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(soft music)

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- Why do we need to talk 
about race in medicine?

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- Why talk about race?

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- That's a great question.

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- It's really important 
to talk about race.

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- How can we not?

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- Race and racism are critical 
determinants of health.

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- Racism directly 
impacts the care

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that our patients receive.

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- Race is sort of the 
fable of how we've created

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who has and who doesn't have.

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- Probably the biggest 
reason that I see

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is just all the 
disparities in healthcare.

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- The mission of medicine 
is to provide medical care

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for everyone, no matter what 
the lottery of their birth is.

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- If we're really about 
health, then we have to pay

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attention to the whole person.

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- As a cis white woman, I 
have to name how I show up

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in the world in 
relationship to my patients

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who don't have the 
same experience.

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- We wouldn't do it if we 
didn't do it by intention.

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- We need everyone's 
perspective to come together.

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- This country was built on 
the backs of enslaved people,

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and we are still dealing 
with all of the repercussions

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and all of the trauma.

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- Medicine actually hasn't 
traditionally done a great job

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of understanding people's 
experience of race

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in a really racialized society.

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- It is important 
to call it out.

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- We need patients 
to be able to feel

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a connection with 
their physicians.

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- It's not just who someone is,

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but it's how they're 
treated by others

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in their experience 
in the world.

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- There needs to 
be a safe space.

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- [Announcer] This 
program is funded

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by the Center for 
the Art of Medicine

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at the University of 
Minnesota Medical School,

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and dedicated to all 
the untold stories.

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(gentle uplifting music)

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- Welcome.

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I'm Dr. Jon Hallberg.

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- And I'm Dr. 
Tseganesh Selameab.

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There are very few things 
that are more difficult

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to talk about than race.

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We may be used to having 
intimate, deeply personal

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conversations, but 
when it comes to race,

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we often find ourselves 
tongue-tied and awkward,

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mired in self-doubt, and 
weighed down with the heaviness

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of this topic.

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So not knowing where to start, 
we often choose inaction

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and safety, or politely 
skirting around the issues.

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- But we know this 
has to change.

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We all need to talk about race,

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and we'll make mistakes.

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- Exactly, and it's 
okay to make them.

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That's actually 
part of this journey

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that we're on together.

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- When faced with uncertainty,

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we turn to our 
friends and colleagues

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and ask them to tell 
us their stories.

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Stories invite us in, 
expand our experience,

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and surprise us 
with truths and joys

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we may have otherwise missed.

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- This show is an invitation 
to settle in and listen.

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We start with the stories 
of Drs. David Hamlar

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and Blanche Chavers, 
both leaders

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in their fields of medicine.

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(bright uplifting music)

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- I grew up in 
Clarksdale, Mississippi,

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which is a small town in 
the Mississippi Delta.

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Healthcare was very segregated.

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- And I grew up in an 
inner city neighborhood.

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Then the neighborhood 
was your village,

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and in that village there were 
people you could model after.

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I was very lucky my 
dad was a dentist.

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Something my father 
told me, he would say

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never say never, never say 
should have or could have.

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If you want to pursue 
something, do it.

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- I wanted to become a physician

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because of two 
serious life events

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I had as a child.

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We had one Black physician 
who took care of me

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during both of my episodes.

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Following that, I decided I'd 
like to become a physician

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and be able to 
hopefully save lives.

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So I started medical 
school in 1971.

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There were 19 women.

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There were four 
African-American students,

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and one Native American student.

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- When I was younger and 
people would walk in the room,

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and they would go 
wow, you're my doctor?

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It'd be that shock.

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- There were four percent 
African-American students

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in my medical school class.

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There are approximately four 
percent African-American

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students in the incoming class

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at the University of Minnesota.

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- There are actually more 
African-American men,

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specifically, in medical 
school during the 70s

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than the late 80s and 
even going into the 2000s.

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So you actually saw a 
decline in the number

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of Black medical students.

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- Progress has been very slow.

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We were rounding one day on 
a Native American patient

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who had just been diagnosed 
with a severe kidney disease.

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And one of the senior 
physicians said

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I think this is a lost 
cause because I don't expect

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this patient to take the 
medication that we prescribe.

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And I spoke up and said 
the senior attending

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had just prejudged this patient.

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We all deserve care, and 
a chance to be successful

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with our course of treatment.

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- The greatest 
medicine in the world,

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the greatest research 
in the world,

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doesn't always 
deliver the best care.

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And that's what we 
need to do better.

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- I would believe that 
the needle was changing

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when I can actually see 
more People of Color

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in all aspects of healthcare.

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- Right now, I 
think in this space,

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we're so busy talking, 
we're not looking

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for those actual items.

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And maybe because of my 
aging, I'm getting impatient.

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There's a bigger picture.

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And the bigger picture is 
how we influence society.

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How we change policy.

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And that is something 
that's just as important.

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- So there's a lot 
of work to be done,

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and we need more People of 
Color entering the field,

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because that's how we 
bring about change.

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- When we talk about race, we 
have to talk about identity.

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Who we are as people.

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Our heritage, our 
family, our culture,

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and our language.

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- [Producer] Okay, let's 
start at 50 years ago.

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(bright music)

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- 50 years ago, my 
parents left India.

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They took with them 
their combined histories,

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cultures, food, and fears.

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My father, Ramaiah, was 
the first in his family

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to leave the small 
farming village

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where my parents grew up.

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My mother, Vimala, was 17 
years old when she left home.

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And eventually they 
moved to Michigan

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where my brother 
and I were born.

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I was born early.

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And so I had to stay in a 
neonatal ICU for several weeks

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after I was born.

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Because my arrival was 
unexpectedly abrupt,

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my parents had not yet 
chosen a name for me.

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So the nurses called 
me Baby Boy Muthyala.

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My parents wanted my 
grandmother to help

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choose a name for me, 
but the phone connection

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to her small village was poor,

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and so we couldn't hear 
from her for days and weeks,

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and this went on and on.

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And the NICU was about a 30 
minute drive from our home,

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so everyday my dad 
would pile everybody

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into the car, drive 
to the hospital,

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drop my mom off.

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He would take my older 
brother to school

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before going to work himself.

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And then after work, he 
would pick my brother up,

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and they would go 
to the hospital,

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we would all spend 
time together,

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and my family would return home,

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only to just do it 
again the next day.

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During this time, my brother, 
who was very outgoing,

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made friends with 
the neonatologist.

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And they would actually 
go on rounds together.

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And one day, the neonatologist 
asked my brother,

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does your little 
brother have a name yet?

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And in classic 
fashion, he said yes.

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His name is Brian.

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And so the next day, 
when my parents returned

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to the hospital, 
written above my crib

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was the name Brian Muthyala.

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To this day, no one knows 
how he came up with it.

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And my parents, as 
you could imagine,

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were a little surprised.

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But in our traditions, 
it is considered bad luck

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to take a name away from 
a child once it's given.

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So eventually, I got old enough,

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and I was sent home to 
join my family a Brian,

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living with Ramaiah, 
Vimala, and Sharat.

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As the son of immigrant parents,

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I often felt torn between 
cultures, values, and beliefs.

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Brian could play 
soccer, go to the mall,

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play video games, whereas 
Kirti, my middle name,

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was a dutiful son, and 
who knew just how to act

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with the aunties 
and uncles who lived

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in our small Indian community.

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As a teenager, I was 
grateful that my brother

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gave me a name that 
allowed me to blend in.

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Strangers would see my 
brown skin, my last name,

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but my otherness was 
often less visible

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because Brian felt so familiar.

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Today, as a doctor, 
I watch my patients

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stare wide-eyed at my ID badge 
after I introduce myself,

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trying to enunciate Moothealla?

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And I quickly interrupt 
them, and I say

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you can just call me Dr. Brian.

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And I often will see the 
relief wash over their face

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as we share a quick 
smile together.

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I have often reflected on 
how my life has been simpler

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because of the mysterious 
split second decision

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of a six-year-old brother.

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But more recently, these 
thoughts have made me uneasy.

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Names are important.

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And while my name 
made introductions 
comfortable for others,

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it also put me further 
away from the rich history

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and traditions that my parents 
worked so hard to maintain

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in our family.

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So when it came time 
to name our children,

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my wife and I intentionally 
chose traditional Indian names,

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realizing that they will not 
have some of the benefits

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that I had.

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And at times I fear for my 
two young beautiful kids.

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How will I teach them 
to not be afraid,

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shy, or embarrassed of 
the richness of those

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that came before them?

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I hope I'm as 
courageous as my parents

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who braved an unknown 
world to make a better life

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for me and Sharat.

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I hope I can be the 
parent, son, partner,

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doctor, friend, and neighbor,

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and live up to the 
name I was given

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all those years ago.

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(soft music)

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- May 2020.

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Two days after the 
murder of George Floyd.

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I am seeing a 
two-year-old Black patient

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in my primary care clinic.

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He's a ball of energy, 
full of joy and curiosity,

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not yet aware of the 
cruel inequalities

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that will surely shape his 
life, and already have.

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My heart breaks for his mother

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as she shares with 
me her fears for him,

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and her hope that by the 
time he becomes a man,

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the world will be better.

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I promise his mother 
that as his doctor

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I will do whatever I can to 
help him have a better life.

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And yet this is a promise that 
I'm not sure how to fulfill

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and I wonder how 
she perceives me,

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sitting there across from her 
in that cramped exam room.

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Am I an allied 
underrepresented minority,

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or as another white person 
with good intentions,

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but little understanding of her

250
00:11:16,900 --> 00:11:18,500
and her son's lived experience?

251
00:11:20,100 --> 00:11:22,266
The truth is, I'm not 
sure how to answer

252
00:11:22,266 --> 00:11:23,433
that question myself.

253
00:11:24,300 --> 00:11:26,100
I identify as Latina.

254
00:11:26,100 --> 00:11:28,966
But I've recently 
been questioning what 
that means for me.

255
00:11:30,900 --> 00:11:33,266
My father's parents immigrated 
to the United States

256
00:11:33,266 --> 00:11:36,766
from Peru, and my mother 
identifies as white.

257
00:11:37,966 --> 00:11:39,833
My younger sister 
and I are proof

258
00:11:39,833 --> 00:11:41,900
that genetics are complicated.

259
00:11:41,900 --> 00:11:44,100
Her skin is much 
darker than mine,

260
00:11:44,100 --> 00:11:47,300
and I'm six inches 
taller than she is.

261
00:11:47,300 --> 00:11:49,566
She looks more 
"Latina" than I do.

262
00:11:50,433 --> 00:11:52,400
Recently I've wondered what role

263
00:11:52,400 --> 00:11:55,466
our physical appearance 
played in shaping our lives.

264
00:11:55,466 --> 00:11:58,266
I realize now that my identity 
has always been a choice.

265
00:11:59,566 --> 00:12:01,400
Our society uses 
appearance to define race

266
00:12:01,400 --> 00:12:02,800
and set expectations.

267
00:12:02,800 --> 00:12:05,233
My appearance does not 
tell my whole story,

268
00:12:05,233 --> 00:12:07,133
and I find myself 
consumed by the questions

269
00:12:07,133 --> 00:12:10,166
around my position as a 
Latina who looks white,

270
00:12:10,166 --> 00:12:12,500
and in recognizing my privilege,

271
00:12:12,500 --> 00:12:15,166
I struggle to keep 
hold of my identity.

272
00:12:15,166 --> 00:12:17,300
Do I count as a minority?

273
00:12:17,300 --> 00:12:18,833
Am I getting all the perks

274
00:12:18,833 --> 00:12:21,200
without having paid the 
same price as my peers?

275
00:12:22,666 --> 00:12:24,666
I grew up with the trauma 
of racism surrounding me,

276
00:12:24,666 --> 00:12:26,133
but not directly touching me.

