Speaking Up Is Hard to Do…
Today, while I was at work, one of the teachers made a comment about wanting to choose a doctor who had gone to school in the United States. Then, she said “I’m sure that’s biased…” to me in a half-joking kind of way, since I’m the resident anti-bias lady, and I immediately responded, “Oh, that’s okay.” also in a half-joking kind of way.
But then, walking to the train station on my way home, I wondered should I have said something more? Did I miss a teachable moment? What if a student had heard her inadvertantly? How would a child from another country feel about such a statement? Would training in a European country be better than training in an Asian or African country? This brings up lots of questions.
In the moment, I immediately thought about my mother, and how she feels similarly. I started to share that, then decided not to. I think I’m kind of ashamed that my mom feels that way, though she states that her primary issue is whether or not she can understand the doctor’s speech if they have an accent. And I agree that it is important to be able to understand one’s medical care provider. Honestly, I think in my mom’s case it has more to do with having been frustrated about not being able to choose her medical provider due to HMO issues.
In the case of this teacher, I see her being overwhelmed at the long list of providers to choose from, looking for some way to narrow it down. But it does seem problematic to make such a judgment. But what really confounds me is this: when do I decide to speak up about something, and when do I let it go? When is it appropriate? Anti-bias work requires that you generally make an effort to confront bias more often than a person typically would. Now I’m wondering if I should mention it to her sometime.
I’ve spent my life attempting to cultivate some credit as a badass straight-talker who tells it like it is and calls ‘em like I see ‘em. Really though, I’m kind of a wuss when it comes to confrontation. I’ll do it, but first I’ll procrastinate and ignore the problem and avoid it and start to address it and chicken out and dance around it and see if I can get out of it somehow. Then, when I can’t avoid it anymore, when avoiding it will lead to clear and certain disaster, then I’ll deal with it. And of course, after that I’m totally relieved, wishing I’d done it sooner. Life’s funny that way.
But there will always be an excuse as to why I can’t confront bias. There will always be a reason why it seems like the wrong moment. Why it seems like it’s not such a big deal. Anti-bias only works if we stop making so many excuses, bite the bullet, and act. So I think I will say something to her about it. I’m not gonna pick a fight or anything, but I’ll just mention it, find some way to relate it to the classroom setting. This is the hard work, and if I’m not willing to do the hard work, then I have no right to ask anyone else to.
I’ll report back on what happens. Until then…
One of the problems that leads to moments like this is that, to my knowledge, there is, at present, no internationally recognized single standard or guarantee of competence. The core issue which is being discriminated in favor of is, simply put, competence. A lot of people are not willing to take any risks whatsoever with their doctors, whether those risks are real or perceived, because, very simply, they want a guarantee of competence, and the highest commonly accepted guarantee of competence at present tends to be graduation from medical institutions in technocratic, industrialized cultures where the rigor of the scientific method is accorded its dues.
One key, core, indispensable aspect of competence in a medical practitioner is a mastery and complete understanding of the scientific method, and it is a plain and simple fact that, in the present day, certain cultures and institutions foster rigorous inquiry into the mechanics of the physical world and some do not, or do so to a lesser, and less acceptable extent. How long did it take before it was understood that the carriers of bubonic plague were the fleas present on rats and other mammals? How long did it take before it was understood what a bacterium was, and how many types there were, and what they did? How long did it take before the means were present to make an analysis of the chemical composition of aspirin, and to understand exactly why it had the effect that it does? The fact is, in some parts of the world, there are people who think you can cure HIV or AIDS by having genital contact with a virgin girl, that witches can cause diarrhea or drought, that perhaps one could eradicate a tumor with a poultice of peanut butter and some syllables chanted in repetition until the chanter is hoarse. All the understanding, the work and insight that it took to break free from ignorance, this is in no small part enabled through what is valued and esteemed within a culture. (Aside 1: We as a nation are definitely not prioritizing the spirit of relentless inquiry within our educational system– not for everyone, at least. Children are tracked and stratified at a very early age into the prep process for the creator/producer class, the administrative class, the subservient drone class, the minimal skill-set class, etc. etc. etc. Infuriating, yes. A whole ‘nother can of worm-beans, possibly…. certainly a related point.) (Aside 2: Why is it that people talk about “race” when what they really mean is culture? When you confuse the two everything goes to the dogs. One is almost entirely fictional, literally skin deep differentiation, the other is the social construct which governs the very real ongoing process by which we form our own brain connections…. Something we do in fact have a varying amount of control over…. )
Case in point: Not too long ago in our species’ past, there were non-European cultures and institutions which deservedly put the best European doctors and practitioners of “physic” to total shame, because the scientific method of inquiry was cultivated in those times and places and explored strenuously and rigorously in a way that had not yet taken hold in Europe. (Again… culture, culture, culture.) Perhaps the results were not always perfectly understood, but the important thing was the refinement of the process, the method of discovery, the scientific method, the never-ending examination and analysis, the insistence on reproducible results and consistency. That is the thing which allows progress/advancement/developement/evolution…. and it takes time, resources, infinite curiosity, and cultural settings where those things are highly valued and carefully fostered.
(Final aside:) What is unfortunate is that here and now, primarily in the U.S., the educational process that leads to competence is overly profit-driven, which follows directly from the industry itself. The medical establishment makes the argument that cost is a direct function of the practitioners’ competence and the effectiveness of the methods used, with all the time, effort and resources that make that competence and effectiveness possible being implicitly stated. This is partly true, but there is still an overriding profit motive, as opposed to any altruistic motive. There has not, at least in the United States, been enough pressure from anywhere that would force the majority of the medical and insurance establishment to make the profit motive of equal or secondary concern to the welfare of tax-paying U.S. citizens. This is something of the highest importance that needs to be figured out.
(As a final, final aside, I would recommend any books recently written by John McWhorter for some pertinent thoughts on American cultures and the values held within/by them. One is entitled “Losing the Race” and a following book is entitled “Winning the Race”. Both are published by the Manhattan Institute, I am pretty sure. He also tackles the fascinating subject of language and linguistics in other books. He is a professor (?) of that subject at U of Cal., Berkeley. See http://en.wikipedia.org/wiki/John_McWhorter for more complete info.)
| Posted 3 years ago