The Congruence in My Quest

From the 10/9/2020 newsletter

Perspective/Opinion

The Congruence in My Quest

By Sherréa Jones, PhD – MCW Milwaukee Medical Student

What made you decide to actively pursue your career?

Traditionally, when this question is posed to the majority of people, their response involves seeing someone congruent to themselves in the profession they are seeking. For many Black individuals in this country, our answer to this question is, overwhelmingly, because we do not.

I grew up in the inner city of Milwaukee, WI. I graduated from a severely underperforming school system and I found myself, as a child, pregnant with my very own child. I was raised by a single Black woman in a family where I was surrounded by other single Black women, none of whom were in a career that aligned to the professional aspirations I was captivated by on Thursday night
television. Sure, every child wants to be a superhero growing up, and eventually those dreams become more realistic. In contrast to some other children, these fictional characters served as my only visual source of hope for a career in medicine.

During my first semester at UW-Madison, I found myself engulfed in feeling ridiculous for wanting to be a physician. Here I was, at a nationally recognized research institution, with 40,000 other students of which only 2% were Black. Five years later, I matriculated as the only Black student within the entire Department of Biological Sciences at Marquette University. I remained the only Black student for the duration of my tenure as a PhD candidate. As you might imagine, my scholastic unpreparedness resulted in grave academic struggles. I felt intimidated, shamed, defeated, embarrassed, and increasingly believed myself inferior in intellect compared to my white peers.  

When I was granted the opportunity to join the class of 2024 at the Medical College of Wisconsin, I decided I was going to own this experience. I made the conscious decision to be transparent about my personal and academic struggles, my feelings of ineptness and, most importantly, my intentionality about using my voice as a vehicle to speak for the disenfranchised. Moreover, I desired to utilize the uniqueness of my physical presence to be there for those seeking racial, socioeconomic and/or gender congruence in their aspirations. Being in the racially distinct faction, as a student, was no longer shocking to me, it was the anticipated norm. What I did find resounding was the glaring lack of visible support for Black students at one of the largest teaching hospitals in the state of Wisconsin. A campus with an ever-expanding and commanding presence directly adjacent to the city of Milwaukee, which is nationally referenced as one of the most segregated cities in the United States, and consistently leads the nation in having the largest race-based disparities in health, wealth, and incarceration rates. 

During my first year of medical school, I was introduced to a parade of PhDs and MDs who were facilitating my education, yet only one of them (Dr. Erica Arrington) looked like me. Prior to starting school, I read about well-established mentorship programs in place at numerous institutions that are targeted to help Black students thrive. There was, however, nothing in place here at MCW. Although I did not see a tangible support network for Black students at MCW - except for a small number of individuals (Dr. Jennifer McIntosh, Jean Mallett, Dr. Cassie Ferguson, Dr. Michael Levas, Dr. Greer Jordan, Dr. Marty Muntz and Dr. Malika Siker), I refused to believe there was no interest in its erection. Similarly, I refused to believe that, a hospital that cares for a largely impoverished and disadvantaged population, where many of its children were born, was a hospital that did not care to support the success of its future Black physicians in training. Furthermore, I refused to believe that, an institution that welcomes over 200 students each year (albeit only 4% are Black) did not have a proactive committee to offer resources and refuge to students who found themselves on academic probation - the frightening place I was in at the conclusion of my first semester at UW-Madison. I refused to believe that absolutely no one, within administration, faculty, or staff had a genuine concern about the mental health and well-being of Black students.

Despite the daunting data and the countless conversations with my Black student colleagues surrounding feelings of isolation, frustration, and powerlessness, I am glad I held on to my skepticism. Through our activism and advocacy, we have been introduced to a village of physicians, administrators, staff, and non-Black students who have tremendous concerns about the deficiency of a culture that ensures the support and success of Black students. Through my student leadership roles, I have discovered a team of individuals that have launched a collective effort on shifting the paradigm at MCW built around anti-racist directives. There is a community at MCW that works tirelessly, while facing insurmountable organizational hurdles, against the structural inequalities that are systemically designed to perpetuate the failure of Black students that choose to enroll at MCW based on the advertised supportive nature of the program.

