Creating a Collection: Chaplaincy Services at the University of California, San Francisco

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Introduction by Polina Ilieva:

After a four-year break, last semester the archives team hosted a History of Health Sciences course, the Anatomy of an Archive. This course was developed and co-taught by the Department of Humanities and Social Sciences Associate Professor, Aimee Medeiros and Associate University Librarian for Collections and UCSF Archivist, Polina Ilieva. Charlie Macquarie, Digital Archivist, facilitated the discussion on Digital Projects. Polina, Peggy Tran-Le, Research and Technical Services Managing Archivist, and Edith Escobedo, Processing Archivist, served as mentors for students’ processing projects throughout the duration of the course.

The goal of this course was to provide an overview of archival science with an emphasis on the theory, methodology, technologies and best practices of archival research, arrangement and description. The archivists put together a list of collections requiring processing and also corresponding to students’ research interests and each student selected one that they worked on with their mentor to arrange and create a finding aid. During this 11-week hybrid course students developed competencies related to researching and describing archival collections, as well as interpreting the historical record. At the conclusion of this course students wrote a story about their experiences highlighting collections they processed. In the next few weeks, we will be sharing these stories with you.

This week’s story comes from Alexzandria Simon, PhD student, UCSF Department of History & Social Sciences.

Post by Alexzandria Simon:

Having never stepped into any kind of archival space or discussion, I was excited to engage with, learn about, and understand what the archives are and mean. Now, after working with Polina Ilieva and Aimee Medeiros, at UCSF, I realize all the intricacies, time, and special attention that goes into the archival collection process. There are practices and standards that guide researchers and archivists, and emotions and ethics play a role in shaping collections and entire archives. The journey of processing a collection is time consuming, interdisciplinary, and sometimes messy. However, the craft of processing a collection allows individuals to discover new characters, information, and stories that take place during a different time and space.

            When I saw my collection for the first time, all I could think to myself was how small the collection is. I was surprised after seeing others, some that consisted of 5 boxes worth of documents, that the one I was planning to work on could be confined to one file. I could not begin to comprehend how the file could tell such a large story. I began flipping through all the documents, photographs, and pamphlets and skimming through the letters and correspondence trying to put all the pieces together. The file had no organizational layout, and so my priority was to put everything in chronological order. I wanted to understand the starting point and the ending point. What I came to discover is that sometimes, collections do not always have a solid beginning and concluding aspect. Stories sometimes begin right in the middle and then end abruptly, leaving many questions.

Figure 1: “Physician – Patient – Pastor” Pamphlet, San Francisco Medical Center, May 1961, Chaplaincy Services at UCSF, MSS 22-03.

Figure 1: “Physician – Patient – Pastor” Pamphlet, San Francisco Medical Center, May 1961, Chaplaincy Services at UCSF, MSS 22-03.

The Chaplaincy Services at UCSF Collection began with correspondence between UCSF administrators interested in starting a chaplaincy program. They sought to understand how chaplains, priests, and rabbis could have a role in their hospital space and provide services to patients. What they came to learn and understand, from informational pamphlets, is the connection between chaplains and patients is a powerful one. Chaplains offer judgement free support and a space for patient’s belief and repent needs. When a patient is alone with no family members or loved ones, they can call upon their religion to give them a person of guidance and care.

Figure 2: Installation Service Program for Reverend Elmer Laursen, S.T.M., Lutheran Welfare Service of Northern California, September 18, 1960, Chaplaincy Services at UCSF, MSS 22-03.

Figure 2: Installation Service Program for Reverend Elmer Laursen, S.T.M., Lutheran Welfare Service of Northern California, September 18, 1960, Chaplaincy Services at UCSF, MSS 22-03.

These discussions would ultimately lead to the establishment of a Clinical Pastoral Education Program initiated and headed by Reverend Elmer Laursen, S.T.M. Reverend Laursen was a prominent figure in the Chaplaincy Services at UCSF and established clinical pastoral work as necessary for patient care. Reverend Laursen engaged in public outreach, fundraising, patient and student advocacy, and building relationships with other colleges and hospitals. His work inspired other pastors, reverends, and religious officials to begin implementing clinical pastoral education programs to develop student learning and patient care. He believed that pastoral care is imperative to patient care. Patients deal with challenging, and sometimes traumatizing and scary, medical procedures. The Chaplaincy Program could offer solitude and peace for patients who have no one else to call on. Chaplaincy Programs offer a humanistic approach to patient care in a field that is saturated with data, clinicians, and the medical unknown.