277
00:12:27,333 --> 00:12:28,900
I can still remember 
the pained expression

278
00:12:28,900 --> 00:12:32,166
on my grandma's face on the 
day that her car was impounded

279
00:12:32,166 --> 00:12:34,300
after she was pulled 
over for speeding

280
00:12:34,300 --> 00:12:37,133
on her way to the airport 
after her brother died.

281
00:12:37,133 --> 00:12:39,000
She was flustered and sad

282
00:12:39,000 --> 00:12:42,300
and the police officer didn't 
understand her English.

283
00:12:42,300 --> 00:12:44,366
At the time, I could 
not yet understand

284
00:12:44,366 --> 00:12:46,466
the complexity of 
her expression,

285
00:12:46,466 --> 00:12:48,466
and I could only offer a hug.

286
00:12:48,466 --> 00:12:51,133
Now, I know I should 
have been angry.

287
00:12:52,533 --> 00:12:55,966
Angry for her, but also 
angry that these situations

288
00:12:55,966 --> 00:12:58,966
for which my family led to 
inconvenience and shame,

289
00:12:58,966 --> 00:13:02,366
might have cost someone, like 
my young patient, their life.

290
00:13:04,433 --> 00:13:06,433
In learning to recognize 
my own privilege,

291
00:13:06,433 --> 00:13:09,933
I also see the harsh reality 
of injustice and indifference

292
00:13:09,933 --> 00:13:11,766
based solely on the 
color one's skin

293
00:13:11,766 --> 00:13:14,033
won't be limited 
to this generation.

294
00:13:14,033 --> 00:13:15,900
I think about something 
as seemingly innate

295
00:13:15,900 --> 00:13:17,366
as our last name.

296
00:13:17,366 --> 00:13:19,700
I take pride in being an Alejos,

297
00:13:19,700 --> 00:13:23,266
but also recognize its role 
in defining my identity.

298
00:13:23,266 --> 00:13:25,866
And so I make a 
promise to myself,

299
00:13:25,866 --> 00:13:28,600
to continue putting myself 
in the humbling position

300
00:13:28,600 --> 00:13:31,533
to ask patients about their 
experience with racism,

301
00:13:31,533 --> 00:13:33,033
their fears for their children,

302
00:13:33,033 --> 00:13:34,533
and their hopes for the future.

303
00:13:34,533 --> 00:13:36,800
My own experience 
constantly reminds me

304
00:13:36,800 --> 00:13:39,400
that race is not simple 
or straightforward,

305
00:13:39,400 --> 00:13:41,633
and each person 
experiences it differently.

306
00:13:41,633 --> 00:13:44,633
However, regardless 
of how I see myself,

307
00:13:44,633 --> 00:13:47,200
I know society places 
me among the privileged.

308
00:13:47,200 --> 00:13:49,466
To ignore that is to 
be part of the problem.

309
00:13:53,200 --> 00:13:54,700
(soft music)

310
00:13:54,700 --> 00:13:58,066
- I first came to the United 
States as a 24-year-old.

311
00:13:58,066 --> 00:14:02,933
Coming in, I thought it was 
very obvious that I was cool.

312
00:14:02,933 --> 00:14:06,200
I mean, for me back 
then, it was aspirational

313
00:14:06,200 --> 00:14:08,366
in a way that I kind 
of cringe at now

314
00:14:08,366 --> 00:14:10,933
to be as American as possible.

315
00:14:11,966 --> 00:14:13,833
I was arguably well-spoken.

316
00:14:13,833 --> 00:14:16,266
I got the pop 
culture references.

317
00:14:16,266 --> 00:14:18,933
I engaged in sarcasm very well.

318
00:14:18,933 --> 00:14:20,766
I watched all 10 
seasons of Friends,

319
00:14:20,766 --> 00:14:23,033
and all the episodes 
of "Star Wars".

320
00:14:23,033 --> 00:14:24,766
I thought I had it down.

321
00:14:24,766 --> 00:14:27,600
I saw myself as one of the guys,

322
00:14:27,600 --> 00:14:30,466
every bit American 
as the next person.

323
00:14:30,466 --> 00:14:33,100
However, I remember the 
first time I ordered

324
00:14:33,100 --> 00:14:35,466
at McDonald's in Boston.

325
00:14:35,466 --> 00:14:37,966
The person at the counter 
kind of double checked

326
00:14:37,966 --> 00:14:40,866
that my non-vegetarian order 
was in fact intentional.

327
00:14:42,033 --> 00:14:43,666
Then it happened 
a few other times

328
00:14:43,666 --> 00:14:46,266
before I realized that 
the color of my skin

329
00:14:46,266 --> 00:14:49,600
may mean I was automatically 
considered vegetarian

330
00:14:49,600 --> 00:14:51,266
in some circles.

331
00:14:51,266 --> 00:14:52,933
It was not a big deal at all,

332
00:14:52,933 --> 00:14:55,366
but as a hardcore bacon lover,

333
00:14:55,366 --> 00:14:57,500
I was very offended.

334
00:14:57,500 --> 00:15:00,000
Then, as an exchange 
medical student,

335
00:15:00,000 --> 00:15:03,600
I started taking my 
first patient history.

336
00:15:03,600 --> 00:15:06,533
I saw this split second 
look of confusion

337
00:15:06,533 --> 00:15:08,666
on the elderly gentleman's face.

338
00:15:08,666 --> 00:15:10,866
He screwed up his eyes 
like he was bracing

339
00:15:10,866 --> 00:15:13,000
to not be able to understand me

340
00:15:13,000 --> 00:15:16,000
before eventually realizing 
I did speak English

341
00:15:16,000 --> 00:15:18,066
in a way he could understand.

342
00:15:18,066 --> 00:15:20,900
My eager and insecure 
little 24-year-old heart

343
00:15:20,900 --> 00:15:23,200
however sank a teeny bit.

344
00:15:23,200 --> 00:15:25,366
Then the same thing 
happened with a younger guy

345
00:15:25,366 --> 00:15:28,033
who showed me around 
the first gym I joined.

346
00:15:29,200 --> 00:15:32,000
Eventually, that split 
second look of confusion

347
00:15:32,000 --> 00:15:35,200
became so familiar, 
I began to expect it

348
00:15:35,200 --> 00:15:36,666
at every new interaction.

349
00:15:37,833 --> 00:15:41,000
I have now realized, 
after all these years,

350
00:15:41,000 --> 00:15:44,500
that maybe it was not 
so obvious to others,

351
00:15:44,500 --> 00:15:47,766
my coolness, or my 
fitting in-ness.

352
00:15:47,766 --> 00:15:50,833
I think it finally clicked 
that one time I realized

353
00:15:50,833 --> 00:15:54,400
my friend here, who to 
me was just my friend,

354
00:15:54,400 --> 00:15:56,700
referred to me to 
her other friends

355
00:15:56,700 --> 00:15:58,400
as her Indian friend.

356
00:15:59,600 --> 00:16:02,400
My dear friend meant no 
harm at all, obviously,

357
00:16:02,400 --> 00:16:04,900
but I essentially had failed

358
00:16:04,900 --> 00:16:07,733
in my aspirational Americanness.

359
00:16:07,733 --> 00:16:09,900
Whether these 
aspirations were acquired

360
00:16:09,900 --> 00:16:12,900
or well-placed is a 
question for another day.

361
00:16:12,900 --> 00:16:14,933
And I cannot help but feel

362
00:16:14,933 --> 00:16:17,166
like these are 
trivial grievances.

363
00:16:17,166 --> 00:16:20,400
That is a common theme with 
these experiences often.

364
00:16:20,400 --> 00:16:21,833
Am I imagining it?

365
00:16:21,833 --> 00:16:24,666
Was it because I'm brown, 
or a woman, or young?

366
00:16:24,666 --> 00:16:25,900
Was it even real?

367
00:16:25,900 --> 00:16:27,066
I must be overreacting.

368
00:16:27,066 --> 00:16:28,400
This is all in my head.

369
00:16:28,400 --> 00:16:29,566
I'll go take a walk now.

370
00:16:30,433 --> 00:16:31,966
Do they matter that much?

371
00:16:31,966 --> 00:16:34,066
Another close friend 
asked once recently

372
00:16:34,066 --> 00:16:35,766
while we were discussing 
the perceptions

373
00:16:35,766 --> 00:16:37,566
and nuances of racism.

374
00:16:37,566 --> 00:16:40,966
Must we all be such wallflowers?

375
00:16:40,966 --> 00:16:43,666
Of course none of these 
people meant any harm.

376
00:16:43,666 --> 00:16:46,800
In fact, they were all 
genuinely lovely people.

377
00:16:46,800 --> 00:16:49,900
But the thing is, sometimes 
it's the little things

378
00:16:49,900 --> 00:16:52,233
that define our otherness.

379
00:16:52,233 --> 00:16:54,400
When you look back in middle 
school or high school,

380
00:16:54,400 --> 00:16:56,733
do you remember not 
wanting to stand out

381
00:16:56,733 --> 00:16:58,300
in any way at all?

382
00:16:58,300 --> 00:16:59,566
I did.

383
00:16:59,566 --> 00:17:01,700
The most pressing 
motivational factor

384
00:17:01,700 --> 00:17:03,166
was the need to fit in.

385
00:17:03,166 --> 00:17:07,466
The need to not be seen as 
different or weird in any way.

386
00:17:08,566 --> 00:17:10,200
But then do you also 
remember that first day

387
00:17:10,200 --> 00:17:13,233
you had to wear glasses 
to school, or braces?

388
00:17:13,233 --> 00:17:15,233
You can perhaps still 
feel that anxiety

389
00:17:15,233 --> 00:17:17,300
in the pit of your stomach 
as you turn the corner

390
00:17:17,300 --> 00:17:19,300
of the hallway and 
walked into class.

391
00:17:20,466 --> 00:17:23,066
When you think about it, 
that motivation remains

392
00:17:23,066 --> 00:17:25,466
for most of our 
lives on some level.

393
00:17:25,466 --> 00:17:28,233
At the end of the day, you 
kind of hope you fit in

394
00:17:28,233 --> 00:17:31,500
within the community you 
spend most of your time with.

395
00:17:31,500 --> 00:17:33,900
And that's why it 
matters, because it feels

396
00:17:33,900 --> 00:17:36,133
like middle school a 
bit, all of the time,

397
00:17:36,133 --> 00:17:39,466
for all of our lives in this 
country we as immigrants

398
00:17:39,466 --> 00:17:42,333
earnestly choose to call home.

399
00:17:42,333 --> 00:17:45,133
The anxiety in the pit of 
your stomach, everyday,

400
00:17:45,133 --> 00:17:47,333
at work, at school, 
at the grocery story,

401
00:17:47,333 --> 00:17:49,400
being a little bit fearful,

402
00:17:49,400 --> 00:17:52,166
fearful of microaggressions 
and exchanged glances,

403
00:17:52,166 --> 00:17:55,533
and subtle changes in body 
language indicating discomfort,

404
00:17:55,533 --> 00:17:58,300
fearful of being 
dismissed and talked over.

405
00:17:58,300 --> 00:18:00,866
It makes the path a 
little more arduous.

406
00:18:02,033 --> 00:18:04,366
But these discomforts 
are going to be here

407
00:18:04,366 --> 00:18:06,566
for a long time, 
for People of Color,

408
00:18:06,566 --> 00:18:09,033
because change is 
hard and takes time.

409
00:18:09,033 --> 00:18:12,366
And there are far more overt 
racially charged experiences

410
00:18:12,366 --> 00:18:14,200
we need to tackle first.

411
00:18:14,200 --> 00:18:16,766
So in the interim, 
what can we do?

412
00:18:16,766 --> 00:18:20,200
What we could do is maybe 
offer some extra kindness

413
00:18:20,200 --> 00:18:22,866
to that one intern who's 
treated a little differently.

414
00:18:23,866 --> 00:18:26,466
Thank you.

