Essays and poetry celebrating the lives of healthcare students, educators, and practitioners.
Monday, January 30, 2023
Reflecting the Change You Want to See – The Importance of Involvement in Equity and Inclusion Initiatives
Monday, December 19, 2022
“Is There a Doctor Onboard?” Doctoring and Prayers at 35,000 Feet
From the December 16, 2022 Spiritually in Medicine issue of the Transformational Times
“Is There a Doctor Onboard?” Doctoring and Prayers at 35,000 Feet
By Adina Kalet, MD, MPH
Given the theme of Spirituality in Medicine in this week’s Transformational Times, Dr. Kalet shares the most recent of many experiences she has had answering the overhead call on airplanes. In this case, the faith traditions of both the doctor and of the patient led to series of surprises and unique styles of gratitude for caring and kindness expressed in prayer …
Given that I was listening to a movie through my headphones while my hands were busy knitting, the announcement just barely registered. We were three hours away from our destination, and a long, uncomfortable eight hours into our flight. After a few seconds delay, I untangled myself and headed toward the uniformed purser standing in the aisle.
“I am a doctor. How can I help?” She looked me over and nodded discretely toward the young, pale, diaphoretic, and mildly distressed bearded man slumped in his seat.
The flight attendant whispered, “He is asking for medication, but I can’t administer anything without a physicians order.” She gestured to her handheld device. “This is what we have available.” She looked back-and-forth from the man in the seat to me. “We are over land now, so if you decide…” Her voice trailed off, suggesting that, on my say-so, they were prepared to land the plane.
“Give me a minute to assess the situation,” I said. She offered to retrieve a blood pressure cuff and oxygen tank.
My new patient’s religious garb, facial hair, and head covering told me that he was part of an Ultra-Orthodox Jewish family. I grabbed my sweater and covered my bare shoulders since, in his culture—one I know intimately—modesty is paramount. In his community’s view of the world, a secular appearing, barefooted and bareheaded woman might be dismissed or treated with suspicion. I assumed he would avoid eye contact and refuse to let me touch him. To be trusted enough to make an accurate medical assessment, I needed to minimize the barriers.
Leaning over him, I introduced myself and asked him to tell me what was going on. I was happy to see that he was fully awake and alert, spoke fluent mildly-accented English, was willing to make eye contact, and seemed eager for my help. He described his weakness, dizziness, and nausea. After asking permission, I carefully and firmly ran my hand over the key locations (no belly, chest, or calf tenderness) landing on his wrist to feel for his radial pulse. I engaged him in conversation about his health and recent events as I monitored the cardiac rate and rhythm. He had been perfectly healthy and described no ominous symptoms.
The relatives surrounding him were eager to tell me that they had all spent the day before in a hospital emergency room with a beloved relative. As his uncle graphically described the details of how the old woman had fallen and had sustained a nasty, bloody gash, my patient became paler, his heart rate went up, and his pulse became “thready.” Before long, he was dry heaving into a plastic bag. Clearly, the stress of hearing the story again was taking a toll. I expressed my empathy for the upsetting situation to the group. My patient’s pulse slowed a bit.
The flight attendant handed me the automatic blood pressure device. As I wrapped the cuff around his arm, I confirmed he had eaten little, had slept poorly, and had not had anything to drink during the flight because the options were not guaranteed to meet his religious requirements. The machine finished its reading and, although not dangerous, his blood pressure was quite low.
We laid him as flat as the airplane seat would allow and elevated his legs. I assessed the width of the aisle just in case we needed to get him on his back. Happily, his blood pressure climbed a bit and his pulse headed toward normal.
The flight attendant pointed out that we were seven miles above the Earth, and some supplemental oxygen might help. We put the mask on him and started the flow. He “pinked” up immediately, and his nausea resolved. Soon, he was able and eager to drink fluids. As time passed, his symptoms resolved, and he felt stronger.