Figure 3: Group Photo of Chaplains, Reverends, Nuns, and Administrators at the 21st Anniversary Celebration of Chaplaincy Training Event, September 1982, Chaplaincy Services at UCSF, MSS 22-03.

Figure 3: Group Photo of Chaplains, Reverends, Nuns, and Administrators at the 21st Anniversary Celebration of Chaplaincy Training Event, September 1982, Chaplaincy Services at UCSF, MSS 22-03.

After reading through the collection, I began dividing the documents into subject folders. These consisted of “Chaplaincy Service Materials,” “Pamphlets & Booklets,” “Funding,” “Chaplaincy Facility Space,” “Chaplain Elmer Laursen,” “Correspondence – August 1959 – September 1974,” “Photographs,” “21st Anniversary Celebration,” and “Rabbi Services.” Through these folders, the collection is now organized in a way researchers and others can trace the narrative. While I was processing the collection, I kept reminding myself to make the finding aid easy and accessible. I want anyone, scholar or not, to be able to open the finding aid or file and know what the collection includes. It is difficult to not let the records overwhelm you with tiny details. It is difficult to not get lost in every aspect of a collection. I found gaps in the correspondence, and every time I read something new, I seemed to come up with more questions. However, I believe that to be a part of the journey and work of archivists and scholars. We are always left wanting more. The documents in the collection are only a portion of the much larger story around Chaplaincy Services at UCSF. Even more miniscule in the larger history around religion and hospitals.

Kathryn Stine Joins UCSF Archives & Special Collections

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We are excited to introduce Kathryn Stine who joined the Archives & Special Collections team as a Digital Health Humanities Program Coordinator. This position will support development and day-to-day operations of a new Digital Health Humanities Pilot. The goal of this initiative is to guide and support faculty in their engagement with digital tools and methods to facilitate interdisciplinary scholarship that will advance understanding of the profound effects of illness and disease on patients, health professionals, and the social worlds in which they live and work.

Kathryn Stine, UCSF Library digital health humanities program coordinator
Kathryn Stine

Kathryn Stine has an extensive background in developing and providing access to digital collections. Her experience includes nearly 10 years working for the University of California system at the California Digital Library (CDL) in various roles, the most recent of which as the Senior Product Manager for Digitization & Digital Content. In that position, Kathryn managed the team that supports and coordinates the University of California Libraries’ engagement with HathiTrust and mass digitization activities. 

Prior to joining CDL, Kathryn held several positions at the University of Illinois at Chicago where she was responsible for leading the university archives program and managed special collections processing. 

Kathryn is deeply experienced in developing and managing cross-institutional and cross-departmental library projects and building communities across diverse functions and perspectives. Her work at CDL  included managing and contributing to both investigative and operations-focused systemwide project teams, coordinating web archiving initiatives, advising for the UC Berkeley digital lifecycle program, and leading a team of developers and analysts to launch, maintain, and enhance a metadata management system for and with HathiTrust. She is motivated by supporting cross-functional teams in bringing both collaboration and creativity to common purpose.

Working with (meta)data is a throughline in Kathryn’s career, and she is enthusiastic about encouraging new ways of deriving and analyzing collections data in support of innovative digital research. In developing and providing workshops and providing project consultation, Kathryn has found working with researchers to make the most of digital collections to be incredibly rewarding. She is very excited to be joining the UCSF Library for the opportunities to work with researchers, technologists, and archivists to match health humanities research inquiry to relevant collections, digital analysis methods, and technical tools.

Kathryn loves a good metadata challenge to puzzle through, and also enjoys improvisational cooking, garment sewing, and getting outdoors with her family, especially to camp and open-water swim.

