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Some Animals Are Equal, but Some Are More Equal
Dean Robinson is an associate clinical professor of psychiatry at Tulane School of Medicine. During his 37 years of experience, he has worked in community mental-health centers, the VA, prisons, and at training hospitals. So it takes a lot to surprise him, he admits. Furthermore, growing up in Louisiana taught Mr. Robinson about racism. He considers himself very fortunate to now live in a culture that has worked hard to eradicate this “cancer” from our society.
That’s why it made sense for Tulane to offer and encourage optional courses covering cultural sensitivity, diversity, and related issues for the faculty and staff. I consider these resources to be potentially quite helpful for clinical care, since New Orleans has such a rich cultural heritage.
Nevertheless, he is “not inclined to take this progress for granted: individual attitudes of bias and intolerance can still “potentially rear their ugly heads.” Essentially, Mr. Robinson was told that providing equity in access and outcome should be the goal in medicine, rather than providing the best care to the patient in front of doctors.
It now appears that Tulane School of Medicine has revised its mission to ensure that our faculty and students receive indoctrination that divides us into either “oppressors” or “victims.” This mindset, as unreasonable as it is inflexible, is degrading our ability to deal with the health-care world as it really is.
Over the summer, explains Mr. Robinson to readers in NRO, every member of the department of psychiatry was ordered to attend a daylong “Diversity, Equity, and Inclusion Retreat.” Mr. Robinson’s turn came 1 October, when he and his colleagues were subjected to seven hours of stereotyping and shaming.
It stigmatized white people as being responsible for the ongoing oppression of others and insisted that the only way Caucasians may demonstrate opposition to racism is to acknowledge and admit to being racist. I’m still scratching my head over that one.
Asked his thoughts during a breakout group session, Mr. Robinson’s response included the above George Orwell quote, which was met with silence (cluelessness).
… silence and professional timidity carry a price for our patients. Physicians, and especially psychiatrists, must be willing to delve deeply into the history and sensibilities of each patient to provide the best treatment. Tulane should be teaching our residents and students how to competently and empathically finesse this delicate and difficult process.
Instead, my colleagues and I are increasingly concerned that our frank guidance could be interpreted as microaggressions or manifestations of our “oppression” and “privilege.” Out of self-preservation, we are thus likely to limit the instruction and feedback we give future physicians, depriving them (and their future patients) of the skills vital for optimal treatment.
That’s especially evident when considering Tulane’s new “bias in curriculum reporting form.” Introduced in late October, it allows any student or resident to report any instructors whom they consider to be biased in any manner. Naturally, there is no standard for what constitutes a transgression. These complaints are of course subject to higher review, but if denunciations are determined by the sensitivities of the beholder, then the ranks of skilled educators will diminish. Sure enough, one of our most respected senior instructors resigned recently out of concern that he could no longer be an effective mentor in this political minefield. Several others tell me they may retire at the end of the academic year — quite a surrender by those labeled as ostensible oppressors.
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