Identity and Inclusion during COVID19
like many people my age
i grew up watching a tv show called mr
rogers neighborhood
and the theme song of that show started
with the words
it’s a beautiful day in the neighborhood
however in 1968 when that first show
aired
there were many neighborhoods not
singing that song
because the jim crow era laws that
mandated racial segregation
made it such that the neighborhood in
which you lived determined the life that
you had
the golden rule tells us to treat your
neighbor as yourself
but it doesn’t tell us who you should
consider your neighbor or that you
should ignore the people that aren’t in
psychology there’s a phenomenon that
people call the familiarity principle
put simply that means that people tend
to be more comfortable
with things that they’re familiar with
therefore jim crow era laws that
mandated racial segregation
exacerbated an already problematic
societal structure
that made it such that people did not
get to know each other because they
weren’t around each other
but that was 50 years ago so therefore
we should think that
the neighborhood in which you live now
should have no bearing on the impact of
the covet 19 pandemic
but unfortunately the neighborhood in
which you live
has more of an impact on your survival
than you may even know
i first want to start with getting you
more familiar with my story
my family moved to the states from
nigeria when i was young
both of my parents were physicians but
they had to redo their residency in the
states when they got here
so they did so at johns hopkins
georgetown and howard university
we then moved to indiana where i went to
elementary school and junior high
before i attended high school at a
boarding school in western massachusetts
called deerfield academy i then went to
stanford university where i was on the
captain of the track team
president of my class and graduated with
honors
before matriculating to the university
of michigan medical school
and matching into the department of
orthopedics at yale
i went on to get a master’s degree from
notre dame was appointed to the saint
joseph county indiana board of health by
pete boutige
and then did a family medicine residency
in south bend before going back to
michigan
to be on faculty in the departments of
family medicine and physical medicine
and rehabilitation
as a physician i can appreciate the
level of privilege that i have
however i do know that that level of
privilege changes
because even though i have all of these
degrees on the pedigree
if you know nothing about those i know
that people still just see me
as a young black man whether i’m driving
in my car
trying to pay with cash at a convenience
store or going for a run
no matter how long my white coat or how
visible my stethoscope
i know that there are still some people
that are not going to see beyond the
color of my skin
it has become brutally obvious to me
that the perceptions other people have
of me
are based more on their perceptions of
what neighborhood i belong in
and less to do with the intersectional
framework with which i see my own life
now you may think that that level of
privilege
and the life that i lead doesn’t impact
things at all but once again i tell you
that today
we now see that the covert 19 pandemic
has had a disproportionate impact
on communities of color all over
now the world health organization
describes the social determinants of
health
as the conditions in which people are
born live work
and grow those are the conditions that
are responsible for these health
inequities
these health inequities which are the
unequal uneven
and unfair factors that lead to the
determination of your health
national data have shown that the covet
19 death rate
is six times higher in communities that
are non-white
when compared to communities that are
white
a colleague of mine dr malika fair
recently talked about the fact that
these social determinants of health
are the reasons and the differences
between the health that we see in our
populations
now i just recently had a conversation
with a group of my students
about the tuskegee experiments of
untreated syphilis in the
african-american male
which happened all too recently in our
history
those are the reasons why people still
have a mistrust for the health care
system
because in those experiments the
national health service
intentionally withheld treatment and
diagnosis of syphilis
for the black men that were enrolled in
that study
now if we want to consider death the
ultimate example of a lack of health
then the recent deaths of george floyd
ahmad aarberry
and brianna taylor should be a striking
example of the fact that
black people are not valued equally as
others in our country today
now after those conversations about
tuskegee a lot of my students left
discouraged
wondering how they were ever going to be
able to dismantle the structures
that had been built upon long before
they came here
but in order to change the culture of
all of these institutions
we must first start by changing
individuals
and that is precisely what a group of
university of michigan medical students
are doing
with steer hd steer hd stands for
students
teaching educating and evaluating to
reduce health disparities
we have partnered with walgreens and
omron health to deliver blood pressure
cuffs free of charge to communities in
our area
as well as teaching them about
educational practices to manage their
blood pressure
each individual has an ability to make a
difference and to change the cultures
and the structures that we are in
now the disabled community is another
one that has been disproportionately
marginalized for quite some time
the describes certain populations of
disability
as having an increased risk of being
affected or
