I had the good fortune to speak at the March for Science in Boston over the weekend. The speakers were a diverse bunch, more so than what is reflected in the scientific workforce in the United States at large. That’s a problem for science and medicine.
In my work as a female physician of Iraqi and Iranian descent, I’m intimately familiar with the lack of diversity and the abundance of prejudice in the health care realm. Here’s a story I told at the march about a recent encounter with a patient’s husband after I introduced myself as his wife’s neurologist. “A Muslim doctor? How about that,” he said incredulously. “I hope you’re not one of the violent ones! Don’t shoot me!”
Amid a polarized and tense political climate, it is easy to dismiss that exchange as a “new” phenomenon in the Trump era. But anti-Muslim discrimination in medicine is not a new phenomenon. In 2012, presidential candidate Herman Cain revealed the anxiety he felt when one of his cancer surgeons had an Arab name. Cain was later relieved to learn the doctor was a Christian Arab, and not a Muslim. Surveys conducted in 2013 and 2014, before the anti-immigrant rhetoric of the presidential campaign got turned up to full blast, showed that nearly half of Muslim-American physicians reported feeling more scrutiny at work compared to their peers. One in four said they experienced religious discrimination during their careers, and 1 in 10 said patients had refused their care because they are Muslim.
Just as the presence of anti-Muslim sentiment isn’t new in the hospitals and science laboratories where we work, sexism and racism aren’t new, either. Many female physicians and minority physicians and biomedical scientists understand these experiences. They contend daily with both subtle and more obvious signals of racism and sexism in the workplace. Like me, they are often mistaken for nurses, food service staff, or janitors. In a 2014 survey of 500 female scientists of color conducted by the Center for WorkLife Law at the University of California Hastings College of the Law, 48 percent of black women and 47 percent of Latinas reported having been mistaken for administrative or custodial staff. Muslim female scientists and physicians like myself are especially vulnerable to bigotry, caught in a triple bind of institutionalized racism, religious discrimination, and gender discrimination.
Leading up to the March for Science, a contentious debate broke out about whether a focus on diversity should be a part of the march. Some scientists, such as Harvard cognitive scientist Steven Pinker, discounted the importance of diversity by referring to it as one of “the distractions.” Pinker’s statement undermined the experiences of female and minority scientists and physicians like myself.
Views that discount the importance of diversity and inclusion also run counter to numerous scientific studies showing that having a diverse range of ideas and perspectives breeds innovation and discovery. We are stronger, smarter, and more innovative when we open our doors to those from different backgrounds and beliefs. Taking a firm stand in support of diversity does not detract from standing up for science and research funding; it merely welcomes more scientists to the proverbial table.
The debate about whether to advocate for diversity within the March for Science is emblematic of the burdens placed on women and minorities in the scientific workforce at large. We are expected to advocate on behalf of a community that simultaneously makes us feel undervalued and requires us to continually prove our existence. For example, both women and minorities are less likely to be granted funding from the National Institutes for Health, whose budget is expected to be hard hit by the Trump administration.
At the Boston March for Science, the coordinators took diversity seriously from the outset, as reflected in the speaker list. The emcee of the event was Chiderah Okoye, the president for the Boston chapter of the National Society of Black Engineers, who was recently appointed to the newly commissioned Black Advisory Council for the commonwealth of Massachusetts. Alicia Wooten, who spoke before me, is a deaf PhD candidate in molecular and translational medicine at Boston University and a deaf community advocate.
When diversity is at the forefront of organizational goals, rather than an afterthought, it need not be mired in controversy.
Eliminating bias and ensuring diversity is more complex than simply, in the words of Ta-Nehisi Coates, turning on a magical “Hey Guys, Let’s Not Be Racist” switch. There must be deliberate efforts to bring the abstract to reality. This will be accomplished by committing to specific goals and metrics and encouraging an iterative process with both assessment of and accountability for whether those goals and metrics are met.
Some businesses have recently tied pay and performance evaluations to whether managers meet diversity metrics. Leaders of hospitals and scientific research centers may be wary of being held to such standards, but actions like these demonstrate efforts that go beyond lip service to diversity.
Moving forward after the March for Science, the scientific and medical community must be committed to both learning from and writing the next chapter of its history. This begins with acknowledging that the very real prejudices that exist within our professions — whether along racial, ethnic, religious, or gender lines — did not start with Trump. This is something that has existed within and outside our hospitals, classrooms, and laboratories for decades and is only now getting the attention it deserves peak after years of complacency.
I hope that the march will prompt scientists and physicians to speak out in solidarity with those affected by recent government policies like the Muslim ban and also to recognize that silence implies consent and paves the road for continued and escalating discriminatory and anti-science policies.
The interaction with the patient’s husband who said “Don’t shoot me!” started out poorly, but it ended with a hug. I made a lighthearted quip, gently told him his comment was both inaccurate and inappropriate, and reframed the conversation back to how I wanted to help his wife and focus on the neurologic issue at hand. This is routine for me as I have prepared this answer after previous difficult conversations. If we are both mindful and intentional about including, preparing, and advocating for often-difficult conversations about diversity, we are more likely to set ourselves up for success.
Altaf Saadi is a chief resident in the joint Partners Neurology Residency Program at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston.