Anti-Racism, Health Care Equity Initiative Launched

Its inaugural event, a Feb. 18 virtual conference titled “Beyond the Knife: Anti-Racism & Health Equity,” featured Cornel West, PhD, Harvard University professor, bestselling author, political activist and public intellectual, as its guest speaker.

“The UB Department of Surgery is committed to sustained action toward a more diverse and equitable world,” said Steven D. Schwaitzberg, MD, professor and chair of surgery and president of UBMD Surgery. “Inviting Dr. West — the preeminent voice on this topic for 40 years — is a demonstration of the seriousness with which we approach this task. Creating an annual endowed lectureship, paired with a slate of robust new initiatives, is a demonstration of our long-term commitment. This is our collective responsibility as physicians and surgeons in the 21st century. I have every confidence that, working together, we can create real and lasting change.”

In his opening remarks, West said it was fairly clear that we are living in a moment of increasing spiritual decay and escalating moral decrepitude.

“What we need more than anything else is the best the Black Freedom Movement has to offer and that has always been an attempt to look chronic, systemic hatred in the face and still muster the courage to love, to love truth, to love beauty, to love greatness,” he said.

West used the term ”love warrior” to describe the type of people needed to step forward and fight systemic racism.

“Love warriors are those who have decided to cut radically against the grain and attempt to engage in forms of care and concern for others. They have a hypersensitivity to the suffering of others,” he said. “They are willing to give oneself, to emptying oneself, to give whatever gifts one has cultivated to make the world a better place.”

“The love warriors at the University at Buffalo Department of Surgery are taking action in a big way to address the inequities our dear brothers and sisters must endure in regards to their health,” West said. ”Their efforts to connect doctors with the communities they serve is a powerful step forward in the fight for equality, fairness and healing that is so long overdue.”

West took questions from a panel featuring Jacobs School of Medicine and Biomedical Sciences students, surgical residents and faculty, as well as community leaders.

The panel consisted of:

• Timothy M. Adams, MD, clinical assistant professor of surgery 
• Karole Collier, a fourth-year medical student
• Rita Hubbard-Robinson, chief executive officer of NeuWater & Associates, LLC, and lead member of the African American Health Equity Task Force.
• Henry Louis Taylor Jr., PhD, professor of urban and regional planning and director of the Center for Urban Studies in UB’s School of Architecture and Planning
• Frances I. Uwechue, MD, a PGY-1 trainee in the general surgery residency program

West fielded questions on a variety of topics, including how physicians can become better allies in the fight against health disparities and how they can encourage people of color to receive the COVID-19 vaccine.

West said that restricted access to health care is the worst form of inequality and social movements are important for action to occur.

“We need to have a moral and spiritual awakening. We need people in motion inside institutions and against institutions to make sure that in the end those most vulnerable, the weakest, are given a priority,” West said.

“With organized greed and institutional hatred, there is not enough focus on the weak and the vulnerable, so you end up with a cultural callousness and ways of life that put indifference to the suffering of others at the center,” he added. “We need to shatter the culture of indifference.”

He quoted Rabbi Abraham Joshua Heschel, one of the leading Jewish theologians of the 20th century, who said “indifference to evil is more insidious than evil itself.”

On the topic of vaccine hesitancy in minority populations, West said that “we have to recognize that everyday Black people are not stupid. They have a history of insight, a memory of violations.”

“We have to unflinchingly and candidly confront those insights and memories and convince them that out of our deep care and concern for them this vaccine is going to be a force of good in their lives,” he said.

“Most people rightfully understand that it is never a question of how much you know, it’s fundamentally a question of how much you care, so that what you know can be of service to others,” he said. “This is part of the moral and spiritual awakening I talk about. Doctors are at the vanguard, meaning they not only have the skill, they have the capacity to intervene.”

West told a deeply personal story to illustrate the level of distrust many Blacks have of the health care system.

“My grandmother died at the age of 31 in 1939 because a vicious Jim Crow hospital in Crowley, Louisiana, would not let her in after she pulled a tooth and started to bleed. The white doctor would not touch her with a 10-foot pole,” he said. “My whole family had to move to Texas after my grandfather showed up at the hospital with a shotgun and was run out of town.”

“I’m sorry to get so personal, but this is my history. It is part of who we are,” West said.

James “Butch” Rosser, MD, clinical professor of surgery in the Jacobs School, served as master of ceremonies and moderated the question-and-answer session. Rosser, an activist and thought leader on racial dynamics in medicine, worked with the Department of Surgery to launch the effort.

“We, as health care professionals, must not bury our heads in the sand in the aftermath of George Floyd’s death,” Rosser said. “The public must know that we are one of them and we are ready to do our part. This is urgent work: to address the monumental issues before us and map out specific actions to move the national conversation forward.”

Following the lecture, West stayed on to take additional questions from Collier, Uwechue and Goda Savulionyte, MD, a PGY-3 trainee in the general surgery residency program.

Schwaitzberg added that COVID-19 has stretched the health care system to the brink while illuminating entrenched inequities that determine health status on the basis of neighborhood and skin color.

“With African Americans and Hispanics suffering and dying of COVID-19 at a disproportionate rate, and given the underrepresentation of people of color in surgery, this initiative seeks to comprehensively address these issues and mitigate the effects of systemic racism and inequality in our own community and beyond,” he said.

“Our department prides itself on its expert faculty, working every day to provide the best in patient care and cultivate today’s residents into future leaders in surgery,” he continued. “We aim to bring surgery to a new level. Every aspect of our mission — patient care, research and education — must be grounded in an understanding of health care disparities and the effects of institutional racism. We call on all medical schools to determine their strategy and contribution. It is long past time for all departments of surgery to reflect on what measures need to be taken and to get to work.”

The virtual conference represented the first of what will be an annual lecture series, initially funded by UBMD Surgery, focused on social justice and health care inequity.

Schwaitzberg said the department’s programmatic response to racism and health care inequity is already underway and includes:

• establishment of a new research opportunity in the summer of 2021 for underrepresented medical students interested in surgery
• development of a new curriculum for surgical trainees focusing on the effects of racism and implicit bias — this new curricular emphasis seeks to place operative/clinical discussions within the larger matrix of social inequality 
• establishment of a mentorship program to allow underrepresented future surgeons increased opportunities to work closely with established local surgeons in the operating room
• a virtual learning mentorship program, currently underway, which is working to spark the imaginations of high school students in Western New York and to recruit them into STEM and medical careers
• establishment of meaningful partnerships with the residents and organizations of the neighborhoods where UB’s affiliate hospitals are located, Buffalo’s Fruit Belt and the Delavan-Grider community
• development of a pilot elective rotation for medical students focused on health disparities for surgical trainees