In discovering this assemblage, I have begun a personal quest to bring awareness to this community. Although this quest feels strikingly reminiscent of the imaginary characters I held on to in an effort to catapult me to a realistic place of actively pursuing my dreams, I unequivocally embrace the intangible ideal that, one day, the members of this community will be unapologetically and unashamedly empowered to speak up for Black students, visibly support Black students, and enforce palpable change for the betterment of the Black student experience at MCW. 

It took over 400 years to structure the system that anticipates my failure. I am well aware that I cannot unravel it in four.

Sherrea Jones, Ph.D. is an M.D. Candidate in the MCW-Milwaukee Class of 2024. She serves as a liaison to the Student Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

A “Sermon” for Medical Students about Civic Character

 Guest Director’s Corner

A “Sermon” for Medical Students about Civic Character

Mark D. Schwartz, MD

If individual character is what we do when no one is looking, civic character is what we do when everyone is looking!
-Eric Liu “Citizen University”

I remember the excitement and fear of drinking from the fire hose as a medical student in the 1980s. I was aware of, but could not fully understand, how the AIDS epidemic was shaping and honing my professional identity, just as the current pandemic is shaping yours.

In this moment when the country is sick and suffering – when our health, our economy, and democracy are threatened and when science itself is being undermined – we need to impact the world beyond our next exam, our next rotation, our next patient, or our next scientific hypothesis.

Given the situation we are in, let’s talk about what it means to be civically- engaged physicians and scientists in this new world. Here are some simple but profound questions I have been living in, wrestling with, and trying to answer:

• Given our positions, capabilities, and resources, what are our responsibilities? And for whom are we responsible?
• What are our roles as a civic physicians, civic scientists, and civic healers?
• How can we use our professional roles and power to strengthen democracy?

I can’t tell you what your answer should be, but I do know that we need to think bigger.

Physicians have privilege and tremendous, untapped power. Power is misunderstood and mistrusted, yet there is no greater mechanism for positive change than through the harnessing of power and creating civic action. Power calls physicians to be positive agents of change in our communities.

Where and how do we begin?

I can guess what you are thinking. Listen – I get it. I am a doctor, a professor, a researcher, and a leader. I would put my “To-Do” list up against anyone’s! I know how unthinkable it is to add one more task. It is overwhelming enough to develop into the best doctor or scientist you can be.

Besides being incredibly busy, I hear other reasons why physicians and scientists are hesitant to engage in strengthening our democracy. Here are three of them:

Who can fight big money?

Science and politics don’t mix!
It’s not my job

Let me unpack these with you.

Myth #1: We shouldn’t engage in strengthening democracy because Who can Fight Big Money?

Undoubtedly, our democracy is driven by money and power. How can the rest of us ever have a voice? How can we not throw up our hands in cynicism and despair when we see how big oil, big banks, and big medicine turn policies, laws, and regulations in their favor? Here are two reasons why I am optimistic about your chance to make changes.

The first is that you have more power than you think. As voters we exercise a vital act of civic power, and forming, joining, and aligning forces supercharges your civic power. Organizations like the American Medical Association, American Hospital Association, or the Association of American Medical Colleges are out there every day, shaping how we educate, train, and practice medicine and science. When you align with your school’s advocacy agenda, national student organizations, and professional societies, your voice is amplified. Take advantage. As Samuel Adams, who incited the Boston Tea Party, famously said: “It does not take a majority to prevail... but rather an irate, tireless minority, keen on setting brushfires of freedom in the minds of men.”


