Valuing Inclusion
As individuals, we come to work focused on our mission of delivering the most advanced and compassionate care, pushing the boundaries of medicine through innovation and discovery, training the next generation of health care professionals, and making a difference in the health of the communities we serve, locally and globally. For some, the events in the external environment can challenge our focus, especially when what is happening conflicts with our values.
Every patient, family member, visitor and employee who comes to the Brigham should be treated with warmth, dignity and respect. Brigham Health President Betsy Nabel, MD, is proud to reaffirm this as one of our institutional values and invites all staff to share their thoughts about what inclusion at the Brigham means to them, as well as their hopes for a brighter future.
Please note that comments will be moderated. We ask all contributors be respectful and professional when expressing their views. Thank you.
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29 Responses to “Valuing Inclusion”
I have the privilege of leading an organization that is guided by its moral compass. We live our values each day. I want to be very clear that we will not allow anyone or anything to affect who we are – our mission, vision or values – or what we stand for. Brigham and Women’s Hospital will continue to be a safe, welcoming place for all who come through our doors. Racism, hatred and intolerance have no place at the Brigham.
While no one can predict the future, I suspect we will continue to be challenged by events happening in the world around us. Together, we must continue to follow our moral compass and work in unity to deliver on our precious mission for the benefit of our patients, their families, and one another.
— Betsy Nabel, MD, President, Brigham Health
— Wanda McClain, MPA, Vice President, Community Health and Health Equity, Co-chair Brigham Health Social Justice and Equity Task Force
The demonstrations of intolerance that we have all witnessed are meant to incite fear and to cause divide. They are hurtful to experience and can have a deep and threatening impact on many in this country, including our colleagues and patients.
Our departmental and institutional values are such that we openly denounce and take a stand against displays of ignorant intolerance, hate, or bigotry. We are committed to our community and our goal to provide world-class care to our diverse patient population. We provide a safe place of tolerance, unity, peace, and support that allows us to work toward our ultimate mission. Together we will drown out fear and root out hate with the warmth, commitment, dedication, and appreciation we show toward each other and toward our patients. Day in and day out, you carry out one of the most important missions one can imagine—alleviating pain and suffering, and this places you as leaders committed to kindness and respect.
— Daphne Haas-Kogan, MD, Professor and Chair, Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston Children’s Hospital and Harvard Medical School; and Brandon Mahal, MD, Resident, Harvard Radiation Oncology Program
— Antonio E. Chiocca, MD, PhD, Chair, Department of Neurosurgery
— James D. Kang, MD, Chair, Department of Orthopedic Surgery, Brigham and Women’s Hospital; Thornhill Family Professor of Orthopaedic Surgery, Harvard Medical School
— Sabrina Williams, MBA, Interim Vice President of Human Resources, Chief Diversity and Inclusion Officer, Brigham Health
— Terrie E. Inder, MD, MBChB, Chair, Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital; Mary Ellen Avery Professor of Pediatrics in the Field of Newborn Medicine, Harvard Medical School
One of the many things I love about working at the Brigham is that our values are on display every day. We foster a culture of inclusion, professionalism and collaboration. We meet challenges with integrity and transparency, and we infuse empathy into all that we set out to accomplish. It makes me proud to be part of an organization that does such important work in such a heartfelt way.
— Erin McDonough, MBA, Senior Vice President, Chief Communication Officer, Brigham and Women’s Hospital
— Martin A. Samuels, MD, DSc(hon), FAAN, MACP, FRCP, FANA, Chair, Department of Neurology; Director, Brigham and Women’s Institute for the Neurosciences; Miriam Sydney Joseph Professor of Neurology, Harvard Medical School
— David Silbersweig MD, Chair, Department of Psychiatry, Brigham and Women’s Hospital; Co-Director, Institute for the Neurosciences, Brigham and Women’s Hospital; Academic Dean, Partners HealthCare; Stanley Cobb Professor of Psychiatry, Harvard Medical School
My hope is we will lead by taking on the hard work of investing in people, community assets, and institutions that promote an equitable social context for health and, particularly, that we confront social inequities due to racism, income inequality, heterosexism, and other factors.