I spent a few minutes talking with his relatives, including the old woman with the fresh stitches and a bandage above her eye. I was able to fend off one of his aunts who offered several nonspecific pills she had in her carry-on bag. Everyone noticeably relaxed and soon I felt comfortable enough to return to my seat.
The flight attendant stopped by, reporting that she had told the pilot we were not anticipating an emergency landing. She offered me a gift from the airline which I tried to refuse but, in the end, I accepted some extra miles for my frequent flyer account.
After a while, the patient’s aunt came by, an emissary from the senior male members of the family. She thanked me profusely for my help, then said, “Your smile and gentleness are a blessing from G-d! You didn’t need to be kind, but you were.” The family wanted to give me something in return for my kindness.
“No!” I said. “That is very kind, but this is my work. There is no need for gifts.”
“Well, then,” she replied, “you will be in our daily prayers.” She nodded, thanked me again, and returned to her seat. I smiled, found my headphones, and went back to my knitting.
I was relieved that things turned out so well; they don’t always. This was not my first rodeo. I have had a few opportunities to answer “the call” on airplanes, at the theater, and on the sidewalk. Given the settings, the medical intervention and decision-making options are severely limited. Had the situation worsened, and I had needed extra hands to help start an IV or do chest compressions, I suspect other healthcare workers might have appeared, or the trained crew members would have been there to assist. Depending on the acuity of the crisis, I might have recommended to the pilot that she land the plane.
But, on this day, that was not what was needed. In the end, what was most needed and appreciated was kindness. This experience, as well as medical student Sarah Root, in her essay in this issue of the Transformational Times, reminds me once again, through the the words of Sarah’s physician grandfather, “that medicine is not just a practice, but a privilege.”
We reached our destination and headed our separate ways. I am humbled to know that there is a family, not so very different from my own, that is prayerfully grateful for our moments together at 35,000 feet.
Adina Kalet, MD MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.
Thursday, April 1, 2021
The news from Atlanta this week is horrifying
From the 3/19/2021 newsletter
The news from Atlanta this week is horrifying.
A gunman took the lives of eight people, six of whom were Asian women. This has been one among many recent hateful crimes that have terrorized the Asian American community. Every one of us at The Kern Institute expresses our unconditional support for this community, and we want to express our love and concern for MCW’s Asian students, trainees, faculty and staff during this acutely difficult time. We continue to invite dialogue about racism, discrimination, character, caring, compassion and medical education because we understand that it is only in bringing these discussions into the light that we might learn from one another and be a part of changing our profession and our world for the better.
Friday, February 5, 2021
Providing Space to Shed Tears may be Key to a Better Post-COVID Future
From the 2/5/2021 newsletter
Director’s Corner
Providing Space to Shed Tears may be Key to a Better Post-COVID Future
By Adina Kalet, MD MPH
COVID-19 is wreaking havoc in the lives of working women. In this Director’s Corner, Dr. Kalet shares some learnings from Dr. Ellinas’s work in the Center for the Advancement of Women in Science and Medicine (AWSM) and talks about what to do when someone cries …
Over the past couple of weeks, I have witnessed more tears among my colleagues and mentees than I normally see in a year. Even though I care deeply, I am not particularly worried about those who have cried. I find it reassuring that they reached out, seeking support and a reliable pep talk. I know that while shedding tears in someone else’s presence makes one vulnerable, it is also a sign of strength, resilience, and self-care. These individuals are bending under the prolonged pressures of the COVID pandemic but are unlikely to break.
On January 21, 2021, Libby Ellinas, MD, Director of the MCW Center for the Advancement of Women in Science and Medicine (AWSM), Associate Dean for Women's Leadership, and Professor of Anesthesiology at MCW, gave Kern Institute Grand Rounds on Women in COVID. Her talk was a tour de force of cautionary tales and sobering data. She reminded us that the majority of people on the front lines of healthcare and education – and nearly half of our medical school faculty – are women. Data from multiple sources are consistent: women as a group are under special pressures during this pandemic. This poses a threat to both our medical education and health care systems.