The second reason why I am optimistic about your chances is that culture eats policy for lunch every day. Although policy includes the levers of public laws and regulations, culture – our norms, civic ideals, beliefs, habits, and practices – shapes our society’s norms, values, and the spirit of democracy. Culture is tied to our “civic character.” If individual character is what we do when no one is looking, civic character is what we do when everyone is looking! Civic character and behavior are contagious. If you doubt this, look around the country and notice how different regions of the U.S. have responded differently to the pandemic and our emerging social conversations.

We mimic what we see – what we do grows and becomes social norms. We are not stuck in traffic – we are traffic. We are part of the ecosystem we create. Democracy is not a machine, but a garden that needs active tending – like a garden, it needs water, sunlight, planning, understanding and respect of cycles, weeding, and adaptation.

So, what can you do in your daily life to promote civic character and to close the gap between our ideals and our practice in this American democracy
project? What does it mean to live like a citizen? John Wesley, the founder of Methodism in the 1700s, said, “Do all the good you can, By all the means you can, In all the ways you can, In all the places you can, At all the times you can, To all the people you can, As long as ever you can.”

We need to think bigger!

Myth #2: We shouldn’t engage in strengthening democracy because Science and Politics Don’t Mix!

I teach a course on research methods each summer. Physicians and scientists venerate evidence. It is the ground on which we stand to do our work.

Were you as concerned as I was when it appeared that we were being pulled into an evidence-free world? Where truth becomes truthiness? Where each of us has our own dictionaries, our own encyclopedias, our own fragmented sources of evidence? Where national, scientific experts are pushed aside, data disappears, and evidence is ignored by our leaders?

I’ve got data, you’ve got data, we all have data. The power that you have, given your position, is to bring these data to life – with real, lived stories about how all these data play out in the world and affect real people. With cameras on computers and phones, I have been inside the lives, families, and homes of many people suffering or worried about COVID-19. Yes, I have graphs of rising and falling cases and deaths, but I also have stories of loss, fear, hope, and how families and communities are coming together to help us heal, cope, and mourn. We are in a unique position to link data to stories. People will listen.

As citizen physicians and scientists, we have the responsibility to tell these stories, to bring the data and evidence to life. Each of us can strengthen our democracy by telling these stories to provide compelling, living context for our science, our data, and our evidence.

We need to think bigger!

Myth #3: We shouldn’t engage in strengthening democracy because It’s Not My Job to Fix the Country

As a physician, my job is to help one person at a time when they come to see me.
Of course, only about 20% of health is affected by what doctors and scientists do in the office, the hospital, the lab. The other 80% is explained by our genes, our individual and civic behaviors, and the social determinants of health – where we grew up, learned, lived, worked, and played. These social determinants, with their history and the ways in which they are baked into society’s institutions and structures, all drive the disparities that the twin pandemics of coronavirus and of racially-targeted violence and injustice have made undeniable.

Each day, we look into the eyes of the patient in front of us, to plumb the depths of a scientific problem, and stare into the computer to do the work we are preparing to do. That is difficult, valid, valiant, and vital work, but it is not enough. If we want to have a larger, more enduring impact, we must lift our eyes from the patient, problem, and computer and embrace the context and culture of our populations and communities.

We need to think bigger.

I teach a course on health policy, and so I get to watch students learn the language, the anatomy, and the physiology of how health policy is made. Their brows furrow and their faces get heavy as they grasp our crazy-complex policy machinery. They discern how policy is shaped by money and by self-interest.

But I have also seen their faces brighten after they pick a policy issue about which they are passionate, prepare and practice their advocacy pitch, and visit their representatives in Congress. They are surprised how easy and how important it is to engage as citizens and to leverage their power as future physicians and scientists. Participating in acts that engage our civic character strengthens our democracy and repairs the world, given our position, our capabilities, our resources, and our power.

A central tenet in Judaism is the responsibility we each have of Tikkun Olam, that is, to repair the world. We can’t do the entire work, but we are called to do what is in our reach to knit together the broken ends and to partner in the work.

