Secondary Logo

Journal Logo

Teaching and Learning Moments

Dare to Look

Davis, Denise Lynne MD

Author Information
doi: 10.1097/ACM.0000000000003583
  • Free

I remember finding my mother’s nursing textbooks inside the dark walnut panel in her headboard. I was fascinated by the color plates of veins, arteries, and nerves; the hollow organs of the stomach and intestines; and the graphic representation of the human skeleton.

When I was 11 years old, my brother’s friend slid while playing in our living room and sustained a gash on his leg that exposed the white tissue underneath. I remember that my brother and the others moved away from their friend while I moved forward. I had only a first-aid kit and I used supplies from the linen closet before calling my mother. I knew that bringing the edges of his broken skin together was important, but I didn’t have the right tools. I wanted to make right what had been torn. I wanted to be a physician.

This week I’m working with an expert interprofessional team on preparing first-year medical students to become physicians. My message to students participating in our school of medicine’s diversity, equity, and inclusion orientation needs to be clear. I’ve thought for months about what I need to say in those first minutes to students on their third day of medical school. Bias kills. Racism maims. Able-ism obstructs. Sexism traumatizes. Anti-immigrant bias sickens. My voice feels like an ambulance siren.

I hope to reach the champions and skeptics, as well as the students who are well-meaning but are novices in their understanding of, and ability to talk about, inequality in medicine. I need the right tools. I rehearse: “The warmest welcome to every person here today. I don’t know you, but I’ve been thinking about your class for months.” I imagine standing in front of 158 students and their faculty mentors and I weep. I wonder what is so urgent about this work that I spend countless strained hours rehearsing my brief introductory remarks.

The urgency I feel is both personal and professional. Black, brown, and Native lives will continue to be lost due to well-documented injuries from racial disparities in health care. I know that learners will see my brown face convey a deep resolve connected to both my life experiences and my beliefs in the importance of teaching medicine for excellence and justice. It is written on my face that I’m not simply checking a diversity and inclusion box.

Though the charge to address the effects of discrimination and bias is weighty, I feel empathy for the students and faculty I teach when I remember my own limitations. Like most faculty, I received no training in addressing racism, power, and privilege in my professional education. I’m learning, with some anxiety, to ask the hard questions of students, like, “How is bias active in our care for this patient?” I’ve learned to say, “I wish that bias was not present in our institution. I will check in regularly with you about what you witness. No one should experience this alone.” As a teacher, I want to create a climate of fairness—for the sake of our patients and to honor the calling I felt when I was young. I remember moving toward the boy with the wound. Inequality in health care and medical education is now the emergency I’m running toward.

I know how burning the mission is because I develop palpitations preparing for this orientation. I feel in my chest the “urgency of now” that the Rev. Dr. Martin Luther King, Jr spoke of. I persist in moving toward the gash of racial injustice. I’m willing to take the risk and look at the wound to make right what’s been torn. Are you?

Copyright © 2020 by the Association of American Medical Colleges