UCSF Archives & Special Collections awarded grant to archive data, documents, and social media of The COVID Tracking Project at The Atlantic

UCSF Archives & Special Collections (A&SC) has been awarded a grant from the Alfred P. Sloan Foundation to compile and archive the data products, public websites, social media, and select internal documents of The COVID Tracking Project (CTP). The project was a citizen-science initiative housed by The Atlantic magazine which tracked COVID data from March 7, 2020 to March 7, 2021. It had a tremendous impact on public, media, scientific, and governmental understanding of and response to the pandemic. This $249,866 grant will help preserve the products and culture of a unique organization created in difficult times.

Products produced by the CTP include testing, outcomes, and hospitalization data that was used by thousands of news organizations and millions of individuals to understand the early phases of the pandemic. The project’s Racial Data Tracker and Long-term Care Tracker highlighted the different ways the pandemic was impacting people of color and residents of nursing homes and similar facilities. Funding from the grant will help ensure these critical datasets are preserved in Dryad and immediately available to researchers in public health.

As an organization that existed only online, archiving the project will require new approaches to storing data from tools like Slack, Github issues, and Google drive. Unlike digital files similar to a Microsoft Word document, data in these tools have multiple levels of interface and context that is not easily preserved. The grant will support developing tools for archiving these rapidly-adopted forms of communication, and making them open source for other archiving projects.

Every datapoint collected by the project was the result of multiple discussions, revisions, and public inquiry. Capturing the entire history of say, the total number of tests in California on November 22, 2020 requires reviewing Slack threads, Github issues, emails, spreadsheet revisions, and unique tools built by tracking project members. The grant will help build a “Data Explorer” that pulls all these disparate metadata into a single web interface for researchers to understand the many contexts around every datapoint collected by the project.

“We’re extremely proud to support a digital preservation project capturing a remarkable record of online collaboration that also provides a unique blueprint for future archiving initiatives,” says Joshua Greenberg, director of the Sloan Foundation’s technology program. “The team is doing more than just creating a rich and valuable repository of a historic moment—it is generating novel and much-needed methods of storing information from modern technology platforms, an approach that will become invaluable as online collaborations increasingly become the norm.”

This 12-month project is being launched in January 2022 and will be overseen by an advisory board composed of former project staff and advisors with backgrounds in data science, medicine, history, and epidemiology. A&SC would like to thank Amanda L. French, Ph.D., former Community Lead at the COVID Tracking Project and other supporters for their help with this proposal. Kevin Miller will serve as an archive lead for this grant project

About the Sloan Foundation

Logo of the Alfred P. Sloan Foundation

The Alfred P. Sloan Foundation is a not-for-profit, mission-driven grantmaking institution dedicated to improving the welfare of all through the advancement of scientific knowledge. Established in 1934 by Alfred Pritchard Sloan Jr., then-President and Chief Executive Officer of the General Motors Corporation, the Foundation makes grants in four broad areas: direct support of research in science, technology, engineering, mathematics, and economics; initiatives to increase the quality, equity, diversity, and inclusiveness of scientific institutions and the science workforce; projects to develop or leverage technology to empower research; and efforts to enhance and deepen public engagement with science and scientists.

About UCSF Archives & Special Collections

The mission of the UCSF Archives and Special Collections is to identify, collect, organize, interpret, and maintain rare and unique material to support research and teaching of the health sciences and medical humanities and to preserve institutional memory. Please contact Polina Ilieva, Associate University Librarian for Collections with questions about this award.

New NHPRC Grant Will Bring to Light Stories of Women Physicians and Social Workers

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UCSF Archives & Special Collections (A&SC) is excited to announce that it was awarded a grant by the National Historical Publications and Records Commission (NHPRC) in support of the project titled Pioneering Child Studies: Digitizing and Providing Access to Collection of Women Physicians who Spearheaded Behavioral and Developmental Pediatrics.

The $149,814 award will support the creation of a digital collection on Calisphere containing materials from five collections held at UCSF documenting life and work of five women physicians and social workers, Drs. Hulda Evelyn Thelander, Helen Fahl Gofman, Selma Fraiberg, Leona Mayer Bayer, and Ms. Carol Hardgrove, who were pioneers in the developmental-behavioral pediatrics research, patient care, and public-health policy. These materials will enable researchers and general public to understand evolution of social policy and cultural norms as they relate to special education, people with disabilities, and equitable access to health care.

