23 minute read
A trauma surgeon takes on the public health crisis of racism
A trauma surgeon takes on the public health crisis of racism
BY KAT CARLTON Ask Brian Williams, MD, to identify his defining moment as a trauma surgeon, and, without skipping a beat, he will tell you about what happened in Texas on July 7, 2016. That night, during a protest against police shootings, a man ambushed and shot at a group of police officers, killing five and injuring nine others. Seven of the wounded officers were transported to Parkland Memorial Hospital in Dallas. Williams was the attending on call that night and the only Black trauma surgeon on a team of 12. “At the time of the crisis, I wasn’t giving any thought to the external social political climate,” Williams said. “It was a medical crisis, and I’m a trauma surgeon. This is my job.” After working through the night to save the officers’ lives, Williams had to break the news to three families that their loved ones did not survive. “After talking to the families, I went to a back room and fell to the ground and started bawling,” he recalled. “I do not cry. I had not cried in so long before that, but that night I was crying. It was a perceptible shift in me personally and professionally.” That night and its aftermath led Williams to put down his scalpel for two years to work on police-community relations in Dallas and catapulted him to prominence as a national thought leader on public health and racism. He worked full time as the medical director of a community health institute to address healthcare disparities within Dallas County, and the mayor appointed him chair of the Dallas Community Police Oversight Board. Today he continues his work as a trauma surgeon at the University of Chicago Medicine—and his work to tackle the toll gun violence and now COVID-19 are taking on the Black community. This spring, he’s teaching a course in the University of Chicago Harris School of Public Policy related to violence and communities of color. “When public policy becomes weaponized,” he said, “people suffer. Policy can affect the lives of millions of people per year. What if I could teach what I know to a bunch of public policy grad students with no end goal other than to say here’s my experience, you’re all smart folks going into public policy — you’re looking at this outside of a healthcare lens and can help find some really creative solutions.”
While that tragic and traumatic moment in Dallas looms large for him as a trauma surgeon, Williams is further defined and motivated by the racism he has experienced his whole life, in and out of the workplace.
Racial slurs hurled at him from cars. People asking him outside of a restaurant to park their cars or mistaking him for janitorial staff in the hospital. He and his wife even learned that adopting a baby of color was less expensive than adopting a child who is white.
One day as Williams waited for a car to the airport outside of his apartment in Dallas, someone called the police on a “suspicious Black male.” Officers approached him, asking for identification to prove his residence. His wife, who is white and was not yet aware of the rampant racism that would later come to light in the media, was surprised he complied. She asked him why he did so.
He replied simply, “I didn’t want to get shot.”
From engineering to medicine
Williams, an Air Force brat, moved around every few years as a child and eventually became an aeronautical engineer after attending the Air Force Academy as the first person in his family to go to college.
“While on active duty, I got this bug to go into medicine,” Williams said. “My social circle was all nurses and doctors. I was exposed to these folks talking about their day-to-day all the time, and I thought their jobs sounded great.”
At 28, he started medical school at the University of South Florida, where he did rotations in trauma surgery and surgical critical care. On the second day of his trauma rotation, Williams said, he knew that’s what he wanted to do with his life.
“The pace of the specialty, patients coming in the door near death and the team bringing them back— trauma surgeons seemed like my kind of people,” Williams said. “I enjoyed operating and the fast pace of the ICU, including the adrenaline.”
“ What are the root causes of gun
violence? I see there’s a lot more
than the injury. It’s a complicated
intersection of inequality of
income, of infrastructure, of jobs
and more that’s impacting
communities where my patients
come from. This requires me to go
upstream and see what I can do.”
Brian Williams, MD
Brian Williams, MD, studied aeronautical engineering at the Air Force Academy.
Williams at a memorial set up after the Dallas shootings.
Williams did his internship and residency in Boston at Harvard-affiliated Brigham and Women’s Hospital. Boston is also where he met his wife, Kathianne Sellers Williams.
