(soft music)

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

- Why talk about race?

- That's a great question.

- It's really important
to talk about race.

- How can we not?

- Race and racism are critical
determinants of health.

- Racism directly
impacts the care

that our patients receive.

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

who has and who doesn't have.

- Probably the biggest
reason that I see

is just all the
disparities in healthcare.

- The mission of medicine
is to provide medical care

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

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

attention to the whole person.

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

in the world in
relationship to my patients

who don't have the
same experience.

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

- We need everyone's
perspective to come together.

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

and we are still dealing
with all of the repercussions

and all of the trauma.

- Medicine actually hasn't
traditionally done a great job

of understanding people's
experience of race

in a really racialized society.

- It is important
to call it out.

- We need patients
to be able to feel

a connection with
their physicians.

- It's not just who someone is,

but it's how they're
treated by others

in their experience
in the world.

- There needs to
be a safe space.

- [Announcer] This
program is funded

by the Center for
the Art of Medicine

at the University of
Minnesota Medical School,

and dedicated to all
the untold stories.

(gentle uplifting music)

- Welcome.

I'm Dr. Jon Hallberg.

- And I'm Dr.
Tseganesh Selameab.

There are very few things
that are more difficult

to talk about than race.

We may be used to having
intimate, deeply personal

conversations, but
when it comes to race,

we often find ourselves
tongue-tied and awkward,

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

of this topic.

So not knowing where to start,
we often choose inaction

and safety, or politely
skirting around the issues.

- But we know this
has to change.

We all need to talk about race,

and we'll make mistakes.

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

That's actually
part of this journey

that we're on together.

- When faced with uncertainty,

we turn to our
friends and colleagues

and ask them to tell
us their stories.

Stories invite us in,
expand our experience,

and surprise us
with truths and joys

we may have otherwise missed.

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

We start with the stories
of Drs. David Hamlar

and Blanche Chavers,
both leaders

in their fields of medicine.

(bright uplifting music)

- I grew up in
Clarksdale, Mississippi,

which is a small town in
the Mississippi Delta.

Healthcare was very segregated.

- And I grew up in an
inner city neighborhood.

Then the neighborhood
was your village,

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

I was very lucky my
dad was a dentist.

Something my father
told me, he would say

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

If you want to pursue
something, do it.

- I wanted to become a physician

because of two
serious life events

I had as a child.

We had one Black physician
who took care of me

during both of my episodes.

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

and be able to
hopefully save lives.

So I started medical
school in 1971.

There were 19 women.

There were four
African-American students,

and one Native American student.

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

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

It'd be that shock.

- There were four percent
African-American students

in my medical school class.

There are approximately four
percent African-American

students in the incoming class

at the University of Minnesota.

- There are actually more
African-American men,

specifically, in medical
school during the 70s

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

So you actually saw a
decline in the number

of Black medical students.

- Progress has been very slow.

We were rounding one day on
a Native American patient

who had just been diagnosed
with a severe kidney disease.

And one of the senior
physicians said

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

this patient to take the
medication that we prescribe.

And I spoke up and said
the senior attending

had just prejudged this patient.

We all deserve care, and
a chance to be successful

with our course of treatment.

- The greatest
medicine in the world,

the greatest research
in the world,

doesn't always
deliver the best care.

And that's what we
need to do better.

- I would believe that
the needle was changing

when I can actually see
more People of Color

in all aspects of healthcare.

- Right now, I
think in this space,

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

for those actual items.

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

There's a bigger picture.

And the bigger picture is
how we influence society.

How we change policy.

And that is something
that's just as important.

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

and we need more People of
Color entering the field,

because that's how we
bring about change.

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

Who we are as people.

Our heritage, our
family, our culture,

and our language.

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

(bright music)

- 50 years ago, my
parents left India.

They took with them
their combined histories,

cultures, food, and fears.

My father, Ramaiah, was
the first in his family

to leave the small
farming village

where my parents grew up.

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

And eventually they
moved to Michigan

where my brother
and I were born.

I was born early.

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

after I was born.

Because my arrival was
unexpectedly abrupt,

my parents had not yet
chosen a name for me.

So the nurses called
me Baby Boy Muthyala.

My parents wanted my
grandmother to help

choose a name for me,
but the phone connection

to her small village was poor,

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

and this went on and on.

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

so everyday my dad
would pile everybody

into the car, drive
to the hospital,

drop my mom off.

He would take my older
brother to school

before going to work himself.

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

and they would go
to the hospital,

we would all spend
time together,

and my family would return home,

only to just do it
again the next day.

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

made friends with
the neonatologist.

And they would actually
go on rounds together.

And one day, the neonatologist
asked my brother,

does your little
brother have a name yet?

And in classic
fashion, he said yes.

His name is Brian.

And so the next day,
when my parents returned

to the hospital,
written above my crib

was the name Brian Muthyala.

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

And my parents, as
you could imagine,

were a little surprised.

But in our traditions,
it is considered bad luck

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

So eventually, I got old enough,

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

living with Ramaiah,
Vimala, and Sharat.