Dr. Selma Fraiberg

In her support letter for this project Dr. Alicia F. Lieberman, the Irving B. Harris Endowed Chair in Infant Mental Health and Vice Chair for Academic Affairs at the UCSF Department of Psychiatry, and Director of the Child Trauma Research Program stressed that this grant is extraordinarily timely because these women physicians and social workers “have been trailblazers in creating new knowledge and revolutionizing clinical care, but their contributions are at risk of being neglected or overlooked. These five women excelled against enormous odds in fields where women had difficulty establishing their own independent contributions, and the long-term ramifications of their work continue to benefit millions of children worldwide.”

A relatively new field in medicine, developmental-behavioral pediatrics came out of an increased demand for mental health services in pediatric care starting in the 1920s. While infant and child mortality rates declined in part due to public health campaigns and medical breakthroughs, concerns over behavioral problems and developmental delays grew as pediatrics began to look beyond mere survival and started to consider the whole child.

Dr. Leona Mayer Bayer

“These five women,” says Dr. Jeffrey L. Edleson, Professor and Harry & Riva Specht Chair Emeritus in Publicly Supported Social Services in the School of Social Welfare at the UC Berkeley, “studied and practiced in the same time period and were instrumental in establishing and developing training programs for pediatricians, nurses, and social workers. All of them also published works for the general public addressing issues that emerged at that time and continue to be discussed today, including the role of the mother in the early life of the child, emotional life of children and the importance of including the whole family in pediatric patient care.

 A digital collection unifying the records of these five remarkable women scholars […] will benefit historians of medicine and public health, sociologists, educators, social workers, policymakers, health care providers, patient advocates, and parents.”

 Carol Hardgrove with unidentified colleagues
Carol Hardgrove with unidentified colleagues

Documents from these five collections often illustrate the work of their creators on the same or similar projects and collaboration between the creators; these will be digitally “reunited” in the course of the grant by being posted on the same digital platform, Calisphere and being linked through extended metadata. They speak to the contribution women made early on in developmental-behavioral pediatric clinical research through the papers of Dr. Thelander. In 1952, she founded the Child Development Center at the Children’s Hospital of San Francisco where she conducted studies on children with brain-damage and general pediatric neurology. These women were influential in the training of pediatricians as documented by the records of Dr. Gofman. Since 1966 she served as a director of the Child Study Unit at UCSF, one of the first training programs in behavioral pediatrics in the US. The papers of Dr. Fraiberg document several important aspects of developmental-behavioral pediatrics, including the influence of psychoanalysis on the field and her groundbreaking work on intergenerational transmission of trauma. These women were also instrumental in the evolution of pediatric nursing. Ms. Carol Hardgrove collection documents her role as an educator with the School of Nursing and Child Care/Study Center who authored many works dealing with children and parents and the hospital experience. The collection also features professional correspondence of Dr. Leona Mayer Bayer whose life’s work was focused on child development and in particular human growth and psychology of sick children.

 Hulda Evelyn Thelander
Dr. Hulda Evelyn Thelander

According to Dr. Andrew J. Hogan, Associate Professor and Director of the Science and Medicine in Society Program at Creighton University, “Filling in these silences and gaps in the historical records, by making available more widely their various ideas, aspirations, and institutional negotiations, will allow this story to be told in much fuller detail. Gofman, Thelander, and others’ stories are likely to inspire another generation of groundbreaking young physicians to organize care for populations in need. It will be valuable for students and researchers to learn more about the many challenges that these women physicians faced, and how they overcame them to provide improved resources and support for children with behavioral and developmental conditions and disabilities, a population that was historically overlooked in pediatrics, especially in the mid-20th century, when these women were professionally active.”

As part of this project UCSF archivists will engage with communities of women physicians, researchers, and health care providers, discussing how to document their voices that have been underrepresented, absent, or excluded from the history in general and history of their institutions (including UCSF) or professions in particular. By collecting their stories and learning how to document and share them, we will create a more inclusive and equitable historical record.

