S01_E08 - An Essential Conversation on Race, Racism and the Healthcare System

Speaker 1: 0:03

Welcome to the healthy matters podcast with Dr. David Hilton, primary care physician and acute care hospitalist at Hennepin healthcare in downtown Minneapolis, where we cover the latest in health healthcare, and what matters to you. And now here's your host, Dr. David Hilton

Speaker 2: 0:20

Him back to the podcast, everybody. I'm your host, Dr. David Hilton. And today I'm gonna be talking with my friend and colleague, Dr. NECA. Edstrom the chief health equity officer at Hennepin healthcare. We're gonna tackle the subject of race and racism in healthcare. NECA welcome to the shell. Thank you.

Speaker 3: 0:36

It's

Speaker 2: 0:36

Nice. Be here. It's great to have you on and to lay the groundwork for while we're gonna talk about today. Tell us, first of all, what a chief health equity officer is and does, and why is it important that we're talking about race and racism and healthcare?

Speaker 3: 0:51

Sure. So, uh, I like to explain what I do as the, the person in the hospital who helps to address the inequities that our patients see and feel the disparities, their outcomes, and the racism that they may encounter in medicine and at the bedside. Uh, I was actually speaking with a young man who is going to hopefully be one of our interns this summer for our black men with stethoscopes internships. That we'll talk more about later. I'm sure. Uh, and he asked the same questions, like what is a chief health equity officer? And when I explained it to him, he looked at me in all seriousness and he said, so you're like the CEO of all black people at the hospital. And I said, you know what? I think I could claim that title. Yes. I'll claim that titles, the CEO of black people at the hospital. So that's what I am. I

Speaker 2: 1:36

Love that. I love that. And we are indeed gonna talk about the black men with stethoscopes events and the programs and all the work that you, your team and our organization are doing around health equity. You made some comments about, um, just in, in that little introduction about what it's like to experience racism in healthcare. I wonder if it comes as a surprise to people that such things exist. Now, it doesn't, to me, you've taught me so much just in the year that I've been working with you. But I wonder if that comes as a surprise to people. Yeah. Tell us about, about racism in healthcare.

Speaker 3: 2:09

Sure. It does. It, it comes as a surprise because I think most people think of racism in spaces like education or in politics or in academia, where there are these really clear, defined structure of power differentials. And people can actively see that as you kind of climb the ladder in a certain space, it, it, it becomes all white faces are right. Well, all white male faces. And so they can see that they don't think of healthcare in the space of racism because everybody needs healthcare. Everybody uses healthcare. So it doesn't have the same feel of, well, I can understand how I can discriminate against one group of people in this space versus another. But with healthcare hospitals, they're all, you know, everybody has to use'em and everybody needs them. So,

Speaker 2: 2:56

And we have, we care for everybody who comes in, what you're talking about. Right?

Speaker 3: 2:59

Exactly. And doctors and nurses are, are caring people. And why would you give up your life and go through all that stress to become them? If that's not what you wanted to do, take care of people. So it's kind of like a against the grain to say racism and medicine, because the function of how people in the healthcare space they act it is to be of caring individuals. Problem is, is that there's still individuals who were raised in society where racism is the basis of the structures that they were brought up in. So even though they are caring, they still continue to move along the continuum. Like everybody else is on racism because racism exists in all our structures, as well as being trained in mechanisms that perpetuate and maintain racist ideology and stereotypes. And that's why we have all these disparities, because even though everybody needs hospitals, and even though everybody goes to the same doctors and are thought to get the same care, data has shown that they don't get the same care. They don't receive the same level of care. They don't receive the same interventions or opportunities for interventions and they have terrible outcomes. So that's what we have to address specifically, is those implicit biases in the providers and the nurses and the teams that make up hospitals that cause this consequence of a negative outcome for our patients.

Speaker 2: 4:16

How do you respond to people when they say the yeah, yeah, yeah. I get it. But I'm not a racist.

Speaker 3: 4:23

Yeah. That's my favorite.

Speaker 2: 4:25

How many times have you heard that way? No, no, I'm not a racist.

Speaker 3: 4:28

I'm not a racist. I have a black friend. Yeah. Yeah.

Speaker 2: 4:30

I have a black friend.

Speaker 3: 4:31

Yeah. I, I, uh, I, I like to make people take a step out of that name mostly because the fear is that if I I'm called a racist and I'm some, you know, terrible human that is burning crosses and, and wearing a KKK outfit. And that's not what we mean when we say that people are racist. What we mean is that you're continuing to perpetuate structures of racism because you're not actively going against those structures. So until you go against those structures, even, but unbeknownst to you, you're still perpetuating and upholding them. So that is maintaining racism. And that is making you a racist. It's not that you're actively overtly trying to hurt other people of color, but you're just not doing anything to ensure that they have the same rights and accessibilities, as you

Speaker 2: 5:16

Do. And, and while you continue to benefit from things yes. The privilege that you have and when say you, I mean guys like me, it, I, I love that you brought that up. Um, because I hear all the time from people that look like me and I'm a white man that, uh, that the racism and structural racism may exist, but it's not my issue because, you know, it's not mine to, for where, and indeed it is, right. It is indeed the work of white folks, to be honest yeah. To address it.

Speaker 3: 5:50

Yes. And the reason it's

Speaker 2: 5:51

Not your job to teach me or to do that work for me. Right.