So, I leave you with the questions with which I began:

• Given our positions, capabilities, and resources, what are our responsibilities? And for whom are we responsible?
• What are our roles as a civic physicians, civic scientists, and civic healer?
• How can we use our professional roles and power to strengthen democracy?

As a leading rabbinic scholar, Rabbi Tarfon, taught 2000 years ago, "It is not your responsibility to finish the work [of perfecting the world], but you are not free to desist from it either.” My charge to you is to wrestle with these questions, connect with one another to engage the world where you can, and spend your careers searching for the answers. By developing and sharing your civic character, your work can lead to lasting change.

Thank you.

Dr. Schwartz is a Professor of Medicine and Population Health, Vice Chair for Education and Faculty Affairs, Department of Population Health, New York University Grossman School of Medicine. In 2010, as a Robert Woods Johnson Health Policy Fellow he “staffed” the Ways and Means Committee in the U.S. House of Representatives while they wrote the Affordable Care Act. He leads pre- and post-doctoral fellowship programs in population health and health policy.

First- and Second- Year Medical Students’ Responses to Remote Learning

From the 10/2/2020 newsletter

First- and Second- Year Medical Students’ Responses to Remote Learning

by Eileen Peterson and Anna Visser

MCW Students Eileen Peterson and Anna Visser organized a student survey to better understand how their colleagues adjusted to the remote learning environment, and lessons learned moving forward that can connect to well- being efforts ...

While online degree programs have existed for decades, they made up a small minority of degree programs in the United States until 2020, when remote learning became the norm, forcing students and faculty members to adapt to its benefits and challenges.

The Medical College of Wisconsin was just one of the many institutions affected once the threat of disease spread materialized during the spring semester of this past academic year. In-person lectures for first- and second-year medical students (M1s and M2s, respectively) stopped for the rest of the spring semester, and third- and fourth-year medical students were pulled from the clinics and hospitals during their rotations. As we all learned more about COVID-19 and how to safely bring students back to campus, things have slowly shifted to a “new normal.” The third- and fourth-year students were allowed back at their rotations. However, the path to this “new normal” has been a bit rockier for first- and second-year medical students.

As the first- and second-year medical school curriculum is largely lecture- based, many changes have had to occur to transition to mostly-virtual learning.

During the spring semester, virtual learning for first- and second-year medical students consisted of watching lectures that had been recorded the previous year. This fall, we have transitioned back to live lectures that are given on campus by masked faculty members and clinicians behind Plexiglass. Attendance is capped at 50 students, and everyone must sit 6 feet apart with their masks on. This is certainly not the same pre-COVID experience of cramming into Kerrigan with friends. We are not able to roll our chairs closer together to discuss which lunch talk might have the best food that day. We no longer make the trek to anatomy lab with all 200 fellow first-year medical students. We understand that it would not be safe for things to be like they were pre-COVID. Even with all the terms that fall under this “new normal,” being able to watch live lectures again, from home or at school, has been a great improvement from this past spring.

We wanted to know: How has this transition affected students? We sought out answers from first- and second-year medical students at MCW through a voluntary survey distributed at the beginning of September. Within mere days, we garnered 53 responses. Selected data are presented below, along with free responses published anonymously with permission.

Ease of Transition

The transition to mostly-remote learning this semester has been easy for me:

There was a wide variety in thoughts about the ease of transition to online learning. We postulate that this variety may be based on class year; since current M2s experienced remote learning last spring, they may have already formulated schedules and study habits that work well for them, whereas remote learning may be new to current M1s. Here are a couple free responses related to the ease of transition:

“The hardest part is not being able to separate school and studying from home and relaxing. There is no barrier between my desk and my bed, so work and life have meshed into one thing.”

“The transition was relatively easy as I had already been watching lecture and studying from home 99% of the time. I suppose the most difficult aspect has been not seeing many people. As introverted and painfully shy as I am, humans are largely social creatures. Not being able to seefamiliar faces after a while began to take its toll.”

Has mostly-virtual learning and/or COVID-19 affected how/where you are living this year?