The ways in which COVID-19 has disproportionately affected women
Dr. Ellinas shared survey data from the USC Dornsife Center for Economic and Social Research confirming that the mental load – including concerns about the health of their families, themselves, and financial strain – is significantly higher among women compared with men. And while married men with children have the lowest mental distress, women with children have, by far, the highest. This is not news. Sociologists have shown over-and-over that being married with children is associated with better health and more happiness for men while, for women, being married/partnered with children is associated with relatively high levels of stress and distress. Women do measurably more emotional work than men, both in families and at work. While often this work is energizing, it is a mental load that can overwhelm.
Among MCW faculty members, Dr. Ellinas demonstrated that the social isolation necessitated by the pandemic is wreaking havoc for working women. With schools inconsistently in session, direct childcare hours have increased for both men and women, but the number of additional hours per week has been greater for women. Data from an MCW AWSM COVID survey show that while nearly 60% of male faculty have spouses employed part-time or not at all, this is true for only 21% of female faculty. Thus, MCW working women with families are much less likely to have robust support systems than their male counterparts.
There is also heterogeneity in how COVID-19 increases stress. Some find value in working from home, but many do not. Clearly, working from home – for those privileged to be able to do so – allows more flexibility and autonomy, reduces time spent commuting, and decreases costs associated with working away from home. It might even provide unexpected “quality time” with family. However, especially for working women with school-aged children, working from home is associated with less sleep and decreased self-care. Adding to this, the intersectionality of race and gender can weigh even more heavily on Black and Brown women.
And, as if that wasn’t challenging enough, there are signs that the COVID-19 pandemic negatively impacts the academic productivity of early-career women more that it does men. The long-term impact of this is worrisome and may lead to the reversal of recent gains in women’s academic status on the whole. These are challenges for us all.
Institutional solutions are critical and complex
What did Dr. Ellinas recommend? She offered a number of institutional recommendations that are consistent with AWSM’s inspiring and audacious vision that “MCW will be a destination for women leaders, cultivating an inclusive and vibrant culture that supports all genders to grow and thrive in the health sciences,” and mission “to advance the careers of women at MCW through data-informed strategic projects that enhance opportunity and improve workplace climate.
- Evaluating leadership structures to ensure women are well represented in decision making
- Valuing parenting through generous parental leave and creative childcare
- Supporting women to “step forward” rather than depending on “step back” policies
- Valuing the hard work of mentoring, equity, diversity, and inclusion
- Valorizing women role models for us all
We need policies that can be individualized and flexible over time. Extraordinary caregiving responsibilities may be acute, due to an illness or urgent need, chronic, as in having a child with special needs or an aging relative with evolving needs, or both, as in this stuttering pandemic. Community resources are distributed unevenly. Some people do not have enough help while others have what they need, if not to excess. Institutions like ours can improve the quality of life for our employees and community by offering concrete services, such as low-cost, high-quality childcare, sick childcare, food preparation and delivery, and help with chores.
To support women (and men) whose academic careers have been impacted by the pandemic, some institutions have found ways to provide assistance that enable researchers to continue collecting and analyzing data while they tend to a “special” personal need. One program, the Doris Duke Fund for the Retention of Clinical Scientists (see “For Further Reading” below), has funded such efforts. Many workplaces provide access to high quality food, recreation, and other wellness services. Much can be done.
How do we, as an institution, come out of COVID-19 better and stronger? We need a flexible range of options going forward that includes working from home. Our men need to engage. We all need to honestly complete surveys to have quality data that inform best solutions. Men who have the relative privilege of having more support at home and at work – as well as having disproportionately higher salaries – need to be allies and advocates for equity and flexibility. No one should assume that they, alone, know what will work; we need to ask women. Don’t insist on “fairness” or “equality” until you have a full-thickness view of the situation.