415
00:18:26,466 --> 00:18:28,966
(man singing)

416
00:18:34,066 --> 00:18:35,600
- When I was eight years old,

417
00:18:35,600 --> 00:18:37,766
I was in my grandparents' 
house on the reservation,

418
00:18:37,766 --> 00:18:40,700
and my grandpa asked me what 
I wanted to be when I grew up,

419
00:18:40,700 --> 00:18:43,466
and I said I want 
to be a doctor.

420
00:18:44,866 --> 00:18:47,200
His response to me, this 
man who loved me very much,

421
00:18:47,200 --> 00:18:48,700
and took really good care of me,

422
00:18:48,700 --> 00:18:52,200
his response was well, you're 
too stupid to be doctor.

423
00:18:52,200 --> 00:18:55,733
My grandpa is really wise, 
so I thought oh, okay.

424
00:18:55,733 --> 00:18:57,800
I believed him for 
about 20 years,

425
00:18:57,800 --> 00:19:00,200
and then in my late 
20s, I was a cop,

426
00:19:00,200 --> 00:19:04,766
and I was driving my 
patrol car down the road.

427
00:19:04,766 --> 00:19:06,633
I had this really 
striking thought

428
00:19:06,633 --> 00:19:09,466
that came to me, it was like 
somebody else was telling me.

429
00:19:09,466 --> 00:19:10,766
You know, you can do this.

430
00:19:12,166 --> 00:19:14,766
I decided right then that 
that was what I was gonna be,

431
00:19:14,766 --> 00:19:15,866
was a doctor.

432
00:19:17,433 --> 00:19:19,766
I still doubted myself 
every once in a while.

433
00:19:19,766 --> 00:19:22,666
I remember telling my Elders 
who were like grandpas to me,

434
00:19:22,666 --> 00:19:24,033
this is too hard.

435
00:19:24,033 --> 00:19:26,100
Thinking maybe I need to 
be doing something else.

436
00:19:26,100 --> 00:19:28,166
And they said no, we need you.

437
00:19:29,366 --> 00:19:30,766
How could I say no to that?

438
00:19:33,800 --> 00:19:36,966
(bright music)

439
00:19:36,966 --> 00:19:38,533
My name's Bret Benally Thompson.

440
00:19:38,533 --> 00:19:41,033
I'm a palliative care 
and hospice physician

441
00:19:41,033 --> 00:19:43,166
at the University of Wisconsin.

442
00:19:47,600 --> 00:19:50,966
What we do as physicians 
is really precious.

443
00:19:52,100 --> 00:19:53,700
I hear people's 
stories all the time.

444
00:19:53,700 --> 00:19:56,100
A lot of times, they're 
really tough stories.

445
00:19:56,100 --> 00:19:59,466
And sometimes we can fix them,

446
00:19:59,466 --> 00:20:01,100
sometimes they 
don't need fixing,

447
00:20:01,100 --> 00:20:03,933
but we still hear their stories.

448
00:20:03,933 --> 00:20:06,866
We walk people through 
that part of their life

449
00:20:06,866 --> 00:20:09,200
that they're there, 
asking us for help.

450
00:20:10,466 --> 00:20:13,000
Most people don't want 
to leave this life,

451
00:20:13,000 --> 00:20:15,166
and most people don't want 
to leave their families

452
00:20:15,166 --> 00:20:16,666
and the people that they love.

453
00:20:18,966 --> 00:20:21,533
As a vet myself, 
I a lot of times

454
00:20:21,533 --> 00:20:23,833
will connect with veterans.

455
00:20:23,833 --> 00:20:26,333
I figure they've probably 
suffered in some way

456
00:20:26,333 --> 00:20:29,500
to take care of us, so 
it's something I can

457
00:20:29,500 --> 00:20:31,600
give back to them, by 
taking care of them.

458
00:20:35,200 --> 00:20:37,000
A lot of times, the families 
or patients thank me

459
00:20:37,000 --> 00:20:38,500
for taking care of them.

460
00:20:38,500 --> 00:20:40,533
I say well it's an honor 
for me to take care of you.

461
00:20:45,200 --> 00:20:48,000
I don't tell people that I'm 
Native unless they ask me.

462
00:20:48,000 --> 00:20:50,933
Because I'm one of those guys 
that could pass for either.

463
00:20:50,933 --> 00:20:55,033
But it's definitely a part 
of who I am spiritually.

464
00:20:55,033 --> 00:20:57,433
The way I've been taught, 
and the way I've learned

465
00:20:57,433 --> 00:21:01,100
as an adult in our ceremonies, 
and our way of life,

466
00:21:01,100 --> 00:21:03,266
really helps keep me 
grounded in what I do.

467
00:21:04,700 --> 00:21:06,533
Part of what I really love 
about being a physician

468
00:21:06,533 --> 00:21:10,433
is I get to go back and 
talk to young people

469
00:21:10,433 --> 00:21:12,500
about what it's 
like to be a doctor,

470
00:21:12,500 --> 00:21:16,366
and if they have any inkling 
about being a doctor,

471
00:21:16,366 --> 00:21:19,500
that it's actually 
something that they can do.

472
00:21:19,500 --> 00:21:23,066
Some people go right from 
high school to college

473
00:21:23,066 --> 00:21:24,333
to medical school.

474
00:21:24,333 --> 00:21:26,333
That's probably 
the most common way

475
00:21:26,333 --> 00:21:28,000
that people become physicians,

476
00:21:28,000 --> 00:21:29,900
is they just go 
straight through.

477
00:21:29,900 --> 00:21:32,666
But my path has never 
been a straight path.

478
00:21:32,666 --> 00:21:34,400
I've had a very 
rich and full life,

479
00:21:34,400 --> 00:21:36,666
but it's taken a lot 
of twists and turns,

480
00:21:36,666 --> 00:21:39,366
and I think a lot of 
Native people are that way.

481
00:21:39,366 --> 00:21:41,033
We don't have the 
same opportunities,

482
00:21:41,033 --> 00:21:42,900
maybe don't have 
the same resources

483
00:21:42,900 --> 00:21:44,733
that some other people have.

484
00:21:45,733 --> 00:21:47,366
When I encounter an obstacle,

485
00:21:47,366 --> 00:21:48,833
if I can't go over 
it or through it,

486
00:21:48,833 --> 00:21:50,566
I go around it.

487
00:21:50,566 --> 00:21:52,700
That might take some extra time,

488
00:21:52,700 --> 00:21:56,666
or it might take a more 
ingenious way to do it,

489
00:21:56,666 --> 00:21:59,166
but Native people 
are pretty ingenious.

490
00:21:59,166 --> 00:22:00,433
It's how we've survived.

491
00:22:02,400 --> 00:22:04,233
I always tend to get there,

492
00:22:05,400 --> 00:22:07,633
and that's how I got 
to be a physician.

493
00:22:07,633 --> 00:22:11,466
I never gave up, never 
gave up on my dream.

494
00:22:15,266 --> 00:22:18,300
- Why is it important 
to tell our stories?

495
00:22:18,300 --> 00:22:20,966
- If we tell our stories, we 
understand each other better.

496
00:22:20,966 --> 00:22:23,666
- When everyone is able 
to share their story,

497
00:22:23,666 --> 00:22:26,500
when we understand those 
multiple perspectives.

498
00:22:26,500 --> 00:22:29,433
- We all come with 
a special nuance

499
00:22:29,433 --> 00:22:30,733
that makes us different.

500
00:22:30,733 --> 00:22:32,900
- We're able to build 
systems and structures

501
00:22:32,900 --> 00:22:35,333
that take into account 
the diverse needs

502
00:22:35,333 --> 00:22:38,066
and desires of the 
entire community.

503
00:22:38,066 --> 00:22:39,833
- When people hear 
these stories,

504
00:22:39,833 --> 00:22:41,633
they feel like they're 
part of something.

505
00:22:41,633 --> 00:22:43,500
- It's important for 
my story to be told,

506
00:22:43,500 --> 00:22:46,066
because people are 
oftentimes not even aware

507
00:22:46,066 --> 00:22:48,300
that Native Americans still 
exist in this country.

508
00:22:48,300 --> 00:22:51,566
- The world is very 
harsh and unkind,

509
00:22:51,566 --> 00:22:54,666
and when we share 
stories and connections,

510
00:22:54,666 --> 00:22:57,166
that is how we build empathy, 
and that is the only way

511
00:22:57,166 --> 00:22:59,733
that we can possibly 
begin to heal the world.

512
00:22:59,733 --> 00:23:01,800
- Understanding the narrative

513
00:23:01,800 --> 00:23:05,400
really identifies elements 
people can latch onto.

514
00:23:05,400 --> 00:23:06,700
It pulls them along.

515
00:23:06,700 --> 00:23:08,633
- And sometimes we 
just need to be quiet

516
00:23:08,633 --> 00:23:10,133
and listen to patients.

517
00:23:10,133 --> 00:23:14,300
- We have a head and a 
heart and a hands problem.

518
00:23:14,300 --> 00:23:16,866
So the head is just 
the data, the facts,

519
00:23:16,866 --> 00:23:19,200
that we have these 
healthcare disparities.

520
00:23:19,200 --> 00:23:20,700
The heart are the 
stories, right?

521
00:23:20,700 --> 00:23:23,300
They're the actual 
stories that we all tell

522
00:23:23,300 --> 00:23:25,233
about how we experience 
them, how our patients

523
00:23:25,233 --> 00:23:26,666
and families experience them,

524
00:23:26,666 --> 00:23:29,300
and then the hands are 
what we actually can do

525
00:23:29,300 --> 00:23:30,633
to make a difference.

526
00:23:30,633 --> 00:23:32,966
And so without having the heart,

527
00:23:32,966 --> 00:23:34,966
it's really hard 
to do the hands.

528
00:23:38,466 --> 00:23:40,166
- Our stories have to be told

529
00:23:40,166 --> 00:23:42,200
so that we can activate change.

530
00:23:46,466 --> 00:23:50,300
- Traveling a path less 
worn requires constant

531
00:23:50,300 --> 00:23:52,900
calculation and readjustment.

532
00:23:52,900 --> 00:23:55,200
It involves 
celebrating milestones,

533
00:23:55,200 --> 00:23:57,966
as well as marking the 
hazards and pitfalls

534
00:23:57,966 --> 00:24:00,200
for those who come after.

535
00:24:00,200 --> 00:24:04,633
The experience can be both 
lonely and exhilarating.

536
00:24:04,633 --> 00:24:08,100
These next storytellers 
take us on that journey,

537
00:24:08,100 --> 00:24:10,866
and share with us the 
lessons that they've learned.

538
00:24:16,233 --> 00:24:18,733
- I have come to understand 
that in the fight

539
00:24:18,733 --> 00:24:22,200
for health equity, my presence 
as a Black woman physician

540
00:24:22,200 --> 00:24:26,300
is welcome so long as I 
am seen and not heard.

541
00:24:27,700 --> 00:24:30,866
This conditional acceptance 
has been a painful realization,

542
00:24:30,866 --> 00:24:33,633
and dissent is not 
without its consequences,

543
00:24:33,633 --> 00:24:35,366
a lesson I learned one 
night while working

544
00:24:35,366 --> 00:24:37,433
on the adult inpatient 
medicine ward.

545
00:24:38,633 --> 00:24:40,900
I received a call from 
the nurse of Patricia,

546
00:24:40,900 --> 00:24:42,733
a Black sickle cell patient.

547
00:24:42,733 --> 00:24:45,533
I learned that a pill find 
while cleaning out her handbag

548
00:24:45,533 --> 00:24:48,733
had been identified as 
a narcotic medication.

549
00:24:48,733 --> 00:24:51,233
Security and nursing staff 
requested our presence

550
00:24:51,233 --> 00:24:52,466
for a room search.

551
00:24:52,466 --> 00:24:54,766
Patricia's mental 
status had not changed.

