April 3, 2021
In the summer of 1963, my parents, my older brother and I boarded the westbound Western Star in Chicago. Our passenger car was designed with three bench seats on each side of a center aisle. As the fourth person in our party, I was seated behind my family next to a soldier in full dress uniform. He was black. He was kind enough to allow a long conversation with a curious 15 year old boy. Among other things, we talked about baseball and movies. Our family had traveled to Chicago from our small hometown of Chester in north-central Montana. We primarily intended to see a major league baseball game. My father was able to nourish his son’s passions because he had been awarded a 20 years-of service pass that allowed him and his immediate family to travel free on second class trains. All five of us had attended a movie in busy downtown Chicago the prior evening. My parents saw Irma la Duce (considered an adult film) while my brother and I watched The Great Escape across the street. The soldier went to The Music Man in the same cluster of motion picture theaters. The soldier and I loved the movies we saw. I admitted that I was afraid when entering the theater without my Mom and Dad. The soldier, a fully grown young man, disclosed that he was also afraid. I was puzzled why an adult male might also experience boyish fear. I have continued to learn about possible reasons for his fear now well into my 8th decade of life.
Racial hatred has bothered me all of my life. It is particularly repulsive for me to have witnessed racism in healthcare during my long career as a family doctor. I thought that my line of work would stand above such disgusting bigotry. But my years of labor repeatedly proved that assumption wrong. Writing about racism in medicine is difficult. I generally try to offer unique perspectives based on some scholarly research backed by factual data. This subject is different, but I think it is too important for me to exclude. I, of course, am aware of poorer health outcomes for impoverished populations and people “of color”. But I assumed poverty, genetics and living environments rather than healthcare are likely responsible for most of the discrepancies. Perhaps I have focused blame on those other factors because of my indoctrination in systemic racism.
During my working years I witnessed name-calling, negative stereotyping and disgusting jokes. I regret that I did not always object. I do not recall witnessing outright poor care delivery due to racial differences, but I suspect that I rationalized. During this last year I delved more deeply into this persisting problem that I have dubbed “America’s Original Sin”. I watched too many replays of George Floyd’s death. I read Isabel Wilkerson’s outstanding book The Warmth of Other Suns and re-read Bury the Chains by Adam Hochschild. I pursued some writings by Frederick Douglas, Marcus Garvey and George Washington Carver. I watched Judas and the Black Messiah, One Night in Miami and re-watched Hidden Figures. I learned too many things that I should have known from my experiences in life. Slavery in the US lasted decades longer than the institution was permitted in more mature countries. Black people fled the South during the Great Migration to escape lynching and demeaning Jim Crow laws. But in the North they still could not secure housing and were forced to take difficult jobs that paid poorly. They could only enroll their children in poorly-funded schools. I increasingly realize how my immersion in a country awash in systemic racism has blinded me to many similar awful truths.
I despair that we cannot seem to meet the challenge of racism in our culture. I know that it cannot be eliminated by laws alone. Laws help in some ways but most of the legal gains are short term. In a lecture titled “The Perils of Forced Agreement…” University of Montana Professor Luke Conway referenced a model known as “the agreement paradox”. The model asserts that top-down pressures may be necessary in the short run, but rarely result in long term changes of heart. Self-determined agreement must follow or people will rebel against imposed pressures and perhaps become even more opposed to a mandated issue.
So how do we accomplish self-determined changes of attitudes? We are blessed with marvelous brains capable of embracing logic, but our actions are often governed by our limbic reactions and false information that negates a logical conclusion. In order to change we have to want this problem to resolve. Racism is unjust and destructive. We cannot progress as a species until we embrace all of humanity equally. I have friends and acquaintances who say that they have given up on this issue. I cannot live happily unless I harbor hope. I have not done enough to separate myself from my country’s depravity. I plan to proceed by reviewing some of my previous work addressing change. I will also try to develop interracial relationships to further my education. As Kerry Patterson and colleagues wrote, we can Change Anything. But will we?