1/ Beginning of a long thread.
Yesterday a CBC report noted that myself and a surgical colleague reported the hanging of a noose in June 2016. Thank you to everyone who has sent me supportive messages and phone calls since the story was published. It means a lot.
Yesterday a CBC report noted that myself and a surgical colleague reported the hanging of a noose in June 2016. Thank you to everyone who has sent me supportive messages and phone calls since the story was published. It means a lot.
2/ I have spoken out about racism, discrimination and bias for almost 20 years. There are many within AHS that have championed this message, including our CEO who amplified this message (and me) both when she was over PPIH and in her current role.
cbc.ca/player/play/24…
cbc.ca/player/play/24…
3/ I want to share with you the conversation I had with my 12 year old daughter last night. In it I shared my truths, and together she helped me arrive at some worthwhile insights. As she told me, “Dad you’ve always said things clearly to people. Why stop?” She’s right of course.
4/ For those who’ve never submitted a serious concern to AHS or other governing body, this may educate you. For those who have, this may remind you.
Reporting a serious concern is very scary. Even for me.
Reporting a serious concern is very scary. Even for me.
5/ I sit on several national boards. I’ve been an elected regional rep at @albertadoctors for years.
I’m male, straight, tall and have a college degree. I’m wrapped in many types of #privilege.
I’m male, straight, tall and have a college degree. I’m wrapped in many types of #privilege.
6/ But if I’m being completely honest with you right now, as an Oji-Cree, Métis and Polynesian person, I have always remembered that all that privilege can be stripped away in a moment. This is systemic racism in action.
7/ I don’t blame systemic racism on any individual person, but this the lived reality of a racialized person. It’s something I’m keenly aware of every time I speak up.
Some privilege is permanent. Some can be stripped away. The privilege I’ve aggregated over years is the latter.
Some privilege is permanent. Some can be stripped away. The privilege I’ve aggregated over years is the latter.
8/ I have spoken up as a president of the Indigenous Physicians Association of Canada. I have spoken up as an expert witness at parlimentary hearings. I have spoken up to politicians, colleagues, etc. But in the moment I reported this event I was very afraid.
9/ Theres an acronym called DARVO. Deny, Attack, Reverse Victim and Offender. I have seen it in action many times, in racialized situations beyond just health. It’s what I grew up seeing. It’s what I’ve seen as a grown up. Even though #blm and #idlenomore gives me hope...
10/ ...I still worry it will happen to me.
This is a major reason why racism is reported at lower levels than it likely occurs in most systems, not just health. We’re afraid of being DARVO’d. Our privilege does not protect us from this because it’s not permanent.
This is a major reason why racism is reported at lower levels than it likely occurs in most systems, not just health. We’re afraid of being DARVO’d. Our privilege does not protect us from this because it’s not permanent.
11/ All those layers we’ve built around us as protection can be peeled away by the systems we live in.
This what makes systemic racism systemic. Behaviours that are abnormal become normalized, systems where racism is systemic interrogate and discredit the reporter.
This what makes systemic racism systemic. Behaviours that are abnormal become normalized, systems where racism is systemic interrogate and discredit the reporter.
12/ Again, this comment is not focused at any single individual. This is just how systemic racism works. Its how it sustains itself and resists change.
13/ Systemic racism is not specific to AHS.
All systems built within settler-colonial societies have issues with systemic racism. We inherited and will pass on these problems to later generations without understanding and treating these issues.
en.m.wikipedia.org/wiki/Settler_c…
All systems built within settler-colonial societies have issues with systemic racism. We inherited and will pass on these problems to later generations without understanding and treating these issues.
en.m.wikipedia.org/wiki/Settler_c…
14/ There are honest efforts to resolve this in AHS. In a system as large and complex, this will take sustained effort and iterative solutions. We are not in a post-systemic racism world. Like COVID, we can relapse after convincing ourselves we’ve flattened the curve.
14/ How do you know racism persists in health? There are racialized outcomes for patients. Every health system in Canada struggles with this. As long as health outcomes remain inequitable, racism exists.
15/ Other -isms like classism, sexism, ageism, exist. When we have equitable health outcomes we will achieve equity and achieve inclusion. Inclusion is the impact of anti-racist actions.
16/ The individuals in any racialized situation are not 2-Dimensional characters, although we may want to cast them that way. As 3D beings there is good and bad in everyone. Certain racist actions are 1D however, clearly good or bad.
17/ Intuitively we all have a sense of this. We have to make societal decisions together of how to respond to these clearly good and bad actions.
18/ Racism is real. It causes real harm to those involved in every context.
Full stop.
There is no harmless racism. Just racism that doesn't harm you personally.
Full stop.
There is no harmless racism. Just racism that doesn't harm you personally.
19/ Racism can be blatant or be hidden in subtext.
If you train your eyes you can see it.
I see patients experience it. I see colleagues experience it. I still experience it, despite my privilege.
If you train your eyes you can see it.
I see patients experience it. I see colleagues experience it. I still experience it, despite my privilege.
20/ A Netherlands study from 2011 by Christiaans-Dingelhoff suggests only 3.6% of patients ever report their negative experiences in healthcare. For those less empowered, I believe this number goes to zero. I also believe this is likely similar to provider reporting rates.
The study.
bmchealthservres.biomedcentral.com/articles/10.11…
The #1 reason why negative experiences don’t get shared is fear of retaliation IMO.
bmchealthservres.biomedcentral.com/articles/10.11…
The #1 reason why negative experiences don’t get shared is fear of retaliation IMO.
21/ As a patient, retaliation is expressed through how care is provided. Being labelled difficult. Tension-filled encounters.
For providers, it’s expressed as being labelled disruptive. Not a team player. Being passed over for promotions. Tension-filled work environments.
For providers, it’s expressed as being labelled disruptive. Not a team player. Being passed over for promotions. Tension-filled work environments.
22/ AHS has a policy for Just Culture. Operationalizing this can still be tricky.
IMO we need a new way to hear these stories. We need to be wary of those that report and racialized individuals being DARVO’d.
IMO we need a new way to hear these stories. We need to be wary of those that report and racialized individuals being DARVO’d.
23/ We also need to discuss these issues in a way that everyone, including those accused, are treated as fully complex, 3D humans while still calling out actions that are unacceptable.
Blame and shame isn’t helpful for system change, though consequences must meet the action.
Blame and shame isn’t helpful for system change, though consequences must meet the action.
24/ It made me sad to report this in 2016.
It still makes me sad to revisit this in 2020.
Thanks again for all the kind messages. It means a lot to me.
For those who are afraid to report, you’re not alone.
Please speak up, there are many of us here to support you.
*End
It still makes me sad to revisit this in 2020.
Thanks again for all the kind messages. It means a lot to me.
For those who are afraid to report, you’re not alone.
Please speak up, there are many of us here to support you.
*End