Back to crying
I have always kept a box of tissues on my desk. When seeing patients, the box was discretely tucked just out of view, easily slid toward the patient at the first glisten in the eyes. As a colleague and mentor, the box would be brought forward when the face flushed, the head dropped, and the tears rolled. It has been my experience that, most of the time, a good cry in the presence of an empathic other is the most efficient way to clear the air and help the words and problem-solving flow. People cry for all sorts of reasons. Sometimes it is sadness and grief, but just as often people cry because they are overwhelmed, angry or frustrated. I have come to believe that an effective mentor, like the good physician, must learn to invite and sit with the tears of others without needing to fix anything; just listen, sit quietly, check in. Fighting back tears takes energy, blocks thinking, and keeps others away. Letting tears fall clears the air and loosens the voice.
Did I say that it is mostly women who shed tears in my office? Well, it is. But occasionally, the men cry as well. Three times in the past three weeks, I have spoken with distraught educational leaders, people who are deeply respected by colleagues and beloved by trainees. They were emotionally and physically exhausted from the expanding and rapidly evolving needs of school-aged children and elderly parents. They had less help from their working spouse than they needed. Their jobs presented new and growing demands on themselves and their trainees (e.g., being “deployed” to care for critically ill COVID-19 patients). They feared a loss of income. They were at the brink.
In each case, I pushed the virtual box of tissues. Why doesn’t Zoom design a “tissue box” emoji?
I hope my message is clear: It is okay to cry here. I am not afraid of your tears. I will hear you out and empathize. You are not crazy, this is hard. I know you will find your way through this. I will help if I can.
These folks do not need to be fixed, they just need a shoulder to cry on, a good night’s rest, regular meals, and an occasional walk in the woods. I think we can get them that.
For further reading:
Jagsi, R, Jones, RD, Griffith, KA, Brady, KT, Brown, AJ, Davis, RD, ... & Myers, ER (2018). An innovative program to support gender equity and success in academic medicine: Early experiences from the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists. Annals of Internal Medicine, 169(2), 128-130.
Jones, RD, Miller, J, Vitous, CA, Krenz, C, Brady, KT, Brown, AJ, ... & Jagsi, R (2020). From Stigma to Validation: A Qualitative Assessment of a Novel National Program to Improve Retention of Physician-Scientists with Caregiving Responsibilities. Journal of Women's Health, 29(12), 1547-1558.
Adina Kalet, MD MPH is the Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.
Thursday, December 24, 2020
The Patient Told Me “You cannot take care of me. You’re black and I don’t like black people.” How Do You Respond?
From the 12/18/2020 newsletter
Perspective
The Patient Told Me “You cannot take care of me. You’re black and I don’t like black people.” How Do You Respond?
Victor Redmon, MD
Dr. Redmon, a resident in the Med/Peds Program, shares what he has learned about speaking up when experiencing or witnessing moments of injustice …
My name is Victor Redmon. I am a fourth-year internal medicine and pediatrics resident here at the Medical College of Wisconsin Affiliate Hospitals (MCWAH). I have served on the MCWAH Diversity and Inclusion (D/I) Committee since my intern year. Given the current political landscape and the ever-present pandemic, we felt it necessary to put out a narrative centered around “accountability,” both for yourself and your colleagues around you.
The year of 2020 has been one for the ages. I have been more cognizant of reading articles addressing intolerance, injustice, and micro-aggressions this year, more so than in years past. A student of mine recently asked me particularly good questions about accountability and when to speak up for yourself and others, when either your colleagues or patients make insensitive remarks. I do not know if I gave him the best answer at the time, partly because I do not know if there is one right answer give.
