Transformational Times
Words of Hope, Character & Resilience from our Virtual Community
Friday, June 12, 2020
In this Issue:

  1. Director's Corner by Adina Kalet, MD: Let's Talk About Racism and Be Ready to Get It Wrong
  2. Racial Injustice & Inequities Perspective from Loren Nunley, MD, MBA: An Open Letter to my Colleagues
  3. Racial Injustice & Inequities Perspective from Bruce Campbell, MD: Microaggression
  4. Racial Injustice & Inequities Perspective from Megan L. Schultz, MD, MA: My White Privilege
  5. Racial Injustice & Inequities Perspective from Kathlyn E. Fletcher, MD, MA: A Personal Call to Action
  6. Educational Perspective from by Amy J. Prunuske, PhD and Jacob Prunuske, MD, MSPH: Marrying the Basic Sciences to Clinical Medicine
  7. Reflections: What's one concept you understand more deeply now?
  8. Links | Resources | Ways You Can Help
Director's Corner
Let's Talk About Racism and
Be Ready to Get It Wrong

Dr. Kalet calls for difficult, uncomfortable conversations about race, racism, and equity within the white community to make the needed culture changes in medical education. It will take character and courage because we will get it wrong much of the time…

“Would you like me to cut it too short or too long?” I asked the surgery resident in my head, an ironic, exaggerated smile on my face. “ How would you like me to get it wrong this time?” I murmured defiantly, out loud to no one, as I walked home late at night replaying the endless surgery clerkship day in my head.

What had actually happened? I was scrubbed in the OR, standing at the head of the patient, wedged next to the anesthesiologist (who was leering down my scrub shirt), holding the heavy steel retractor lifting the patient’s liver (don’t ask), so that the chief resident had an unobstructed surgical field to remove the gall bladder. I imagined him – but could not see – carefully dividing tissue planes, isolating the common bile duct, tying off small bleeding vessels. Once the gallbladder was “delivered,” plopped into the kidney shaped metal bowl, and examined thoroughly (none of which I could see), the chief instructed me to release so he could remove the retractor. Then he stripped off his gloves and left the OR. Without a word, the lower ranked resident stepped into place and the scrub nurse firmly slapped the needle holder, suture in place, into his hand, and he began stitching the surgical wound closed.

I stood with my hands above my waist, not daring to contaminate the field, looking longingly at the needle and thread. Taking pity, the nurse – the only other woman in the room besides the sleeping patient – handed me scissors. How did she know I love to sew? The resident tied the sutures. With each stitch, he growled, “Cut!” I fumbled. “Too short!” Longer next time!” “Cut!” “Shorter next time!” He never made eye contact or said “please” or “thanks” as he barked at me. 

I should have been more assertive even in the face of withering criticism or ridicule in the OR, I would have learned more, had fewer regrets and felt better about myself. At the time, though, it seemed clear that if I wanted to avoid being judged and considered wrong the only choice, was to be passive and “just go along” with what was the dominant culture in the small part of the world.

That is how I am feeling now. 
Milwaukee Art Museum Mall - June 8, 2020
Photo courtesy of Julia Schmitt
Seeking Co-Editors!

We are seeking individuals to assist with the Kern Institute's Transformational Times newsletter. Although all members of the MCW community are welcome to apply, we are particularly interested in adding student and trainee voices to our team. Persons identifying as members of underrepresented minority groups are strongly encouraged.
Racial Injustice & Inequities Perspective
An Open Letter to my Colleagues

by Loren Nunley, MD, MBA
Dr. Nunley is a fellow in the Division of Infectious Diseases at MCW. This letter, originally shared with his colleagues, is reprinted here with his permission.

I am a black man.
Ten days after my sixteenth birthday I caused a car accident (with minimal damage and no injuries). As I made a sharp turn in the pouring rain, I lost control hitting another vehicle stopped at a red light. Witnesses included two police officers. I was immediately ordered to step out of my vehicle. My white friend in the passenger seat was ordered to get out and stand across the street. Upon silently complying with the order, I was slammed against my own car. Moments later, still silent, I found my face, bloodied, on a curb with something heavy on the back of my neck. It was the knee of the police officer trapping my head against the curb as I struggled to breathe. I am fortunate. It wasn't for nine minutes. I was not murdered. But I will never forget the weight of that knee on my neck.
George Floyd isn't a stranger. You work with him. You know him.
I am George Floyd.
This does affect you. So how will you affect it?
There are many meaningful actions you can take and places you can contribute. I offer these links as a starting point, but you can also take it upon yourself to do further research on how you can help work towards positive change. 