We should respond to social conditions that affect health with a commitment to “continuous equity improvement.” When crises abate, we must draw from our sense of institutional and personal accountability, loving kindness, empathy, and resolve to ensure we advance equity and do not resume status quo operations.
What does this look like? In part, it means we must partner to build opportunity for employees and patients in our clinics who battle chronic illness alongside income inequality. It means having institutional strategies to support homeless patients in our hospital beds and on the park benches across from the hospital. It looks like having the curiosity to ask patients who they are so we may treat them respectfully along the lines of race/ethnicity, preferred language, gender identity, and sexual orientation. It entails conducting research and cultivating innovation that prioritizes the health needs of diverse groups. It requires us to make continuous improvements to our campus to enhance accessibility for faculty, staff and patients of all abilities. And certainly — it should not need to be said – it means not being timid about opposing the ideologies of the Klan and neo-Nazis when they gather loudly in our public spaces, or when these ideas ooze quietly from our public policies in ways that support the inequities we know damage the strength of our society.
Taking on the social determinants of health, as individual leaders and as an institution, is necessary because it is right and because it invites in the right friends, partnerships, and allies we need to achieve the highest standard of health for our patients, employees and the communities who partner with us. From a purely pragmatic perspective, we will depend on a broad set of partners outside our hospital walls to confront these health challenges — and our payment models are slowly starting to hold us accountable.
As I reflect on what it means to be a leader at Brigham Health, and how to create a culture of inclusivity, I hope we will most of all embrace the chance to change: to have an honest conversation about what we need to do next to promote health, and to dedicate ourselves to new actions that demonstrate our commitment to a continuous process of improving health and all of its determinants.
— Cheryl R. Clark, MD, ScD, Director, Health Equity Research & Intervention, Center for Community Health and Health Equity; Hospitalist, Division of General Internal Medicine & Primary Care, Brigham and Women’s Hospital
— Gerard M. Doherty, MD, Moseley Professor of Surgery, Harvard Medical School; Surgeon-in-Chief, Brigham Health and Dana-Farber Cancer Institute; Crowley Family Distinguished Chair, Department of Surgery, Brigham and Women’s Hospital
I spent a great deal of my career in NYC, such a melting pot of people from different cultures and ethnicities. I believe that my experiences in NY have helped mold who I am as a mother, wife, family member, friend, nurse and professional.
Our work related to diversity and inclusion is now more critical than ever as we see demonstrations of hate and violence towards others. We have a deep responsibility to lead by example, work toward creating not just a tolerant environment but one that fosters an open, active inclusion of all people.
— Maddy Pearson, MSN, MA, RN, NEA-BC, Chief Nursing Officer and Senior Vice President for Patient Care Services, Brigham and Women’s Hospital
Inclusion, one of the core values of this great institution, keeps us on the course of providing excellent care to patients of all backgrounds. It leads to great outcomes of care delivery through collaboration and partnership. Our many best practices and success stories are symbolic of who we are and what we can accomplish. Adopting inclusion as a core value is the right thing to do, from the social justice perspective and also as a smart, proven business strategy.
Diversity and inclusion, if handled well, can unleash the fullest potential of each individual, regardless of race, gender, religion, country of origin, language, and sexual orientation. However, if not managed well, they can be a double-edged sword. When we put people in boxes and see them as representatives of an entire group, instead of as individuals, we fall into the trap of divisiveness and judge others through our own lenses. No one is free from biases and prejudices, but as responsible adults, we can consciously check such tendencies, bad behaviors, and inappropriate and insensitive remarks.