Helen Gofman, MD, playing with girl with tea set and toys
Helen Gofman, MD, playing with girl with tea set and toys

This 24-month project was launched in September and will be managed by our processing archivist, Edith Escobedo. The materials will be digitized by the UC Merced Library’s Digital Assets Unit that has been partnering with UCSF on successful collaborative digitization projects for more than 10 years. 

A&SC would like to thank the National Historical Publications & Records Commission; the California Historical Records Advisory Board; Dr. Aimee Medeiros, assistant professor in the Department of Humanities and Social Science at UCSF; Emily Lin, Head of Digital Curation and Scholarship, UC Merced Library; and other supporters for their help with this proposal.

About UCSF Archives & Special Collections

The mission of the UCSF Archives and Special Collections is to identify, collect, organize, interpret, and maintain rare and unique material to support research and teaching of the health sciences and medical humanities and to preserve institutional memory. Please contact Polina Ilieva, Associate University Librarian for Collections with questions about this award.

Kevin Miller Joins the UCSF Archives Team

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The UCSF Archives & Special Collections is excited to welcome our new colleague, Kevin Miller who was appointed as the COVID Tracking Project Archive Lead. He will direct a team, comprising of Charlie Macquarie and Edith Escobedo, to preserve and provide online access to the entirely born-digital organizational records and datasets of the COVID Tracking Project at The Atlantic (CTP) to make this archive usable by researchers and to advance current practices in digital archives.

Kevin Miller picture
Kevin Miller

Kevin was the Website Team Lead of the COVID Tracking Project, managing a large group of volunteers building and maintaining one of the most critical sources of information during the first year of the pandemic. He worked alongside hundreds of researchers, epidemiologists, reporters, and passionate individuals to help make interfaces and write articles that ultimately informed public policy at the state and national level.

He received a Bachelor of Arts in Social History in one of the earliest graduating classes of Cal State Monterey Bay, and worked for the University for twelve years as its only web developer. During that time, he collaborated on several projects with the university library and special collections. He is passionate about web accessibility and has built several open-source tools that audit web content against current standards.

He was a founding archivist of the Fort Ord Museum and Archives and volunteered with the Monterey Maritime Museum on auditing their collection. He worked as an archival researcher for the book “Work or Fight!” on race and gender in the draft during World War I.

When he is not in front of the computer, he can be found outside somewhere backpacking, canyoneering, surfing, biking, river rafting, or trying to combine several of these activities into one outing with mixed success.

GRAD 219 Course – The Black Experience in American Medicine – Week 2

This is a guest post by Rhea Misra, PhD Candidate, UCSF Biomedical Sciences (BMS) Program

In reading “The Black Politics of Eugenics,” I learned about how eugenics was not initially a negative concept. Eugenics relates to the idea of human improvement through reproduction and understanding hereditary. It has been associated with Nazi doctrine; however, Nuriddin brings up in the article that, at one point, eugenics was embraced by marginalized communities to combat scientific racism and improve racial equality. The idea that marginalized communities would embrace eugenics to combat scientific racism, reminds me how slurs and negative concepts are reclaimed by these same communities that are harmed by such things to bring about improvement or change. This article also made me reflect on if eugenics, in the modern times, could ever have a positive association? I am not sure I have an answer to that. On one hand and thinking about the research I conduct, genomic editing tools such as using CRISPR or AAVs to make changes to genome have become commonplace.  Because of the inherent nature of these genetic tools, do they fall under the category of eugenics? They have been used to treat diseases. In a previous course, I had met a patient who had undergone gene therapy to treat his hemophilia, and now no longer requires blood transfusions. But on the other hand, gene editing tools have been used in some cases to make cosmetic edits. The whole idea of human improvement in eugenics comes with deeming certain traits better than the other; thus, marginalizing certain groups of people. Because of the inherent “othering” that comes with eugenics, I can understand how it quickly turned into a negative concept utilized to uphold a racist system rather than breaking it down.

GRAD 219 Course – The Black Experience in American Medicine – Week 3

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This is a guest post by Jackie Roger, Ph.D. Candidate, UCSF Program in Bioinformatics (BI)

During our class on 5/21, we learned about the term “biopolitics”. After our discussion in class, I wanted to learn more about it and ended up doing some additional reading. Biopolitics, conceptualized by Michel Foucault, is the intersection of life and politics. In practice, it is the governance and control of human life. Many of the topics that we have covered in class can be contextualized within biopolitics.

