Racism in Medicine has an unfortunate, long, storied past. In a prior era, the socially progressive response to an American history that denied opportunities to those of color was to replace the system with one that was color blind. It was Martin Luther King that captured the imagination of a nation striving to rectify its wrongs in his speech at the National Mall where he dreamed that his “four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character.” But it became quickly apparent that colorblind opportunities were never the end goal of progressive activists. If racial upward mobility was to be accomplished quickly, the institutions that had long systemically kept people of the wrong color out couldn’t just be color blind, they had to now focus on race and skin color in order to demonstrate racial preferences. Sadly, the real legacy of Martin Luther King is not the soaring, inspirational rhetoric that brought Americans together, but rather policies that were in line with what he pushed the last six years of his life: race conscious affirmative action and boycotts to force racial quotas in employment.
The profession of Medicine, ever on the progressive vanguard was swept along by the prevailing winds, and enshrined race based affirmative action under the auspices of the Association of American Medical Colleges (AAMC) in 1969 with a goal of using preferential race based admission to medical school to “rectify” the makeup of the physician community. The AAMC task force had a specific goal in mind - the minority task force to investigate minority underrepresentation recommended that 12% of all first year medical students be black by the year 1975-76. Despite significant efforts made to reach this goal, these goals were not achieved.
Writing in a special article about this failure in the New England Journal of Medicine in 1977, sympathetic authors noted that despite the fact the majority of medical schools were accepting blacks at acceptance rates much higher than all applicants, the AAMC’s minority recruitment goals were not able to be fulfilled because “so few blacks applied.” The authors went on to write that the “ problem of few black applicants is compounded by the fact that many of the applicants are poorly prepared for medical school… 54% of black college freshmen, as compared to 35% of nonblack freshmen, thought that they needed special help with mathematics.” As a result, in 1970, only 77.8% of first year black medical students compared to 97% of their white counterparts were promoted with their class. The conclusion after a decade’s worth of affirmative actions was that black under-representation among doctors was not due to a lack of effort on the part of medical schools, there were simply not enough qualified blacks in the population applying to medical school. The solution proposed by the NEJM authors was to invest in the educational system so that blacks may attain a “ high level of academic achievement in college if they [were] to compete for admission to medical schools on an equal basis with other groups.”
Since those words were written, billions of public dollars have flowed into the education system on an annual basis, and the defacto policy of racial preference for admission to medical school continues, surviving a number of legal challenges at the highest court in the land.
A system designed to fail?
And yet, despite these significant efforts over more than a half-century the under representation of certain minorities in medicine remains. There are many possibilities for the current sorry state of affairs, but the most convenient diagnosis for many is to double down on the theory that the problem stems from a system that excludes black people from medicine. The current crop of progressive jihadists would blame the tests being administered to black students as being racist manifestations of a system built to elevate whites. In their reality, the system is fixed. If more black students struggle with proficiency in Math, well then its Math that by its very nature is racist.
Once established that the system is designed to fail the black population, the solutions that necessarily must arise don’t just flirt with racism, but wallow in it. A recent tweet from a cardiologist at Washington University in St. Louis embodies the kind of solutions that are likely being carried out behind closed doors right now.
What’s even more telling is that a completely serious proclamation calling for a moratorium on leadership positions by skin color garnered the open endorsement of hundreds of physicians around the country. There is clearly institutional momentum behind the idea that the only solution to historically racist policies is the institution of contemporaneously racist policies.
The pathology is so complete that even those who publicly dared to disagree with the tweet prompted Indiana Cardiologist Dorian Beasley to write a blog concluding that the disagreement with Dr. Brown was more evidence Medicine was not ready to be inclusive of black people.
In Beasley’s eyes, a moratorium on white male leadership would simply be a suspension of a caste system that worked to anoint white males leaders, and keep black people out. Beasley sources these ideas from Isabel Wilkerson, author of a book titled Caste: The Origins of Our Discontent that was published in August of 2020 and makes the case America is a caste based society systemically organized to keep whites dominant.