Speaker 3: 5:54

Yeah. And the reason is because it, it is the majority of white people who don't understand how they are continuing to uphold and perpetuate those structures. If those majority shifted those structures would end undoubtedly shift. And we've seen that happen in spaces. Um, one of the great examples is with the, the covenants in the housing, the deeds around Minneapolis, and some other cities, big cities across the country when people realized that there were racial covenants in their deeds, there's been news stories of white families choosing to sell their houses and, uh, give them to black families and then donate the proceeds from that house sale to a, a black scholarship program or to any other community players that are focusing on addressing the wealth gap and black and brown communities. And that's the little bit of their recompense for the fact that their family was able to benefit from these structures of oppression. And instead of continuing it by saying, well, this housing, you know, I didn't buy it. My, my grandfather built it on, you know, the, the farm is the land that my family owns. And I grew up maybe poor because we worked the farm. And so now that farm is in my family and I inherited it. That's, that should be my right, right. To have that. Instead of just staying in that space, like many people do what they did was own the, that the farm was only allowed to be bought by their grandfather because their grandfather was white and it was taken from native people as landed. They did not own. And as a result of being a white man, he was able to get a loan from a bank in order to buy the farm and build the family wealth. And they recognized that it's only because of those structures that allowed them to get to this place now where they are inheriting, what they see as sort of their due, because their family did work hard to maintain that house and maintain that land. But how they got it has, has never been brought into consideration. So these families are now thinking about that and trying to make amends for those wrongs that were done way before their time. So they're donating the proceeds of, of these

Speaker 2: 7:59

Cells. Sounds like what you're describing in is something that I've been my, the thinking has been evolving over the years about, it's not really, what's in your heart. You might have racist thoughts in your heart, but what it really is is that it's built into the system. The structures of our society literally have them intentionally, not even unintentionally, but intentionally built in. I saw a, a TV show on, on local public television called Jim Crow of the north. Great show. Have you seen that show? Yes. Love it. I recommend that to everyone listening. If you don't think that our structures have this built in watch Jim Crow of the north, it's not an accident. It was intentional. I want to shift to healthcare, but I wanna talk about you for a second. How did you, I, I, I got to know you about a year ago. Uh, about one year ago when I was in a leadership role at our organization and, and was in charge of putting together an ethics program, you have a deep background in ethics, in clinical ethics and in scholarly work about ethics. So I had not met you, but I gave you a call. And I said, you don't know me, but can you gimme some advice about an ethics program? And that was my first conversation with you. You have an extraordinary background. Could you tell us a little bit about that? I wanna tell our listeners little bit about Dr. Cedars room's background. And then if you could tell us how, uh, in your own words, like your story. So you have a BA yes. You have an MPH. Yes. You have a PhD. You've been the director of a spiritual care program. You've been the director of ethics. You have worked in Washington, DC. You have worked in men soda. You are from, I think you told me Alabama world tide. Yeah, because you have this very unacceptable love for the rural tide to the university of Alabama. So you're known nationwide on, on your work around health equity and around ethics. How the heck did you land in downtown Minneapolis at our safety and net hospital? Tell us a little bit about your story, if you would.

Speaker 3: 9:59

Well, you forgot one degree. I also have another master's public book into that. Um, I

Speaker 2: 10:03

You've got a master of arts and an MPH. Yeah. Okay. There's two masters and a PhD doctor.

Speaker 3: 10:08

Yes. Thank you. Um, yeah. The short story is, is I fell in love with the one Minnesota outside of Minnesota in Washington, D C working at Washington hospital center. And as we all know, Minnesotans, don't like being outside of Minnesota. And that's why I

Speaker 2: 10:23

Got here. So you came here for, You came here for love, not love. I came here for love place, but

Speaker 3: 10:29

Yes, yes. Uh, but, um, yeah, my history is actually a little different than most. I, I grew up a kid who was very much in love with medicine. I had one of those human torsos since I was about three years old. I would love taking all the body parts out and putting them back together. And I could tell you, I wanted to be a surgeon, um, which was always really difficult to say as a three year old, you can't get the words, right? So when I was in preschool all night, it was, what do you wanna be wanna grow up day? I was the only black kid in this private preschool in, in Northern Alabama. I said I wanted to be a surgeon. And my preschool teacher heard that I wanted to be a servant. So, so you can imagine that when the parents came for, uh, when you wanna be, when you grow up day, uh, in this, this cute little black girl or Afro puffs, this standing in front

Speaker 2: 11:18

Said, I wanna be a servant. I don't think so.

Speaker 3: 11:21

I didn't go over so well with my mother. I promise. Um, and my, my preschool teacher who is still around today, who still remembers how mortified she was when she realized what I was saying, uh, still tells that story and, and how it helped her to be a little bit more clear on what the little ones are saying. But I did wanted to be a surgeon my whole life. So my parents, um, being from a very privileged background and my dad was a, a diplomat with United nations. And my mom was a super educated educator. I had privilege to be able to do a lot of summer programs in medicine and, and things that kids do when they wanna go into this field. Um, and I wanted to be a pediatric neurosurgeon. Can you imagine to you mean, as a pediatric,

Speaker 2: 12:02

I have never in my life wanted to be a, a neurosurgeon, a surgeon, a pediatric, anything,

Speaker 3: 12:07

A pediatric anything. Yeah. Pediatric neurosurgery was where I would thought I was destined to go, cuz I loved all things surgery and I loved peds and I felt that brain surgery was the most impactful way to help people. So that was the goal was what was gonna be the most impactful way to help people. Um, and so on that continuum, I, I ended up being nominated for a program called the national youth leadership forum on medicine. And, uh, I went, it was the summer before my senior year in high school. Um, and I was super excited cuz it was for kids who were med school bound and you were definitely gonna become a doctor. So this was learning what it meant to actually be a doctor, not what you saw on Grey's anatomy in ER, but like what really is that life like, it's

Speaker 2: 12:51

Just like that.

