It’s Not Equity If There’s An Asterisk
Vanessa Grubbs, MD, MPH and Dr. Qaali Hussein, MD
Since the televised violence and murders of Black people in the midst of a pandemic that laid bare stark racial health disparities, a nation quarantined has been forced to sit with racism and its impact, no longer able to look away. For the first time, more than half the country agreed that Black Lives do indeed Matter. Some were even on the verge of finding enough courage to say so out loud. Almost.
But as the news cycle moved on and the country reopened, the empathy for Black lives that swelled to gain global attention has waned. For some groups, especially White Americans, research has shown that the support for Black Lives Matter has not only declined, but has fallen below pre-pandemic levels and before the police killing of George Floyd.
That empathy has declined despite the global social uprising against anti-Black racism and the declaration of racism as a public health threat by the CDC begs the question of what it takes to mobilize support and empathy for other marginalized groups including Indigenous, disabled, LGTBQ, and Palestinian people. What will it take for the majority to value those lives, empathize with their unique causes, and truly stand in solidarity?
This is where we, two Black women physicians who were part of an organization that presented itself as a champion of equity and justice, began to see that the fight for equity comes with an asterisk. Members who called themselves “allies,” and “equity warriors” even, transitioned from promoting “justice for all” empowered by action to questioning who was deserving of our action and support. Somehow what was born as a bold invitation to push for justice in medicine through media, petitions, protests and whatever else it took to impact change, became so diluted that lukewarm support and acknowledgment of the rampant oppression, discrimination and abuse in medicine became enough. And when the group was challenged to push the boundaries and address controversial issues such as censorship of medical students on the issue of Palestine head-on, it became clear that we were beginning to mirror the very institutions we were supposed to hold accountable. Our actions were severely limited by comfort. More specifically, White/White-adjacent comfort. The motivation to maintain this comfort was demonstrably deemed more valuable than disrupting and dismantling oppressive structures.
And so we resigned.
We resigned because centering and maintaining White comfort requires incrementalism. Comfort centers the voices of the privileged. More time and energy is spent on justifying the importance of addressing inequities we were presented with than actually addressing the inequity itself. Actions leading to equitable changes are delayed by the need to convince others to acknowledge the inequity, a task which usually falls on the minoritized members who are often forced to share their own lived experiences, sometimes being gaslit in the process. When bold actions that call for accountability are suggested, potential repercussions are raised and actions become more muted. The hesitation is usually labeled as “too much, too fast,” with a continued insistence on incrementalism, one of the main reasons diversity, equity and inclusion work usually becomes ineffective.
This hesitation is not new. As James Baldwin stated in a 1989 PBS documentary:
“What is it that you wanted me to reconcile myself to? I was born here more than 60 years ago. I’m not going to live another 60 years. You always told me that it’s going to take time.
It’s taken my father’s time, my mother’s time, my uncle’s time, my brothers’ and my sisters’ time, my nieces and my nephew’s time. How much time do you want for your progress?”
It’s been over 30 years and Baldwin’s words still ring true. It will continue to ring true as long as White comfort is prioritized.
The alternative, getting uncomfortable and taking action, requires doing something that most “allies” and “equity champions” are not prepared to do: taking a risk, including possible loss of privileges. As MLK wrote, “fair-weather supporters were nearly as bad as segregationists,” and allies who impede change in order to preserve comfort are a detriment to the movement for equity and justice.
This work requires telling and acknowledging uncomfortable truths, acknowledging our own biases and the impact they have on the specific equity concerns we are faced with.
As this recent experience has shown us, it is usually Black women at the bottom of the race and gender hierarchy/caste system, invented by White supremacy and misogyny, who do this truth-telling. Perhaps because we can’t be cast down further by our truth-telling, we are able to see, feel, and empathize with every other group’s pain. And in our empathy, we are not desirous of simply moving up in the ranks, only to oppress another group in order to maintain our new place. Rather, we want to see everyone free of oppression.
We are calling on everyone to join us in moving beyond comfort.
We are calling on the same physicians who speak up loudly against being called “provider” and the massive support behind similar campaigns, i.e #MedBikini, to think about how the causes impacting minoritized physicians, such as racial epithets hurled at Black trainees and physicians who are often advised to just “let it go”, don’t get similar support. Often times, the discrimination and inequity experienced and reported by minoritized individuals are minimized, questioned, and explained away as a “misunderstanding.” There are times when reports of frank discrimination are met with disbelief and the claim of “I’ve never seen it,” therefore it may not be true, leading to further gaslighting. It’s usually those with similar lived experiences who are able to empathize and speak up against these inequities.
What if we started with empathy? What if, instead of questioning the veracity of one’s lived experience, we centered it and tried to understand it? What if we centered and empathized with the lived experiences of Black people? And Indigenous people. And disabled people. And Palestinian people. And trans people. And anyone else treated inequitably.
When fighting for justice and equity for all, which inevitably will include those whose lived experiences differ from our own, we must start with empathy. As healthcare workers, we are attuned to practicing empathy in our everyday clinical practices. Most of us have no lived experience with the serious illnesses we so aggressively work to ameliorate or cure. Yet, we can imagine what our patients must be going through and empathize with them.
What if we approached equity and justice from the perspective of placing ourselves in other’s positions. Ask yourself “If I were treated like that, what would I do?” If it feels wrong for you/your group, then why is it acceptable for others? Jane Elliot demonstrated this poignantly when she asked a majority White audience “if you as a White person would be happy to receive the same treatment that our Black citizens do in this society -please stand!” When no one stood in response to her repeated question, she stated, “That says very plainly that you know what’s happening. You know you don’t want it for you. I want to know why you are so willing to accept it or to allow it to happen for others.”
Preserving White comfort through incrementalism is an impediment to equity and justice. Diversity, equity and inclusion initiatives are largely ineffective because this comfort is centered and prioritized over dismantling systemic forces which create inequity. It’s past time we remove the asterisk on equity.