A patient care story
In medical school, I was taking care of a woman during my third-year internal medicine clerkship. She was Caucasian and in her 60s. We were treating her for a pneumonia, UTI and encephalopathy. She was admitted overnight and the next morning I decided to follow her as one of my primary patients. I walked in the room alone and introduced myself along with my role on the team. She took one look at me and said, “You cannot take care of me. You’re black and I don’t like black people.” I paused and then she went ahead to ramble on about other things that didn’t make much sense. I asked permission to examine her and she stopped talking and let me perform my examination. Once I was done, I thanked her and told her I would see her later in the day. She said “Okay, but I don’t like black people.” As we continued to treat her infections, she became more coherent and "with it.”
The next day when I went to see her, she greeted me with a “Good morning,”
I replied back, “Good morning. It looks like you are feeling better today.”
She said, “Yes, I am. Who are you?”
I realized that she did not remember our first encounter, so I re-introduced myself. She thanked me and the team for our treatments. The rest of the encounter with her was very pleasant and we discharged her home eventually.
I keep thinking about how and why I handled this encounter the way I did. I knew the patient was delirious from her active infections and hospitalization. Does that give her a pass for what she said to me? How much truth was in her words? I never told anyone on my team about what she said to me. Not my fellow third-year student colleague, not my intern, not my senior resident and not my attending. Why did I choose not to?
Another patient care story
During my second year of residency, I was senior resident of one the medical ward teams at the VA. We had a patient who was notorious for his abuse of the health system, bigotry, and sexism. He was homeless, and every time he was admitted to the hospital, it was a saga to get him discharged. If you worked at the VA long enough, you knew this guy by name alone. You were either on his good side or his bad side. I had taken care of him several times in the past, starting when I was still a medical student. The patient and I had a good doctor-patient relationship, and he was never disrespectful to me. I wish I could say that for others.
My third day on the team, my intern following this particular patient came back to the room laughing. I chuckled and asked him what was so funny. “Oh Mr. So-and-So being Mr. So-and-So,” he replied, “he’s not so bad if you’re on his good side.” The patient had been medically ready for discharge for weeks and we had been working with social work and case management to find him a place to stay since he required home oxygen therapy. After rounds, my attending went to speak with the patient alone to basically tell him that he will be discharged the following day, and he could not stay in the hospital any longer. My intern, who was of East Asian descent, was now very nervous about how this will affect his relationship with the patient. I told him that the patient would be more likely to be mad at the attending, but I offered to be there for him if he needed me. My intern declined and said, “I’ll just see how it goes.”
The next day, my intern came in laughing again: “Mr. So-and-So being Mr. So-and-So.” I took it as a positive sign and moved on. During rounds, my attending asked how Mr. So-and-So was doing today. My intern said “He’s fine, nothing has changed medically. But he hates you,” referring to my attending. My intern then said, “He says he never wants to see ‘that brown, Jihad *********** again’.”
This statement is wrong on so many levels. My intern then laughed it off. My attending, of Indian descent, was silent for a moment, but then said, “Well unfortunately, he doesn’t have a choice.” I looked around and the rest of the team (the other intern and two medical students) was dead silent. As a team we moved on and finished rounds. The patient was discharged without much drama.
Internally, I was an emotional wreck. I felt anger, remorse, shock and regret all at once. I didn’t know how to respond in that moment. I was with people I had not grown comfortable with yet, so I froze and didn’t respond at all.
The following day was switch day for both the interns and the attending, so I had a whole new team. Approaching the patient about what he said would have not been a battle worth fighting. However, I never approached anyone else on the team about what was said, how they felt and how we could have done things differently. I missed an opportunity to point out intolerance and injustice and to take a stance on a perpetuated culture that needs to end. I feel like I failed my team. I feel like I failed as a leader.
What I have realized
I could continue to write about countless stories that are similar and worse than which I discussed above.
Whatever personal accounts or stories that my friends and colleagues have experienced, these types of encounters happen every single day. Often, we are silent and decide not to say anything so we can keep the peace. I no longer regret being timid in those moments. I felt I was doing what was necessary to “survive” and progress to where I want to be in life. I imagine that others have taken similar stances for similar reasons.