Speaker 3: 12:52

It's

Speaker 2: 12:52

Just like

Speaker 3: 12:53

The TV still haven't found my MCD dreamy, but we'll

Speaker 2: 12:55

Work on that.

Speaker 3: 12:57

So, uh, at this program, this was the first year that they brought in clinical ethics or bioethics as a topic for the kids to learn about. It was just starting to kind of take hold in hospital systems where bioethics committees were being developed and in ethics councils, patient service was being developed. And so they figured us kids who were gonna be doctors at some point should know ethics. And what does that mean? Um, and so they changed the entire program, unbeknownst to us where half of it was now gonna be dedicated to bioethics and the other half was gonna be stuff like, how do you live through med school? And, and what does it look like to go in the, or, and kinds of things? And I was very angry. I was super angry cuz I thought this is finally my chance to see what it feels like to be a doctor. And you're taking half of it away for me to sit in a room and pretend to be an ethics committee and talk about what, like what is this nonsense that I have to talk about? Uh, and my little group got the topic of fetal tissue research and we are supposed to come up with a strategy to create policy for our hospital to accept or say that they will not accept doing fetal tissue research. And I was just like, oh God, this is ridiculous. All right, fine. That's a heavy topic. It's a heavy topic, but I didn't think so. Right. I'm like as a kid, I'm just like, whatever, let's just say yes or no and then move on. So as we work through, what does it mean to have fetal tissue research and how would you allow a hospital to do that? And of course, every kid in there comes from a different background with different lenses and they brought their personal opinions on the topic. It quickly turned into a lot of conversation and debate. And one thing I love to do is debate. Just ask to my mother, uh, so that turned into me, fighting for what I thought was actually the right answer of yes, but with a lot of people saying no, and we spent way more time than any other group deciding what our policy restrictions would be to allow it to happen. I convinced everybody that doing

Speaker 2: 14:58

Right there did convince them that

Speaker 3: 14:59

I got, I got everybody

Speaker 2: 15:00

Your side prevailed.

Speaker 3: 15:01

Yes. But then I had to get everybody there in a manner that made them feel comfortable. And so we actually missed out on a whole bunch of the program because we were forced to, to stay in our room to get this worked out. Uh, and I didn't see a lot. I only got to see a cat hysterectomy, which was very fascinating, but that was the only surgery I got to see in the entire time I was there. But when we presented at the very end, everybody had to go up with the little, little intro of what their topic was. And then what they decided was the policy, uh, yay or NA on whether their host hospital should agree. And all the rest of us were sort of the hospital and they got to vote down or, or approve it. And it was based on any questions, interactions and, and the audience and every topic that came up, even with a little bit of knowledge of what it was my mind would just say, well, that's not gonna work when they, they came up with ideas and I was like, that's not gonna work. So I ended up sitting, uh, on the ground by the mic, the entire presentation for everybody's group and challenging back all the various things. And the only, only policy that passed was my group. Nobody had any, all

Speaker 2: 16:02

The rest weren't were not. So you were thinking about sticky, challenging, ethical issues

Speaker 3: 16:08

Was a young

Speaker 2: 16:09

Year old. You were a teenager. You were a

Speaker 3: 16:12

Yeah. But then I got done with that. I was like, that was cool, but I'm still going to medical school. Yeah. And then I got to GW, cuz that was, the dream was like, all right, I'm gonna do some combo. Uh, undergrad med program. GW has a seven year program that I was gonna apply for. Do the standard psych in Washington. Yep. The psych bio major that everybody was doing by in the late 1990s. Um, and that was the path. But my freshman year, something about that experience just kind of stuck with me. And it may have been because I was in my first biology class in my first psych class. And I was like, I don't know if I really like this the same way, but that ethic stuff, that was pretty cool. Maybe I'll do a minor in that. So I went to the psych department and they were like, well, Nope, you can't do ethics here. You gotta go to philosophy. And that was a little weird to me. I was like, what? Why is it in philosophy? But I made an appointment to talk to the Dean of the philosophy school. And after telling him my story and a thing that I liked, he was like, actually, this is exactly where you need to be. Cuz we are just started our first bioethics course. So you can take that. But before you do that, I went to, to also take a philosophy one on one, because you need to understand what the world philosophy is like before you decide that you wanna do ethics. So I did, I took a bioethics course and the second half of philosophy, one on one and my second half of my freshman year and I was hooked, fell in love instantaneous Lee with philosophy. First day I took the class. The professor was terrible. Its something you can't do nowadays. He was just awful. He came in and he said, any of you who believe in any sort of religion, you're all idiots and you can leave my class. So you could imagine

Speaker 2: 17:49

That's how he started it off.

Speaker 3: 17:50

That's how he started it off. Um, but that was to me, was like, no, that's a good fight. Right?

Speaker 2: 17:54

That's a good fight. You know, you're that is so interesting. My sister happens to be a bioethicist and a philosopher and a professor of that and philosophers do some funny things. I remember she one time had to go to a conference in pro in the Czech Republic and the, the topic of the, of the conference was evil. So okay. Here's what you get a whole bunch of philosophers talking to about evil in the world that, you know,

Speaker 3: 18:19

That's that would've been a really cool copy.

