A Year Later


Has anything changed since the nation confronted systemic racism?

In our July 2020 issue, several surgical professionals bravely shared their experiences of racism and expressed hope for a more inclusive future. We asked them to reflect on what’s changed — and what hasn’t — as the nation continues to grapple with issues of racial and social injustices. Their thoughts are just as powerful and poignant today.
— OSM Editors

‘The Overall Climate Is the Same’

As a person of color, I’d been fragile and reflective for more than a year as a result of the George Floyd murder. No one, regardless of their race, should be treated so inhumanely. To see such horrible conduct from a police officer playing out in front of our eyes was gut-wrenching. I will never forget those images.

Since sharing my thoughts in these pages last summer, the overall climate at work has remained the same. A doctor approached me and said, “I don’t get the Black Lives Matter thing. They’re a bad group of people, and they’re causing more problems.” I was shocked and obviously disagreed, but realized it wasn’t worth my energy to try to change his mind. I simply said, “My lived experiences are different than yours, so I support the movement.” We can agree to disagree.

I’ve also had several constructive conversations with coworkers, most of which were empathetic in nature. Some colleagues have shared with me their disgust and frustrations about the amount of racial injustice that has gone on in the last couple of years. The George Floyd incident pushed them over the edge regarding the lack of accountability.

I appeared on the cover of last year’s July issue because I wanted to be a voice of change. I’m not sure how things will be different in surgery if discrimination in America continues or if new ways of recruitment and inclusion aren’t implemented. Minority representation in surgery will continue to be minimal if there’s a continued lack of awareness and affordable access to the wide variety of jobs available, if minorities in health care are made to feel as if they don’t belong and the input on matters important to persons of color remains unaddressed by leaders or management. Not much has changed in a year, so the work must continue.

Ari Collins, SA-C, CST
Surgical Technologist
University of Colorado Health System

‘We Must All Do Our Part’

My reaction to the Derek Chauvin verdict was a tiny sigh of relief for George Floyd’s family and the community who protested and prayed on his behalf. The verdict cautiously elevated my hope that we might be one step closer to this type of behavior ending. Sadly, more people of color have been killed by law enforcement in extremely questionable situations since George Floyd’s death. The reality is that there is still a system in place that allows more murders to be committed against people of color.

Cultural awareness has definitely been elevated in the last year. A strong effort has been made to break down the barriers that prevent constructive communication. Safe spaces have been created for people to examine their own beliefs and learn how unconscious bias plays into systemic racism, racial disparities, inequity and injustice. Progressive action is being taken in pockets across the country, but individual efforts and decisions are not as robust because some people are nervous to say anything, unwilling to do the hard work on themselves or refuse to give up their privilege by speaking out.

I have spoken up, and the experience has been enlightening. I’ve been genuinely asked how I’m feeling, and about things I have dealt with in my life. People have asked how they can be an active ally in the workplace and in their communities. Some of my friends and colleagues apologized to me for not taking personal responsibility in situations where they witnessed racism, but said and did nothing.

Moving forward, we need more education, awareness and an evidence-based road map to make change happen. People with a passion for diversity, equity and inclusion must continue to push for change. As the second woman and person of color elected to AORN’s National Treasurer Office, I have an obligation to help increase diversity in health care. We all must do our part to ensure positive change for our patients and generations of nurses to follow.

Nakeisha M. Archer, MBA, RN, NE-BC, CNOR, CSSM
Director of Perioperative Services
Texas Children’s Pavilion for Women

Change Requires Action
Walk the Walk
AT THE FOREFRONT Joseph Betancourt, MD, MPH (second from right) held more than 40 town halls and meetings about the Massachusetts General Hospital (MGH) Structural Equity Plan, an initiative launched last year to address structural and overt racism with clearly defined initiatives and measurable goals.  |  Massachusetts General Hospital

Last year, our health system launched a multimillion-dollar investment for our organization to change the systematic, institutional racism that is finally being recognized as a public health crisis. The effort, which we called the Massachusetts General Hospital (MGH) Structural Equity Plan, is a 10-point strategy to address structural and overt racism within and outside the organization through clearly defined initiatives, action steps and measurable goals.

The plan isn’t a flashy endeavor that looks nice in the short term but won’t lead to meaningful, long-term change. It’s a deliberate and rigorous attack on the systematic problem that has seeped into the cracks of institutions in this country — including health care. We began the initiative with a closer look at our own organizational processes.

Each of the points in the plan identifies where we want to be, where we currently are, and the steps needed to bridge that gap. The plan also aims to create a more diverse workforce, an area in which we’ve made major inroads. In fact, 27% of the members of our incoming intern class are from underrepresented minority groups — a new record for us and a significant increase from the previous high of 17%.

If your facility is serious about combatting systemic racism and embracing diversity in earnest, you need to understand the scope of the problem you’re addressing. Addressing systemic racism requires building new systems, creating hard and fast timelines, and achieving tangible goals and milestones. Celebrate small victories, but commit to long-term, big-picture solutions.

Joseph Betancourt, MD, MPH
Senior Vice President, Equity and Community Health
Massachusetts General Hospital

‘This is Everybody’s Fight'

CAUTIOUSLY OPTIMISTIC Imani E. McElroy, MD, MPH (third from right), is heartened to see more minority representation among medical school classes.  |  Imani McElroy

Over the past year, I’ve felt proud and found reasons to celebrate some positive developments, but anger and worry remain. I’ve noticed a larger number of minority men and women among photos on Twitter feeds that featured incoming interns to medical school programs. I’m excited and energized by this type of progress.

I’m also glad to see a shift in people’s willingness to have uncomfortable conversations about racism. Some of my best friends have had those hard discussions with their parents and other family members. Hearing about these talks and knowing people understand that the current state of affairs isn’t acceptable has been very reassuring to me.

The week that the verdict in the Derek Chauvin trial was reached was a difficult one. When he was convicted on all counts, I felt a sense of relief. The verdict resulted in accountability, but justice wasn’t served. Justice would have been served if George Floyd had been able to go home that day and hug his daughter.

The collective events of the past year make it hard for me to say how far we’ve come. Things are changing for the better for me personally and professionally, but on a national level I’m still worried. None of us can afford to stop talking about racism because we’re sick of dealing with it. Minorities can’t break down the system on their own. We need everyone to participate and understand that this is everybody’s fight.

Imani Elizabeth McElroy, MD, MPH
Resident Surgeon
Massachusetts General Hospital

‘We Can’t Remain Silent’

After a long workday at the onset of the pandemic, I experienced terrifying anti-Asian hatred while leaving the hospital. After what happened to me last year, my colleagues have been incredibly supportive. In the general public, there’s been a lot more awareness as there were many more reports publicized in the media and then, of course, the shootings in Atlanta, which propelled the concerns about hate against Asian Americans and Pacific Islanders (AAPI) to the forefront of the American consciousness. I hope that momentum continues.

My hospital’s diversity and inclusion committee created a solidarity event for our AAPI community in response to the Atlanta shootings. Some of my colleagues shared intimate stories of hate they’ve encountered or that their kids have encountered. It was a safe space where people could share, and it was a very supportive environment.

We can’t remain silent. We must constantly educate people around us about anti-Asian racism to promote supportive behavior and develop allies, to institute a culture of breaking the silence in everyday lives. We must hold onto little advances, and keep moving forward.

Lucy Li, MD
Resident Anesthesiologist
Massachusetts General Hospital

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