by Kelsey Hamlin

“It started with medical student activism,” said University of Washington Assistant Professor Frederica Overstreet.

Over the course of one academic year, UW medical students formed Students for an Anti-Racist UW (SARU), School of Medicine.

Where it began

There was no particular incident that spurred the formation of SARU but, rather, a collection of individual experiences.

“Our school has not really addressed how race will impact health, patient outcomes and treatment provided by physicians,” said Stephanie Han Yu Liou, a second-year UW med student.

For her, one incident of institutional racism happened in an ethics class. They were discussing a case in which a young Black patient was suffering from sickle cell, an extremely painful disease, and had asked for a higher dose of morphine than expected.

“There was this really deep level of discussion about drug-seeking,” Liou recalled. “Comments were made about his lack of parental accompaniment. Someone suggested doing painful things to him because they didn’t believe he was really in pain.”

It was then that Liou raised her hand and asked her classmates if they would treat a middle-class lacrosse athlete the same.

“Some people were really upset and felt like I was trying to make it about race,” Liou said, “which is interesting because I didn’t say the LaCrosse player was White — and, also, it is about race.”

Many students, according to Liou, felt she was trying to race-bait the class, and make people feel guilty for being White.

“I know my classmates are intelligent and compassionate people,” she said. “So it’s not a matter of capacity, but a level of exposure and expectation.”

This issue balloons whenever exposure and expectation remains undefined and, furthermore, considered optional.

Another UW medical student, Annie Young, experienced institutional racism in an ethics class. This topic, however, centered on the unforgettably horrid Tuskegee trials. The infamous clinical study conducted by the U.S. Public Health Service studied the natural progression of untreated syphilis in rural Black men under the guise of offering them free health care.

“We had an hour class in ethics,” Young said, “when race and racism wasn’t mentioned even one time.”

When Young and others were subsequently frustrated by the white-washing of the curriculum, the classroom environment and their classmates’ reactions became very negative.

“Some of our classmates have a lack of racial literacy and a lack of willingness to learn about privilege and social determinants,” Young explained. “The sense is it’s not important or relevant to medicine.”

Following the conflict, an anonymous letter was sent to SARU threatening to shut down the group, and called their actions inappropriate.

“The classroom environment that was predominating at that time, and is still, allows a threatening letter to be sent,” Young contended.

SARU in the UW context

Within the university, the discussion of institutional racism is nothing new. The UW’s own School of Public Health coincidentally had its own slew of action and discussions, which were actually not intended to be in tandem or in connection with SARU’s plans.

“Students are increasingly aware of demographic mismatch between medical school matriculants,” Overstreet said, “and the increasing diversity in our country.”

Overstreet added that there’s even more complications: gaps in one place’s health performance by race (like infant mortality rate, and life expectancy) are mirrored in enrollment demographics and educational disparities in public schools.

Even while there has been an increased enrollment in Asian and International demographics at the UW, Latino, Black, Pacific Islander, and other communities of color have remained consistently low.

For the past three years, the break down of new entrants into the University of Washington Medical School has been approximately 1 percent Black, and approximately 5 percent Hispanic.

“It’s not representative of regional demographics,” Liou said, “and I think that is noticeable when you’re in the hospitals…and everybody’s white with an Asian person sprinkled in here and there.”

Liou herself is a Taiwanese American. She additionally notes that the UW’s faculty also noticeably lacks diversity.

“It’s challenging because you have to be able to talk about it in a way so as to not say ‘oh, these people don’t deserve to be here,’” Liou explained, “but it’s a necessary conversation.”

The Call to Action

What began as an approximately five-person group of UW medical students turned into a larger one led by more than ten core members in a matter of months. These activists focus on racial issues within their own departments, while also trying to keep up with the intense demands of their own medical school education.

Since SARU’s fruition, the group has planned to have a call to action within the medical department for students, administration, staff and faculty. That plan became a reality Wednesday evening, May 24, where alumni, faculty, and students spoke.

Overstreet was one such faculty speaker. She led a discussion that reviewed statistics around health disparities and diversity in medical education and academic medicine. She also defined racism and explained how it operates.

But beyond her discussion, she wanted to point out the line students are forced to tote, calling it “politically tricky.”

“They are in the position of having to be passionate and respectful at the same time of different worldviews,” Overstreet explained, “while hoping that they will engage their peers who may be at a different point of their journey in understanding inequity and injustice around race.”

The challenge, according to Overstreet, is motivating other students while respecting the inherent vulnerability students of color have. Those can be the very same students who are just trying to get through, and don’t want to make waves.

“Which, of course, is how institutional racism operates,” Overstreet said. “How do you balance the way each institutional system operates and make change at the same time?”

While there is undoubtedly a lot of pressure on the students, they are turning pressure toward administration. SARU put forth a petition enumerating the action for administration to take. As of Friday night, the petition had 248 signatures.

The CEO and Dean of the UW School of Medicine, Paul Ramsey, agreed with all of the points brought forth during the Call to Action, and even recited the points back to the crowd in affirmation. Ramsey also said he will require all deans and all of the 30 department chairs to attend Anti-Racism Education Trainings. To lead the work, Ramsey assigned Carlos Pellegrini, the UW Chair of Surgery.

“It’s their job to show how it’s important,” Young said, addressing the need for race and racism to be discussed in a frank and honest way.

But Liou’s question still remains of her medical field:

“What’s the responsibility of our faculty, and administration? Is there a minimum standard of education about race and racial issues that needs to happen in order to meet our occupational duty?”

Kelsey Hamlin is a journalism major at the University of Washington, planning to double-major in Law, Societies & Justice (currently her minor). She has worked with various Seattle publications and just finished an internship with The Seattle Times as an Olympia legislative reporter. Currently, Hamlin is the Vice President of the UW chapter’s Society of Professional Journalists, and is elected to become the chapter’s next President. See her other work here, or find her on twitter @ItsKelseyHamlin.