I do not think there one “right or wrong” way to handle these situations, but I do think it is a reflection on how little improvement we have made as a society in addressing these issues.
I realize now that it is not about me or one person at a given time. It’s about all of us as a society. As a medical society, we have a significant impact on our communities, especially the marginalized communities. It does not matter if you are a medical student, a physician, nurse practitioner, physician assistant, a nurse, a medical assistant, a physical therapist, or a speech therapist. You have a voice. You have a platform to use to speak out against injustice, intolerance, and micro-aggressions that we too often meet in our work environment.
I am far from perfect and I do not pretend to be free of my own implicit biases. I hope to further an inclusive culture. I want to be called out if I am being insensitive or have a moment of intolerance -- because that’s how we grow as humans. I hope that I can learn from my failures and successes. At the same time, I hope others can learn from my experiences and their own experiences as well.
A challenge to all of us
We can no longer stay silent about these issues. There is a lot of work to be done, but small simple steps eventually lead to larger ones. I intend to start speaking up for my colleagues; especially for my trainees and students, who are in a particularly vulnerable period in their life. I hope I am not alone. For MCWAH D/I, we hope that we are not alone.
Victor Redmon, MD is a fourth-year resident in the MCW combined medicine and pediatrics (Med/Peds) residency program.
Friday, December 4, 2020
Learners and Justice: Our Present and Future
Learners and Justice: Our Present and Future
Joseph Kerschner, MD – Dean, EVP, and Provost of the Medical College of Wisconsin
In a Leadership Plenary Address as the Chair of the Board of Directors of the Association of American Medical Colleges (AAMC), Dr. Kerschner explains the importance of listening to our learners, creating culture change, focusing on diversity, committing to being anti-racist, and transforming medical education.
Dr. Kerschner gave his address on November 17th, 2020 and the video of his full address is available here and the complete transcript is available here.
The AAMC is a unique organization with a unique position to influence medical education, research, and our nation’s health. I have always tried during my leadership year on the AAMC Board to put learner topics front and center, because at the very core of the AAMC, our organization needs to be about our medical students and residents who, after all, represent – not only our future – but our present. And, when given a voice, they provide important insights and identify solutions to our current challenges. Below are three topics students identified as the most important areas for emphasis by our medical schools, academic health systems, and the AAMC.
The first area we must tackle is learner well-being
This is at the top of my list. We simply cannot be satisfied with the state of our overall learner well-being. Although there are encouraging trends, the level of depression and distress for physicians (and other health care professionals) remains enormously high, and difficulties become manifest early in one’s journey to becoming a physician. There is not a single one of us who does not have a personal responsibility to actively reduce barriers to mental health access and to remove the stigma for those seeking healing as they struggle with mental health, addiction, and other related concerns.
Changes to curricula and assessment are making a difference. We must improve learning environments and assess how we provide instruction and evaluation. I personally believe that the recent change to pass/fail for the Step 1 exam will have a positive impact.
But we must do more to explore access to mental health resources, financial support, and milestone-based curricula that will provide more flexibility to our learners as they progress in their development. I believe we must provide the ability for a student to finish medical school and residency in less time – or more time – than the “standard number of years,” depending upon her or his previous experiences and aptitude.
Changing the culture to address well-being
We can change our cultures, in part, simply by bringing the conversations forward and highlighting the importance of engaging in this manner. The currency of leadership is time — and, as leaders, if we do not spend time on this issue, we will devalue the importance of well-being. Have we stressed the importance of taking time for oneself and one’s loved ones with the same passion that we have stressed completion of the latest research project or preparation for the next presentation on rounds? Do we intentionally “clear the deck” to talk to our struggling colleagues to provide guidance, resources, and support?
Well-being and mental health are broad topics that demand systemic approaches, yet I believe that the most critical systems change we need — throughout medicine and education — is a change in our culture. Until we enable our culture to truly see those who are suffering, remove all negative connotations, and offer what is needed to support our colleagues, we will continue to risk our own and our colleagues’ mental health and wellness.