552
00:24:54,766 --> 00:24:56,566
There had been no change 
in her vital signs

553
00:24:56,566 --> 00:24:59,200
or clinical status, and 
there was no indication

554
00:24:59,200 --> 00:25:00,600
that she had consumed any pills

555
00:25:00,600 --> 00:25:02,700
preceding security's presence.

556
00:25:02,700 --> 00:25:04,433
Upon relaying this to the nurse,

557
00:25:04,433 --> 00:25:07,100
and asking for time 
to review the policy,

558
00:25:07,100 --> 00:25:09,966
she paused briefly before 
asking me to confirm

559
00:25:09,966 --> 00:25:12,766
that I would not 
be participating 
in the room search.

560
00:25:13,933 --> 00:25:16,666
I sat for a while 
in stunned silence.

561
00:25:16,666 --> 00:25:19,500
If a room search was 
indicated for Patricia,

562
00:25:19,500 --> 00:25:22,200
why had it not been 
indicated earlier in the week

563
00:25:22,200 --> 00:25:25,166
for my other patient who 
happened to be a white male,

564
00:25:25,166 --> 00:25:27,766
when he left the unit, 
returned somnolent,

565
00:25:27,766 --> 00:25:30,033
and returned to normal 
when he got Narcan,

566
00:25:30,033 --> 00:25:33,600
the antidote for opioid 
pain medication overdoses.

567
00:25:33,600 --> 00:25:35,766
By the time I had learned 
there was no defined

568
00:25:35,766 --> 00:25:38,800
room search policy, 
it had concluded.

569
00:25:38,800 --> 00:25:41,166
When I visited Patricia 
later, she wept

570
00:25:41,166 --> 00:25:44,100
while recounting the 
indignity of being separated

571
00:25:44,100 --> 00:25:46,200
from her belongings, 
and being patted down

572
00:25:46,200 --> 00:25:48,333
by uniformed staff.

573
00:25:48,333 --> 00:25:50,633
Nothing had come 
of the room search,

574
00:25:50,633 --> 00:25:53,600
but she was left to pick up 
the pieces of her mistreatment.

575
00:25:55,100 --> 00:26:00,166
My internal response 
was a visceral thing.

576
00:26:01,433 --> 00:26:05,700
A living, breathing 
amalgamation of ancestral voices

577
00:26:06,833 --> 00:26:10,866
coalescing into a single 
reverberating word.

578
00:26:11,933 --> 00:26:12,766
No.

579
00:26:14,366 --> 00:26:16,033
This was wrong.

580
00:26:17,366 --> 00:26:20,000
But even rooted in the 
assurance of advocacy

581
00:26:20,000 --> 00:26:23,766
and social justice, an 
insidious, intoxicating fear

582
00:26:23,766 --> 00:26:26,333
pressed forward, 
determined to lull me

583
00:26:26,333 --> 00:26:28,233
into the safety of silence.

584
00:26:29,400 --> 00:26:33,033
Speaking up would be a 
radical act of defiance

585
00:26:33,033 --> 00:26:35,566
for a Black woman who 
has been conditioned

586
00:26:35,566 --> 00:26:39,366
to keep her head 
down, to be agreeable,

587
00:26:39,366 --> 00:26:40,566
to not make trouble.

588
00:26:42,233 --> 00:26:44,100
When Patricia's nurse 
asked to debrief,

589
00:26:44,100 --> 00:26:46,666
I steeled myself in a 
stance of curiosity,

590
00:26:46,666 --> 00:26:48,533
and asked many questions.

591
00:26:48,533 --> 00:26:51,166
What was the concern from 
a nursing perspective?

592
00:26:51,166 --> 00:26:53,666
How could we have improved 
our communication?

593
00:26:53,666 --> 00:26:55,666
How do we make decisions 
on when to implement

594
00:26:55,666 --> 00:26:56,666
a room search?

595
00:26:56,666 --> 00:26:58,733
What alternatives did we have?

596
00:26:58,733 --> 00:27:01,633
When invited, I shared 
my own perspective.

597
00:27:01,633 --> 00:27:03,633
Together, we created 
a plan to address

598
00:27:03,633 --> 00:27:05,733
similar concerns in the future.

599
00:27:05,733 --> 00:27:07,733
We shook hands and hugged.

600
00:27:07,733 --> 00:27:10,833
The chasm between us 
didn't feel so wide.

601
00:27:10,833 --> 00:27:13,133
While it wouldn't change 
what happened with Patricia,

602
00:27:13,133 --> 00:27:15,266
we could prevent harm 
to another patient,

603
00:27:15,266 --> 00:27:16,733
and that was something.

604
00:27:18,066 --> 00:27:21,566
The next night, I was 
informed that nursing staff

605
00:27:21,566 --> 00:27:24,733
had filed a complaint stating 
I had been unsupportive,

606
00:27:24,733 --> 00:27:26,900
and refused to act 
collaboratively.

607
00:27:29,500 --> 00:27:31,433
First came shock.

608
00:27:31,433 --> 00:27:33,100
Then anger.

609
00:27:33,100 --> 00:27:35,400
And when the anger was spent,

610
00:27:35,400 --> 00:27:38,400
an overwhelming 
emotional exhaustion.

611
00:27:39,566 --> 00:27:43,100
I cried for days afterward.

612
00:27:43,100 --> 00:27:47,233
It had taken me years of 
training and education

613
00:27:47,233 --> 00:27:50,566
to learn to abandon 
the lessons handed down

614
00:27:50,566 --> 00:27:53,600
by my forefathers to 
keep my head down.

615
00:27:53,600 --> 00:27:55,566
To be agreeable.

616
00:27:55,566 --> 00:27:57,600
To not make trouble.

617
00:27:57,600 --> 00:27:59,000
I wonder if they understood

618
00:27:59,000 --> 00:28:02,166
that through the weaponization 
of their feedback,

619
00:28:02,166 --> 00:28:03,966
they had taken something from me

620
00:28:03,966 --> 00:28:05,466
that I couldn't get back.

621
00:28:06,400 --> 00:28:07,866
What had they given up?

622
00:28:07,866 --> 00:28:10,300
I was ready to have 
difficult conversations

623
00:28:10,300 --> 00:28:11,800
to bridge the divide.

624
00:28:12,866 --> 00:28:15,300
But even though I had arrived,

625
00:28:15,300 --> 00:28:17,366
had been welcomed, even,

626
00:28:17,366 --> 00:28:20,166
I am still subject to 
the same inequities

627
00:28:20,166 --> 00:28:21,666
that my patients face.

628
00:28:23,133 --> 00:28:24,866
I think of Patricia often.

629
00:28:26,300 --> 00:28:29,400
I worry that the damage 
done to her is irreparable.

630
00:28:29,400 --> 00:28:31,666
I worry that 
progress is too slow,

631
00:28:31,666 --> 00:28:33,300
and patients are being harmed

632
00:28:33,300 --> 00:28:35,233
while we strive 
for what could be.

633
00:28:36,133 --> 00:28:37,966
I worry that while I believe

634
00:28:37,966 --> 00:28:40,966
being the dissenting 
voice was right,

635
00:28:40,966 --> 00:28:44,000
I may not always 
have the fortitude

636
00:28:44,000 --> 00:28:47,733
to always be a voice 
for the voiceless.

637
00:28:59,633 --> 00:29:01,366
- Are you the doctor?

638
00:29:01,366 --> 00:29:04,366
(gentle music) 
(monitors beeping)

639
00:29:04,366 --> 00:29:07,300
Your frayed undertone 
alerts me to what's coming.

640
00:29:07,300 --> 00:29:09,733
Grievances, waiting 
for a scapegoat.

641
00:29:09,733 --> 00:29:11,600
I suppress a sigh.

642
00:29:11,600 --> 00:29:13,433
17 patients to see, and you were

643
00:29:13,433 --> 00:29:15,700
the only straightforward one.

644
00:29:15,700 --> 00:29:17,700
This is not how I 
wanted to start my day.

645
00:29:18,633 --> 00:29:20,433
I fix my face.

646
00:29:20,433 --> 00:29:22,700
Yes, I'm your doctor.

647
00:29:22,700 --> 00:29:25,700
My hollow words hang 
silently in the air.

648
00:29:25,700 --> 00:29:27,600
The most charitable 
observer would find

649
00:29:27,600 --> 00:29:29,866
no warmth in your gaze.

650
00:29:29,866 --> 00:29:32,700
The nurse's curt assessment 
of you is still fresh,

651
00:29:32,700 --> 00:29:34,766
difficult and standoffish.

652
00:29:34,766 --> 00:29:36,066
How are you feeling?

653
00:29:36,066 --> 00:29:37,700
I silently repeat the mantra.

654
00:29:37,700 --> 00:29:38,933
I'm here to help.

655
00:29:38,933 --> 00:29:40,133
Tell me your story.

656
00:29:40,133 --> 00:29:43,200
Projecting a safe space 
that doesn't exist.

657
00:29:43,200 --> 00:29:45,066
You reject the mirage.

658
00:29:45,066 --> 00:29:48,233
The rigid lines etched into 
your face don't soften,

659
00:29:48,233 --> 00:29:50,866
but it's your eyes 
that speak the truth.

660
00:29:50,866 --> 00:29:52,933
Exhaustion has 
smothered everything,

661
00:29:52,933 --> 00:29:56,100
leaving muted embers of 
anger in its aftermath.

662
00:29:56,100 --> 00:29:59,633
Dread crouches at the 
periphery, waiting.

663
00:29:59,633 --> 00:30:01,533
I came here because 
I can't breathe.

664
00:30:01,533 --> 00:30:04,200
I've been asked four times 
already if I do drugs.

665
00:30:04,200 --> 00:30:06,533
Why do y'all keep 
asking the same thing?

666
00:30:06,533 --> 00:30:09,300
This question is not an 
extended olive branch.

667
00:30:09,300 --> 00:30:11,466
It's the crisp crinkling 
of a test booklet

668
00:30:11,466 --> 00:30:13,966
as you prepare to 
grade my answer.

669
00:30:13,966 --> 00:30:15,566
I'm restless.

670
00:30:15,566 --> 00:30:18,133
Precious time is leaking away.

671
00:30:18,133 --> 00:30:20,233
Weariness coils 
tightly around me

672
00:30:20,233 --> 00:30:23,966
like a boa constrictor made 
of impotence and cynicism.

673
00:30:23,966 --> 00:30:25,933
My legs can no longer 
bear the weight.

674
00:30:29,866 --> 00:30:30,633
May I sit?

675
00:30:31,633 --> 00:30:32,433
You nod.

676
00:30:33,700 --> 00:30:36,266
I settle in at the 
edge of your bed.

677
00:30:36,266 --> 00:30:39,133
There's no quick way 
through this conversation.

678
00:30:39,133 --> 00:30:42,533
I could say we ask all 
patients about drug use.

679
00:30:42,533 --> 00:30:44,700
Normalize it, and 
attempt to sidestep

680
00:30:44,700 --> 00:30:46,866
the traumatic undercurrents.

681
00:30:46,866 --> 00:30:48,800
I might acknowledge 
your distress,

682
00:30:48,800 --> 00:30:50,933
and ask you to tell me more.

683
00:30:50,933 --> 00:30:52,866
The med school answer.

684
00:30:52,866 --> 00:30:55,033
I could even say I'm 
sorry that happened,

685
00:30:55,033 --> 00:30:56,866
and then take control 
of the conversation

686
00:30:56,866 --> 00:30:58,700
by asking about your breathing.

687
00:30:58,700 --> 00:30:59,933
The hospitalist answer.

688
00:31:01,200 --> 00:31:04,600
Suddenly, I'm back in college.

689
00:31:04,600 --> 00:31:06,766
An officer is approaching 
my black Honda Civic

690
00:31:06,766 --> 00:31:08,433
with his weapon drawn.

691
00:31:08,433 --> 00:31:11,200
He's shouting show 
me your hands.