As the son of immigrant parents,

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

Brian could play
soccer, go to the mall,

play video games, whereas
Kirti, my middle name,

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

with the aunties
and uncles who lived

in our small Indian community.

As a teenager, I was
grateful that my brother

gave me a name that
allowed me to blend in.

Strangers would see my
brown skin, my last name,

but my otherness was
often less visible

because Brian felt so familiar.

Today, as a doctor,
I watch my patients

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

trying to enunciate Moothealla?

And I quickly interrupt
them, and I say

you can just call me Dr. Brian.

And I often will see the
relief wash over their face

as we share a quick
smile together.

I have often reflected on
how my life has been simpler

because of the mysterious
split second decision

of a six-year-old brother.

But more recently, these
thoughts have made me uneasy.

Names are important.

And while my name
made introductions
comfortable for others,

it also put me further
away from the rich history

and traditions that my parents
worked so hard to maintain

in our family.

So when it came time
to name our children,

my wife and I intentionally
chose traditional Indian names,

realizing that they will not
have some of the benefits

that I had.

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

How will I teach them
to not be afraid,

shy, or embarrassed of
the richness of those

that came before them?

I hope I'm as
courageous as my parents

who braved an unknown
world to make a better life

for me and Sharat.

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

doctor, friend, and neighbor,

and live up to the
name I was given

all those years ago.

(soft music)

- May 2020.

Two days after the
murder of George Floyd.

I am seeing a
two-year-old Black patient

in my primary care clinic.

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

not yet aware of the
cruel inequalities

that will surely shape his
life, and already have.

My heart breaks for his mother

as she shares with
me her fears for him,

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

the world will be better.

I promise his mother
that as his doctor

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

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

and I wonder how
she perceives me,

sitting there across from her
in that cramped exam room.

Am I an allied
underrepresented minority,

or as another white person
with good intentions,

but little understanding of her

and her son's lived experience?

The truth is, I'm not
sure how to answer

that question myself.

I identify as Latina.

But I've recently
been questioning what
that means for me.

My father's parents immigrated
to the United States

from Peru, and my mother
identifies as white.

My younger sister
and I are proof

that genetics are complicated.

Her skin is much
darker than mine,

and I'm six inches
taller than she is.

She looks more
"Latina" than I do.

Recently I've wondered what role

our physical appearance
played in shaping our lives.

I realize now that my identity
has always been a choice.

Our society uses
appearance to define race

and set expectations.

My appearance does not
tell my whole story,

and I find myself
consumed by the questions

around my position as a
Latina who looks white,

and in recognizing my privilege,

I struggle to keep
hold of my identity.

Do I count as a minority?

Am I getting all the perks

without having paid the
same price as my peers?

I grew up with the trauma
of racism surrounding me,

but not directly touching me.

I can still remember
the pained expression

on my grandma's face on the
day that her car was impounded

after she was pulled
over for speeding

on her way to the airport
after her brother died.

She was flustered and sad

and the police officer didn't
understand her English.

At the time, I could
not yet understand

the complexity of
her expression,

and I could only offer a hug.

Now, I know I should
have been angry.

Angry for her, but also
angry that these situations

for which my family led to
inconvenience and shame,

might have cost someone, like
my young patient, their life.

In learning to recognize
my own privilege,

I also see the harsh reality
of injustice and indifference

based solely on the
color one's skin

won't be limited
to this generation.

I think about something
as seemingly innate

as our last name.

I take pride in being an Alejos,

but also recognize its role
in defining my identity.

And so I make a
promise to myself,

to continue putting myself
in the humbling position

to ask patients about their
experience with racism,

their fears for their children,

and their hopes for the future.

My own experience
constantly reminds me

that race is not simple
or straightforward,

and each person
experiences it differently.

However, regardless
of how I see myself,

I know society places
me among the privileged.

To ignore that is to
be part of the problem.

(soft music)

- I first came to the United
States as a 24-year-old.

Coming in, I thought it was
very obvious that I was cool.

I mean, for me back
then, it was aspirational

in a way that I kind
of cringe at now

to be as American as possible.

I was arguably well-spoken.

I got the pop
culture references.

I engaged in sarcasm very well.

I watched all 10
seasons of Friends,

and all the episodes
of "Star Wars".

I thought I had it down.

I saw myself as one of the guys,

every bit American
as the next person.

However, I remember the
first time I ordered

at McDonald's in Boston.

The person at the counter
kind of double checked

that my non-vegetarian order
was in fact intentional.

Then it happened
a few other times

before I realized that
the color of my skin

may mean I was automatically
considered vegetarian

in some circles.

It was not a big deal at all,

but as a hardcore bacon lover,

I was very offended.

Then, as an exchange
medical student,

I started taking my
first patient history.

I saw this split second
look of confusion

on the elderly gentleman's face.

He screwed up his eyes
like he was bracing

to not be able to understand me

before eventually realizing
I did speak English

in a way he could understand.

