#WhiteCoats4BlackLives Speech

Monday, December 15, 2014

Good afternoon. Thank you all for being here today.

I’d like to begin by addressing the range of emotions that we as organizers have felt in the last week. We have felt sadness, we have been angry. We have felt frustration. Of the many emotions we’ve felt, let it be known that today, in standing here with you, we do not feel afraid and we have not given up hope. I hope that the same will be true to each and every person present in this action.

Today we stand together as a UCSF community - students and faculty from each of UCSF’s great schools - Medicine, Nursing, Pharmacy, Dentistry, the graduate division. Additionally, we stand with more than two thousand students from over 80 medical schools across the US, more than half of all the medical schools in our country. 

People have asked me, “Oh, is this just another protest?” First of all, this is not a protest. And even if it were, it would not be “just” anything. This is the beginning of a movement. A movement of health professional students coming together to address two of our nation’s most potent predictors of social inequity and health disparity - namely, violence and racism.

I’d like to take a moment to address racism specifically. There will be those who say, that this is less about race than it is about education. To them I ask, why are our nation’s classrooms as segregated as they were before Brown vs Board of Education? Others will say that it's not race, but socioeconomic status that is driving inequality in the United States. To them I ask, why is it that a resume with an ethnic surname is less likely to be interviewed, hired, or mentored relative to their equally qualified white peer. And finally, there are others who will say, race and racism are a thing of the past and we need to move on. To them I say that pretending something does not exist will not make it go away.

So yes, racism is central to what we see happening in America. It cannot be ignored relative to educational disparity, the incidence of violence, poverty trends, or patterns in conviction and sentencing in the criminal justice system. But if we want to be honest with ourselves and if we want to do something about racism in the United States, we must also acknowledge that racism is present in medicine and research.

  • In clinics and hospitals around the country, minority patients receive a lesser standard of care, they are less likely to encounter a provider who speaks their language, who understands their culture or their social circumstance. They are more likely to be treated with stigma or suspicion, and ultimately, are more likely to suffer and die from otherwise preventable conditions.
  • In research and clinical trials, we know that people of color are less likely to be included in the scientific research that informs their care. This lack of representation remains even when minority populations are rising to become the majority of the US population, even when communities of color are disproportionately impacted by the clinical outcome of interest.  
  • Finally, in our academic institutions, with regard to our minority faculty, I can only ask: “where are they?” Nationally, the numbers for minority faculty are abysmal. Equally troubling is the rate of promotion. Furthermore, as a community, we are concerned regarding the bias that leads to Black scientists being less likely to receive NIH funding than their equally qualified white peers.

I read this week a passage by the late Martin Luther King. He said that “riot is the language of the unheard”, of those without a voice. As future physicians and health care professionals we almost by definition have a voice, and we must be heard. It is incumbent upon us to use our voice as individuals and as a collective to advocate for constant progress. For as Dr King also taught us, human progress is not the inevitable product of time.

Today, we honor the memory of all victims of violence and structural inequality by renewing our dedication to advocate for changes in policy and practice. Moving forward I hope that we will address both the prejudice and bias that exists in medicine, and also the various forms of social inequality tied to race that affect the health of our patients in the community. Present circumstance and current public health practices call our attention beyond the clinical setting. We see that maternity leave impacts health, minimum wage impacts health, quality housing availability impacts health, gun ownership laws impact health, documentation status and immigration reform, anti-bullying laws, school-based discipline, patterns in the geographic distribution of alcohol and tobacco retailers, all these things matter. And when we talk about health, we must remember to address all of its forms. Social exclusion is a central element to mental illness. Until we address the barriers that prevent people from fully participating in society we will not begin to adequately address the pervasiveness of depression and substance abuse in the US.

So ultimately, we aim to work towards a world in which all people have the power and resources to thrive without fear of discrimination, exclusion, or harm…. a world where the deaths of Michael Brown and Eric Garner would have would never have taken place.

Today is the day of International Human rights. Today, when we laid down, we did to so grieve the tragedies that have befallen this nation and to declare the offense that they are to the human spirit. Now, we stand, acknowledging the centrality of human rights in our chosen professions, and with a renewed commitment to an equitable society.

As a way of closing, please join me by reciting a brief selection stemming from our professional oath:

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. 

I will prevent disease whenever I can, for prevention is preferable to cure.                         

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

Thank you. Let us go in peace.

Speech given on December 14, 2014.