From the floor of my heart, thank you for your kind consideration.
Be courageous,
Racial Injustice & Inequities Perspective

by Bruce Campbell , MD

Dr. Campbell recalls a time when he was schooled about his own racism…

I hand out a short story to the fifteen residents and students. They follow along as one of them reads aloud:

One last blow, and, blind as Samson, the black man undulates, rolling in a splayfooted circle. But he does not go down. The police are upon him then, pinning him, cuffing his wrists, kneeing him toward the van. Through the back window of the wagon – a netted panther.

I am working to integrate narrative into medical education. On this early morning, the ENT residents and a few medical students concentrate – heads down, brows furrowed – as they take turns reading aloud “Brute” by Richard Selzer, a riveting first-person short fictional story first published in 1982 and republished in 1996 .
Racial Injustice & Inequities Perspective
My White Privilege

by Megan L. Schultz, MD, MA  

Dr. Schultz offers herself as an example of what white privilege looks like and makes a vow…
I am racist. As a white person born into a racist society where white people have all the power – and always have – I am racist. It is essential that white people say this out loud, believe this is true in our white privileged hearts, and work unendingly to fix this in ourselves. It is essential that white people understand that racism is our problem to solve – we are the perpetrators. It is essential that white people conduct a personal reckoning with the infinite ways we have sustained, promoted and profited from the racist structures that oppress Black people in our country. As a white person, I will start.
Racial Injustice & Inequities Perspective
A Personal Call to Action

by Kathlyn E. Fletcher , MD, MA

Dr. Fletcher issues a call to focus on character and the humanities as we struggle to see the way forward in our medical and societal roles…

“With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right. Let us strive on to finish the work we are in; to bind up the nation’s wounds; to care for him who shall have borne the battle, and for his widow, and his orphan – to do all which may achieve and cherish a just and a lasting peace, among ourselves, and with all nations.”
Thus ends Abraham Lincoln’s second inaugural address. The speech was given as the Union was close to winning the civil war, much of the country (particularly the South) was in ruins, the country mourned over 620,000 lives lost to battle and disease, and just weeks before Lincoln would be assassinated by John Wilkes Booth. This speech is beautiful in its brevity and prescient in its call to action. 
With George Floyd’s senseless and violent death, we see yet another stark example of structural racism. Like Lincoln’s second inauguration, this moment in our history presents a call to action. 
Educational Perspective
Marrying the Basic Sciences to Clinical Medicine

by Amy J. Prunuske, PhD and Jacob Prunuske, MD, MSPH

The two Doctors Prunuske explore how some of the concepts of a great marriage carry over into transforming medical education by integrating the basic and clinical sciences…

We recently celebrated our twentieth wedding anniversary. Spring 2000 was a busy time. Jake graduated from medical school. We had our wedding in Milwaukee, a honeymoon in Peru, and a move to Utah where Jake began a family medicine residency and Amy started graduate school in molecular biology. The next twenty years involved both conflict and resolution as we learned to balance individual and shared goals. They also gave us plenty of opportunities to discuss the relationship between clinical medicine and the basic sciences.
"Last week we found ourselves sharing yet again — first with anger, then with despair — the story and horrific images of another black life being stolen by police brutality ... But [as physicians], when the institutions that recruited us remain reticent in the face of our particular pain, the promise of inclusion rings hollow."

from an essay by resident physicians
Chijioke Nze, Elorm F. Avakame, Olusola J. Ayankola, and
Jamaji C. Nwanaji-Enwerem

Police Brutality is our Lane Too, Doctors Say
STAT - June 5, 2020
"Recently, I have gained a better understanding of white apathy. White apathy is only knowing the names of Black men and women who lose their lives to police violence if they receive sufficient media attention. White apathy is the ability to choose when we want to engage with racial injustice and when we want to look away. White apathy is asking our Black peers to teach us about racism instead of doing the work ourselves, and failing to recognize the privilege of studying rather than experiencing it directly.

We must unlearn our legacy of silence and commit to continuously fight for racial justice."

-Jess Sachs, Student, MCW-Milwaukee

Respond to next week's reflection prompt:
Tell us about something you did for
someone else this week.
“I had come to my breaking point: I knew that my Blackness is my lifeline and that if I didn’t allow every part of me to enter the classroom, I wouldn’t be able to survive.”

from an essay by medical student
LaShyra "Lash" Nolen

This Is What I Want To Tell My White Professors When They Ask, ‘How Are You Today?'

HuffPost - June 8, 2020
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