For the majority of students who responded to our survey, their living arrangements were not impacted by the transition to mostly-remote learning or COVID-19. For those whose living arrangements have been impacted, there are many reasons why this could be the case. At the start of the pandemic, in the spring, many students chose to go back home for some time. There was also much uncertainty about how we would be coming back to school in the fall. 

Some students weighed in on their experiences:

“As an M1, I waited as long as possible to sign a lease because I was unsure of whether or not I would have any in-person classes this semester. As a result, I’m now living alone and have little to no interaction with my classmates. It’s made the transition significantly more difficult...”

“I had been planning to live at home with my parents this year. Both of my parents are older, and I was worried that somehow, I would be bringing COVID home by going back to school and clinic. I quickly found and moved into a new apartment so that I wouldn’t be putting my parents at increased risk.”

I have more time to study or enjoy recreational activities now that my learning is largely remote:

When asked for their favorite part of remote learning, many students discussed their schedule’s increased flexibility, including getting more sleep, avoiding the commute to school, and being able to watch lectures at their own pace. A student explained,

“I enjoy not needing to drive to campus for class. Even though I live close, it saves at least 30 minutes every day and instead I can continue studying from my desk, watching lectures at my own pace, while still getting a quality education.”

However, not all students feel this way, especially those with families and other commitments at home. One student was frustrated with the increase in assignments given the remote nature of medical courses:

“It seems that we have more work to do now more than ever. It appears faculty are concerned we have a lot of free time, but we have the same amount of time, if not less, now that we are home. For instance, many people have children they now have to help out with school.”

Faculty and Staff

It is easy to reach out to faculty and staff remotely when I have questions or concerns:

Though our responses to this question were fairly neutral, the majority of responses were positive. Seventeen students chose Somewhat agree, Agree, or Strongly agree; while only ten students chose Disagree or Somewhat disagree. No students strongly disagreed with this statement. Though we have not been able to have as many face-to-face interactions with faculty as we were able to pre-COVID, it has still been fairly easy to reach out to faculty and staff with questions and concerns in this mostly-virtual age. However, there is certainly still room for improvement in the format of mostly-remote learning.

One student commented,

“I don't like the email barriers to asking questions - I'd much prefer to get real-time answers to questions. I don't like Panopto - it’s clumsy and lags.”

I feel supported by faculty and staff, even though my learning has been largely remote:

Based on our personal experiences and our survey responses, is clear that the faculty and staff are still here for students during this time. A large majority of students who answered our survey feel supported by MCW faculty and staff. In an effort to improve their medical school experience, several students offered suggestions for faculty, staff, and MCW as a whole:

“I would love if MCW offered more free virtual workout classes for us to stay mentally and physically healthy, especially if we aren’t comfortable using gyms or wearing masks when working out in more public spaces.”

“I wish that [student organizations] would be able to do outdoor activities/more online events... I'm disappointed by the lack of community especially having just moved here from far away.”

“Brightspace is very clunky - it takes 7-8 clicks to find one thing. I also wish there were more ARS questions instead of professors droning on. It feels very removed watching a lecturer in a mask behind a glass screen and the audio is not always good. I'd rather professors broadcast from home.”

“I really, really wish they could change the scratch paper rule during tests.”

“Send us something once in a while, a joke, a song, something to keep us connected.”

“Be supportive when we have illnesses or injuries. We are students, but we are patients too.”

“Be receptive to changes especially with the [Black Lives Matter] movement sweeping the nation. We finally feel open to talking about these hot topics. It may seem like an attack or uncomfortable but imagine decades of that for [people of color].”

