton) 1846, 6/5/2020). https://twitter.com/rfentonmd/status/1269052938296557568?2=21). In the midst of a pandemic that lays bare structural racism that disproportionately impacts minority communities, compounded by repeated episodes of police violence that devalue and end Black lives, describing these conversations as “difficult” is distressing. This framing centers the feelings of non-Black colleagues, and I’m left wondering how to walk a fine line between my value and their discomfort.
Interrogating this narrative has transformed my relationship with my true voice. I am exhausted, but I’m also compelled to speak loudly. We have taken an oath to heal—racism is a public health issue, the use of race-based medicine in medical education causes harm, and physicians are activists. Just as we would interrogate, study, and act upon any other disease that causes death and injury, we must also address racism (American Medical Association. “Prioritizing Equity: Police Brutality and COVID-19.” June 4, 2020.).
We all benefit when everyone is valued. Let us evaluate our polices, structures, practices, values, and norms. Let us acknowledge previous harm from inequity. Let us scrutinize how power, resources, and opportunities are allocated. To achieve health equity, we must invest in and empower our minoritized patients and communities. To achieve equity and inclusivity in our workspaces, we must listen to, invest in, and empower Black healthcare professionals. We must create a space for meaningful dialogue that discusses race as a social construct with assigned value that allows racism to persist. The conversations must be ongoing—not only during times of righteous protest. We must develop meaningful, transparent goals and actions in collaboration with minority patients, students, and health professionals. Finally, we must acknowledge that anti-racism is a process rather than an outcome. We must unlearn current structures based on old knowledge and learn hard new truths. Mistakes will be made. But if we’re to embody the change we want to see, we must be open to critique in order to reflect and change course for the better.