My eager and insecure
little 24-year-old heart

however sank a teeny bit.

Then the same thing
happened with a younger guy

who showed me around
the first gym I joined.

Eventually, that split
second look of confusion

became so familiar,
I began to expect it

at every new interaction.

I have now realized,
after all these years,

that maybe it was not
so obvious to others,

my coolness, or my
fitting in-ness.

I think it finally clicked
that one time I realized

my friend here, who to
me was just my friend,

referred to me to
her other friends

as her Indian friend.

My dear friend meant no
harm at all, obviously,

but I essentially had failed

in my aspirational Americanness.

Whether these
aspirations were acquired

or well-placed is a
question for another day.

And I cannot help but feel

like these are
trivial grievances.

That is a common theme with
these experiences often.

Am I imagining it?

Was it because I'm brown,
or a woman, or young?

Was it even real?

I must be overreacting.

This is all in my head.

I'll go take a walk now.

Do they matter that much?

Another close friend
asked once recently

while we were discussing
the perceptions

and nuances of racism.

Must we all be such wallflowers?

Of course none of these
people meant any harm.

In fact, they were all
genuinely lovely people.

But the thing is, sometimes
it's the little things

that define our otherness.

When you look back in middle
school or high school,

do you remember not
wanting to stand out

in any way at all?

I did.

The most pressing
motivational factor

was the need to fit in.

The need to not be seen as
different or weird in any way.

But then do you also
remember that first day

you had to wear glasses
to school, or braces?

You can perhaps still
feel that anxiety

in the pit of your stomach
as you turn the corner

of the hallway and
walked into class.

When you think about it,
that motivation remains

for most of our
lives on some level.

At the end of the day, you
kind of hope you fit in

within the community you
spend most of your time with.

And that's why it
matters, because it feels

like middle school a
bit, all of the time,

for all of our lives in this
country we as immigrants

earnestly choose to call home.

The anxiety in the pit of
your stomach, everyday,

at work, at school,
at the grocery story,

being a little bit fearful,

fearful of microaggressions
and exchanged glances,

and subtle changes in body
language indicating discomfort,

fearful of being
dismissed and talked over.

It makes the path a
little more arduous.

But these discomforts
are going to be here

for a long time,
for People of Color,

because change is
hard and takes time.

And there are far more overt
racially charged experiences

we need to tackle first.

So in the interim,
what can we do?

What we could do is maybe
offer some extra kindness

to that one intern who's
treated a little differently.

Thank you.

(man singing)

- When I was eight years old,

I was in my grandparents'
house on the reservation,

and my grandpa asked me what
I wanted to be when I grew up,

and I said I want
to be a doctor.

His response to me, this
man who loved me very much,

and took really good care of me,

his response was well, you're
too stupid to be doctor.

My grandpa is really wise,
so I thought oh, okay.

I believed him for
about 20 years,

and then in my late
20s, I was a cop,

and I was driving my
patrol car down the road.

I had this really
striking thought

that came to me, it was like
somebody else was telling me.

You know, you can do this.

I decided right then that
that was what I was gonna be,

was a doctor.

I still doubted myself
every once in a while.

I remember telling my Elders
who were like grandpas to me,

this is too hard.

Thinking maybe I need to
be doing something else.

And they said no, we need you.

How could I say no to that?

(bright music)

My name's Bret Benally Thompson.

I'm a palliative care
and hospice physician

at the University of Wisconsin.

What we do as physicians
is really precious.

I hear people's
stories all the time.

A lot of times, they're
really tough stories.

And sometimes we can fix them,

sometimes they
don't need fixing,

but we still hear their stories.

We walk people through
that part of their life

that they're there,
asking us for help.

Most people don't want
to leave this life,

and most people don't want
to leave their families

and the people that they love.

As a vet myself,
I a lot of times

will connect with veterans.

I figure they've probably
suffered in some way

to take care of us, so
it's something I can

give back to them, by
taking care of them.

A lot of times, the families
or patients thank me

for taking care of them.

I say well it's an honor
for me to take care of you.

I don't tell people that I'm
Native unless they ask me.

Because I'm one of those guys
that could pass for either.

But it's definitely a part
of who I am spiritually.

The way I've been taught,
and the way I've learned

as an adult in our ceremonies,
and our way of life,

really helps keep me
grounded in what I do.

Part of what I really love
about being a physician

is I get to go back and
talk to young people

about what it's
like to be a doctor,

and if they have any inkling
about being a doctor,

that it's actually
something that they can do.

Some people go right from
high school to college

to medical school.

That's probably
the most common way

that people become physicians,

is they just go
straight through.

But my path has never
been a straight path.

I've had a very
rich and full life,

but it's taken a lot
of twists and turns,

and I think a lot of
Native people are that way.

We don't have the
same opportunities,

maybe don't have
the same resources

that some other people have.

When I encounter an obstacle,

if I can't go over
it or through it,

I go around it.

That might take some extra time,

or it might take a more
ingenious way to do it,

but Native people
are pretty ingenious.

