Learning, Unlearning, and Learning Again

Author

Vincent Tang | University of Toronto, Class of 2021

I was born in Canada, but I didn’t grow up here. I spent most of my formative years growing up and being educated in the Southern United States. Where I lived, 90%+ of the student body was white and 95%+ of the teachers were white. As a young, gay, Chinese-Canadian/American boy trying his best to fit in, I remember being pigeonholed into being a “model minority”. I was “smart”. I was “good at math” and “hard-working”. These were characterizations I was quick to accept, because it seemed to me to be a requisite to building connections and making friends at the time.

Over time, even though I was one of only a few people of colour in my schools, I began to make friends and find that sense of community that I yearned for after having been uprooted from what I knew as my home in Canada. But despite finding my place in this predominantly white community, I never felt like I belonged. I was often shamed for the lunches my mom would pack for me. Occasionally, my peers would yell racial epithets at me and gesture towards me with squinted and narrowed eyes. I was always reminded that my acceptance into these groups was precarious and conditional.

But regardless of my own experiences with racism and discrimination, what I didn’t realize then was that, despite everything, I was being enculturated with the racism of white supremacy. When I learned social studies in middle and high school, I was reading textbooks approved by a government made up predominantly of white people and written by white authors. My only view into the “other” was through events such as the Civil War in the 1860s, where white people are portrayed as the saviours of slaves. I was constantly surrounded by white people, and so I had internalized what was “socially acceptable” from their point of view.

When I began to transition from high school to university, I noticed that I felt more comfortable when I was surrounded by white people. I had begun to view people of colour, including other Asian and Chinese people, but especially Black and Indigenous people, with an innate heightened suspicion, based on how I saw my peers and my family interacting with them for years. Without me even knowing, white supremacy, anti-Black, and Indigenous racism had interwoven itself into every fibre of my being.

The indoctrination of white supremacist ideologies is insidious and instills within us a certain set of beliefs and stereotypes that becomes tied to our identities. We begin to turn a blind eye to the prison-industrial complex and the policing and mass incarceration of Black people because it doesn’t directly impact us. We make excuses for our own biases by saying we cannot be racist because we have lots of racialized friends and they are all “good people”. When we watch yet another news story of the police shooting someone, of which the majority have been Black and Indigenous peoples, we begin to make rationalizations as to why the police committed those acts “in the name of public safety” and “law and order”. We never think to take a step back to question the origin of our beliefs and we learn to simply accept the world for how it is. Especially for people of colour, we think we can’t be racist or discriminatory towards others because of our own identities and our own experiences with racism – only to not realize that we use those justifications as excuses to absolve ourselves of doing the deeper work of being truly anti-racist.

Medicine is a societal institution that likes to hold itself up as a progressive bastion of social change – at least to those inside its walls. But unfortunately, medicine is not immune to these tendencies – if anything, medicine serves as a perpetuator of the everyday stigmas and structural inequities that we so easily ignore. We learn that “being Black” is a risk factor, but the same clinicians we look up to don’t explain the why. They don’t explain how centuries of systemic discrimination, socioeconomic inequalities, and barriers to care contribute to the pathology we see. No one speaks about the history of experimentation on Black and Indigenous people as the foundations for our medical knowledge today. Social constructs are conflated with biological risk factors in teaching, in exams, and thus, in the way we approach the patients we see in our shadowing opportunities and clinical rotations.

When schools attempt to make efforts to teach from an equity and justice lens, these concepts are taught as theories only, without any connection made to medicine and our clinical work. We’ll spend one hour talking about social justice and being culturally sensitive and three hours talking about medicine and science, only for the medicine and science to make up 100% of our examinations. And so, when we encounter the topics related to the social determinants of health again, we tune ourselves out, since these topics won’t help us on our exams. The social history is only emphasized in specialties that perceive themselves to play a significant role in SDOH, such as family medicine and psychiatry, but certainly it should also play a significant role in other specialties too. When we, as medical learners, encounter microaggressions or outright racism in our clinical work, we’re taught to be quiet about it, lest we be marked as unprofessional for speaking out.

I’ll be the first to admit that I’m not perfect and that I still have lots of unlearning and learning to do. It’s taken years for me to work through my own biases regarding anti-Black and Indigenous racism, and it’s work that continues as I write this. When I feel myself getting defensive while having a conversation with someone or when I read or watch something, I have to take a step back and remember: this isn’t about me; this is an opportunity for me to learn and to continue to work on untangling the threads that have bound me and my thinking for so long.

As medical students and future medical professionals, we have a professional and moral obligation to do this work, to educate ourselves, and to understand the violence that the medical community and society writ large has and continues to inflict on BIPOC communities. Medical institutions continue to ask BIPOC to do the work of educating their peers as to their own experiences, to continue to pay an emotional labour tax without the guarantee of any change. While we need to continue to amplify BIPOC voices, we cannot expect BIPOC to constantly educate us. The act of asking them to relive their own traumas day in and day out in a display for our own education is an act of racial violence. We must stop labelling ourselves as being “progressive” simply because we are in medicine and recognize that simply by being in this field, we inherently have accumulated metric tons of societal privilege and a history of discrimination and racism.
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As a profession entrusted with safeguarding the lives of others, we can no longer stay silent. The society we’ve lived in, some of us comfortably and some of us not, has regardless inflicted traumas on communities that stretch back generations. If we can sit back and accept that, it’s a sign that we have more work to do. Black Lives Matter.