Speaker 2: 18:21

Yeah. Yeah. That was, that was ripe for some discussions there. And so you, you did pursue the ethics spread. I'm here to tell you here's the deal. Okay. Here's the deal else. You, you could have made a difference, uh, um, in people's lives as a pediatric neurosurgeon, but you corners of magnitude more, I think going in, going in the path that you did go

Speaker 3: 18:42

Yeah. The, I got hooked to philosophy and got hooked to ethics and that started my journey bachelors in philosophy, masters in pH PhD, in medical, sociology, race, class, and gender inequalities and philosophy.

Speaker 2: 18:55

Now, early on when I met you and, and I'm just off the top of my head. You said that you were one of just a handful of black women at your level in clinical ethics.

Speaker 3: 19:04

Yes. Yeah. In the country, in the country. When I became the director of the center for ethics at a Washington hospital center in DC, which is now called the John J. Lynch center for ethics, he was my mentor and rest his soul, miss him a lot. I was the only, and the first black woman director of a clinical ethics department. And I was the youngest in the country. I got, I became director at 27. So I was holding all three titles at a really engage. And there's still not many. There are much, there are more than when I started as being the only, but there's still only a handful, maybe four or five around the country right now that are directors or department chairs of clinical ethics divisions. That's a problem. What

Speaker 2: 19:45

I'd like to talk about, we're gonna take a short break, but what I, what I'd like to talk about is representation in healthcare, because what you just brought up is that there, there were relatively little people that looked like you or with your background in clinical ethics, the same holds true in what I do, being a doctor. And we're taking some steps to correct that. But I wanna talk about that topic. When we come back,

Speaker 1: 20:08

You're listening to the healthy matters podcast with Dr. David Hilton, have a question or a comment for the doctor become a part of our show by reaching out to us@healthymattersathcmed.org. Or give us a call at six one two eight seven three talk that's 6 1 2 8 7 3 8 2 5 5. And now let's get back to more healthy conversation.

Speaker 2: 20:32

And we're back. I'm talking with Dr. Nero, my friend and colleague from Hennepin healthcare. She is the chief health equity officer at Hennepin healthcare here in downtown Minneapolis. Before the break, we were talking about representation and you were talking about being one of the first, you were the first and then joined by just a small group of black ethicists. And in what I do, I'm a, I'm a doctor and there aren't very many, well, when I went to med school, there were, if I remember three, three black people in my class, and this was in the late 90, uh, in a class of some 200 people, sadly, I don't think that number's any better today.

Speaker 3: 21:13

Yes.

Speaker 2: 21:14

And so can you talk to us your thoughts about why that's a problem? Why does representation matter?

Speaker 3: 21:22

Well, first off it is mostly because of the history that we have in this country with racism and how racism was the foundation of healthcare and, and the way we practice medicine today, that reality has set a stage for people who look like me. When they go into a doctor's office to see their physician who looks like you immediately, there's a physical response. That physical response means that our bodies are more stressed. They have higher cortisol rates. There's more anxiety. These are things that physically affect us, even unbeknownst to ourselves, just because of the historical trauma. And that interaction creates a lot of other stream effects. It may be much harder for me to tell you, honestly, what's going on with me out of fear of whatever repercussions or thoughts that you may have. It may be that because you see me and your implicit biases are against black women. When you don't even know it, that you cut me off before I'm even able to get my message out to you. So that shuts down communication. All of these things are really important when trying to figure out how to best treat somebody. And if we don't address the fact that that initial interaction causes so much anxiety and stress for our patients, by providing patients with clinicians that are racially the same as they are in order to bring those stress levels down, then we're gonna have these ridiculous outcomes. Like we've been having studies have shown that just by the sheer fact of having black doctors with black patients, they have more than a 30% increase in their outcomes and that's across the board. So they're more compliant. They have more information that they provide their providers. They are more in line with the medical plan. They have better mortality across Lord people say, well, what is about being a black physician that does it, is there something different that black doctors say or something different that they do? And the answer is no. What it is is that there is an immediate, safe space feeling that brings all those other bodily reactions down. So you don't feel the fight or flight response or cortisol levels aren't crazy or constantly high. It gives you an, an opportunity to feel that the person in front of you truly has your best interest and you're willing to be open and honest with them. Now that doesn't mean that white doctors can't take care of black patients. What it means is that we just have to teach white doctors how to better take care of black patients. Because right now there's no clear direction on how to do that. They all believe like yourself that you treat everybody the same way, but it's impossible to treat everybody the same way. We haven't trained our clinicians in any way, shape or form to see that there is a need for a difference in how we treat people. Because right now out equally treating folks is why we have these disparities.

Speaker 2: 24:07

So the whole idea of, I don't see color is a crack.

Speaker 3: 24:11

It's terrible. Yeah. Yes. Cuz that means you don't see me cuz my color is very much a part of who I am.

Speaker 2: 24:16

Let's say more about that because um, I'm a white doctor and a white male doctor and I'll be really honest. I have never walked into a room and felt what you just said.

Speaker 3: 24:26

Yeah.

Speaker 2: 24:26

I've never felt uncomfortable with, you know, or the one who has to be defensive or a term I've heard you've used. I've never had to put my armor on. And so say more about that. How can white people like me do better at caring for black patients say more please?