It's how we've survived.

I always tend to get there,

and that's how I got
to be a physician.

I never gave up, never
gave up on my dream.

- Why is it important
to tell our stories?

- If we tell our stories, we
understand each other better.

- When everyone is able
to share their story,

when we understand those
multiple perspectives.

- We all come with
a special nuance

that makes us different.

- We're able to build
systems and structures

that take into account
the diverse needs

and desires of the
entire community.

- When people hear
these stories,

they feel like they're
part of something.

- It's important for
my story to be told,

because people are
oftentimes not even aware

that Native Americans still
exist in this country.

- The world is very
harsh and unkind,

and when we share
stories and connections,

that is how we build empathy,
and that is the only way

that we can possibly
begin to heal the world.

- Understanding the narrative

really identifies elements
people can latch onto.

It pulls them along.

- And sometimes we
just need to be quiet

and listen to patients.

- We have a head and a
heart and a hands problem.

So the head is just
the data, the facts,

that we have these
healthcare disparities.

The heart are the
stories, right?

They're the actual
stories that we all tell

about how we experience
them, how our patients

and families experience them,

and then the hands are
what we actually can do

to make a difference.

And so without having the heart,

it's really hard
to do the hands.

- Our stories have to be told

so that we can activate change.

- Traveling a path less
worn requires constant

calculation and readjustment.

It involves
celebrating milestones,

as well as marking the
hazards and pitfalls

for those who come after.

The experience can be both
lonely and exhilarating.

These next storytellers
take us on that journey,

and share with us the
lessons that they've learned.

- I have come to understand
that in the fight

for health equity, my presence
as a Black woman physician

is welcome so long as I
am seen and not heard.

This conditional acceptance
has been a painful realization,

and dissent is not
without its consequences,

a lesson I learned one
night while working

on the adult inpatient
medicine ward.

I received a call from
the nurse of Patricia,

a Black sickle cell patient.

I learned that a pill find
while cleaning out her handbag

had been identified as
a narcotic medication.

Security and nursing staff
requested our presence

for a room search.

Patricia's mental
status had not changed.

There had been no change
in her vital signs

or clinical status, and
there was no indication

that she had consumed any pills

preceding security's presence.

Upon relaying this to the nurse,

and asking for time
to review the policy,

she paused briefly before
asking me to confirm

that I would not
be participating
in the room search.

I sat for a while
in stunned silence.

If a room search was
indicated for Patricia,

why had it not been
indicated earlier in the week

for my other patient who
happened to be a white male,

when he left the unit,
returned somnolent,

and returned to normal
when he got Narcan,

the antidote for opioid
pain medication overdoses.

By the time I had learned
there was no defined

room search policy,
it had concluded.

When I visited Patricia
later, she wept

while recounting the
indignity of being separated

from her belongings,
and being patted down

by uniformed staff.

Nothing had come
of the room search,

but she was left to pick up
the pieces of her mistreatment.

My internal response
was a visceral thing.

A living, breathing
amalgamation of ancestral voices

coalescing into a single
reverberating word.

No.

This was wrong.

But even rooted in the
assurance of advocacy

and social justice, an
insidious, intoxicating fear

pressed forward,
determined to lull me

into the safety of silence.

Speaking up would be a
radical act of defiance

for a Black woman who
has been conditioned

to keep her head
down, to be agreeable,

to not make trouble.

When Patricia's nurse
asked to debrief,

I steeled myself in a
stance of curiosity,

and asked many questions.

What was the concern from
a nursing perspective?

How could we have improved
our communication?

How do we make decisions
on when to implement

a room search?

What alternatives did we have?

When invited, I shared
my own perspective.

Together, we created
a plan to address

similar concerns in the future.

We shook hands and hugged.

The chasm between us
didn't feel so wide.

While it wouldn't change
what happened with Patricia,

we could prevent harm
to another patient,

and that was something.

The next night, I was
informed that nursing staff

had filed a complaint stating
I had been unsupportive,

and refused to act
collaboratively.

First came shock.

Then anger.

And when the anger was spent,

an overwhelming
emotional exhaustion.

I cried for days afterward.

It had taken me years of
training and education

to learn to abandon
the lessons handed down

by my forefathers to
keep my head down.

To be agreeable.

To not make trouble.

I wonder if they understood

that through the weaponization
of their feedback,

they had taken something from me

that I couldn't get back.

What had they given up?

I was ready to have
difficult conversations

to bridge the divide.

But even though I had arrived,

had been welcomed, even,

I am still subject to
the same inequities

that my patients face.

I think of Patricia often.

I worry that the damage
done to her is irreparable.

I worry that
progress is too slow,

and patients are being harmed

while we strive
for what could be.

I worry that while I believe

being the dissenting
voice was right,

I may not always
have the fortitude

to always be a voice
for the voiceless.

- Are you the doctor?

(gentle music)
(monitors beeping)

Your frayed undertone
alerts me to what's coming.

Grievances, waiting
for a scapegoat.

I suppress a sigh.

