Dispatches: Opening up a difficult conversation around systemic racism

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Dawn M. Coleman

Recent times have wrought a potent cocktail of cultural disarray on the psyche of the United States. In medicine and vascular surgery, this confluence of events has been acute. First COVID-19 halted elective surgery, bringing the specialty to a near standstill and anxiety to the wider medical sphere. Then the cultural moment quickly melded with the harsh reality of systemic racism suffered by people of color, including within the healthcare system, following the killing of African American George Floyd by police.

As a set of events, they combined to confront and confuse. Normal life evaporated with the coming of the novel coronavirus. Passivity in the face of racism also disappeared after Floyd’s killing in Minneapolis. Difficult questions started to be asked. Including of those who work in medicine, often around the role they may or may not play in the system—but also the kind of healthcare disparities exposed by COVID-19.

It was a moment that struck Dawn M. Coleman, MD, associate professor of surgery at the University of Michigan in Ann Arbor, Michigan, hard. During the worst moments of COVID-19 in her workplace, Coleman—an active member of the military—was part of an effort to put together an emergency field hospital. Then came Floyd’s death in Minneapolis, and the U.S. started to boil. Medical professionals and societies were challenged to step up.

As she puts it, she’s incapable of sitting back in silence, and felt compelled to take action. So wearing her hat as co-chair of the Society for Vascular Surgery (SVS) Wellness Task Force, she recently staged a webinar in conjunction with the SVS Equity, Diversity and Inclusion Task Force aimed at giving voice to the realities faced by her colleagues of color.

Mural for George Floyd

“I’m not an expert in COVID, I’m not an expert in racism, I’m not an expert in putting together a field hospital. I think I have just found myself in a position where there’s a lot of really heavy, complicated problems right now. Some days it feels really overwhelming,” Coleman told Vascular Specialist.

“I try very carefully to listen, and I try to be readily available to vascular surgeons in the space of wellness. I think it’s a volatile time right now for everybody in the U.S. for a lot of different reasons. COVID may be new but a lot of things we are experiencing right now so sharply are not. I think COVID has really clarified in a very acute way disparities that were already well in existence. There has been recurrent evidence of such, concurrent with mounting civil unrest.

“I feel at times really ignorant. I’m really trying to learn a lot, now more than ever. I think people are feeling a lot right now. You wake up and there’s a lot of bad news. There’s tremendous human suffering. There are a lot of wrongs being performed. I think as surgeons, as fixers, we are naturally always trying to do our best to help, and I think we carry this weight. I think it’s increasingly difficult to steward your compassion and to compartmentalize certain things.”

That’s when Coleman realized a conversation had to be initiated. Hearing stories of injustice, watching matters unfold amid the healthcare disparities given fresh exposure by the coronavirus pandemic, she got to work. “With the Wellness Task Force, I feel at least there is a space we can use to bring people together, and maintain a focus on active support of our diverse workforce and membership—and also this ongoing commitment we have made to our patients—focusing on our vulnerables, our trainees.

“Change is desperately needed, large-scale change, bigger change than any one of us can accomplish. But I think if we don’t start someplace, that change will never happen.”

It’s a long road, Coleman observed. Some of the correspondence she has received laid bare the challenge. One particularly poignant, raw piece of communication from a dear friend brought the reality into sharp focus. “It’s hard to hear that suffering, that emotion, and not have any understanding about what that feels like, what that injustice feels like, what racism feels like,” she explained.

In that vein, Coleman wanted to cultivate openness. The webinar, she says, was about giving people a platform to talk and share—but also to enable those motivated to listen. “How can any of my peers and partners and trainees thrive as surgeons of color—or any of our minority surgeons—when they are afraid. Some of them, many of them? They don’t feel supported locally, or even higher. It’s a lot to unpack. I have a really hard time sitting silent. This was the one thing I thought I could do, quickly, urgently with the hat that I wear—the Wellness Task Force seemed to be a good place to start. I hope it will complement the work the SVS is already doing with the Equity, Diversity and Inclusion Task Force because there are people already thinking about this.”

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