Speaker 3: 24:48

Right. So one of the first things is that I believe is super powerful and I've been trying to teach this when I talk to residents and such about dealing with racism and medicine, especially young white residents. You're like, what do I do? Cuz I don't want to become that to me. The first thing that's probably the hardest thing is for white physicians to just acknowledge it, to walk in the room. If you have a black or brown patient, the first thing to do after saying, hi, my name is Dr. Hilton, nice to meet you, Ms. Brown or whoever your name is first. I just wanna acknowledge before I ask how you're doing. I just wanna acknowledge the fact that I realize that as a white man, my presence may cause you discomfort. So I

Speaker 2: 25:26

Should say yes,

Speaker 3: 25:27

Absolutely. And I am just here to tell you that I'm doing my part to try and diminish that I will honor you. I will respect you. I will be as, as best as I can to you as I would to anybody else. And if you feel that somehow I'm not doing right or I'm misstepping, I am completely open for you to tell me, because what that does is it brings the volume down. It

Speaker 2: 25:49

Brings it's simple, but it's something that

Speaker 3: 25:50

Very simple we don't

Speaker 2: 25:51

Do.

Speaker 3: 25:52

Yeah. Just own that. My whiteness is an issue because they're already armored. You have no idea how many versions of microaggressions that they went through just getting into your office, right? And these are stacked upon stacked upon stacked, right. Is a death by a thousand cuts. So they're ready for this interaction to already be bad. They've already had multiple situations occur to them leading up to this space. So they're super armored and super stressed having that, just be acknowledged and say, I am doing my part to not continue that trauma to you. And I I'm going to do my best, but if I missed up cuz I'm still learning. I really just hope that you help me better understand that brings the volume down. That builds the trusting relationship that is needed in order for black and brown patients to say, okay, so you get that just my existence is stressful. I'm gonna trust you now and tell you all the other things that may be stressful. And you see my color cuz you didn't walk in here and pretend that somehow I'm just like everybody else. I am not like everybody else. Everybody doesn't walk around in the spaces that I walk around in as a black person. And that is very important. So I need you to see that and recognize that that by itself means that it there's a whole host of other things that I'm dealing with that I may not share.

Speaker 2: 27:05

That's so powerful. That is. So just to hear that simple acknowledgement is so powerful and the downstream effects of that lived experience that I don't have any clue about is that health outcomes are then not as good. Um, and it starts right from that very first encounter. It's well known that outcomes for black women in maternal care yeah. Are not as good if you correct for every other difference. Right. Um, just a little, uh, a little, uh, show note, we're gonna do a show about, um, uh, black maternal issues, um, childbirth issues for black women, um, and a future episode of the podcast. I'm looking forward to doing that. Yes.

Speaker 3: 27:46

When we talk about dealing with racism and medicine, we have to look at it from every angle. It's not just when you're in our hospital, if a nurse or a para or you know, the rad tech or somebody like that treats you appropriately, it's truly, how are all the elements around taking care of you and allowing you, you to live your best life or being impacted that includes at happy moments like when you have a baby or sad moments, like when you're saying goodbye to a loved one, like the entire continuum, we have to pay attention to how these stressors affect you and how they cause you to have negative outcomes.

Speaker 2: 28:19

Okay. So we've talked about the fact that the, the very fact of a, a per person of color is the patient and their doctor being white. We've talked a little bit about that, but it is a true statement that, that, that isn't gonna change overnight. The fact that most of our physicians and other healthcare providers are white, how can we change that?

Speaker 3: 28:40

We have to invest in our kids. We have to allow our young black children to see that there is an option to become a physician. And that's why I'm super excited and, uh, very happy about the talent garden program that we started at Hennepin, which is trying to do that exact thing, provide young, black and brown children, the opportunity to see themselves in healthcare, in any position. I would love for them all to become doctors cuz I really them so that we can hire them. Uh, but I also want them to become the researchers, the bioengineers at the entire spectrum of healthcare, the, the folks who are in administration and in insurance companies and all the spaces that impact health, because we need the lens to be able to help make the difference. And the talent garden program is a opportunity to staff establish a path for young black children, young brown children to see a way forward in healthcare. And one of the first things that we did was establish what we call our youth summit, which was the first one, was the black men with stethoscopes youth summit. We're going to be having our black women with Sato scopes, youth summits. There are two of them cuz the first one was such a big hit. Everybody was like, you need to do more a year. And those will be at the end of April and May 15th. So I think April 30th and May 15th would be the next two. But the idea was to bring in kids from the community and to the hospital and let them see black doctors let them see black, advanced practice, clinicians, black dentists, black, everything to not just see them. But to know that they can be one, right, because the old saying you can't be with you. Can't see. And so we wanted to provide that space for them and to fall in love with all things medicine, I think they had a great, there was an 80 young black men who showed up on our doorsteps on December 4th and had a blast. They loved it. The stories that have come from it have been incredible. There's been this continuous group of about 20 of them that are constantly emailing, asking when the next one is coming. I think we got a, we got a nice chunk of future doctors out of that one day experience that, uh, it's just, I feel like I could just retire off of that and it'd be good. I like I've done my part. Yeah.