17 patients to see, and you were

the only straightforward one.

This is not how I
wanted to start my day.

I fix my face.

Yes, I'm your doctor.

My hollow words hang
silently in the air.

The most charitable
observer would find

no warmth in your gaze.

The nurse's curt assessment
of you is still fresh,

difficult and standoffish.

How are you feeling?

I silently repeat the mantra.

I'm here to help.

Tell me your story.

Projecting a safe space
that doesn't exist.

You reject the mirage.

The rigid lines etched into
your face don't soften,

but it's your eyes
that speak the truth.

Exhaustion has
smothered everything,

leaving muted embers of
anger in its aftermath.

Dread crouches at the
periphery, waiting.

I came here because
I can't breathe.

I've been asked four times
already if I do drugs.

Why do y'all keep
asking the same thing?

This question is not an
extended olive branch.

It's the crisp crinkling
of a test booklet

as you prepare to
grade my answer.

I'm restless.

Precious time is leaking away.

Weariness coils
tightly around me

like a boa constrictor made
of impotence and cynicism.

My legs can no longer
bear the weight.

May I sit?

You nod.

I settle in at the
edge of your bed.

There's no quick way
through this conversation.

I could say we ask all
patients about drug use.

Normalize it, and
attempt to sidestep

the traumatic undercurrents.

I might acknowledge
your distress,

and ask you to tell me more.

The med school answer.

I could even say I'm
sorry that happened,

and then take control
of the conversation

by asking about your breathing.

The hospitalist answer.

Suddenly, I'm back in college.

An officer is approaching
my black Honda Civic

with his weapon drawn.

He's shouting show
me your hands.

They shake as I stick them out
of the driver's side window.

I'm taken to jail.

I spend my phone call on a
friend who doesn't pick up.

I'm released the next
day with a gruff apology

from the officer.

You aren't the right guy.

Sorry.

My doctor mask slips,
exposing the human beneath.

My answer is all bitter edges.

Some people get the benefit
of the doubt, others don't.

I can't promise it
won't happen again,

but I'll do what I can.

At some point I ask you,
when did your symptoms start?

You have trouble answering me.

I reach back to a
conversation with my dad.

I don't get why doctors
expect us to know

the difference between
regular discomfort

and bad discomfort.

Life is pain.

You work through
it until you can't.

I reframe the question.

When did life start
getting harder than usual?

Your answer is instantaneous.

Five months ago.

Gathering the rest of
your history is easy.

You're comfortable with my plan.

You smile for the first time.

Thank you, doctor.

Later today, we'll discuss
your abnormal results

and upcoming procedures.

You'll cry.

I'll sit with you again.

You'll talk about the
pressures of your job,

and the challenges of
being a single parent.

When I look at
you, I see family.

Several generations
of hard lessons

discouraging vulnerability.

You can't afford to be
less than invincible

when shielding others
from the struggle,

and yet you're here,
unable to go on.

I can't resolve this
cognitive dissonance for you.

All I can offer is this
small fleeting space

carved out with the keen
edges of shared trauma.

Maybe here, you can
temporarily afford to be human.

Two days from now,
you'll ask me about life

as a Black hospitalist.

You'll listen as I talk
about George Floyd,

sick family members,
protests, and COVID-19.

I will no longer track
the time during our visit.

Flakes of clinical detachment

will fall from me
like a shattered cast,

revealing the
exhausted husk beneath,

The wall separating the
personal from the professional

will completely vanish,
trapping me in a moment

that is both cathartic
and triggering.

You'll extend an incredible
amount of compassion

as tears soak my mask,
and ragged breaths

fog up my face shield.

You'll take my hand,
lending me your resolve.

Somehow, you'll know
exactly what I need to hear.

Don't give up on
us, Dr. Williams.

You're not alone.

We need you.

- And the summer of
2020 was really hard.

(soft tense music)

We were all, I think,
feeling isolated and stunned.

When we finally started talking
about the issues of race,

and I kept waiting for
something to happen,

and nothing seemed
to be developing,

specifically for
healthcare professionals,

and so I talked to
our whole department,

and the medical students
and the residents

I worked with, we
decided to partner

with White Coats
for Black Lives,

and to organize our own rally.

Safety was at the
utmost importance

for all of us,
because we didn't want

to take ourselves out of
the essential workforce,

and so we decided
that a silent sit-in

would probably be the most safe.

It felt really
good for all of us,

to be there, and to
be there in force,

and to have our voice heard,

and for us to come
together like that.

I think messaging and
witnessing are important,

but only up to a
point, and systems

are very, very hard to change.

At some point, you can't
spend all your energy

just messaging, and witnessing,

and demonstrating
and protesting,

you have to really
transform that into action.

But I think at key moments,

when everybody has this
need to come together

for our message, it
serves that purpose.

So it felt like a
good starting point.

- My new therapist
peers at me through Zoom

and asks me to
describe my childhood.

Where do I start?

- [Producer] Brenda
Her, take one.

- In my culture, childhood
begins before you are born.