692
00:31:11,200 --> 00:31:14,800
They shake as I stick them out 
of the driver's side window.

693
00:31:14,800 --> 00:31:16,433
I'm taken to jail.

694
00:31:16,433 --> 00:31:19,633
I spend my phone call on a 
friend who doesn't pick up.

695
00:31:19,633 --> 00:31:21,933
I'm released the next 
day with a gruff apology

696
00:31:21,933 --> 00:31:23,433
from the officer.

697
00:31:23,433 --> 00:31:24,766
You aren't the right guy.

698
00:31:24,766 --> 00:31:26,300
Sorry.

699
00:31:26,300 --> 00:31:30,266
My doctor mask slips, 
exposing the human beneath.

700
00:31:30,266 --> 00:31:32,166
My answer is all bitter edges.

701
00:31:33,666 --> 00:31:36,366
Some people get the benefit 
of the doubt, others don't.

702
00:31:37,600 --> 00:31:39,366
I can't promise it 
won't happen again,

703
00:31:39,366 --> 00:31:40,500
but I'll do what I can.

704
00:31:42,100 --> 00:31:45,633
At some point I ask you, 
when did your symptoms start?

705
00:31:45,633 --> 00:31:47,766
You have trouble answering me.

706
00:31:47,766 --> 00:31:50,833
I reach back to a 
conversation with my dad.

707
00:31:50,833 --> 00:31:52,500
I don't get why doctors 
expect us to know

708
00:31:52,500 --> 00:31:54,200
the difference between 
regular discomfort

709
00:31:54,200 --> 00:31:55,533
and bad discomfort.

710
00:31:55,533 --> 00:31:56,833
Life is pain.

711
00:31:56,833 --> 00:31:59,000
You work through 
it until you can't.

712
00:31:59,000 --> 00:32:00,433
I reframe the question.

713
00:32:01,833 --> 00:32:04,100
When did life start 
getting harder than usual?

714
00:32:04,100 --> 00:32:06,000
Your answer is instantaneous.

715
00:32:06,000 --> 00:32:07,000
Five months ago.

716
00:32:08,200 --> 00:32:10,266
Gathering the rest of 
your history is easy.

717
00:32:10,266 --> 00:32:12,266
You're comfortable with my plan.

718
00:32:12,266 --> 00:32:14,666
You smile for the first time.

719
00:32:14,666 --> 00:32:15,700
Thank you, doctor.

720
00:32:17,100 --> 00:32:19,533
Later today, we'll discuss 
your abnormal results

721
00:32:19,533 --> 00:32:21,500
and upcoming procedures.

722
00:32:21,500 --> 00:32:22,333
You'll cry.

723
00:32:23,333 --> 00:32:24,600
I'll sit with you again.

724
00:32:25,833 --> 00:32:27,666
You'll talk about the 
pressures of your job,

725
00:32:27,666 --> 00:32:29,866
and the challenges of 
being a single parent.

726
00:32:31,000 --> 00:32:33,833
When I look at 
you, I see family.

727
00:32:33,833 --> 00:32:35,600
Several generations 
of hard lessons

728
00:32:35,600 --> 00:32:37,500
discouraging vulnerability.

729
00:32:37,500 --> 00:32:39,500
You can't afford to be 
less than invincible

730
00:32:39,500 --> 00:32:41,500
when shielding others 
from the struggle,

731
00:32:41,500 --> 00:32:44,833
and yet you're here, 
unable to go on.

732
00:32:44,833 --> 00:32:47,566
I can't resolve this 
cognitive dissonance for you.

733
00:32:47,566 --> 00:32:50,333
All I can offer is this 
small fleeting space

734
00:32:50,333 --> 00:32:53,533
carved out with the keen 
edges of shared trauma.

735
00:32:53,533 --> 00:32:56,500
Maybe here, you can 
temporarily afford to be human.

736
00:32:58,000 --> 00:33:00,166
Two days from now, 
you'll ask me about life

737
00:33:00,166 --> 00:33:02,066
as a Black hospitalist.

738
00:33:02,066 --> 00:33:04,800
You'll listen as I talk 
about George Floyd,

739
00:33:04,800 --> 00:33:09,166
sick family members, 
protests, and COVID-19.

740
00:33:09,166 --> 00:33:11,633
I will no longer track 
the time during our visit.

741
00:33:12,566 --> 00:33:14,066
Flakes of clinical detachment

742
00:33:14,066 --> 00:33:16,500
will fall from me 
like a shattered cast,

743
00:33:16,500 --> 00:33:18,566
revealing the 
exhausted husk beneath,

744
00:33:19,933 --> 00:33:22,100
The wall separating the 
personal from the professional

745
00:33:22,100 --> 00:33:24,966
will completely vanish, 
trapping me in a moment

746
00:33:24,966 --> 00:33:26,900
that is both cathartic 
and triggering.

747
00:33:28,233 --> 00:33:30,433
You'll extend an incredible 
amount of compassion

748
00:33:30,433 --> 00:33:32,966
as tears soak my mask, 
and ragged breaths

749
00:33:32,966 --> 00:33:34,900
fog up my face shield.

750
00:33:34,900 --> 00:33:38,566
You'll take my hand, 
lending me your resolve.

751
00:33:38,566 --> 00:33:42,000
Somehow, you'll know 
exactly what I need to hear.

752
00:33:42,000 --> 00:33:44,133
Don't give up on 
us, Dr. Williams.

753
00:33:44,133 --> 00:33:45,400
You're not alone.

754
00:33:45,400 --> 00:33:46,500
We need you.

755
00:33:55,766 --> 00:33:58,666
- And the summer of 
2020 was really hard.

756
00:33:58,666 --> 00:34:01,800
(soft tense music)

757
00:34:01,800 --> 00:34:06,133
We were all, I think, 
feeling isolated and stunned.

758
00:34:07,466 --> 00:34:10,900
When we finally started talking 
about the issues of race,

759
00:34:10,900 --> 00:34:14,233
and I kept waiting for 
something to happen,

760
00:34:14,233 --> 00:34:16,633
and nothing seemed 
to be developing,

761
00:34:16,633 --> 00:34:18,666
specifically for 
healthcare professionals,

762
00:34:18,666 --> 00:34:21,033
and so I talked to 
our whole department,

763
00:34:21,033 --> 00:34:23,166
and the medical students 
and the residents

764
00:34:23,166 --> 00:34:24,966
I worked with, we 
decided to partner

765
00:34:24,966 --> 00:34:26,466
with White Coats 
for Black Lives,

766
00:34:26,466 --> 00:34:29,500
and to organize our own rally.

767
00:34:32,033 --> 00:34:34,800
Safety was at the 
utmost importance

768
00:34:34,800 --> 00:34:36,366
for all of us, 
because we didn't want

769
00:34:36,366 --> 00:34:39,000
to take ourselves out of 
the essential workforce,

770
00:34:39,000 --> 00:34:41,300
and so we decided 
that a silent sit-in

771
00:34:41,300 --> 00:34:42,966
would probably be the most safe.

772
00:34:45,900 --> 00:34:48,066
It felt really 
good for all of us,

773
00:34:48,066 --> 00:34:49,966
to be there, and to 
be there in force,

774
00:34:49,966 --> 00:34:52,366
and to have our voice heard,

775
00:34:52,366 --> 00:34:54,300
and for us to come 
together like that.

776
00:34:56,466 --> 00:34:58,833
I think messaging and 
witnessing are important,

777
00:34:58,833 --> 00:35:01,800
but only up to a 
point, and systems

778
00:35:05,233 --> 00:35:08,100
are very, very hard to change.

779
00:35:08,100 --> 00:35:12,200
At some point, you can't 
spend all your energy

780
00:35:12,200 --> 00:35:13,700
just messaging, and witnessing,

781
00:35:13,700 --> 00:35:15,200
and demonstrating 
and protesting,

782
00:35:15,200 --> 00:35:17,533
you have to really 
transform that into action.

783
00:35:18,366 --> 00:35:21,233
But I think at key moments,

784
00:35:22,433 --> 00:35:24,933
when everybody has this 
need to come together

785
00:35:24,933 --> 00:35:27,033
for our message, it 
serves that purpose.

786
00:35:28,733 --> 00:35:32,200
So it felt like a 
good starting point.

787
00:35:38,633 --> 00:35:41,633
- My new therapist 
peers at me through Zoom

788
00:35:41,633 --> 00:35:44,566
and asks me to 
describe my childhood.

789
00:35:44,566 --> 00:35:45,933
Where do I start?

790
00:35:45,933 --> 00:35:47,866
- [Producer] Brenda 
Her, take one.

791
00:35:47,866 --> 00:35:51,700
- In my culture, childhood 
begins before you are born.

792
00:35:51,700 --> 00:35:54,200
I am the daughter of Cher 
Thang Her and Xong Yang.

793
00:35:55,433 --> 00:35:57,533
I am a descendant 
of the Hmong people

794
00:35:57,533 --> 00:35:59,366
who fought during 
the Secret War,

795
00:35:59,366 --> 00:36:02,666
some who are shaman 
spiritual healers.

796
00:36:02,666 --> 00:36:05,100
I carry the imprint of trauma

797
00:36:05,100 --> 00:36:07,166
from war and genocide,

798
00:36:07,166 --> 00:36:09,100
sexism and racism,

799
00:36:09,100 --> 00:36:12,100
passed down from one 
generation to the next

800
00:36:12,100 --> 00:36:15,933
through parenting, modeling, 
and societal pressure.

801
00:36:15,933 --> 00:36:18,766
I carry the unhealed 
wounds of my mother,

802
00:36:18,766 --> 00:36:21,500
my grandmothers, 
and Hmong sisters,

803
00:36:21,500 --> 00:36:25,600
living in a culture of 
silence ruled by patriarchy.

804
00:36:25,600 --> 00:36:29,266
I witness my parents hide 
their wounds and suffer

805
00:36:29,266 --> 00:36:31,633
from the unresolved 
trauma they didn't have

806
00:36:31,633 --> 00:36:33,266
the luxury of healing.

807
00:36:33,266 --> 00:36:36,166
And so, they imprinted 
their children

808
00:36:36,166 --> 00:36:38,133
with the lessons of survival

809
00:36:38,133 --> 00:36:41,133
that were given 
by our ancestors.

810
00:36:41,133 --> 00:36:44,033
The survival lessons 
I learned in childhood

811
00:36:44,033 --> 00:36:46,266
continue to be my 
inner struggle.

812
00:36:47,433 --> 00:36:49,700
I learned that in 
order to survive

813
00:36:49,700 --> 00:36:52,000
as a Hmong woman in America,

814
00:36:52,000 --> 00:36:55,933
I had to please, 
perform, and perfect.

815
00:36:55,933 --> 00:36:59,100
No exceptions, no mistakes.

816
00:36:59,100 --> 00:37:01,733
And anything less was a failure.

817
00:37:01,733 --> 00:37:03,933
I worked hard on fixing myself,

818
00:37:03,933 --> 00:37:07,200
cycling between podcasts, 
online cognitive

819
00:37:07,200 --> 00:37:10,066
behavioral therapy, 
and self-help books,

820
00:37:10,066 --> 00:37:13,233
searching for something 
to teach me how to balance

821
00:37:13,233 --> 00:37:15,666
my mother's worsening 
heart failure

822
00:37:15,666 --> 00:37:18,366
and dialysis-dependent 
kidney disease

823
00:37:18,366 --> 00:37:21,733
to teach me how to make 
sure my brothers and sisters

824
00:37:21,733 --> 00:37:24,600
had what they needed 
to thrive in school.

825
00:37:24,600 --> 00:37:27,500
To teach me to navigate 
the grueling work hours

826
00:37:27,500 --> 00:37:29,600
in the middle of a pandemic,

827
00:37:29,600 --> 00:37:32,500
to prove that I 
belong as a woman,

828
00:37:32,500 --> 00:37:35,166
and Person of Color in medicine.