A favorite saying of mine is, “Our attitudes influence our perceptions, which in turn create our realities.” The message here is that we can change our culture so that the health and well-being of our learners — and, really, all who pursue health and science careers — will improve!
The second area we must tackle is student debt and transition to residency
Often linked to well-being for our learners is overall debt and residency opportunities — or competitiveness. I will focus here mostly on the overall debt of our learners.
The US is an anomaly in the world, in which those who have chosen to dedicate their lives to the practice of medicine are often asked to take on an enormous debt burden before they even begin to see patients. We have resisted solutions, because, the thought process goes, physicians are well-compensated and can afford to pay back loans. In addition, many medical students come from relatively privileged backgrounds. There is some truth in these assertions. However, if we seek to encourage diversity among our medical workforce, how many potential students from less advantaged socioeconomic backgrounds never even consider medicine because, early on, they learn of the overwhelming cost and debt?
I believe that if medical school debt could be limited through means-based support of those with fewer economic advantages, we would see progress in well-being and a more diverse workforce. A legislative solution would require a realization that medical students are a national treasure that deserves our support.
The third area we must tackle is student diversity
Our students view medical school diversity as a critical area to strengthen education, improve health outcomes, and bring much needed racial and social justice to our society. As a nation, we simply have not made enough progress in this regard. For example, the matriculation rate for Black and African American men has not made any appreciable progress in fifty years!
Racial concordance between patients and providers can contribute to better patient communication, satisfaction, and trust — and that these attributes and others can provide at least a part of the solution to the lack of equity in health outcomes. We must construct our admissions processes, pipeline programs, and support systems to enable this reality. I believe that our medical schools and institutions must become truly anti-racist. We must establish institution-wide practices that address unconscious bias in all faculty, staff, and learners.
How I learned a diversity lesson
When I became Dean nearly a decade ago, there were many who were willing to work on equity, diversity, and inclusion; enhanced structures to measure pay equity; changes in policies influencing the manner in which inequities were handled; and institution-wide unconscious bias training for every leader, student, staff member, and faculty. We doubled the number of underrepresented in medicine matriculants. We enhanced our pipeline programs, and students of color specifically shared with me their heightened feelings of inclusion at MCW. Leadership diversity improved, thanks to conscious efforts in faculty hiring and leadership searches. On the financial side, an annual process was instituted to rectify gender-based and other inequities. And we were in the early stages of developing the Center for the Advancement of Women in Science and Medicine, which would soon become a reality. We were gaining momentum.
Then, six years ago, a group of MCW medical students raised their concerns about police brutality, the Black Lives Matter movement, and racial injustice. They requested support from my office for a local “White Coat Die-In” — a national initiative in 2014 that many listening today will remember. My office was supportive and helped arrange for the most prominent location at MCW’s Milwaukee campus for this to occur — the entrance to our Medical Education Building.
The event took place and received some local media coverage. Although I was well aware that MCW still had a great distance to travel, I remember believing that this student-led “die-in” was yet another example of MCW’s progress on its journey to becoming an anti-racist institution.
Fast-forward to 2020: Like the rest of the world, we watched the coverage of George Floyd’s senseless, horrific, and tragic death and read about the ongoing issues of police accountability. We convened a Town Hall meeting and panel, including expert opinions on racial justice and steps to move forward. The conversation was honest and, at times, raw, but action-oriented — qualities that I believe embody a maturing, questioning, and vibrant organization.
One of the panelists, a person of color who had been a student at MCW during the 2014 “die-in,” provided her impressions of the event. She stated that she felt the event was an enormous disappointment. Why? Because of low turnout; the overall lack of dialogue about the event by leaders and the broader MCW community; and a general sense that this issue was not important at MCW.
And she was right.
