Overcoming prejudice and uniting vascular surgery

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Bhagwan Satiani

The United States has been living through some charged times recently. Our profession is not immune to these conflagrations. In recent times, minority members of the diverse specialty of vascular surgery have seen people who look like them come under attack. And there are politicians and other actors who make it their mission to try to divide us. Against this backdrop, I will relate a personal journey of confronting discrimination and, ultimately, of hope and acceptance.

Confusion, frustration, depression, anger and, finally, determination: These emotions represent stages of a personal journey, reflecting just a few of my early professional experiences in the United States.

There are many practical examples.

There was the time when I did not make the “cut” three times during my pyramid general surgery residency. Only eight residents out of 13 were selected to finish the five-year program. As destiny would have it, I sneaked in after three consecutive residents picked ahead of me chose to drop out.

Or there was the time when my three-month scheduled rotation as chief resident at an elite university hospital was suddenly switched by the chair to another institution the week before. I presume it was because I might not “fit in” among the almost all-white team there. When I complained, I was taken to the woodshed by the powerful chair, who warned me about destroying my career.

Or the time when, after finishing my final year (apparently as the first resident of color), I was not selected for the vascular surgery fellowship at the same university hospital. In recent years, for instance, any resident from the same general surgery program who applied was selected.

Among my many experiences here, these incidences ran counter to my impression of the United States. I gained perspective when, as a junior resident working a busy surgical emergency room, I walked across to the medical side. There, I could see the remnants of a sign fixed over the water fountain. Barely legible, yet still discernible after being scrubbed, it read: “For whites only.” My anger subsided and was replaced by a determination to show “them” that I was more than capable of succeeding.

This process of acculturation is experienced by most immigrants in one form or another. Immigrants tend to work much harder to prove themselves, and, if they so choose, blend into the American melting pot. Personally, I did not have a backup option to which I could return.

Support

On the other hand, my reaction may also have been muted due to my having grown up in a place where religious bigotry was acceptable. The false accusation of blasphemy hung over minorities like a sword. I survived because of half a dozen wonderful friends from the majority religion, two of whom are members of our society. That perspective alone helped me see the difference. In the U.S., most people I have met have been accepting, supportive and borne goodwill toward immigrants.

As Shelby Steele once said in reference to racism: “It was not an outrage, but an impersonal and immutable feature of the world, like snow in the winter or rain in the spring.” Or, I had simply exchanged a far worse life-threatening environment for one that, to a large degree, I could overcome. Ultimately, the U.S. has shown me the true spirit of this nation. Despite some of my early experiences, there were other examples of great kindness. And elsewhere along the way, I have seen that many hearts would change.

Starting with the white security guard at my destination airport, who, at midnight, offered to take me—an unknown, disheveled foreigner—in his yellow Volkswagen and drop me off at the downtown hospital where I was going to work. There was the white senior nurse who took my wife and I under her tutelage, and later became a Godmother to our two children. There was also the elderly white physician-owner of the (same?) hospital who tore up the large medical bill for my father’s bypass surgery, saying, “You are one of us.”

Another senior faculty at the same university hospital where I completed my residency hired me as a trauma fellow for a year because I did not get an offer from one of the few vascular surgery programs in existence. He allowed me to spend one month on the vascular surgery service that rejected me, just so I could demonstrate my capabilities. That vascular surgery program director would later tell me he made a mistake in not selecting me. The chair who sidelined me in my final year—an individual considered a giant in American surgery—would later praise me in writing as one of the finest residents to complete the program. He would also call the fellowship director with whom I ended up the following year, advising that I be selected, and offered a money-back guarantee if said director was not happy with my performance.

As I saw this acceptance, my faith in the American people grew and I never doubted that the system could work. Immigrants are eager to make contributions. Like all Americans, we want our children to do better than we did. We may start on the bottom rung, but, given an opportunity, we do not stay down there for very long. Indeed, I saw the real U.S. through thousands of my elderly patients, who were respectful, and placed their trust both in God and a brown-skinned immigrant surgeon for more than 40 years.

Hope and refuge

Again, my story is probably not that different from many immigrants. One of the most memorable moments of my life was the day I took the citizenship oath after going through the prescribed legal process. The First Amendment to the U.S. Constitution, which protects the right to freedom of speech, religion and the press remains my favorite from that founding document.

Of course, we still have some way to go as a nation. I fully agree that we should push back against crimes related to hatred against minorities, just as I do for any serious criminal offence. But, the question remains: Is it fair to hurl accusations of racism at a whole class of people of any race? Over the long haul, ordinary citizens of all races will vastly outnumber the few racists in our midst. To the second or even third-generation immigrants, ask your parents or grandparents some questions. First, are they happy that they came to America? Besides the recent turmoil, from a racial perspective, are things better here than they were when they arrived? The answer, I would proffer, will be yes. Despite all of its warts, the U.S. gives hope and refuge to oppressed people from all over the world. The French political theorist Alexis de Tocqueville aptly remarked that Americans “take pride in the glory of their nation.” We immigrants and our children are proud to be a part of this great nation. We should guide it closer to its founding ideals and help America shine even brighter.

I ask each one of us to look past the politicians and others who try to divide us to be united in our small, increasingly diverse yet vulnerable specialty. Please be kind to each other. We have enough external challenges ahead. If you or your parents have been afraid to speak up in the places from which you came, you will understand how crucial that right to freedom of speech is. We should respect those on the other side of arguments. We should also continue to listen to one another. Let me be clear: I have not forgotten any of the affronts. I simply choose to move forward. Because dwelling on the negative experiences is a losing proposition. You are free to disagree.

Bhagwan Satiani, MD, is professor emeritus in the division of vascular diseases and surgery in the College of Medicine at The Ohio State University. He is an associate medical editor of Vascular Specialist.

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