Speaker 2: 30:47

I had a chance to, to be present, um, and observe that what, that event, that black men with stethoscopes event last December to see, uh, the panel of they were all black men. Yeah. And to see a roomful, a room full of teenage young black men and to see what those possibilities were, that is just an incredibly powerful event. And, and it's not just an event, you've got a whole program around it. Yes. Who came up with talent garden? That's your department came up with that. It's like garden,

Speaker 3: 31:21

It's a garden because we have to, we have to pluck our talent from somewhere. So, um, it was a, it was a, it came out of a conversation that I had with Dr. Hoodie about, uh, developing a programming and, and he said some quote that triggered the idea in my head of a garden. I was like, that's it, that's the name? It's a talent garden. That's the programming. And the use summit is just one element of it. We've got internships that we're starting. So there'll be 20 paid internships this summer where the young men from, uh, the black men with sat scripts as well as opening up to others. So you don't have to have gone through these youth summit to be able to apply for the internships you, anyone can apply, but there's only 20 positions. So, so those who went through the U some already know, and they're really excited. So we'll see how many apply from there. But um, this summer will just be an opportunity for these young men to spend their entire summer working for us in a paid program, learning all the various departments. You you're pretty much getting paid to learn. They'll go from department to department, they'll have, um, experiences with our EMS program that will get them certified to be an, I think it's an EMR is the base level of what you can do for EMS. So they'll at least come out of it with that certification so they can work us bank and some of the other places as a side gig in high school and maybe get to see a couple of cool games while they're working for us. Um, we're going to hopefully develop some black male doulas cuz that's a huge, huge miss

Speaker 2: 32:51

What's that

Speaker 3: 32:52

Doula. Well,

Speaker 2: 32:53

What's a, yeah. What, why is that a huge miss?

Speaker 3: 32:55

There's nobody. There's like one man. Who's a black man, a doula out in California. They no black male doulas.

Speaker 2: 33:03

So tell, tell our listeners what, what does a doula do? I know what a doula is. I I

Speaker 3: 33:07

Do. Yes. Most of them probably do a doula. I mean, is a, is I I'm gonna say I am fully biased. I love doulas. I had a doulas for both my deliveries, but doulas are like, uh, trained mommy helpers to get you through the insanity of pregnancy and delivery. Um, they are very much in tune to what happens to a woman's body and helps you through that process. And they're very, uh, wonderful additions to your healthcare team when you're trying to deliver. They see a lot of things that oftentimes the nurses and the physicians don't see, cuz they're, they've been working with you through your whole pregnancy. They understand how you relate to things. They know the kinds of things that you would say. That means that you're in trouble versus that you're not. And so they're really amazing addition to the delivery in the maternal health team. Uh, and I loved my, it was really sad when we moved here and she was still in Maryland, but um, we're, we have a great doula program for women, but we don't have anything to focus on men. And one of the things we did at the youth summit was to have those wonderful young 80, um, black men go through a birth delivery. So they all got to deliver babies. And,

Speaker 2: 34:23

But that was eye opening for a bunch of teenagers.

Speaker 3: 34:25

Yes. A bunch of teenagers. I thought that they would be a little like disturbed by it. They, but they were all in. They were super serious, really focused. And you know, with the simulation, the baby was like slimy and slippery and they had a whole lot of stress about making sure they cut the baby and didn't drop the baby.

Speaker 2: 34:43

They don't wanna drop the baby.

Speaker 3: 34:44

They don't wanna drop the baby. And they had the biggest smiles on their face when they successfully delivered. It was like this just crazy impact moment of theirs that they, they could do it. Um, and they never thought that they could do it. So hopefully we'll get some, some, uh, young black men who are interested in our doula program coming up and they'll get that certification and maybe going to nurse midwifery or become an OB.

Speaker 2: 35:04

So this is how we change things. This is how we change things. This is how we change things. You know, I remember, I think it was one of the panelists, one of the, one of the black physicians there said that he was an adult before he saw a black physician, you know, his pediatrician growing up had he had never seen one. Right? And so to show, oh, 80 young black men, that this is a possibility, at least this is something you can do and look at and look at these role models that look like you.

Speaker 3: 35:32

Yes. And I think that it was, it's really important to acknowledge that, um, there were so many of our white colleagues at that event to that played supportive, very wonderful roles that helped not only highlight the reality of what you can do when you join forces together with the same common goal, but also made the black colleagues feel loved and, and respected in a way that they oftentimes don't get just by walking in the halls for them to give up their Saturdays and to not just give'em up, but to really be the folks who like did the work so that our black clinicians could shine. It was, it was really, it was really wonderful. And then they talked up the kids so well, I mean, they gave them such amazing feedback that these kids just, they had smiles on their faces, that that came from a place of truly feeling like they, these people believed in them too, not just the black physician saying you could be me too, but their white colleagues being able to say, I see you as that. Not just not that you could be, that I see you as that. I think the, one of the most powerful moments for me at the, um, summit was a 14 year old, a young 14 year old man ran to his mom when his mom was coming to pick him up. And she was like, how'd it go? How was your day? And he was like, mom, I'm gonna be a facial reconstruction surgeon. And he was like, what? He's like, I'm gonna be a, a facial reconstructive surgeon. I did the robotic surgery simulation and I had the best hands of everyone in my group. They all told me I had the best hands and I could be a facial reconstruction surgeon. So that's what I'm gonna be. And I was like, that's it? My job's done. Like I can that's, that's it. We have a facial reconstruction surgeon coming really soon to hospital near you out of our youth summit.

Speaker 2: 37:18

That is, is incredible. So that's what a health equity program looks like. Yeah, right there. What about, um, shifting gears a little bit to about the, our healthcare setting, like all, um, uh, has these structural racist things going on? Yes. Like, like all do, how are your you and your team helping our organization? I'm a, what I'm getting at is the, the compass program. Yes. Could you tell our listeners about that?

Speaker 3: 37:46

Yes. So like you said, like all, um, everyone, who's, at least if you're doing it right. If you're doing this right, you're gonna uncover racism in your walls. Um, if you're not doing it right, then you're gonna say something like, oh, we've handled it. It's the that's

Speaker 2: 38:00

We, we did that. Yeah.

