by Walter Smith
After the widely publicized killing of George Floyd by Minneapolis police last year, University of Virginia Nursing students Milania Harris and Zara Alisa founded Advocates for Medical Equality. Their mission was to confront bias, bigotry and racism in healthcare. They won a Martin Luther King, Jr., UVA Health System Award for their efforts, and even a got a big splash in UVA Today.
I admire anyone who carves out time from studies and other student pursuits for the goal of making the world a better place. But I do find it ironic that these two ladies won an award named after a man who wanted people to be judged by the content of their character, not the color of their skin — in this case by creating a program based on measuring outcomes by color of skin.
Moreover, I am not a little dismayed that that administration lauds, and its house organ UVA Today regularly gives a platform to, students, faculty and alumni who excoriate the United States, Virginia, and the university itself for racism while never — and I mean never — profiling members of the university community who might think differently.
As neither young lady is likely to return my request for a friendly interview, permit me to conduct a dialogue with the text of the UVA Today article.
UVA Today: Floyd’s death motivated Harris and Alisa to start “a movement for nurses at a school and university still coming to grips with its history of exploitation, bigotry and inequality.”
Smith: I’m sorry – is that the entire history of UVA? When exactly did the exploitation, bigotry and inequality end? If it hasn’t ended, why did they choose to attend? If it hasn’t ended, should they call for the administrators and faculty of the nursing school to be fired for running such a horrible place?
UVA Today: “Nurses need to acknowledge the history of discrimination within health care so they don’t continue these discriminatory patterns,” said Alisa. “Our main goal is for people to come out of UVA nursing school aware of how to care of people of all types.”
Smith: Is Alisa implying that prior grads of UVA Nursing graduated without a desire to care for all people, no matter the color or sex? No Hippocratic Oath? Does anyone besides me find this suggestion slanderous? I am offended on behalf of all the doctors and nurses from UVA.
UVA Today: The Harris-Alisa “action plan” entails the following:
- Teaching nursing students about the history of discrimination in health care. (Teaching about past discrimination would improve clinical experience and results… how?)
- Diversifying their clinical experiences, readings and the simulations that inform their care. (As opposed to a course of study in different subjects and clinical rotations?)
- Creating avenues for community outreach, hospital research and a mandatory class focused solely on equitable care across color, ability, gender identity and sexual orientation. Also, pushing white, heterosexual and cisgender students and faculty to educate and immerse themselves in these topics, rather than waiting for peers or even patients from minority backgrounds to teach them.
Smith: How does “equitable care” differ from simple “care,” in which the goal is to achieve what is best for every patient?
Should we apply disparate impact analysis to medical outcomes and attribute any differences between groups to racism, sexism, homophobism, ableism, and cisgender tyrannism? I expect that, in the minds of Harris and Alisa, only white, heterosexual and cisgender students need this reprogramming. But what happens if a nonwhite student disapproves of homosexual behavior, or believes that gender reassignment surgery constitutes medical malpractice, or refuses to participate in abortion procedures? Will that student need reprogramming, too?
UVA Today: Advocates for Medical Equality has developed “educational materials” for weekly “ABIs” – “anti-bigotry infographics” – on “difficult” topics such as racial disparities in maternal mortality, LGBTQ awareness, prison healthcare, structural racism and eugenics at UVA. Harris told the reporter, “We’re kind of forcing people to talk about this stuff, and I like pushing people to talk this way because, at the end of the day, these conversations make us better nurses and better people.”
Smith: How does the imposition of a particular worldview make students better nurses or better people? What’s wrong with just turning out nurses who are qualified and compassionate to all patients? Does anyone really expect better care from a nurse marinating in racial grievance?
There are many different reasons for different outcomes, and we do not know them all. Take COVID-19, for example. Among my acquaintances in their early 60s is one with no symptoms and antibodies, another who had a few days of headaches, and a third who was hospitalized for four days. All three were white males, well educated, upper middle class and healthy.
Another huge factor in COVID mortality is obesity. Blacks have experienced higher death rates than whites. Is racism the problem, or is it poverty? Or obesity? Or hypertension? Do poor, obese blacks with diabetes and hypertension fare worse than poor, obese whites with diabetes and hypertension?
Personal behavior, family history and many other factors affect medical outcomes. Blaming race is itself racist — it denies human agency. That the senior assistant Dean for academic and student services at the Nursing School nominated these ladies for the UVA MLK award shows how far afield UVA has gotten from its core educational mission and Dr. King’s “dream.”