Race, Metaphor, and Myth in Academic Medicine
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COMMENTARY
Race, Metaphor, and Myth in Academic Medicine Nicolás E. Barceló 1
&
Sonya Shadravan 2
Received: 15 February 2020 / Accepted: 2 October 2020 # Academic Psychiatry 2020
“The quality of light by which we scrutinize our lives has direct bearing upon the product which we live, and upon the changes which we hope to bring about through those lives.” —Audre Lorde [1] We are currently living in an unprecedented historical time during which efforts to unmask injustice and demand systemic change are far-reaching and unbridled. Corporations and service institutions alike are struggling to conjure up slogans and marketing strategies to align with the righteous demands of protestors and citizens, often times skipping the critical steps of institutional reflection and fundamental paradigm shifting. As advocates dedicated to promoting racial justice in our residency program and medical center, we have witnessed parallel processes in academic medicine—an expressed wish to market diversity without the institutional accountability requisite to promote justice and radical transformation. Throughout our experience as practitioners of equity initiatives in academic medicine, we have encountered many widely utilized metaphors in the Diversity and Inclusion frameworks provided to us—variably by our own institutions, professional organizations, published in our most prominent journals, and by academic medicine’s flagship, the Association of American Medical Colleges (AAMC). While these tools are intended to advance principles of unity and equity, we have been unsettled by the subtle but nevertheless powerful racial mythology they often advance. Many of these frameworks which remain in common use carry an undercurrent which perpetuates racial hierarchies, cultural determinism, and white hegemony. It is our experience that as they
* Nicolás E. Barceló [email protected] 1
University of California, Los Angeles, Los Angeles, CA, USA
2
Office of Diversion and Reentry, Los Angeles, CA, USA
are currently defined, generally understood, and commonly practiced, many “diversity” frameworks used throughout academic medicine and in the clinical learning environment fail to adequately illuminate mechanisms of injustice. Through use of imagery and rhetorical devices that contain racialized myths, these frameworks often propagate the same unjust paradigms they are intended to address. These metaphors are ubiquitous throughout medical education, and their eradication is a matter of joint accountability among all physicians. As psychiatrists, however, we call on our field to catalyze this work, for we believe that our training offers a unique preparedness to consider how cognitive devices perpetuate oppression. Critical race theory (CRT) asserts that racism is ubiquitous, operating through unspoken assumptions, beliefs, and systems. CRT therefore challenges the organizing principles behind these ideas and racialized power relations not only to understand inequity but to eliminate it [2, 3]. In this commentary, we strive to advanc
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