In this presentation from April 7, 2021, Winfred Williams, MD, and Jamil Sulemana, RN, BSN, discuss kidney disease in the black community, the differences between dialysis and kidney transplant, and when one should consider kidney transplantation.
How much awareness of diversity was there when you first came to Mass General?
The concept certainly wasn’t popular like it is now, but (when I arrived) it was the tail end of the civil rights movement, so there was lots of action to get more people of different backgrounds and to try to make sure there was fairness and more patient participation as part of the culture of the times. The fervor was countrywide, but the city (of Boston) had been pretty open for much of its long history.
Boston lost a lot of its reputation during (the 1970s and 1980s) because of highly publicized negative events like the busing (crisis), and it’s never regained the position it had during the 1940s as a bastion of liberality.
But even when it lost its reputation, it was still ahead of the curve. Certainly when I was in college and medical school, it was ahead of other places. The first blacks at HMS finished before the Civil War, (and) there were females at HMS in the 1940s. So the city—the university specifically but also the city generally—has been a bastion of liberality. Social action groups are commonplace here, maybe more than some parts of the country. Academia was included in that it was never permissible to be hurtful or even mean-spirited.
What was the atmosphere within the psychiatry department specifically when you came?
They were making a conscious effort at that time…to be more diverse. Leon Eisenberg was the chairperson. He himself was an extreme liberal…and so he brought in blacks and women, and he fought hard in the medical school to bring more students of color. As with all of these things, I think you have to have some advocates who put a lot on the line from their own personal resources. (Eisenberg) talked about (these issues) all the time, fought for them in conferences, and brought in people to back up his feelings. Certainly there have been other places that had female residents and black residents, but he made a more dedicated effort and had probably more people (of diverse backgrounds) at the same time and at different ranks. He had residents and faculty and he had staff people, secretaries in the wards and such.
Could you tell us about your own experience as a minority?
(Growing up) in the ’30s, I was taught to be prepared for things that I had never seen. Compared to, say, a black man who’s now 25, I thought much more about my color and limitations it would bring me than he would. And (that) might be a good or bad thing. I can remember there were periods of my life when I probably couldn’t go 20 minutes without thinking something about my race. It never left me. I was always aware of limitations and dangers it posed.
Negotiating as a black in a white world would obviously take lots of adjustment and accommodation. And there must be so many things I do naturally, borne out of experience that I couldn’t elaborate, because from the time I can remember, I’ve always been a black minority person surrounded by mainly whites. And I was taught lots of things to prepare for the evils of a white world. There are advantages to being colored. I’ve seen many. And I know that a lot of blacks feel like I do, how glad we are that we’re black, because we have a cause to live for. We’ve always had things to fight for; we had a culture which is widely imitated. Others want to be like us. …(But) I think it might be a false position to underappreciate the fact that you still recognized as a demeaned member of a social class. If you don’t recognize it and understand it, you’d be in for surprises. The world isn’t quite that good yet that a person won’t have some nasty things happen to him (because of his race).
I wonder whether it’s good or bad (consciousness of race). Some of the things I was taught probably wouldn’t be wise to teach people now. But on the other hand, some (of them) might be—I don’t know. A child of today might think it’s very strange to talk about interracial marriage, because all around we see more and more of it. It’s always been going on, but much more so now than in 1930, and it is accepted with less comment. So with a child growing up today, is it even necessary to talk about it? If you do talk about it, you might be doing (that child) a disservice, because the different set of circumstances under which he lives. He couldn’t see the way I could in the 1930s the disadvantages that the child of an interracial couple would have. So if you talk about (interracial marriage), are you perpetuating something that’s not necessary? But if you don’t talk about it, are you making him less prepared for the existence at some level, even unconscious, of the fact that he’s probably not going to be treated with the same equality as a white in any given situation?
How does the department now compare to the department then in terms of diversity?