Wilkerson even has some sort of an answer for the success of Asian Americans in this caste system by explaining that the lower caste Asians are rewarded for playing and complying with the rules of the caste system. Beasley channels Wilkerson by specifically taking a shot in his blog at brown immigrants who he complains are “vocal in their panic” about a new America being organized based on skin color.
It is possible that my many Indian physician immigrant colleagues are very familiar with caste systems and support an American system that allows ascension up the societal ladder precisely because no one in the American medical community is inquiring about the caste they happened to be born into in India. That these new immigrants may appreciate the relatively caste-less nature of America, and thus register concern about the institution of a new color based caste system isn’t accommodated by Beasley and Wilkerson’s tunnel vision.
One explanation for Beasley’s blinkered world view is the very privileged existence that brought him to this moment. He self describes as a
“Black man, who grew up in the comforts of suburban Kansas City, with two parents who are professionals and bequeathed to me meritocratic inheritance. The only worries in the world I had was what Polo shirt I was going to wear to school that day… “
Apparently, neither his difficult upbringing or Wilkerson’s rigid American caste system worked to stop Dr. Beasley from becoming a cardiologist in the wealthiest country on the planet. The only meager offering proffered about his racial travails relates to cardiology colleagues at a new practice he joins who express reservations about him reading and interpreting his own ultrasound studies because that may cut into their own income. He wonders if a white colleague would get the same treatment, but one suspects he would never accept an affirmative answer to his question. It doesn’t appear to strike the good doctor that this is the usual bickering that takes place when a new member joins a group and necessitates sharing of the revenue pie. This is the tragedy of the race tinted goggles - every action, every utterance, and every slight must be about race.
Sadly, victim-hood is a self fulfilling prophecy of the racial preference movement. The more explicit the policies that support preferential admission for race, the more victims that are created. The victims are of course those who will never be doctors because they were the wrong skin color, but the process goes on to incriminate every underrepresented minority that goes on to wear a white coat. Whether brilliant, or marginal, a color based admissions process casts a cloud over every physician that may be a beneficiary of the process. It would be wonderful to unequivocally applaud Dr. Beasley for his accomplishments, but the current race obsessed climate will have many questioning whether these accomplishments were based on an impressive body of work or a function of the defacto race quota that is currently in place at most institutions of higher learning.
Race baiting and creating victims
Some will want to dismiss these concerns as the panicked words of a dominant white caste member of society expressing grievance, and privilege, and some will no doubt describe these questions as proof of racism, but this is exactly the description used by a black senior author when describing a ‘successful’ program to increase diversity at a cardiology fellowship program in Ohio State. Senior author Quinn Capers notes -
“its possible we simply made it a priority to rank [underrepresented in medicine] applicants more aggressively than in previous years, thus achieving success in matching them regardless of recruiting efforts, with the implication being that we accepted less competitive applicants in an effort to increase diversity.”
Policies that prioritize the polo shirt wearing black son of professionals in a suburb of Kansas over the poor white son of an alcoholic mother from Appalachia takes a lot of work to rationalize. That intelligent free thinking people would demand the state use its powers to discriminate based on color requires the kind of indoctrination found in books by race focused intellectuals like Ibram Kendi, and Isabel Wilkerson. It should matter that the arguments forwarded to support any of their theories are incredibly thin. For instance, Wilkerson cites the poor performance of the United States in the Covid-19 pandemic and its disproportionate effects on ‘lower-caste’ Americans as proof of the detrimental effects of the reigning caste system. And yet if we are to play along with the racial lens that Wilkerson has fitted us with, it is the American black community that had access to highly effective vaccines prior to the black community the world over. How should one square the paradox of a system obsessed with suppressing its lower caste black population that also is responsible for creating such a wealth of vaccines that there are multiple choices of vaccination currently available for free at every single neighborhood hospital, doctor’s office, and pharmacy? Compare the availability of vaccines in America with that in the African continent. Almost half the population in America is vaccinated, while only 1% of Africa is vaccinated.