Speaker 3: 38:01

It's done. We all went through a training. We're

Speaker 2: 38:02

Good. Yeah. We did in our sensitivity training,

Speaker 3: 38:04

Right? Yeah. That's not handling it right at all. That's just, that's running away from the reality of the problem. Uh, but we're doing it right. Which means that we're gonna be the face of all the terribles for a long time, because people aren't really being that vulnerable to say, we are owning that racism is within our walls. We're fine with it going out in the media, that racism is in our walls because we're not shying away from it. It's not something to hide away or that we are embarrassed of. It's something that we're embracing and working day and night to try and fix, because that's the only way to get on the other side of this. We can't run from it. We have to face it head on. And as a result, um, we have finding things like most of our hospital employees have no idea how they interact with their colleagues of color in manners that are problematic. They have no idea how their interactions with our, of patients perpetuate racism. And it's, it's an ignorance problem. It's not because they are actively wanting to do this. It's because they just don't know any better. And so it's our job to help them be better. And, uh, DRT Vang, who works for me, um, as its phenomenal,

Speaker 2: 39:10

She is phenomenal, phenomenal

Speaker 3: 39:11

Educator.

Speaker 2: 39:11

Dr. Vang is an amazing psychologist who works on your team.

Speaker 3: 39:15

She's so great. She developed this immersive comprehensive training program that creates an opportunity for people to not only learn how to be better in an anti-racist space, learn the history of racism in a way that's useful, especially racism and medicine it's useful and not just what was taught in high school, but true the true history, but also to figure out how they, in their own little worlds, those spaces in the world impacted, right. You can't just come in to work at Hennepin. And all of a sudden, when you get to the door, you're now, boom antiracist and you be antiracist from nine to five, and then you go back home and you can be racist. That's not out how it works, right? You, you take yourself in all these spaces. So this program not only helps you to address how you behave while you're in Hennepin, but it also makes you take a step back and look at what's going on in your life when you're home things like where's, what's your sphere of influence. Who are the people who are around you the most? Do you have diversity and whatever level of diversity it is in your social circles. Some of the people that you call that come over your house for dinner, or that are considered your kids' best friends, elements like that, that we just no normally think through because we kind of get in our usual rotations of, oh, these are families that we are good friends with. Or these are kids that my kids grew up with. We're, you know, they're close to their, and we don't sit and look at them and say, are these people different in a way that brings a, a value to my life or to my kids' life? Or are we just kind of regurgitating the same people with the same social economic status, the same race, the same religion, same language

Speaker 2: 40:52

You need to diversify your feed, your, your social media, a feed in your life,

Speaker 3: 40:58

Feed your life, feed everything. Right? So this, this lets you step back into that space and take these honest looks. And it also asks you to do things like walk through your neighborhood as a person of color in your mind. Right? Like, think about what that looks like. How does that feel? Go to your local target? Think about when you're walking around, do you see things around that make you feel like you belong there? Um, as a person of color, if you're, if you don't ask the question, why, why isn't there something here that makes me feel like this is a store for me or your grocery store, look at labels of how things are presented. I actually just noticed the other day and I thought that this was a very interesting crafty trick, um, that, you know, I gotta give'em credit, somebody I'm marketing finally figured it out the, uh, anim brand. Right. Got a lot of flack about the maintaining of that racist image of a black woman with a head scarf, right. As like sort of the, the house Negro image that a Jemima was now they're, they're called the something mill company. I think it's stone mill or something like that. So I was looking at grocery store and I was looking at, um, looking for pancakes syrup. And I was like, who's this new milk?

Speaker 2: 42:13

I

Speaker 3: 42:13

Mean, that's everywhere. Right? Like that was like, and I was like, what is this? Is this some new company? Oh, they got rid of anima. And I'm thinking in my head that maybe Animas gone. Right. So I'm like, oh, that makes me feel better. Yeah. Now I don't have to like brace myself for going down the pancake aisle for these assaulting images that, you know, hit me as a microaggression, but there's this meal company. And then I Googled it. I was like, look at there, it's the same anim brand, same company. They just changed the front now to like a steel mill. And I was like, ah, I see, there you go marketing. So pay attention to the fact that stuff may change visibly, but they still have issues behind them that they haven't changed. Right. They still, they still promote the inch of my messaging, which is where the problem is. So you can change the face. But if you don't change the core, it's a, it's an issue. And that's what the compass program is trying to do. We're not just trying to change the face for people to have the right words so that if the media shows up or someone comes to work at head and we have like this canned phrase of how we're an anti-racist organization and everybody believes that, but we're truly trying to get at the core of people so that they own it and that they live it in all elements of their life. Cuz that just makes it easier to come to work and be that way instead of having to force yourself to be that way. You're just naturally that way.

Speaker 2: 43:26

Right. And I'm privileged that I get to do the, the, the, the health equity, um, program at Hennepin, this compass program, along with a lot of my other colleagues. I, and um, it's just, again like the, like the talent garden and the black men and black women, youth summits, this is how you do health equity. It seems to me, yeah,

Speaker 3: 43:45

You gotta get in it. You

Speaker 2: 43:46

Do have to get in it. And it's sometimes uncomfortable, you know, and, and exhausting. And, and can I read what you wrote on a, on, uh, about very topic? So yes, I, um, you put this comment on, on a social media feed, you wrote fighting racism, takes every ounce of one's soul. And there will be times when that easy, when the easy path is to stop fighting, you've had a, a hard few weeks and you said these few weeks have been challenging in this fight, but I continue to remind myself of why I must go on. This is why I don't do this for me. I do this for my children. I do this for all those who need me to keep doing this work. I will keep going, even when it is hard to do so, it is what I signed up for. How do you carry on, how do you get the strength as a black woman who, with your lived experience, how do you have the strength to continue to fight? What must seem like an endless battle?