There are certainly more black females and certainly more women now, but of course there are more women in the profession in general and specifically in psychiatry. But there hasn’t been a great influx. People have other opportunities, so there still haven’t been very many blacks at the professional level who have finished (training) or who want to come here (for training). I don’t know about Latinos and Asians.
(There is) a wider and more sincere acceptance of difference (now). I think, as with everything, people get used to it. They don’t know what the previous history has been. What they’re seeing is how they think it’s (always) been. It certainly is different now. Nobody’s surprised to say they have a chief who’s female or if someone announces that he or she is gay. (For) a little girl in kindergarten now, it won’t be anything to go to the wedding of a same-sex couple.
By any definition, this has been a very welcoming place (for me). I haven’t had any negative experiences or feelings that I was underappreciated or overworked. So for me, it’s been a blessing to work here. I didn’t feel any direct barriers that prevented me from doing things. All the leaders in the department since I’ve been here have been aware of these (diversity) issues and fair-minded and progressive about them, and that’s saying a great deal.
How can the difficulty of recruiting blacks to the department be addressed?
In any kind of professional academic endeavor, the pool (of blacks) is very small. I would hope that the numbers (in the department) would begin to reflect the ratio in the population between whites and coloreds. That’s a long way from what has happened. There hasn’t been much progress even in a place like this. (But) that’s not this hospital’s fault. It’s a social issue.
I don’t know what the department can do (on that level). They can’t make black grade schools better. Kids are going to be beset by problems of hunger or broken homes. You want to give hope, but on the other hand, you might make unrealistic hopes, and that might not be a positive. I know a lot of blacks who think that the important thing is to get as much education as you can get. But for some kids, to ask them to think about going to college, it’s as likely they can do it as going to Mars. It’s a societal problem. In some ways I guess society has done well considering what it’s up against. Still, that’s what I would feel would be the goal, when a colored person wouldn’t have to give any thought to the color of his skin.
What do you think the diversity center can or should do?
I think you have to have a realistic goal. You put a brick in the wall, but you don’t put up the whole wall yourself. Right now almost anything that’s done would be a gain. I would hope the center would get a lot of research done about the origins and the effects of the negative aspects of diversity: unconscious actions that define lots of colored-to-white interaction and that make life more difficult—and I think shorter—for coloreds. I don’t know if the diversity center can do anything (to directly reduce those effects), but it can raise consciousness.
About Dr. Pierce
Chester M. Pierce was a professor of psychiatry at Harvard Medical School and professor of education at Harvard University. He also served on the faculty of the Harvard School of Public Health.
He was a senior psychiatrist at Massachusetts General Hospital, where he spent much of his career. He was also a psychiatrist at the Massachusetts Institute of Technology for almost 25 years. Dr. Pierce was revered by his many students of all backgrounds and ethnic groups as a brilliant, scholarly, kind, and humble professor who brought great dignity and honor to his profession and the Harvard community. He was a visionary pioneer in the field of global mental health. His wisdom continues to guide us today.
- Feb | 26 | 2021
Employees were invited to celebrate the virtual launch of Black Excellence @ Mass General Brigham. The group provides a new affirming space for Black employees to create a community of support to encourage the welcoming, success, and advancement of Black employees at Mass General Brigham.
- Feb | 25 | 2021
Black History Month 2021
- Feb | 4 | 2021
Mass General staff had the opportunity to take part in three virtual celebrations to honor of Martin Luther King Jr. and illuminate his goals of racial equity and justice. Leaders reflected on King’s emphasis on equity in health care as a racial justice issue.
- Feb | 4 | 2021
In January, Mass General staff had the opportunity to take part in three virtual celebrations to honor of Martin Luther King Jr. and illuminate his goals of racial equity and justice.
- Staff Story
- Jan | 14 | 2021
In recent webinars entitled “Blindspot: Hidden Biases of Good People,” more than 1,300 Harvard faculty and others tuned in to hear from Mahzarin Banaji, PhD, professor of social ethics in Harvard’s Psychology Department.