829
00:37:35,166 --> 00:37:38,233
But all of my efforts 
only led to frustration

830
00:37:38,233 --> 00:37:40,533
when I fell back 
into the old habits

831
00:37:40,533 --> 00:37:43,833
and gave into the 
negative thought patterns.

832
00:37:43,833 --> 00:37:46,333
The critical inner 
voice, and the behaviors

833
00:37:46,333 --> 00:37:49,333
that I thought would 
help me fit in,

834
00:37:49,333 --> 00:37:53,400
but instead, dimmed the 
light of who I really was.

835
00:37:54,566 --> 00:37:57,933
And that is what led 
me to that moment.

836
00:37:57,933 --> 00:38:01,900
Sitting on my couch, 
laptop in front of me,

837
00:38:01,900 --> 00:38:05,800
asking for help for the 
first time in a long time.

838
00:38:05,800 --> 00:38:07,966
It was worth it.

839
00:38:07,966 --> 00:38:11,500
Through therapy, I learned 
mind body practices

840
00:38:11,500 --> 00:38:13,666
that have transformed my life.

841
00:38:13,666 --> 00:38:16,500
I learned to ask 
for and accept help,

842
00:38:16,500 --> 00:38:18,100
not only from my therapist,

843
00:38:18,100 --> 00:38:21,233
but also from 
family and friends.

844
00:38:21,233 --> 00:38:24,800
Healing meant going inwards 
and embracing my roots

845
00:38:24,800 --> 00:38:27,633
as a Hmong woman, 
finding community,

846
00:38:27,633 --> 00:38:29,600
and honoring the warrior in me

847
00:38:29,600 --> 00:38:33,100
who had overcome the 
challenges of childhood trauma

848
00:38:33,100 --> 00:38:36,566
and abuse, sexism and racism.

849
00:38:36,566 --> 00:38:38,900
It meant learning to 
accept that my parents

850
00:38:38,900 --> 00:38:42,400
are human beings, with 
their own unresolved trauma,

851
00:38:42,400 --> 00:38:44,933
that they didn't have 
the luxury of healing.

852
00:38:44,933 --> 00:38:48,500
My journey to healing and 
understanding my traumas

853
00:38:48,500 --> 00:38:51,933
has shaped and influenced 
my career in medicine.

854
00:38:51,933 --> 00:38:56,000
Healing is a daily practice, 
and an ongoing journey.

855
00:38:56,000 --> 00:38:59,966
With it, I honor my 
ancestors and parents,

856
00:38:59,966 --> 00:39:03,300
their blood, sweat, 
tears, and efforts

857
00:39:03,300 --> 00:39:05,666
that led me to where I am today.

858
00:39:09,033 --> 00:39:12,866
- My dreams and hopes 
for the next generation.

859
00:39:12,866 --> 00:39:15,666
- Is that we can create 
a system of health

860
00:39:15,666 --> 00:39:18,866
that is trauma-informed, 
not trauma-imbued.

861
00:39:18,866 --> 00:39:22,366
- Is that they can 
simply be physicians.

862
00:39:22,366 --> 00:39:24,233
- Whether we have a 
commitment to our communities

863
00:39:24,233 --> 00:39:26,466
in our profession, that 
we don't have to pick one

864
00:39:26,466 --> 00:39:27,633
over the other.

865
00:39:27,633 --> 00:39:30,066
We can really satisfy 
our full selves

866
00:39:30,066 --> 00:39:31,700
when it comes to 
practicing medicine,

867
00:39:31,700 --> 00:39:34,966
and knowing that we 
are not only improving

868
00:39:34,966 --> 00:39:37,466
the wellbeing of our 
individual patients,

869
00:39:37,466 --> 00:39:39,666
but our communities 
and society as a whole.

870
00:39:43,166 --> 00:39:46,833
- When talking about race, 
it's easy to feel stuck,

871
00:39:46,833 --> 00:39:49,166
and hard to find a way forward.

872
00:39:49,166 --> 00:39:51,633
However, as we're about to hear,

873
00:39:51,633 --> 00:39:53,833
there is room for hope.

874
00:39:53,833 --> 00:39:56,700
(upbeat music)

875
00:39:56,700 --> 00:39:58,966
- [Tseganesh] Looking at 
me, you see how I appear

876
00:39:58,966 --> 00:40:01,033
when I enter any space.

877
00:40:01,033 --> 00:40:03,700
A youngish Black 
woman with a big smile

878
00:40:03,700 --> 00:40:05,300
and a strong handshake.

879
00:40:05,300 --> 00:40:08,166
What you don't see 
is the manifestation

880
00:40:08,166 --> 00:40:10,233
of my inner white man.

881
00:40:10,233 --> 00:40:11,466
Yes, you heard me.

882
00:40:11,466 --> 00:40:14,033
I have an inner white man.

883
00:40:14,033 --> 00:40:16,700
Joe became a part of 
my life the first time

884
00:40:16,700 --> 00:40:18,966
I put on a white coat 
in medical school.

885
00:40:18,966 --> 00:40:21,300
I had him knock first 
before we entered

886
00:40:21,300 --> 00:40:23,533
the exam room, and 
had him sit next to me

887
00:40:23,533 --> 00:40:25,666
as I took a patient history.

888
00:40:25,666 --> 00:40:28,300
I channel him often 
when I have to explain

889
00:40:28,300 --> 00:40:30,233
no, I'm not the nurse.

890
00:40:30,233 --> 00:40:33,733
Or yes, I have done 
this procedure before,

891
00:40:33,733 --> 00:40:37,133
and no, of course I 
don't mind if you talk

892
00:40:37,133 --> 00:40:39,800
to another doctor about this.

893
00:40:39,800 --> 00:40:43,166
Medicine is the space 
designed to make me feel

894
00:40:43,166 --> 00:40:47,400
alone, uninvited, and 
constantly second guessing.

895
00:40:48,800 --> 00:40:51,700
Joe is expert at protecting 
me from the questions

896
00:40:51,700 --> 00:40:53,300
about my right to be here.

897
00:40:53,300 --> 00:40:56,000
Joe can pull up a seat 
at any of the tables

898
00:40:56,000 --> 00:40:59,533
and be made to feel 
welcome, even wanted.

899
00:40:59,533 --> 00:41:04,200
Listen, Joe is not 
an internalization 
of systemic sexism

900
00:41:04,200 --> 00:41:06,966
and racism that tells me 
my worth is only based

901
00:41:06,966 --> 00:41:10,533
on a scale of whiteness, 
nor is he a demonization

902
00:41:10,533 --> 00:41:12,366
of the white male narrative.

903
00:41:12,366 --> 00:41:14,966
I know every story is different.

904
00:41:14,966 --> 00:41:18,200
But my Joe, he serves 
a dual purpose.

905
00:41:18,200 --> 00:41:21,033
He reminds me of the 
systems that I live,

906
00:41:21,033 --> 00:41:24,566
and I work in, and 
he is a powerful tool

907
00:41:24,566 --> 00:41:27,533
that I can use to thrive 
in those environments.

908
00:41:27,533 --> 00:41:31,200
For example, Joe and I looked 
in the mirror this morning.

909
00:41:31,200 --> 00:41:34,733
We made sure that this dress 
didn't show too much cleavage

910
00:41:34,733 --> 00:41:37,300
and that it didn't hug 
my hips too tightly,

911
00:41:37,300 --> 00:41:39,866
because I want to be 
judged on the content

912
00:41:39,866 --> 00:41:42,533
of my words, and not 
the shape of my body.

913
00:41:43,766 --> 00:41:46,366
Joe also reminds me to 
push back my shoulders

914
00:41:46,366 --> 00:41:49,800
and stand assured that 
my words are important,

915
00:41:49,800 --> 00:41:52,366
and my voice is worth hearing.

916
00:41:52,366 --> 00:41:55,366
My inner white man, my 
Joe, is my shorthand.

917
00:41:56,600 --> 00:41:58,400
Joe is also my systole.

918
00:41:59,866 --> 00:42:02,600
Systole is the powerful 
part of the cardiac cycle.

919
00:42:02,600 --> 00:42:04,633
Systole is this 
life-giving force

920
00:42:04,633 --> 00:42:06,633
that drives oxygen 
out of the heart

921
00:42:06,633 --> 00:42:09,300
and pushes it 
throughout the body.

922
00:42:09,300 --> 00:42:10,600
Systole is loud.

923
00:42:12,433 --> 00:42:17,366
And it often drowns out that 
brief silence of diastole.

924
00:42:17,366 --> 00:42:19,500
When I am in spaces of diastole,

925
00:42:19,500 --> 00:42:22,000
I notice that my body relaxes.

926
00:42:22,000 --> 00:42:24,633
I breathe more fully and deeply,

927
00:42:24,633 --> 00:42:28,033
and I feel myself expand 
to my fullest expression.

928
00:42:28,033 --> 00:42:31,466
My heart is full, so full,

929
00:42:31,466 --> 00:42:34,266
that I can no longer 
accommodate Joe.

930
00:42:34,266 --> 00:42:36,466
I have expanded 
beyond the spaces

931
00:42:36,466 --> 00:42:38,300
that require his presence.

932
00:42:39,533 --> 00:42:42,100
Spaces of diastole are sacred.

933
00:42:42,100 --> 00:42:44,466
And I have come to understand 
that they are formed

934
00:42:44,466 --> 00:42:48,933
through intention and labor, 
and are not happy coincidences.

935
00:42:50,033 --> 00:42:53,033
My spaces of diastole 
include my clinic.

936
00:42:53,033 --> 00:42:56,266
I walk in, I am greeted by 
nurses and fellow physicians

937
00:42:56,266 --> 00:42:58,766
that reflect my 
lived experiences.

938
00:42:58,766 --> 00:43:01,733
My patients are a tapestry 
of new and old Americans,

939
00:43:01,733 --> 00:43:03,866
woven together in a neighborhood

940
00:43:03,866 --> 00:43:06,766
that is full of 
history and promise.

941
00:43:06,766 --> 00:43:11,166
I work in a space 
where my voice, my 
story, they are enough.

942
00:43:11,166 --> 00:43:13,000
I work in diastole.

943
00:43:15,033 --> 00:43:19,866
Advocacy is systole, a 
powerful forward movement

944
00:43:19,866 --> 00:43:23,200
that seeks to make change 
on behalf of others.

945
00:43:23,200 --> 00:43:28,200
In advocacy, just as in life, 
systole requires diastole.

946
00:43:29,333 --> 00:43:32,866
If we want the energy, 
the perseverance,

947
00:43:32,866 --> 00:43:35,500
and power to seek change,

948
00:43:35,500 --> 00:43:37,600
we need spaces of diastole,

949
00:43:38,733 --> 00:43:41,000
where we can relax 
and be filled,

950
00:43:41,000 --> 00:43:44,600
where we can heal, where 
we can thrive and perform

951
00:43:44,600 --> 00:43:46,033
at our highest levels.

952
00:43:47,166 --> 00:43:50,500
We need to become 
advocates for diastole.

953
00:43:55,166 --> 00:43:56,600
- Her eyes brightened,

954
00:43:56,600 --> 00:43:59,733
and her cheeks were 
rounded by her wide smile.

955
00:43:59,733 --> 00:44:02,466
She excitedly stood up 
from where she was playing

956
00:44:02,466 --> 00:44:05,766
and walked towards me 
as I entered the room.

957
00:44:05,766 --> 00:44:08,933
She gave me a long, 
unexpected hug.

958
00:44:08,933 --> 00:44:11,666
Salam, how are you, I asked her.

959
00:44:11,666 --> 00:44:13,933
Are you my doctor, she asked.

960
00:44:13,933 --> 00:44:17,166
Yes, yes I am, I responded,

961
00:44:17,166 --> 00:44:19,266
matching her excitement.

962
00:44:19,266 --> 00:44:21,766
She then followed 
me as I sat down.