Speaker 3: 44:43

You know, uh, I, I think it's probably the mantra of every black woman that we, we always have had to have the strength. We just always have had to have it through our entire existence. It is the burden that we carry as a result of being born black and female. And the difference is, is that most of us carry it for our families. We're the biggest advocates. We're the ones who fight the most when our kids are in school and we come back and we try and challenge the systems. Few of us choose to take it at a big organization or national level, um, because it is hard. It is very hard. And, uh, I think it takes an extra amount of strength, uh, and E Mo intelligence to take it to that next level. And I know that I, I speak for just myself as a black woman, who's taking it to this level. I know the reason why I'm able to move forward is because I have so many people who I can fall back on when times get rough, that help to continue to, to bolster me and keep me moving on the path that I know is the right path. And, and I have some really good self all techs of kniting and drinking wine and dancing, right. And

Speaker 2: 45:56

Baking

Speaker 3: 45:57

And baking.

Speaker 2: 45:57

You're a professional baker. I didn't mention that in your

Speaker 3: 46:00

CV.

Speaker 2: 46:01

Yes. Uh, Dr. Cedars from is indeed a professional baker. And I have been the very fortunate recipient of some of your, uh, uh, baking products.

Speaker 3: 46:10

Yes, yes, yes. So, you know, you gotta have some really good strong, like self care tactics as well when you do that. Um, but it, it, it really is. I mean, my, my children are mixed. My husband is, is weight. And, um, so it's an, it's an interesting space to also say that I'm doing this for my children, because oftentimes my children don't really understand yet what it means to, to be black in America, cuz they visually see themselves different than me and different than their dad. But they don't understand that even though they are lighter than me and a little darker than their dad, they're still considered black. Right. They're very literal at this point. And so six year old and a three year old, very literal. Uh, so, uh, it's, it's a challenge to have these conversations, especially with my son about what it means to be a young black boy. When all of his friends mostly are white boys and there's a difference between what they can do in their house versus what we can do, what they can do in the neighborhood versus what we can do in a neighborhood. And it, it breaks my heart every time I have to have this, cuz I think I kill a little off of his innocence every time I have to have these conversations, but it's required to keep him safe and required to keep him alive. So I'd rather him grow up a little faster and stay alive than to try and protect his innocence. And then something happens to him and he

Speaker 2: 47:33

Dies and every black mother's had to have that conversation heaven. Yes.

Speaker 3: 47:37

Is that right? And that's part of the extra strength that we have to do. So when I, when I take that strength into the workplace, I see all these other mothers and fathers trying to figure out how to best just live their lives so they can go home and keep treating their kids how to be better and live in this world. And I just, I have to make it better if I can do anything, I'm gonna try it. I can't be a sideliner I've never been good at sitting on the sideline. Yeah.

Speaker 2: 48:04

You don't strike me as that. You are ever one who sits on the

Speaker 3: 48:07

Sideline. No, but I can't, I'm all always, I've always been one who has no problems speaking up and, and speaking truth to power again, I've authority figures never really bothered me. So did you get

Speaker 2: 48:20

That from your parents? Why'd

Speaker 3: 48:21

You get that? Yes. With a, with a scientist dad and a early childhood mom. I said that I grew up with logic and illogic as my, as my path. So I couldn't do anything but become a philosopher. And, and, but why was always my favorite words to say?

Speaker 2: 48:38

Why, why, why? Well, can I just, um, say, uh, thank you for coming into my life. Um, thank you for your work that you are doing at our organization, but in this country that I can't think of any more important work in healthcare than the work you are doing. And you keep our organization honest, you speak the truth and you've taught me so much and I know you're doing, if, if you've not just me, for everyone at our organization and everyone that you touch, I think there couldn't be much more important work. Thank you for keeping fighting, like you said in your post, thank you for your, for

Speaker 3: 49:09

That. Thank you so much. It's so important that we talk about these and thank you for the opportunity to have initial discussion. I'll come back.

Speaker 2: 49:15

Yeah. I would like to have you back. We should have a recurring series on this topic. Uh, not just one time, but we should be having this conversation repeatedly. So I've been speaking with Dr. Ne Edstrom about race and racism and healthcare and about her own story and about what the work she is doing at Hennepin healthcare here in downtown Minneapolis to fight racism. Thank you to her for doing that. Thank you. All of you for listening to this episode, I hope there has been some things here for you to contemplate in your own life. Maybe you've been inspired by Dr. Edstrom as have I. Thanks for joining us. I hope you'll join us for our next episode and in the meantime, be healthy and be well.

Speaker 1: 49:58

Thanks for listening to the healthy matters podcast with Dr. David Hilton. For more information on healthy matters or to browse the archive, visit our website@healthymatters.org. And if you have a question or comment for the doctor, email us@mattersathcmed.org, or give us a call at six one two eight seven three. Talk to catch all the latest from Dr. Hilton and the healthy matters podcast. Follow us on Twitter at Dr. David Hilton. Finally, if you enjoyed this podcast and would like to support us, please leave us a review and share the healthy matters podcast with your friends and family. The healthy matters podcast is made possible by Hennepin healthcare in Minneapolis, Minnesota, and engineered by John Lucas at highball executive producers are Jonathan Comito and Christine Hill. Please remember we can only give general medical advice during this program. And every case is unique. We urge you to consult with your personal physician. If you have more serious or pressing health concerns until next time, be healthy and be well.