By 2044, minorities will become the majority, according to the U.S Census Bureau. It is absolutely important that we support the recruitment, retention, and promotion of individuals who reflect the populations we serve. Structural changes are necessary; the recent creation of the Chief Diversity and Inclusion Officer position is a great move. Equally important is the behavior change and mindset transformation of each one of us. One way to bring about such changes is through education and calm, honest, introspective, non-judgmental, and conscious conversations about unconscious biases, prejudices, micro-aggressions, race, and racism. To achieve this, it’s essential to create a space where everybody feels comfortable and safe. Since 2013, the Diversity and Inclusiveness Committee, under Nursing and Patient Care Services, has been an incredible platform where people of all backgrounds and beliefs find their voice. Hopefully, such conversations can be expanded to other areas of the institution as we embark on the journey to becoming a fully diverse and inclusive community.
— Yilu Ma, MS, MA, CMI, Director, Interpreter Services
I think about that horror – that Shoah – which should never be forgotten, and look at my children and grandchild and think: That could have been us. I also think, as the Talmud tells us: “Live well. It is the greatest revenge.” And this is what I feel every day I come to work. We at the Brigham are deeply committed to ensuring everyone lives well, is comforted if they are in pain and is respected no matter color, creed or circumstances. Our institutional value of active inclusion of all who come through our doors gives me solace and energy, and this commitment is its own way of protesting what we see is occurring outside our doors. It is the Brigham Way, every day. Again, to quote the Talmud: “Who can protest and does not, is an accomplice in the act.”
— Dinah Vaprin, Director, Communication & Public Affairs, Brigham and Women's Hospital
— Shelita Bailey, Director, Workforce Development and Volunteer Programs
Combatting ethnic, racial and gender disparities is also a long game. I applaud the protesters who appear in huge numbers to shout down the handful of alt-right demonstrators, but the real work ahead lies in removing barriers to equity and taking an active, proactive approach toward building a workforce that is diverse, multi-ethnic and tolerant. This comes down to the “ground game” of recruiting, retaining and advancing minorities, while aggressively countering those elements that would oppose these measures. This will take another kind of activism, and the Brigham, as a premier academic institution, can lead the city and the nation by example.
We looked with pride upon the tens of thousands of Bostonians who came out to protest, sending a clear message to the movement and the nation. As a result of our collective voices, alt-right organizers have reportedly cancelled 67 “America First” rallies scheduled in 36 states. We’ve taken to the streets. Now we need to take it to the halls of medicine.
— Michael VanRooyen, MD, MPH, Chair, Department of Emergency Medicine, Brigham and Women’s Hospital; Professor, Harvard Medical School Professor and Harvard T.H. School of Public Health; Director, Harvard Humanitarian Initiative; Director, Humanitarian Academy at Harvard
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In second grade, my family watched the nightly news coverage of the LA riots after the acquittal of four police officers who had been recorded beating Rodney King, a 47-year-old black man. I remember asking my mother if it was real or a movie. She referenced the ’67 riots in her reply. “This happened when I was a little girl too. I remember the snipers on the roof of 254.” 254 was the number of her building on Prince Street.
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Darren Wilson shot and killed Mike Brown just as I was beginning my medicine sub-internship. In late October, my little brother, sent me a text that said, “I’m in Ferguson. I’m ok. Don’t tell mom.” I probably replied, “Be careful” or something similar. He made the trip from Oakland to Ferguson and back a few times to protest the murder of Mike Brown and subsequently the acquittal of his murderer. I’d watch the news coverage and wait for him to text that he was ok. He took a break to join us in New Jersey for Thanksgiving and I spilled the beans to my mother over margaritas and holiday meal prepping – she cried and told us she’d once dreamt of him dying at a political protest.
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I was two months into my 32nd year when Donald Trump was elected president. I wrote:
I’d witnessed the election of a man backed by white supremacists followed by efforts to legitimize rather than condemn him for the sake of preserving an imperfect political process. I watched as armed white nationalists organizing in our president’s name were offered police protection in a land where a black children have been murdered by police without consequence for the crime of sleeping on their couch or playing with a toy in a park. Hatred had gone mainstream. Then, in an awesome gesture, tens of thousands of people took to the streets of American cities in protest of white supremacy, hateful bans, walls and deportation.