I am the daughter of Cher
Thang Her and Xong Yang.

I am a descendant
of the Hmong people

who fought during
the Secret War,

some who are shaman
spiritual healers.

I carry the imprint of trauma

from war and genocide,

sexism and racism,

passed down from one
generation to the next

through parenting, modeling,
and societal pressure.

I carry the unhealed
wounds of my mother,

my grandmothers,
and Hmong sisters,

living in a culture of
silence ruled by patriarchy.

I witness my parents hide
their wounds and suffer

from the unresolved
trauma they didn't have

the luxury of healing.

And so, they imprinted
their children

with the lessons of survival

that were given
by our ancestors.

The survival lessons
I learned in childhood

continue to be my
inner struggle.

I learned that in
order to survive

as a Hmong woman in America,

I had to please,
perform, and perfect.

No exceptions, no mistakes.

And anything less was a failure.

I worked hard on fixing myself,

cycling between podcasts,
online cognitive

behavioral therapy,
and self-help books,

searching for something
to teach me how to balance

my mother's worsening
heart failure

and dialysis-dependent
kidney disease

to teach me how to make
sure my brothers and sisters

had what they needed
to thrive in school.

To teach me to navigate
the grueling work hours

in the middle of a pandemic,

to prove that I
belong as a woman,

and Person of Color in medicine.

But all of my efforts
only led to frustration

when I fell back
into the old habits

and gave into the
negative thought patterns.

The critical inner
voice, and the behaviors

that I thought would
help me fit in,

but instead, dimmed the
light of who I really was.

And that is what led
me to that moment.

Sitting on my couch,
laptop in front of me,

asking for help for the
first time in a long time.

It was worth it.

Through therapy, I learned
mind body practices

that have transformed my life.

I learned to ask
for and accept help,

not only from my therapist,

but also from
family and friends.

Healing meant going inwards
and embracing my roots

as a Hmong woman,
finding community,

and honoring the warrior in me

who had overcome the
challenges of childhood trauma

and abuse, sexism and racism.

It meant learning to
accept that my parents

are human beings, with
their own unresolved trauma,

that they didn't have
the luxury of healing.

My journey to healing and
understanding my traumas

has shaped and influenced
my career in medicine.

Healing is a daily practice,
and an ongoing journey.

With it, I honor my
ancestors and parents,

their blood, sweat,
tears, and efforts

that led me to where I am today.

- My dreams and hopes
for the next generation.

- Is that we can create
a system of health

that is trauma-informed,
not trauma-imbued.

- Is that they can
simply be physicians.

- Whether we have a
commitment to our communities

in our profession, that
we don't have to pick one

over the other.

We can really satisfy
our full selves

when it comes to
practicing medicine,

and knowing that we
are not only improving

the wellbeing of our
individual patients,

but our communities
and society as a whole.

- When talking about race,
it's easy to feel stuck,

and hard to find a way forward.

However, as we're about to hear,

there is room for hope.

(upbeat music)

- [Tseganesh] Looking at
me, you see how I appear

when I enter any space.

A youngish Black
woman with a big smile

and a strong handshake.

What you don't see
is the manifestation

of my inner white man.

Yes, you heard me.

I have an inner white man.

Joe became a part of
my life the first time

I put on a white coat
in medical school.

I had him knock first
before we entered

the exam room, and
had him sit next to me

as I took a patient history.

I channel him often
when I have to explain

no, I'm not the nurse.

Or yes, I have done
this procedure before,

and no, of course I
don't mind if you talk

to another doctor about this.

Medicine is the space
designed to make me feel

alone, uninvited, and
constantly second guessing.

Joe is expert at protecting
me from the questions

about my right to be here.

Joe can pull up a seat
at any of the tables

and be made to feel
welcome, even wanted.

Listen, Joe is not
an internalization
of systemic sexism

and racism that tells me
my worth is only based

on a scale of whiteness,
nor is he a demonization

of the white male narrative.

I know every story is different.

But my Joe, he serves
a dual purpose.

He reminds me of the
systems that I live,

and I work in, and
he is a powerful tool

that I can use to thrive
in those environments.

For example, Joe and I looked
in the mirror this morning.

We made sure that this dress
didn't show too much cleavage

and that it didn't hug
my hips too tightly,

because I want to be
judged on the content

of my words, and not
the shape of my body.

Joe also reminds me to
push back my shoulders

and stand assured that
my words are important,

and my voice is worth hearing.

My inner white man, my
Joe, is my shorthand.

Joe is also my systole.

Systole is the powerful
part of the cardiac cycle.

Systole is this
life-giving force

that drives oxygen
out of the heart

and pushes it
throughout the body.

Systole is loud.

And it often drowns out that
brief silence of diastole.

When I am in spaces of diastole,

I notice that my body relaxes.

I breathe more fully and deeply,

and I feel myself expand
to my fullest expression.

My heart is full, so full,

that I can no longer
accommodate Joe.

I have expanded
beyond the spaces

that require his presence.