Connectedness to Peers

I feel connected to my peers, even though my learning has been largely remote:

When asked about the hardest parts of their transition to mostly-virtual learning, many students discussed their feelings of disconnectedness from peers and challenges with social isolation. Compared to students from the Milwaukee area or those who knew each other from undergraduate experiences, these feelings of isolation are exacerbated in first-year students who moved here from out of town and may not have already developed those previous friendships with other medical students. One student expands upon this challenge:

“I just moved to a new city, I’m living by myself, and have little to no interaction with my classmates. I find virtual learning to be significantly more difficult because it requires way more self-discipline than if we were to be attending lectures in person. So.... it’s been not only a tremendous adjustment in terms of just finding my footing as a med student, but I also feel incredibly disconnected from my peers. I worry that I may somehow be missing the opportunities to meet people just because I’m out of the loop somehow.”

Adaptability and Growth

Whether their mostly-remote learning experience has been smooth or rocky, freeing or isolating, or otherwise, students have learned a lot about themselves. They discussed their resilience and adaptability: 

“I can overcome obstacles and still have a meaningful experience.”

“Being flexible and ready to adapt to new changes and plans is the key to success.”

“Nothing will stop me from reaching my goal, not even a pandemic.”

Because of the various challenges associated with being a medical student during a pandemic, many students advocated for prioritizing mental health and other efforts to promote wellness:

“It has been further cemented into me that I alone am in charge of my wellness. With nearly all learning being remote, the days of the week blend together and a weekend is almost no different than a weekday. Taking the necessary time to unwind and take a break from studying needs to be an intentional act, and deciding when enough studying is enough on any given day is also important to prevent burning out. I’ve learned that spending time alone, whether it be reading a book or playing guitar, is a great and fulfilling alternative to hanging out in big groups when trying to enjoy some time away from school work, given the circumstances.”

“I’ve learned that I need to keep myself accountable for my work by keeping checklists and to do lists so I can do my school work, keep the house chores under control as well as think about eating right and staying social.”

Being a medical student is notoriously challenging, much less during a pandemic. From technological hiccups on Brightspace to feelings of isolation, students discussed struggles that are shared by many of their classmates. Amidst the difficulties, it has been inspiring to witness the resiliency, adaptability, and courage of learners, faculty, and staff as we navigate our “new normal.” Until handshakes, coffee shop meetings, and large-group gatherings return, we encourage you to continue promoting wellness for yourself and others, one small step at a time. 

If you or anyone you know is struggling, you are not alone. Below are some resources for students, shared via Dr. Cassie Ferguson and the REACH curriculum:

MCW Student and Resident Behavioral Health Services

- Referral Coordinator: Carolyn Bischel, MS, LPC

- (414) 955-8933

- Referral Hours: 8:00 am-4:30 pm, Monday-Friday

- After-hours Emergency Contact: (414) 805-6700

24/7 Suicide Helplines

- National Suicide Prevention Lifeline: 1-800-273-8255

- Crisis Textline: Text the word "Hopeline" to 741741

Columbia Suicide Severity Rating Scale (research-based screening tool for

assessing suicide risk in individuals)

- https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/cssrs-for-

communities-and-healthcare/#filter=.general-use.english

Milwaukee Health Department/Office of Violence Prevention

- Blueprint for Peace:

https://city.milwaukee.gov/ImageLibrary/Groups/healthAuthors/O

VP/Reports/20171117OVP-Report-MKEBlueprintforPeace-Low-

Res.pdf

Eileen Peterson and Anna Visser are students at the Medical College of Wisconsin with interests in Diversity and Inclusion, Medical Humanities and Student Wellness. They are both Associate Editors of the Kern Transformational Times newsletter. 

Justice Ruth Bader Ginsburg – Losing a Brilliant Voice for Equity

From the 10/2/2020 newsletter

Perspective / Opinion

Justice Ruth Bader Ginsburg – Losing a Brilliant Voice for Equity

Libby Ellinas, MD – Director of the MCW Center for the Advancement of Women in Science and Medicine (AWSM)

Dr. Ellinas shares her perspective on the loss of Supreme Court Justice Ruth Bader Ginsburg at precisely the time when our country needs her most of all ...