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America’s most recent expression of racially provoked violence came 7 hours into a 24-hour shift, when a speeding car deliberately rammed into a crowd of counter-demonstrators killing Heather Heyer, a 32-year-old paralegal from a Virginia town just north of Charlottesville. Heyer was counter-protesting the Unite the Right Rally, a large white supremacist event organized largely out of opposition to removal of a Robert E. Lee statue. One human killed another and injured many under the guise of preserving history, using freedom of speech as his smoke screen. Why, in 2017 were there people still intent upon reaching back in time to align their ideals with organizations such as the KKK, infamous for their lengthy history of lynching African Americans, and Nazis, best known for the genocide of European Jews?
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Nothing occurs in a vacuum. For each of us, present events play against a backdrop colored by our past experiences. I’ll admit that my past makes it difficult to have optimism for race relations in America. The tides of racism have ebbed and flowed throughout my life, my parents’ lives and my grandparents’ lives — leaving too few degrees of separation between history and me. Yet, I, a black American, still love America despite her imperfections. In Notes of a Native Son, James Baldwin highlights the tension that exists between racial identity and national pride with the sentence: “I love America more than any country in this world, and, exactly for this reason, I insist on the right to criticize her perpetually.” This past Saturday, colleagues and I marched in Boston to critique the parts of America that would allow the resurgence of overt white supremacy. The march was a profound representation of what I love about this country — regular people united, believing that we, as a nation can be better.
— Lachelle D. Weeks, MD, PhD, PGY3, Internal Medicine, Brigham and Women’s Hospital; Chair, Resident Social Justice Committee, Brigham and Women’s Hospital; Member, BWH Social Justice Task Force
Incredible words – thank you for sharing your perspective and story. Lot of pain and suffering, sadly. It’s so important to acknowledge the history, conflict and systems of prejudice in this country. You will be a great doctor with great compassion and empathy – thank you for everything you do.
— Pothik Chatterjee, MBA, Director, Business Development, Brigham and Women’s Physicians Organization
One particular forum I attended made one of the most insightful presentations I think I’ve witnessed. The presenter compared this country to an alcoholic household — whether or not one ever touches a drink, if one grows up in a household where there’s alcoholism, ALL are injured by it, and ALL learn the alcoholic behavior; and the only way to recover is to start by acknowledging there’s problem (that’s why there’s both AA and Al-Anon). Likewise with this country, as you wrote regarding the “two critical moments”: we’ve all grown up in a racist household, and all have been injured by it, and have learned racist behavior. We who are white especially need to face this and focus on how we recover, and how to “make amends”, even if we think we’re not racist. I don’t think we’ll heal if we point fingers at those who are more overt about their racism. We all (that is, especially we white folk) need to figure out how we’ve enabled it. And to resist the inevitable defensiveness, and simply ask ourselves, how do we recover? How do we make things right?
— Mark MacMillan, Grants Administrator, Center for Excellence in Vascular Biology
To me, being inclusive at the workplace means cultivating the ability to look beyond someone’s appearance and age, where they come from and their way of life to what they could contribute in terms of intellect, passion, hard work, experience or specific skills. Also, figuring out how to respectfully communicate with each other despite physical, mental, cultural and socio-economic differences so we can focus on working together toward shared goals.
Inclusivity outside of work would be cultivating the ability to acknowledge different people as they are without any expectation of assimilation or conformity beyond complying with the laws of the land. Also, developing a healthy sense of humor both at the individual and population level so we can laugh at our own quirks as well as that of others provided it is respectful and at the right place and time!
Finally, inclusivity anywhere would mean not looking at an individual merely as a representative of some group while simultaneously being able to acknowledge that the individual’s association to a group (by birth, environment etc) could be a part of his/her complex identity.
Live and let live (without harm to others)!