On 5/17 we talked about forced sterilizations in California prisons. This was a mechanism for controlling who could and could not procreate, and was deeply rooted in white supremacist ideologies. On 5/24 we discussed the hysteria in the 1980s about the “crack baby epidemic” that never ended up happening and had no reasonable scientific basis. There was widespread panic about the possibility of babies born with physical and cognitive disabilities, but little concern about the lack of resources and support for women with substance use disorders. In both of these examples, the focus was on the child-bearing potential of women, and not on the personhood of women. Both forced sterilizations and public hysteria were used to police who should be having children.

On 5/19 we reviewed the Tuskegee syphilis study, and on 5/26 we drew parallels between the racial disparities of the HIV/AIDS epidemic in the 1980s and the ongoing COVID pandemic. In all three of these examples, the medical system prioritized white lives over black lives. There was significant investment in caring for white patients, while black patients were often neglected or mistreated.

UCSF Library and San Francisco poets create space for the San Francisco community to “Pause, Breathe, and Re-Connect” during the COVID-19 pandemic

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This is a guest post by Dr. Michelle-Linh (Michelle) Nguyen, a primary care doctor and researcher at UCSF and the Zuckerberg San Francisco General Hospital. 

As social distancing rules and regulations begin to relax, many of us are feeling the strain of prolonged social isolation and re-learning how to reach out to others.

On April 29th, 2021, 48 San Francisco and UCSF community members gathered virtually during the lunch hour on Zoom for a series of poetry readings and discussion centered around the human experience of medicine. Farah Hamade, the inaugural UCSF Library Artist-in-Residence, took visual notes and created an art piece that represents the event and experience (featured below).

Pause, Breath, Re-Connect artwork.
© Farah Hamade 2021. All rights reserved.
© Farah Hamade 2021. All rights reserved

Three poets—Kathleen McClung, Sharon Pretti, and Peggy Tahir—were selected through a submissions process from the San Francisco community to read their work. Sharon Pretti read a series of poems written during and after her brother’s pancreatic cancer diagnosis, treatment, and eventual death. Kathleen McClung read a sequence of sonnets inspired by her partner and her experiences navigating his treatment and surgery for a pituitary mass.

© Farah Hamade 2021. All rights reserved.

Peggy Tahir read a series of poems written for each radiation treatment she underwent for breast cancer. The readings were followed by a 10-second pause to create space for reflection and a rich discussion.

Michelle-Linh (Michelle) Nguyen closed the event with a reading from The Book of Delights by Ross Gay, which can be accessed here: https://www.theparisreview.org/blog/2019/02/14/sharing-love/.

© Farah Hamade 2021. All rights reserved.

The introduction of the event and poetry readings were recorded with the poets’ permission. The recording was turned off for the discussion and closing to create a more comfortable, intimate space. After the event, the poetry reading recording, Farah Hamade’s art piece and a poem by Michelle-Linh (Michelle) Nguyen was shared with event registrants and the public.

© Farah Hamade 2021. All rights reserved.

The public can access the recording at the following link: https://archive.org/details/ucsf-pause-breathe-re-connect-poetry-and-discussion-2021-1.

The event was organized by Michelle-Linh (Michelle) Nguyen, Farah Hamade, Polina Ilieva, and Joanna Kang with support from the UCSF Library.

GRAD 219 Course – The Black Experience in American Medicine – Week 3

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This is a guest post by LauraAnn Schmidberger, Ph.D. Candidate, UCSF Tetrad Graduate Program

Doctors and other scientists are trained to be precise in how they word their hypotheses, methods, and findings, because they know that precision is important in the fields of medicine and science. However, this accuracy does not seem to follow them as they cross into the social sciences. The article “On Racism: A New Standard For Publishing On Racial Health Inequities” highlights some examples of the careless ways scientists discuss race in their studies.

Scientists often say that “societal factors” may contribute to the health disparities they see in Black communities, but they fail to ask what causes those social disparities—that is, racism. This is like attempting to treat a cancer patient’s pain, fatigue, weight loss, and other symptoms instead of acknowledging that they have cancer and attempting to remedy that root cause.