No doubt the race baiting crowd of intellectuals that Wilkerson belongs to would focus on lower vaccination rates in the black community compared to the rest of the population as more proof of ongoing racism in the United States. Any physician who has spent time talking to vaccine hesitant members of the black community would understand the deep undercurrent of distrust that has very real historical roots. But how do Beasley and Wilkerson help the situation by raising doubt about the current motivations of the system? When I approached a man on the street the other day who happened to be black to let him know I was from a clinic that was trying to give out extra vaccines lest they be wasted, is it my whiteness that makes him furrow his brow with suspicion and shoo me away? Or is it Wilkerson’s narrative about a system out to screw blacks at every turn that ensure I’ll fail in my entreaties?
As scenes of horrific mass death of brown people from COVID19 in India and Brazil unfold while the American vaccination effort has to date doled out close to 250 million vaccine doses, one is left flummoxed how anyone with the least bit of insight would not be utterly embarrassed to talk about vaccine apartheid in the United States. The charts comparing access to life saving vaccines across the globe are stunning, and quite conclusive. The best chance of survival, whether black, white, yellow, or green is to have the good fortune of living in the United States of America. To then complain about differences in vaccine uptake among racial groups in the United States is not only emblematic of the current generation of spoiled Marie Antoinette leftists, it's harmful because it just increases suspicion in the community that most needs the vaccine.
None of this matters to Isabel Wilkerson, who calls for the American system to be deconstructed the same way the Allies dismantled Nazism after World War II. These extraordinary claims, endorsed by the likes of Beasley, and even Oprah Winfrey, firmly place authors like Wilkerson in the company of luminaries like Alex Jones, a right wing celebrity that has also written a number of books with outlandish claims. The difference between the two, of course, is that one is regarded as a tin-foil conspiracy theorist, while the other’s views are the basis for medical professionals to seriously ponder suspension of white males in leadership roles in Medicine.
America’s new red guard
The twisted logic of these elite individuals who have ascended to now occupy the highest rungs of American society leads to to them enthusiastically and publicly endorsing discrimination against white people.
When this has happened historically, the group that has gone on to perform atrocities has always grounded their actions under the guise of justice. During the Russian Revolution, the label kulak was used to brand owners of private land, mills, and money lenders as enemies of the people to justify the subsequent seizure of their property and for many, their lives. Mao’s Red Guard attacked people wearing ‘bourgeois clothes’ on the street, tore down ‘imperialist’ signs, exiled and even killed intellectuals who subscribed to the wrong politics. America appears headed in a similar direction. Last year an Asian american cardiologist was sanctioned because he dared to publish a peer reviewed white paper that describes the history of affirmative action in medicine because a twitter mob (made up of the same people that endorse racism against white people in medicine) labeled the well cited facts in the paper as racist and hurtful. Simply questioning the narrative that all white people are racist will get you fired, as the long standing white editor of the Journal of the American Medical Association discovered after noting on a quickly retracted podcast that many physicians are offended at being termed racist. The perils are especially great for any young hopeful future doctors who may mistakenly think free and open debate and discussion on controversial topics is accepted at institutions of higher learning. Kieran Bhattacharya , an Indian american medical student, learned this the hard way when his questions to a speaker on microaggressions were deemed too antagonistic. A ‘professional concern card’ was turned into the dean by the faculty organizer, and lead to his subsequent dismissal from medical school.
In what appears to be a recurring, and persistent theme, there are those in society hell bent on destroying the lives of people that belong in overperforming groups in the name of some transformative version of Utopia.
They have always been wrong, and they are wrong now.
The first step in pushing back against the current justice warriors is to rip the cloak of justice from them and name them for what they actually are: Racists seeking creation of an apartheid state in Medicine.
This generation of physicians with a conscience must not let this go unchallenged.