— Anu Swaminathan, PhD, Director, Scientific Programs & Partnerships, Brigham Research Institute (BRI)
Diversity ensures everyone gets a seat at the table. Inclusion values everyone seated at the table, invites, and welcomes their opinion, point of view and experience in the discourse. We must come to terms with our own implicit biases and continue to ask ourselves, “how am I personally promoting an environment that celebrates diversity and encourages inclusion?” While we may not be able to control what happens in our world at large, we certainly can each do our part to make sure that hatred, prejudice, and bigotry have no place within the walls of the Brigham – not on our watch!
Faith Makka, MSN, MPH
Deland Fellow, Brigham and Women’s Hospital
— Martha Jurchak, PhD, RN, Executive Director, Ethics Service
To me, the most significant measure of inclusion for our organization is increased employment as well as employment advancement for people of color at BWH. A day when we can truly say our organization is truly reflective of our community. I believe this requires us to speak openly and honestly about how our collective history of systemic racism in the United States and how it continues to shape the many institutional systems that work against equity and inclusion.
My hopes for a brighter future draw from the spirit and dedication of the wonderful young people we have the privilege to work with. Over 500 Boston Public School students from the pre-K to the college years we work with at the CCHHE are supported by 300 dedicated BWH volunteers who teach, mentor and support the growth of skills for young people in our local neighborhoods that are so eager for opportunities and have so much to offer our institution and the healthcare field. And as painful as recent events are, these young people will not go backward. They are going forward with a passion, and I am thankful each day that I work in an institution that supports them to do so. In unity we will find strength in in our BWH community, but we must be honest about the challenges we face to make our workplace and nation more equitable for all and have the resolve to work together for sustainable change.
— Michelle Keenan, Director, Community Programs, Center for Community Health and Health Equity
Reading our Community Health Needs Assessment and Implementation Plan (2016) report was heartening and provided vision and direction for our work in our communities- thank-you to the Center for Community Health and Health Equity for leading this assessment and for conducting it in a robust manner. I am proud to work within an organization that strives to address the following inequities-
1. Social determinants of health (employment, education, economic stability, and
transportation)
2. Interpersonal violence and trauma
3. Behavioral health
4. Health equity
5. Healthcare access
I commit to doing my share and look forward to partnering with colleagues throughout BWH to advance this work.
— Annie Lewis-O’Connor, PhD, BC-NP, FAAN, Founder and Director of the Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic, Brigham and Women’s Hospital
To truly understand inclusion, you must first experience exclusion in the most profound way. For those of color this can begin at a very young age.
Initially for me it was the boy next door, whom I adored. He lashed out and called me chocolate face. Now I love chocolate, but even at 6 it was clear that this label inferred something was wrong, and it had everything to do with me. To match his angry rhetoric, I screeched back – strawberry face! He had freckles and I don’t like strawberries, so it seemed appropriate.
I now make light of it, because it sounds so very innocent; yet the impact was huge.
Throughout life I would encounter more attempts of subtle degradation. I was not this or that. I was not white, nor black. Thus, at an early age I came to realize that there are those that must always find someone to look down upon, to make themselves feel, or look better. This is a position noted throughout history, whether it be attributed to race, sexual orientation, class, or religion. It’s all quite ridiculous. It is not something anyone should accept.
To my great fortune, I had wonderful parents. Having been viewed as an interracial couple in a time “less fashionable”, both developed thick skin, but they were never bitter. Instead they taught us to celebrate, embrace and learn from our differences. They taught us not to fear the unknown, but to move toward it with wisdom and compassion.
As a result, I am color blind and character clear. And to my parent’s credit, my family is virtually a rainbow coalition.
My hope for a brighter future, toward inclusion at Brigham, would be to ask others to step out of their comfort zone. Find ways to gain exposure to other cultures, race and religion. I am a firm believer that we have more in common than we could imagine.
— Tracey Martin, Fellowship Program, Emergency Radiology; Former Chair, Association of Multicultural Members of Partners, Brigham and Women’s Hospital