President's Letter, August 11, 2021, Benjamin F. Roy, M.D. August 11, 2021 Part 1 of 3.
It has been a long journey from desegregation to where we are in medical education and as medical professionals. We are in an intellectual war with philosophy. There are no inherent human rights but privileges defined by law and wealth; a government can choose whom it wants to protect, whom it does not, and sadly there is even worse. Too often, Western education descends from eugenics . Too often in the segregated educational system, pre-school ridiculed children who did not have a majority culture name or sound differently when they spoke with the vernacular of the family that raised them. Elementary school labeled imaginations and turned non-adhering learning styles into disorders. The education system tried to conform learning to something more acceptable while shaming the same creativity that formed the child. If a child dared to falsify a teacher's argument and defend against a more powerful adult, the child could be labeled as a problem or oppositional defiant.
In high school, counselors often invalidated dreams and steered the student below their potential. Decisions were based on past performance that did not look at an adolescent's strengths and gifts that were non-conforming to the majority culture. Unlike so many others, intellectuals who believed in themselves did not listen, stayed defiant of what others said, and pressed through to college, where sadly, many faced much of the same scrutiny. In suddenly integrated medical schools, students faced judgment that they didn't deserve to be there. The student on the right believed that you wouldn't be there without affirmative action, and the one on the left thought bitterly you were taking the place of someone who better deserved to be there, even though you earned that spot without affirmative action. Many were finally getting the opportunity that was denied to many others. Residency training which was your first professional interaction with the public, focused on your hair, cornrows with extensions, and that afro for fear white patients would be afraid because you didn't fit the corporate look of a physician due to your non-conforming dress or attire. Much of this had little to do with making a statement and more to do with being Black or, essentially, not White. As an attending with your newfound hierarchy status, you tried to remedy inequities and transform care, but the pressure of lies and entrapment to establish reasoning to question your qualifications despite your level of equivalent training. Once, there was a thriving independent black education and healthcare infrastructure for those interested in medicine . The Flexner Report eliminated nine black medical schools  and abbreviated the number of interns needed to staff the 128 black hospitals at the time . Among these were Homer G Phillips Hospital in St. Louis , Provident Hospital in Chicago , and John A. Andrew Memorial Hospital at Tuskegee  that provided physician and nurse training and cared for African Americans excluded and disabused by segregation. The Hill-Burton Hospital Construction Act of 1946 retained a separate but equal basis of hospital care, siphoning black patients into white hospitals but denying admission privileges to African American physicians. The National Medical Association (NMA) advanced the notion that health care is a right. The NMA opposed the American Medical Association and advocated for the failed National Health Bill of 1939 . John Kenney, MD, President of the NMA, posed questions that addressed the social engineering of the social determinants of health, which was anathema to organized medicine :" Every negro doctor, negro lawyer, negro teacher, or other" leader" in excess of the immediate needs of his own people is an anti-social product, a social menace." Continuing legislation slowly dismantled black hospitals that are gone and forgotten. In 1969 a group of psychiatrists created the Black Psychiatrists of America (BPA) to confront the racism that impacted their colleagues and patients. The BPA was not about self-interest but protecting patients' and psychiatric professionals' hopes and dreams from assault. A safe haven was formed to further the unmet needs of Black mental health.
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