963
00:44:21,766 --> 00:44:24,000
She reached for my 
royal blue hijab

964
00:44:24,000 --> 00:44:25,966
as she pointed to hers,

965
00:44:25,966 --> 00:44:28,833
bright orange and with sparkles.

966
00:44:28,833 --> 00:44:32,466
She was eager to share what 
she was learning in school,

967
00:44:32,466 --> 00:44:35,766
stories about her 
friends, and all the foods

968
00:44:35,766 --> 00:44:38,400
she was eating to help her grow.

969
00:44:38,400 --> 00:44:40,966
As I wrapped up 
our visit, she said

970
00:44:40,966 --> 00:44:44,066
I want to be a doctor just 
like you when I grow up.

971
00:44:47,600 --> 00:44:51,166
Sometimes, it's hard 
to remember the why

972
00:44:51,166 --> 00:44:53,900
when so many days are 
filled with signals

973
00:44:53,900 --> 00:44:56,600
that I don't belong.

974
00:44:56,600 --> 00:44:58,766
Those quick glances 
down at my badge

975
00:44:58,766 --> 00:45:01,466
that says doctor, 
back to my face,

976
00:45:01,466 --> 00:45:03,800
and then back to my badge again.

977
00:45:03,800 --> 00:45:06,466
It's hard for me to 
accept that the white coat

978
00:45:06,466 --> 00:45:09,466
I'm wearing, my 
stethoscope around my neck,

979
00:45:09,466 --> 00:45:11,800
my multiple pagers beeping,

980
00:45:11,800 --> 00:45:14,233
and the patient list in my hand,

981
00:45:14,233 --> 00:45:16,066
are still not 
enough to shield me

982
00:45:16,066 --> 00:45:19,333
from the perception 
that I am out of place.

983
00:45:19,333 --> 00:45:23,233
On those days, she is the why.

984
00:45:23,233 --> 00:45:27,800
She and many others remind 
me why I've dedicated

985
00:45:27,800 --> 00:45:32,800
so much of my life, 
my time, my energy,

986
00:45:34,000 --> 00:45:36,866
to be in the room with 
them as their doctor.

987
00:45:36,866 --> 00:45:39,900
I often ask myself 
what does it mean

988
00:45:39,900 --> 00:45:42,066
to belong in medicine?

989
00:45:42,066 --> 00:45:45,300
For me, belonging is 
not about conforming

990
00:45:45,300 --> 00:45:48,000
to the appearance 
of a typical doctor.

991
00:45:48,000 --> 00:45:50,966
Belonging is about 
changing the perception

992
00:45:50,966 --> 00:45:53,800
of what a doctor looks like.

993
00:45:53,800 --> 00:45:58,166
So every time I get asked 
where are you really from?

994
00:45:58,166 --> 00:46:01,366
I think of bright 
orange and sparkles.

995
00:46:01,366 --> 00:46:04,533
Every time I get 
surprised glances

996
00:46:04,533 --> 00:46:08,300
because I'm explaining 
life-changing diagnoses,

997
00:46:08,300 --> 00:46:11,866
or laying out complicated 
treatment plans,

998
00:46:11,866 --> 00:46:14,933
I think of patients with 
henna-speckled beards

999
00:46:14,933 --> 00:46:17,866
who will agree with my 
treatment recommendations

1000
00:46:17,866 --> 00:46:21,700
because of their faith 
and trust in my presence.

1001
00:46:21,700 --> 00:46:24,533
As I walk around the 
hospital with my stethoscope

1002
00:46:24,533 --> 00:46:27,566
and my hijab, I 
know that I stand

1003
00:46:27,566 --> 00:46:29,900
between two generations.

1004
00:46:29,900 --> 00:46:32,100
I want to inspire 
my young patients

1005
00:46:32,100 --> 00:46:35,800
to dream of becoming intelligent 
and compassionate doctors,

1006
00:46:35,800 --> 00:46:39,200
and I want to be 
worthy of the Elders

1007
00:46:39,200 --> 00:46:42,033
who beam with pride 
because their sacrifices

1008
00:46:42,033 --> 00:46:44,600
and hopes have been realized.

1009
00:46:44,600 --> 00:46:49,033
If I do these things, I'll 
always know that I belong.

1010
00:46:55,600 --> 00:46:59,200
- As clinicians, we have been 
trained to gather information,

1011
00:46:59,200 --> 00:47:02,366
make an assessment, and then 
thoughtfully move forward

1012
00:47:02,366 --> 00:47:03,633
with a plan.

1013
00:47:03,633 --> 00:47:06,166
As you will see, the 
same process is true

1014
00:47:06,166 --> 00:47:08,633
when it comes to addressing 
racial disparities.

1015
00:47:09,800 --> 00:47:11,266
(soft music)

1016
00:47:11,266 --> 00:47:14,433
- It's hard to talk about 
race in Minnesota in general,

1017
00:47:14,433 --> 00:47:16,966
because I think we feel 
like we can and we should

1018
00:47:16,966 --> 00:47:18,766
treat everyone the same way.

1019
00:47:18,766 --> 00:47:21,766
And I think that is 
rooted in a healthy way,

1020
00:47:21,766 --> 00:47:24,000
but if we treat 
everyone the same way,

1021
00:47:24,000 --> 00:47:25,533
we assume everyone's the same.

1022
00:47:29,633 --> 00:47:32,366
Being Vietnamese-American, 
being a refugee,

1023
00:47:32,366 --> 00:47:34,700
when I started doing 
work in medicine,

1024
00:47:34,700 --> 00:47:37,266
I gravitated to 
particularly those who

1025
00:47:37,266 --> 00:47:39,266
are immigrants and refugees.

1026
00:47:39,266 --> 00:47:41,966
As the population changed, 
and as the needs changed,

1027
00:47:41,966 --> 00:47:44,000
I changed with the population.

1028
00:47:44,000 --> 00:47:47,100
And so then my equity work 
had been more around those

1029
00:47:47,100 --> 00:47:49,933
who were dealing with 
opioid use disorder.

1030
00:47:51,700 --> 00:47:53,866
We have a lot of 
individuals come here

1031
00:47:53,866 --> 00:47:56,333
that happen to be Indigenous,

1032
00:47:56,333 --> 00:47:59,133
and I was not doing a 
great service at first,

1033
00:47:59,133 --> 00:48:02,266
because I didn't understand 
what their life was like

1034
00:48:02,266 --> 00:48:05,533
outside of clinic, so I 
knew I had to take time

1035
00:48:05,533 --> 00:48:08,533
and practice to ask questions,

1036
00:48:08,533 --> 00:48:11,500
to learn more about just 
individuals and community,

1037
00:48:11,500 --> 00:48:13,266
beyond just addiction.

1038
00:48:13,266 --> 00:48:17,100
And I learned the good 
stuff, the bad stuff,

1039
00:48:17,100 --> 00:48:18,766
and the everything in between.

1040
00:48:18,766 --> 00:48:21,266
And then also working with 
a researching assistant,

1041
00:48:21,266 --> 00:48:24,500
Koushik Paul, over 
the last three years,

1042
00:48:24,500 --> 00:48:27,233
he and I started 
doing interviews

1043
00:48:27,233 --> 00:48:29,533
with the Native 
American community

1044
00:48:29,533 --> 00:48:32,166
to understand how we 
can better serve them

1045
00:48:32,166 --> 00:48:34,766
around opioid use 
disorder, particularly

1046
00:48:34,766 --> 00:48:36,866
in primary care clinics,

1047
00:48:36,866 --> 00:48:38,500
and make it more 
culturally-centered,

1048
00:48:38,500 --> 00:48:39,666
or family-centered.

1049
00:48:41,100 --> 00:48:43,500
And all these connections 
that we built over time

1050
00:48:43,500 --> 00:48:48,433
in this shared space has 
given me a place of joy

1051
00:48:49,600 --> 00:48:51,100
where I am working 
with communities

1052
00:48:51,100 --> 00:48:55,333
that deserve help, should 
be elevated and celebrated,

1053
00:48:55,333 --> 00:48:58,866
but they have been also 
people who are so accepting,

1054
00:48:58,866 --> 00:49:02,333
and allow me to learn 
and make mistakes

1055
00:49:02,333 --> 00:49:03,300
along the way, too.

1056
00:49:06,400 --> 00:49:07,233
(gentle music)

1057
00:49:07,233 --> 00:49:08,600
- I'm a pediatrician.

1058
00:49:08,600 --> 00:49:12,166
I thought I was giving 
quality care to everyone

1059
00:49:12,166 --> 00:49:14,166
until one of my colleagues said

1060
00:49:14,166 --> 00:49:17,000
you should go hear Dr. 
Heather Hackman speak.

1061
00:49:17,000 --> 00:49:19,266
And she was presenting 
on white privilege.

1062
00:49:19,266 --> 00:49:23,900
And I sat in there, at the 
time, at 47 years of age,

1063
00:49:25,300 --> 00:49:28,500
embarrassed, because I'd never 
thought about that issue.

1064
00:49:28,500 --> 00:49:33,133
So then I started thinking 
about my patients.

1065
00:49:33,133 --> 00:49:35,566
I've had the honor of 
taking care of kids

1066
00:49:35,566 --> 00:49:38,300
with sickle cell disease 
for over 30 years.

1067
00:49:38,300 --> 00:49:40,600
It's an inherited 
blood disorder,

1068
00:49:40,600 --> 00:49:41,900
it's a global disorder.

1069
00:49:41,900 --> 00:49:44,000
It affects people of all races.

1070
00:49:44,000 --> 00:49:45,233
But in the United States,

1071
00:49:45,233 --> 00:49:47,333
virtually all the 
patients are Black.

1072
00:49:47,333 --> 00:49:50,066
And I started thinking 
about me, and the team,

1073
00:49:50,066 --> 00:49:51,566
and the clinic.

1074
00:49:51,566 --> 00:49:54,933
And at that point, every 
single one of us was white,

1075
00:49:56,400 --> 00:49:59,000
and could that fact alone 
affect the quality of care

1076
00:49:59,000 --> 00:50:01,500
that we deliver these 
patients and families,

1077
00:50:01,500 --> 00:50:03,766
or at least the 
perceptions of that care?

1078
00:50:03,766 --> 00:50:07,400
So we asked the question, 
and it matters a lot.

1079
00:50:07,400 --> 00:50:09,600
And that was really 
the impetus for me

1080
00:50:09,600 --> 00:50:11,566
to partner with 
Dr. Heather Hackman

1081
00:50:11,566 --> 00:50:15,400
to develop a training 
module around race, racism,

1082
00:50:15,400 --> 00:50:17,466
and whiteness and implicit bias,

1083
00:50:17,466 --> 00:50:20,400
specifically for 
healthcare providers.

1084
00:50:20,400 --> 00:50:23,766
One very important 
piece to improve equity

1085
00:50:23,766 --> 00:50:26,166
and outcomes for 
patients of color

1086
00:50:26,166 --> 00:50:29,166
is to change the demographics 
of the healthcare team.

1087
00:50:29,166 --> 00:50:32,400
Right now, only four percent 
of licensed physicians

1088
00:50:32,400 --> 00:50:34,433
in the United States are Black.

1089
00:50:34,433 --> 00:50:37,466
And we know that there 
are better outcomes

1090
00:50:37,466 --> 00:50:40,100
when there's racial and 
or cultural concordance

1091
00:50:40,100 --> 00:50:42,833
between a provider 
and their patient,

1092
00:50:42,833 --> 00:50:44,266
because there's better trust.

1093
00:50:44,266 --> 00:50:47,566
So until we get that 
improvement in the demographics

1094
00:50:47,566 --> 00:50:50,400
of the healthcare 
team, I'm the one

1095
00:50:50,400 --> 00:50:52,566
that needs to do the 
work, and build trust.

1096
00:50:57,900 --> 00:51:01,133
- I study racism as a 
fundamental cause of disease.