Hers was the true story — not the one I had told to myself six years before. It was not the “comfortable” narrative which I had constructed at the time of the die-in that rewarded my need to see progress.
I logged off the Town Hall and reflected on the “uncomfortable” place where I now was — and what I should have done differently. I cannot say it any better than did Bryan Stevenson, author of Just Mercy, when he suggested that we must “get proximate” to the issues at hand. My own misinterpretations of student reactions following the “die-in” in 2014 were partly a result of my lack of proximity. I needed to acknowledge the former student’s story and engage in additional dialogue. But, more importantly, I needed to take concrete and meaningful steps forward to make MCW an anti-racist institution.
My challenges to you
My ask of you is threefold:
- First, if you are in an educational leader, always ask, “How will this decision impact our learners?” but, before answering, actually listen to some students to ensure that you have it right.
- Second, if you are a learner who is worried about not being heard, find faculty allies. It might be hard, and might seem “risky,” but it is important.
- Third, if you are neither a major decision-maker nor a learner, ask how you can be a better ally for our learners, because they do matter.
How we listen and provide this support has the potential to change everything in medicine.
Every institution is trying to enhance social and racial justice. We still have a long way to go, and we have made far too little progress, but it is critical that we seize the moment now and not lose this momentum. If we hope to more rapidly “bend the arc of the moral universe toward justice,” as the Rev. Martin Luther King, Jr. so eloquently told us, we must all continue to engage in dialogue, thought, and action.
I would encourage us all to work to elevate the voices of others. We must increasingly see how the judgments we impart, the ways we consciously or unconsciously behave, and the decisions we make, will move us to make progress toward an inclusive, equitable, and healthy environment for all.
Joseph E Kerschner, MD is Dean, Executive Vice President, and Provost of the Medical College of Wisconsin. He is a Professor in the Departments of Otolaryngology & Communication Sciences and Microbiology & Immunology at MCW. These remarks are excerpted from a longer address delivered on November 17, 2020 at the 131st Association of American Medical Colleges (AAMC) meeting in his role as outgoing Chair of the Board of Directors.
Friday, October 30, 2020
Shedding Light on Indigenous People of the Bemidji Area: A Cherokee Nation M2 Perspective
From the 10/30/2020 newsletter
Student
perspective
Morgan
Lockhart, MCW-Milwaukee medical student
Friday, October 23, 2020
Kaleidoscope is Partnering with the Milwaukee Bucks to Offer a Virtual Session
From the 10/23/2020 newsletter
MCW
Kaleidoscope Announcement
Kaleidoscope is Partnering with the Milwaukee Bucks to Offer a Virtual Session
Adrienne German
REGISTER HERE
Kaleidoscope is back! After an eight-month COVID-induced hiatus, this first program back looks to be terrific. While Kaleidoscope events have typically used film as a mechanism to explore diversity, the virtual world allows for new ways to connect and reach a broader audience across all schools and campuses.
Tune in on Thursday, October 29, 2020 from noon – 1:00 p.m. CT for “Confronting Racial Injustice: The Change Begins with You.” In this virtual session, members of the Bucks organization will discuss the bold decision that the Bucks players made to boycott their play-off game against the Orlando Magic this past summer to demand justice for Jacob Blake and action from the state legislature regarding police accountability. The discussion will be led by Arvind Gopalratnam, Vice President, Corporate Social Responsibility and Kareeda Chones-Aguam, Vice President, Partner Strategy and Management.
Although
not everyone has as large a platform as the Milwaukee Bucks, everyone can still
have an impact. The October 29th
session will align with MCW's mission to becoming an ant-racist institution and
teach people how to become an ally/accomplice against racial and social
injustice.
Adrienne
German is the High School Outreach Coordinator for the MCW Office of Academic
Affairs.
Editor:
Kathlyn E. Fletcher, MD MA is a Professor and Residency Program Director in the Department of Medicine at the Medical College of Wisconsin. She is a member of the Curriculum Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.