Supreme Court Justice Ruth Bader Ginsburg died on September 18, 2020. It felt like a punch in the gut. A wave of loss and a fear for our nation’s future. It brought again to mind a deep concern for the health, safety, and opportunities for women in the United States.

This week, the police officer who shot and killed Breonna Taylor was not indicted. That decision brought about a wave of loss and fear for the health, safety, and opportunities for women in the United States. In the faces of my colleagues, I could see that loss, that emotion.

Justice Ginsburg’s loss was personally devastating to me, not only because she was a superb intellect and a dauntingly hard worker (two traits I admire in anyone), but because she was clever – ingenious even – at helping colleagues and justices gain insight into their own views.

There are multiple examples of RBG’s cases that support her creativity and strategy to “Fight for the things that you care about, but do it in a way that will lead others to join you.” One of my favorites is Weinberger v. Wiesenfeld, a case she litigated (as Weisenfeld’s attorney) at the Supreme Court in 1975.

Stephen Wiesenfeld and Paula Polatschek were married in 1970. Paula, the primary breadwinner, worked as a math teacher. When she died in childbirth from an amniotic fluid embolism, Steven became the sole provider for their son, subsequently applying for social security benefits. At the time, a widow under identical circumstances would have been eligible for those benefits. Steven, a widower, was not. Wiesenfeld sued for benefits, and the case was appealed all

the way to the US Supreme Court against Caspar Weinberger, the Secretary of Health, Education, and Welfare.

During the case, Attorney Ginsburg argued that the Social Security Act discriminated against both Paula’s social security contributions (because she was not a man), and Steven survivors’ benefits (because he was not a woman). The 8-0 decision rendered by eight white male Supreme Court justices agreed that the purpose of social security benefits was to allow for the proper care ofchildren, and that “proper care” was not dependent upon the sex of the parent. Arguing not for women’s rights but men’s rights, this case demonstrates Ginsburg’s ability to work within the biases of her listeners, to bring about decisions that helped erode those same biases.

Bringing us to the connection between Breonna Taylor – the individual case – and the Supreme Court. Weinberger v. Wiesenfeld was not “Weinberger v. Gender Equity.” It was brought on behalf of Steven Wiesenfeld. Father. Widower. Individual. With Ginsburg’s death, a similar case brought on behalf of Breonna Taylor won’t have the same chance, the same advocate, the same writer ofbrilliant “dissents” that RBG was notorious for. Even the likelihood that the case would be brought to the court at all is lessened without Justice Ginsburg. And that is a terrible loss.

Ginsburg’s arguments were often for equal treatment, not equitable treatment, in part because many sexist decisions were ostensibly made to “protect” women. RBG is famous for saying, “I ask no favor for my sex. All I ask of our brethren is that they take their feet off our necks.” For too many black Americans, removing pressure from a neck represents a literal first step toward justice. For many women, freeing a figurative neck is still insufficient, because many women’s feet remain firmly fixed to the floor, hemmed in by structures of racism and sexism.

As we all work to move equity forward, I believe that Justice Ginsburg would have continued to advance her thinking as well. She was open to finding her own mistakes, to being told she was wrong, to being unprotected from the truth. She said, "Women belong in all places where decisions are being made. It shouldn't be that women are the exception." But not just “present” at decisions, she furthered:

"When I'm sometimes asked 'When will there be enough [women on the Supreme Court]?' and I say 'When there are nine,' people are shocked. But there'd been nine men, and nobody's ever raised a question about that."

Once again, RBG illuminates our biases, and helps us to see that a statement that seems at first shocking, may not be so shocking after all.

We have lost a brilliant voice for justice at precisely the time when injustice needs her more than ever. It’s up to us to raise our voices now.

Elizabeth (Libby) Ellinas, MD is a Professor in the Department of Anesthesiology, Director of the Center for the Advancement of Women in Science and Medicine, and the Associate Dean of Women's Leadership at MCW. She is a member of the Faculty Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medicine.