Spaces of diastole are sacred.

And I have come to understand
that they are formed

through intention and labor,
and are not happy coincidences.

My spaces of diastole
include my clinic.

I walk in, I am greeted by
nurses and fellow physicians

that reflect my
lived experiences.

My patients are a tapestry
of new and old Americans,

woven together in a neighborhood

that is full of
history and promise.

I work in a space
where my voice, my
story, they are enough.

I work in diastole.

Advocacy is systole, a
powerful forward movement

that seeks to make change
on behalf of others.

In advocacy, just as in life,
systole requires diastole.

If we want the energy,
the perseverance,

and power to seek change,

we need spaces of diastole,

where we can relax
and be filled,

where we can heal, where
we can thrive and perform

at our highest levels.

We need to become
advocates for diastole.

- Her eyes brightened,

and her cheeks were
rounded by her wide smile.

She excitedly stood up
from where she was playing

and walked towards me
as I entered the room.

She gave me a long,
unexpected hug.

Salam, how are you, I asked her.

Are you my doctor, she asked.

Yes, yes I am, I responded,

matching her excitement.

She then followed
me as I sat down.

She reached for my
royal blue hijab

as she pointed to hers,

bright orange and with sparkles.

She was eager to share what
she was learning in school,

stories about her
friends, and all the foods

she was eating to help her grow.

As I wrapped up
our visit, she said

I want to be a doctor just
like you when I grow up.

Sometimes, it's hard
to remember the why

when so many days are
filled with signals

that I don't belong.

Those quick glances
down at my badge

that says doctor,
back to my face,

and then back to my badge again.

It's hard for me to
accept that the white coat

I'm wearing, my
stethoscope around my neck,

my multiple pagers beeping,

and the patient list in my hand,

are still not
enough to shield me

from the perception
that I am out of place.

On those days, she is the why.

She and many others remind
me why I've dedicated

so much of my life,
my time, my energy,

to be in the room with
them as their doctor.

I often ask myself
what does it mean

to belong in medicine?

For me, belonging is
not about conforming

to the appearance
of a typical doctor.

Belonging is about
changing the perception

of what a doctor looks like.

So every time I get asked
where are you really from?

I think of bright
orange and sparkles.

Every time I get
surprised glances

because I'm explaining
life-changing diagnoses,

or laying out complicated
treatment plans,

I think of patients with
henna-speckled beards

who will agree with my
treatment recommendations

because of their faith
and trust in my presence.

As I walk around the
hospital with my stethoscope

and my hijab, I
know that I stand

between two generations.

I want to inspire
my young patients

to dream of becoming intelligent
and compassionate doctors,

and I want to be
worthy of the Elders

who beam with pride
because their sacrifices

and hopes have been realized.

If I do these things, I'll
always know that I belong.

- As clinicians, we have been
trained to gather information,

make an assessment, and then
thoughtfully move forward

with a plan.

As you will see, the
same process is true

when it comes to addressing
racial disparities.

(soft music)

- It's hard to talk about
race in Minnesota in general,

because I think we feel
like we can and we should

treat everyone the same way.

And I think that is
rooted in a healthy way,

but if we treat
everyone the same way,

we assume everyone's the same.

Being Vietnamese-American,
being a refugee,

when I started doing
work in medicine,

I gravitated to
particularly those who

are immigrants and refugees.

As the population changed,
and as the needs changed,

I changed with the population.

And so then my equity work
had been more around those

who were dealing with
opioid use disorder.

We have a lot of
individuals come here

that happen to be Indigenous,

and I was not doing a
great service at first,

because I didn't understand
what their life was like

outside of clinic, so I
knew I had to take time

and practice to ask questions,

to learn more about just
individuals and community,

beyond just addiction.

And I learned the good
stuff, the bad stuff,

and the everything in between.

And then also working with
a researching assistant,

Koushik Paul, over
the last three years,

he and I started
doing interviews

with the Native
American community

to understand how we
can better serve them

around opioid use
disorder, particularly

in primary care clinics,

and make it more
culturally-centered,

or family-centered.

And all these connections
that we built over time

in this shared space has
given me a place of joy

where I am working
with communities

that deserve help, should
be elevated and celebrated,

but they have been also
people who are so accepting,

and allow me to learn
and make mistakes

along the way, too.

(gentle music)

- I'm a pediatrician.

I thought I was giving
quality care to everyone

until one of my colleagues said

you should go hear Dr.
Heather Hackman speak.

And she was presenting
on white privilege.

And I sat in there, at the
time, at 47 years of age,

embarrassed, because I'd never
thought about that issue.

So then I started thinking
about my patients.

I've had the honor of
taking care of kids

with sickle cell disease
for over 30 years.

It's an inherited
blood disorder,

it's a global disorder.

It affects people of all races.

But in the United States,

virtually all the
patients are Black.

And I started thinking
about me, and the team,

and the clinic.

And at that point, every
single one of us was white,

and could that fact alone
affect the quality of care

that we deliver these
patients and families,

or at least the
perceptions of that care?