1097
00:51:01,133 --> 00:51:02,866
- [Producer] 
Cunningham, take one.

1098
00:51:02,866 --> 00:51:05,966
- My research right now 
aims to get white providers

1099
00:51:05,966 --> 00:51:07,566
to talk to their Black patients

1100
00:51:07,566 --> 00:51:09,833
about their 
experiences of racism.

1101
00:51:09,833 --> 00:51:12,533
As I sat in on the focus groups,

1102
00:51:12,533 --> 00:51:16,966
many people were saying yes, 
racism in healthcare is real.

1103
00:51:16,966 --> 00:51:20,500
Yes, I or my family members 
have experienced it,

1104
00:51:20,500 --> 00:51:25,300
and recounted stories about 
not being able to access care.

1105
00:51:25,300 --> 00:51:27,166
And when I say access, 
it's not that they didn't,

1106
00:51:27,166 --> 00:51:29,300
they had insurance, right?

1107
00:51:29,300 --> 00:51:31,666
They had transportation 
to the clinic.

1108
00:51:31,666 --> 00:51:34,566
But not being able 
still once they came in

1109
00:51:34,566 --> 00:51:37,233
through the clinic 
doors to get care

1110
00:51:37,233 --> 00:51:39,900
that they perceived was high 
quality, and met their needs,

1111
00:51:39,900 --> 00:51:41,533
or to be listened to.

1112
00:51:41,533 --> 00:51:45,133
And what I'm hearing, 
which is very encouraging,

1113
00:51:45,133 --> 00:51:48,733
is many of our physicians 
recognize the importance

1114
00:51:48,733 --> 00:51:51,866
of racism as a cause of disease.

1115
00:51:51,866 --> 00:51:54,300
Many patients 
recognize that as well.

1116
00:51:54,300 --> 00:51:56,300
The challenge is 
whether people again

1117
00:51:56,300 --> 00:51:58,466
are willing to have 
that conversation

1118
00:51:59,333 --> 00:52:00,866
in the clinical encounter.

1119
00:52:03,733 --> 00:52:06,266
I really think there's 
the power at the bedside,

1120
00:52:06,266 --> 00:52:10,066
but until we do something 
about those structural

1121
00:52:10,066 --> 00:52:12,766
conditions under which 
people live their lives,

1122
00:52:12,766 --> 00:52:15,366
we're going to continue 
to see health disparities.

1123
00:52:15,366 --> 00:52:19,433
I can only find temporary 
solutions for people.

1124
00:52:19,433 --> 00:52:23,700
So person A comes in, 
and I find a solution.

1125
00:52:24,900 --> 00:52:26,700
But what happens with 
structural conditions

1126
00:52:26,700 --> 00:52:29,033
is that it's not 
just person A, right?

1127
00:52:29,033 --> 00:52:33,366
It's person A, B, C, D, 
E, who are all coming in,

1128
00:52:33,366 --> 00:52:35,700
in similar predicaments.

1129
00:52:35,700 --> 00:52:39,033
And so to the extent that 
those structural conditions

1130
00:52:39,033 --> 00:52:42,366
produce harm, then I'm 
gonna always have patients

1131
00:52:42,366 --> 00:52:43,600
in my office.

1132
00:52:43,600 --> 00:52:46,566
That is what racism is.

1133
00:52:46,566 --> 00:52:50,133
It is classifying people 
into different groups

1134
00:52:50,133 --> 00:52:52,066
and giving them 
differential access

1135
00:52:52,066 --> 00:52:54,366
to resources and opportunities.

1136
00:52:54,366 --> 00:52:58,366
And with that, constructing 
them differently to justify

1137
00:52:58,366 --> 00:53:00,533
that different access.

1138
00:53:00,533 --> 00:53:03,600
So we have to 
change our society,

1139
00:53:03,600 --> 00:53:04,800
and that's more than healthcare,

1140
00:53:04,800 --> 00:53:06,633
but healthcare can 
play a big role.

1141
00:53:06,633 --> 00:53:09,100
Physicians as 
important stakeholders

1142
00:53:09,100 --> 00:53:11,666
with a voice in power 
can play a big role.

1143
00:53:15,333 --> 00:53:16,866
- Thank you for listening.

1144
00:53:16,866 --> 00:53:19,533
No matter who you 
are or what you do,

1145
00:53:19,533 --> 00:53:21,766
we hope that you 
share your story,

1146
00:53:21,766 --> 00:53:24,033
and have a conversation 
about race.

1147
00:53:24,033 --> 00:53:26,366
We believe that it 
is through stories

1148
00:53:26,366 --> 00:53:28,833
that we can begin the 
process of healing.

1149
00:53:28,833 --> 00:53:32,100
We close with a poem 
by Dr. Tolbert Small,

1150
00:53:32,100 --> 00:53:34,533
former physician to 
the founding chapter

1151
00:53:34,533 --> 00:53:36,300
of the Black Panther party.

1152
00:53:36,300 --> 00:53:39,933
- The title of the poem 
is "We Are the Healers"

1153
00:53:39,933 --> 00:53:42,600
and it is a message 
for everyone.

1154
00:53:42,600 --> 00:53:44,666
Doctors don't heal in a vacuum,

1155
00:53:44,666 --> 00:53:47,366
and healing can take many forms.

1156
00:53:47,366 --> 00:53:51,133
We are part of a broader 
community that includes you.

1157
00:53:51,133 --> 00:53:54,433
We are all interrelated 
and interdependent.

1158
00:53:54,433 --> 00:53:57,266
We are all called 
to heal the wounds.

1159
00:53:59,966 --> 00:54:03,433
(gentle uplifting music)

1160
00:54:04,533 --> 00:54:06,200
- To the healers.

1161
00:54:06,200 --> 00:54:08,500
- And their patients who 
have the right to be healed.

1162
00:54:08,500 --> 00:54:11,333
- By Dr. Tolbert Jones Small.

1163
00:54:11,333 --> 00:54:13,600
- We are healers.

1164
00:54:13,600 --> 00:54:16,033
- We toiled for years 
to learn the mystery

1165
00:54:16,033 --> 00:54:17,500
of the human body.

1166
00:54:17,500 --> 00:54:20,866
- We nourish spirits 
from birth to the grave.

1167
00:54:20,866 --> 00:54:22,166
- We mend the bones.

1168
00:54:22,166 --> 00:54:23,833
- We sew the cuts.

1169
00:54:23,833 --> 00:54:25,333
- We kill the pain.

1170
00:54:25,333 --> 00:54:27,700
- We cool the fevers.

1171
00:54:27,700 --> 00:54:30,333
- We soothe the spirits.

1172
00:54:30,333 --> 00:54:32,366
- We are healers.

1173
00:54:32,366 --> 00:54:33,766
- We bring new life.

1174
00:54:33,766 --> 00:54:35,833
- We close old life.

1175
00:54:35,833 --> 00:54:37,766
- [Together] We pick the herbs.

1176
00:54:37,766 --> 00:54:39,500
- We needle away the pain.

1177
00:54:39,500 --> 00:54:41,333
- We cut out the cancer.

1178
00:54:41,333 --> 00:54:43,033
- We poison the germs.

1179
00:54:43,033 --> 00:54:46,066
- We calm the troubled minds.

1180
00:54:46,066 --> 00:54:48,333
- We are healers.

1181
00:54:48,333 --> 00:54:50,033
- [Together] We 
treat the whole body.

1182
00:54:50,033 --> 00:54:51,833
- [Together] As one universe.

1183
00:54:51,833 --> 00:54:54,933
- We treat each part 
of the universe.

1184
00:54:54,933 --> 00:54:57,033
- We keep the hearts pumping.

1185
00:54:57,033 --> 00:54:58,766
- We keep the lungs breathing.

1186
00:54:58,766 --> 00:55:01,566
- We know as long 
as life exists.

1187
00:55:01,566 --> 00:55:02,466
- [All] We will.

1188
00:55:02,466 --> 00:55:03,400
- [All] Be healers.

1189
00:55:08,233 --> 00:55:10,466
- What brings you 
joy in medicine?

1190
00:55:10,466 --> 00:55:12,066
- What brings me 
joy in medicine.

1191
00:55:12,066 --> 00:55:13,266
- [Man] Relationships.

1192
00:55:13,266 --> 00:55:15,233
- Relationships bring 
me joy in medicine.

1193
00:55:15,233 --> 00:55:16,233
- Connections.

1194
00:55:16,233 --> 00:55:19,233
- The experience of my patients.

1195
00:55:19,233 --> 00:55:21,900
- Young people finally get it.

1196
00:55:21,900 --> 00:55:23,500
- To have the light bulb go off.

1197
00:55:23,500 --> 00:55:24,400
- Very rewarding.

1198
00:55:24,400 --> 00:55:25,966
- I have joy in medicine

1199
00:55:25,966 --> 00:55:27,233
when my patients have joy.

1200
00:55:27,233 --> 00:55:29,933
- They give me hope, 
they give me courage.

1201
00:55:29,933 --> 00:55:32,766
I learn so much from their 
cultures, their values,

1202
00:55:32,766 --> 00:55:34,300
their knowledge, 
and their belief.

1203
00:55:34,300 --> 00:55:36,800
- The most joyful part 
of being a physician.

1204
00:55:36,800 --> 00:55:38,833
- They trust me, 
and I trust them.

1205
00:55:38,833 --> 00:55:40,566
- Is being in fellowship 
and partnership

1206
00:55:40,566 --> 00:55:41,800
with my patients.

1207
00:55:41,800 --> 00:55:43,233
- The opportunity of 
working with somebody

1208
00:55:43,233 --> 00:55:45,766
for 15 years to try to 
get them to consider

1209
00:55:45,766 --> 00:55:47,800
stopping smoking, and 
that day when they say

1210
00:55:47,800 --> 00:55:49,600
you know, I really 
need to do this.

1211
00:55:49,600 --> 00:55:51,333
- What brings me joy in medicine

1212
00:55:51,333 --> 00:55:53,800
is listening to the 
stories of patients.

1213
00:55:53,800 --> 00:55:55,833
- I love to sit around, 
and that's probably why

1214
00:55:55,833 --> 00:55:57,433
I can be late in 
clinics sometimes,

1215
00:55:57,433 --> 00:55:59,400
since I love to hear 
people's stories.

1216
00:55:59,400 --> 00:56:03,800
- I feel very privileged 
to share that sacred space

1217
00:56:03,800 --> 00:56:05,300
with our patients.

1218
00:56:05,300 --> 00:56:07,133
- One word that brings me 
joy in medicine is learning.

1219
00:56:07,133 --> 00:56:08,466
Actually learning about people,

1220
00:56:08,466 --> 00:56:09,800
and learning about 
their stories,

1221
00:56:09,800 --> 00:56:11,566
and learning about 
what makes them work,

1222
00:56:11,566 --> 00:56:13,833
and what makes 
them who they are.

1223
00:56:13,833 --> 00:56:15,966
- To be able to apply science,

1224
00:56:15,966 --> 00:56:19,566
but in a way that genuinely 
helps someone feel better

1225
00:56:19,566 --> 00:56:20,833
and have a better day.

1226
00:56:20,833 --> 00:56:23,733
- The opportunity of the 
future, what isn't yet,

1227
00:56:23,733 --> 00:56:26,466
how we deploy our 
insatiable curiosity

1228
00:56:26,466 --> 00:56:29,466
about what if, and what 
can be in terms of next,

1229
00:56:29,466 --> 00:56:31,966
opportunity for 
change for the better.

1230
00:56:31,966 --> 00:56:35,233
- This is excellent. 
- Brilliant.

1231
00:56:35,233 --> 00:56:36,866
- [David] Oh, good.

1232
00:56:36,866 --> 00:56:38,066
- Yes, good stuff. 
- You're happy?

1233
00:56:38,066 --> 00:56:39,666
(bright music)