being unintendedly and not known to be
affected by this pandemic
individuals with physical mobility
problems that are not able to socially
distance well because they rely on other
people’s care
people with intellectual or
developmental disabilities that may not
understand things like washing your
hands
and then people that that that may rely
on other people
people that cannot communicate and
address people and tell them that they
have these things
because they cannot see people’s faces
because they’re deaf and everyone is
wearing a mask
now people with disabilities and with
chronic health conditions
have already been long marginalized they
already felt as though their lives
weren’t valued before this
and now they fear going to the hospital
because they think that when they get
their care is going to be rationed
in favor of saving a life worth living
now this has a silver lining however
because due to the familiarity with
inaccessibility of our world
the disabled community is keenly aware
of how to create solutions to problems
by our ability to then adapt to any
environment
i often tell a story that that a man
told me about his son
he said his son was in kindergarten was
colorblind
and his homework would say color the
circle blue
he used to ask his son’s son how do you
get your homework done
it says color the circle blue but you’re
color blind
and his son looked back at him with this
perplexed look and said
dad i never use crayons that aren’t
labeled
now this is just one indication of the
fact that the solutions to problems that
we see
are sometimes much easier than we would
know especially when we involve the
people who were impacted
by those problems in the first place
now we then ask the question who is
actually impacted by the problems that
we see today
that goes back to the question of who
you think your neighbor is
now if you think that perhaps your
neighbor you may know someone
you may know someone and if your
neighbor’s house is burning down you
feel like that impacts you because you
know them
you feel like that impacts you maybe
because you may even love your neighbor
or that may only impact you because you
then fear that your house will be
burning down next
i didn’t fully understand the plight of
the disabled population
until seven years ago when i myself dove
into a pool
and broke my neck paralyzing me from my
chest down
thrusting me into this world of
disability and then instilling in me the
conviction
to then approach the intersections of
disability and race
to realize the implications that those
intersections have on life
this neighborhood that i now live in
this neighborhood that i now understand
the things that others are going to
even though had you asked me before i
would have thought that i was treating
them as my neighbors
i would have thought that i understood
the things that they were going through
but i did not and not because i had some
intentional desire
to exclude them but because i just did
not know the needs that they had
sit in front of you here today in a
standing frame wheelchair
that has allowed me to do medical
procedures and surgeries that has
returned me to getting access to the
world of medicine that i love
it is with this simple solution that
i’ve been able to then return to this
world
and be able to participate in a way that
i once used to
now people often wonder how one
individual or one group
can create any difference in this
extremely difficult situation that we
see ourselves in
but both of these pandemics covet 19
and racism have demonstrated to me that
institutions that have created these
rules
are only built upon the individuals that
have the power to move the needle
right now a group of medical students
all across the country
are demanding change they are reaching
out to their institutions and saying
that the time for change is now
they’re saying that we must dismantle
the structures of institutional racism
and segregation that the foundation of
medicine and healthcare has been built
upon
in order to eliminate race-based medical
practices
in order to create anti-racist
curriculum for their patients
for the students for the faculty and the
staff
and in order to demonstrate that we need
to create a culture
that is intolerant of any type of
prejudice
i must admit that prior to me having
that accident seven years ago
i had not had this radical change that
is needed right now
i did not fully acknowledge and know
that there were people that were not
being treated the same as others
even though i thought i entered a
profession where that was the reason why
i was there
now not all of you are going to be able
to be disabled black men
but it shouldn’t take you having the
lived experience to be able to
acknowledge that racism
and ableism are the reasons why people
that you may not consider your neighbors
are having a devastating time right now
so while you may not have seen them as
your neighbors yesterday
my hope is that after this you will see
them as your neighbors tomorrow
because even though you may not
understand what people are going through
i sure hope it doesn’t take you breaking
your neck to realize that this problem
affects you as well we are all only as
healthy as our most vulnerable neighbors
and if we cannot find a way to care for
those neighbors
then you too someday will be sitting in
a neighborhood
on top of rubble in what used to be a
beautiful day in your neighborhood
the future will be your fault
even if the past is not we are all
in this together and therefore i want to
end
with just an invitation the same way
that mr rogers always began his
we are all in this together and so
let’s make the most of this beautiful
day
since we’re together we might as well
say
would you be mine could you be mine
won’t you be my neighbor
thank you