The power of inclusion: Overturning the ‘white wall’ standard

Have you ever walked down a long hallway in a building and noticed the uniformity of portraits? It is all too common to see older white men lining each and every wall. Their faces prestigiously positioned, glancing down with expressions connoting, “we have completed great work,” “we should be recognized,” “please take notice.”

These portraits acknowledge institutional founders, leaders, and/or influential stakeholders, yet the homogeneity of their skin tone, dress, and demeanor evoke feelings of alienation and attitudes of resignation, especially from onlookers who do not identify with them.

These “dude walls” or “white walls” are the standard among large and small establishments. Unquestionably, these luminaries worked diligently to shape successes and ensure the maintenance of these walls, however it makes one wonder whose visages have been excluded and in what historical context.

As the sole African American pediatric neuro-oncologist in the United States, I’ve walked and run down many white wall hallways. Navigating these corridors during training left me with feelings of discomfort, discouragement, and exclusion. These feelings, coupled with experiences of racism and sexism, undoubtedly influenced my productivity and distorted my view of potential achievements within science and medicine.

Historically, the lack of diverse identities on these walls is attributed to factors based on structural racism, including discriminatory policies and practices; selection and recruitment biases; a failure of early exposure to science, technology, engineering, and math (STEM) education to foster career matriculation and advancement; and inadequate acknowledgement of contributions from underrepresented staff.

I was fortunate to engage in STEM programs from a young age. Yet at every step in my training and career, I witnessed structural inequities. Uneven distribution of resources and damages from everyday insidious biases were reflected in so many ways: the homogeneity of classmates and colleagues; disparities in patient care and outcomes; and a lack of clinician-scientist mentors with whom I could identify. All the while, gazes from these hallway portraits reinforced presumptions justifying my reality.

Since entering the medical field in 2003, I have walked the gauntlet of many white walls to lead difficult patient discussions, engage in faculty chats on research/career aspirations, and quickly grab meals from the cafeteria or doctor’s lounge. During one harried walk, an older white male adviser stated he wasn’t surprised I didn’t do well on my medical exam, because he “expected that from someone like you.” On another stroll down these hallways, while closely caring for a child with a cancer diagnosis, I overheard her parent call a staff member “darkie.”

As their primary doctor, I wondered what they thought of me and the care I provided. To establish a safe and inclusive space, I often sought refuge with support staff with whom I could relate — learning about their families, longevity within the hospital system, and the best places in town to get my hair styled. There were always a few physicians or scientists from ethnically diverse backgrounds with whom I worked during my medical career, and like others before me, I found a small group who aided in my sense of belonging and successes.

Triumphing through these experiences, in 2015 I accepted a physician-scientist position at the National Institutes of Health, leading innovative neuro-oncology studies. Once again, I was one of few clinicians from an underrepresented group. After George Floyd’s murder, several NIH staff discussions centered on improving inclusion and workplace culture. As an NIH Distinguished Scholar, I suggested that employee contributions from different life experiences be recognized in hallway exhibits and wall portraits. NIH leadership resoundingly agreed, and I led efforts to diversify portraiture across campus and in digital spaces.

In November 2021, we unveiled The Power of an Inclusive Workplace Recognition Project (Recognition Project), which included portraits and murals mixed with inspirational quotes crafted by the NIH’s Medical Arts Branch. These walls now celebrate all NIH staff, from varied career paths and self-identities, working to achieve the agency’s mission. Staff members have praised these initial efforts, stating they finally “feel seen” and are energized by engagement to enrich diversity, equity, inclusion, and accessibility throughout the NIH and who we serve.

What does “I feel seen” mean and why is it so important? Being seen is experiencing a close bond or relationship with a person or place. Identifying common ties provides a foundation of belonging and togetherness that motivates positive interactions and potentiates constructive systemic changes. The Recognition Project is just one petite and long-overdue positive step to unburden the NIH staff of visual oppressions. Our efforts join growing social media campaigns (#Wallsdotalk, #ILookLikeASurgeon, #WhatADoctorLooksLike, #DiversityDrivesExcellence, #InclusionMatters, #RepresentationMatters, #BlackIn[field]) aiming to amplify diverse voices. Collectively, this work highlights that although those in underrepresented groups are present in small numbers, contributions from all are welcomed, recognized, and valued.

I will continue to hurry down these hallways — it is part of the job — but I have already noticed I am lighter afoot by being surrounded by more supportive images, which undoubtedly is better for us all.

Sadhana Jackson is a pediatric neuro-oncologist, clinician-scientist within the Surgical Neurology Branch of the National Institute of Neurological Disorders and Stroke, and an adjunct investigator within the Pediatric Oncology Branch of the National Cancer Institute. She co-chairs the T Committee of the UNITE initiative to end structural racism in the scientific community.