Similarly, we need to examine and begin to treat the root cause of health disparities. Perhaps Black communities do face more financial stress or lack easy access to healthcare, but these are symptoms of the larger issue of pervasive systemic racism. The article points out that there is an abundance of scholarship (largely by Black authors) on the topic of “how racism shapes conditions germane to racial health inequities.” It is not that scientists don’t have access to this information, but that they choose to ignore it or gloss over it for less accurate and less meaningful conclusions.

I also appreciated the distinction the article offers between different types of racism: “interpersonal, institutionalized, or internalized.” While all racism is structural, it can express itself in different ways that all need to be addressed; we can think of these like different types of cancer which require different treatments. Many cancer patients may benefit from chemotherapy, but knowing where the tumor is might allow it to be removed surgically. Knowing the origin of the racism and how it is perpetuated in a given scenario can give us better tools to eradicate it. For example, interpersonal racism may be combated with education on critical race theory, while institutional racism might require breaking down the old systems built on inequalities (i.e. abolition rather than reform).  

Another example of imprecise language arises from the issue of trust. One of the “social disparities” clinicians often point to is the lack of trust that Black individuals and communities feel for the medical community. However, as the article notes, “assertions that patient mistrust drives disparities obscures the etiologies of racial health inequities and tacitly blames affected patients for their disproportionate suffering.” In other words, saying that Black patients suffer from diseases either more frequently or more severely because they don’t trust doctors to help them is a form of victim-blaming. It is not the Black community that has decided not to trust doctors; it is the medical community that has, through both assaults on and apathy towards Black individuals, actively dismantled any good relationship the two groups might have had.

Issues of mistrust have arisen not because of the one event alone (such as the Tuskegee experiments), but because of both historic and ongoing micro- and macro- aggressions against marginalized groups, and these can only be addressed by addressing their root cause: racism. Largely white medical institutions continue to prove themselves undeserving of the trust of BIPOC communities because they continue to perpetuate racism in a multitude of ways, from continuing to utilize race corrections and other concepts that reify biological theories of race, to repeatedly marginalizing and otherwise failing Black faculty and students. While trust between patient and doctor (as well as patient community and healthcare community) is an important factor to consider, “incessant racial health inequities… reveal less about what patients have failed to feel and more about what systems have failed to do.”

Medicine loves precision. A person does not just have lung cancer, they have non-small cell lung squamous-cell carcinoma, or perhaps pulmonary enteric adenocarcinoma. However, when it comes to understanding the disparities between patients of different races, the desire for exactness seems to disappear and is replaced with hesitant generalizations. This is not unique to science, but appears in many corners of society, especially as discussions of race become more common. However, scientists have the ability to give the topic the accuracy it deserves by becoming familiar with the growing wealth of scholarship on the relationship between racism and health disparities and citing it in our own research. Language matters, and taking more care in our wording as it relates to race and medicine is one simple step to combating racism in the field.

GRAD 219 Course – The Black Experience in American Medicine – Week 3

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This is a guest post by Karissa Hansen, Ph.D. Candidate, UCSF Developmental and Stem Cell Biology (DSCB) Program

The readings and conversations in class this week brought forward discussions about how institutions can ensure equitable access and treatment of underrepresented persons in the biomedical professions. The struggles of individuals at each step of this process were highlighted: From early in training during medical school and residency to higher positions of authority at medical institutions. Therefore, extensive changes are not only required at the level of admissions, but also in later career support in hospitals across the country. Despite the conversations that have been reignited in the past year regarding equitable practices, meaningful large-scale change has yet to be seen. Bias in hiring practices accompanied by limited support in part has led to the lack of representation in leadership positions and a reinforcement of such inequities. Moreover, persons of color are often those that are called upon, or volunteer, to expand these efforts at institutions across the country, increasing the burden on these individuals. I feel like I must hold out hope that the education of the current generation of up-and-coming physicians and scientists will lead to such changes as these individuals move into positions of power. It’s hard to be optimistic with such a long road ahead, but the young scientists that I am surrounded by give me hope that we’ll get there.