So we asked the question,
and it matters a lot.

And that was really
the impetus for me

to partner with
Dr. Heather Hackman

to develop a training
module around race, racism,

and whiteness and implicit bias,

specifically for
healthcare providers.

One very important
piece to improve equity

and outcomes for
patients of color

is to change the demographics
of the healthcare team.

Right now, only four percent
of licensed physicians

in the United States are Black.

And we know that there
are better outcomes

when there's racial and
or cultural concordance

between a provider
and their patient,

because there's better trust.

So until we get that
improvement in the demographics

of the healthcare
team, I'm the one

that needs to do the
work, and build trust.

- I study racism as a
fundamental cause of disease.

- [Producer]
Cunningham, take one.

- My research right now
aims to get white providers

to talk to their Black patients

about their
experiences of racism.

As I sat in on the focus groups,

many people were saying yes,
racism in healthcare is real.

Yes, I or my family members
have experienced it,

and recounted stories about
not being able to access care.

And when I say access,
it's not that they didn't,

they had insurance, right?

They had transportation
to the clinic.

But not being able
still once they came in

through the clinic
doors to get care

that they perceived was high
quality, and met their needs,

or to be listened to.

And what I'm hearing,
which is very encouraging,

is many of our physicians
recognize the importance

of racism as a cause of disease.

Many patients
recognize that as well.

The challenge is
whether people again

are willing to have
that conversation

in the clinical encounter.

I really think there's
the power at the bedside,

but until we do something
about those structural

conditions under which
people live their lives,

we're going to continue
to see health disparities.

I can only find temporary
solutions for people.

So person A comes in,
and I find a solution.

But what happens with
structural conditions

is that it's not
just person A, right?

It's person A, B, C, D,
E, who are all coming in,

in similar predicaments.

And so to the extent that
those structural conditions

produce harm, then I'm
gonna always have patients

in my office.

That is what racism is.

It is classifying people
into different groups

and giving them
differential access

to resources and opportunities.

And with that, constructing
them differently to justify

that different access.

So we have to
change our society,

and that's more than healthcare,

but healthcare can
play a big role.

Physicians as
important stakeholders

with a voice in power
can play a big role.

- Thank you for listening.

No matter who you
are or what you do,

we hope that you
share your story,

and have a conversation
about race.

We believe that it
is through stories

that we can begin the
process of healing.

We close with a poem
by Dr. Tolbert Small,

former physician to
the founding chapter

of the Black Panther party.

- The title of the poem
is "We Are the Healers"

and it is a message
for everyone.

Doctors don't heal in a vacuum,

and healing can take many forms.

We are part of a broader
community that includes you.

We are all interrelated
and interdependent.

We are all called
to heal the wounds.

(gentle uplifting music)

- To the healers.

- And their patients who
have the right to be healed.

- By Dr. Tolbert Jones Small.

- We are healers.

- We toiled for years
to learn the mystery

of the human body.

- We nourish spirits
from birth to the grave.

- We mend the bones.

- We sew the cuts.

- We kill the pain.

- We cool the fevers.

- We soothe the spirits.

- We are healers.

- We bring new life.

- We close old life.

- [Together] We pick the herbs.

- We needle away the pain.

- We cut out the cancer.

- We poison the germs.

- We calm the troubled minds.

- We are healers.

- [Together] We
treat the whole body.

- [Together] As one universe.

- We treat each part
of the universe.

- We keep the hearts pumping.

- We keep the lungs breathing.

- We know as long
as life exists.

- [All] We will.

- [All] Be healers.

- What brings you
joy in medicine?

- What brings me
joy in medicine.

- [Man] Relationships.

- Relationships bring
me joy in medicine.

- Connections.

- The experience of my patients.

- Young people finally get it.

- To have the light bulb go off.

- Very rewarding.

- I have joy in medicine

when my patients have joy.

- They give me hope,
they give me courage.

I learn so much from their
cultures, their values,

their knowledge,
and their belief.

- The most joyful part
of being a physician.

- They trust me,
and I trust them.

- Is being in fellowship
and partnership

with my patients.

- The opportunity of
working with somebody

for 15 years to try to
get them to consider

stopping smoking, and
that day when they say

you know, I really
need to do this.

- What brings me joy in medicine

is listening to the
stories of patients.

- I love to sit around,
and that's probably why

I can be late in
clinics sometimes,

since I love to hear
people's stories.

- I feel very privileged
to share that sacred space

with our patients.

- One word that brings me
joy in medicine is learning.

Actually learning about people,

and learning about
their stories,

and learning about
what makes them work,

and what makes
them who they are.

- To be able to apply science,

but in a way that genuinely
helps someone feel better

and have a better day.

- The opportunity of the
future, what isn't yet,

how we deploy our
insatiable curiosity

about what if, and what
can be in terms of next,

opportunity for
change for the better.

- This is excellent.
- Brilliant.

- [David] Oh, good.

- Yes, good stuff.
- You're happy?

(bright music)