“One thing about Brian is that he’s very humble,” Kathianne said. “I remember him giving grand rounds as a surgical resident. A lot of the doctors spoke about how they became doctors because of other people in their families who were also doctors. Brian talked about how his father and grandfather were in the military and traced his roots back to the land his family was enslaved on. He’s the opposite of entitled, and I can tell when he’s working on young Black patients, he sees a lot of himself in them.”
She said for much of their life together, her husband has been guarded, hiding potential vulnerabilities from others to build trust and respect.
Press conference in Dallas
The Monday following the police shootings in Dallas, Williams was called upon to participate in a press conference as the surgeon on call.
“I had no desire to relive what happened in front of cameras,” he said, “but my wife told me I had to go.”
Kathianne said that before the press conference, her husband was an especially private person who turned down any kind of public attention. He didn’t want to leave any room for people’s outside perceptions to hinder his progress, so he had no social media presence and even asked her not to post photos of him on her own pages. But something changed in him the night of the press conference.
“My wife said, ‘The country needs to see there was a Black surgeon there that night trying to save those white officers. Just show up and sit there,’” Williams said. “That’s a statement on our society. Just to be seen as a Black man in that situation made a statement.
“I went and was listening to what people were saying. I felt like—this is not what this is about. I felt there was too much being left unsaid. I don’t remember how, but I came to speak. It was unrehearsed, unscripted, the words just came out. I thought to myself, this has to be said right now or it will never happen:
His powerful words went viral.
“I still have a way to go in terms of recovering and understanding what that night meant,” Williams said. “I learned that any one of us can make a difference, even if we don’t think we can, for good or bad.”
When he announced in 2019 that he was moving to Chicago, the Dallas Morning News wrote that Williams left “an indelible mark on police and community relations in Dallas.”
Back in the trauma bay
During Williams’s career, he crossed paths with several members of the team who opened UChicago Medicine’s Level 1 adult trauma center in 2018. While in medical school, he worked with Jeffrey Matthews, MD, Chair of the Department of Surgery at UChicago Medicine. As a resident in Boston, he worked with Selwyn Rogers Jr., MD, MPH, Founding Director of the trauma center. And during a fellowship at Emory University’s Grady Memorial Hospital in Atlanta, he worked with Kenneth Wilson, MD, Professor of Surgery.
“Since I’ve known Brian, he’s gone straight up to being a thought leader,” Wilson said. “The social determinants of trauma and structural racism are clearly not something you learn about in a fellowship when you’re putting an artery back together. He’s passionate about his trauma patients, especially in communities of color.”
Williams was attracted to the job in Chicago by the opportunities to work on a team with four Black trauma surgeons—rare in the field—and to address healthcare disparities and gun violence.
“I was at a point in my career looking at my professional progress and realizing everything that’s happened prepared me for a moment like this,” he said. “It’s not a job, it’s a mission. It’s a life’s purpose.”
The victims of gun violence injuries he sees as a trauma surgeon at UChicago Medicine are overwhelmingly Black. He can’t remember the last time he told someone who was not African American about the death of their child due to gun violence.
“With the volume of gun violence we’re experiencing, there’s a lot of work to be done,” he said. “You
Speaker, writer, thought leader: Williams hosts the podcast Race, Violence and Medicine. His op-eds have appeared in Newsweek, the Chicago Tribune and other publications.
High profile: Named one of Medscape’s Top 20 Black Physician Social Media Influencers. Received a 2020 Black Leaders Worth Watching award from Profiles in Diversity Journal. Working on: Getting his memoir published this year.
Family life: Williams and his wife, Kathianne, have been married 16 years and have a 10-year-old daughter, Abeni.
Music man: Though his wife says he’s not allowed to listen to heavy metal in the house, Williams plays in a band with fellow UChicago Medicine surgeons, though the musicians are on hiatus due to the pandemic. And a bibliophile: Mostly nonfiction and science fiction. “I’m a science fiction geek,” Williams says. “I fly my science fiction flag high.”
A great laugh: “He’s an unexpected person — pensive and serious, but he has a playful side,’’ his wife says. “I love his laugh.”
put me in the trauma center, and I can treat patients, teach residents, do research and easily finish my career that way, but I want to put myself out of a job.
“I’m excited to be at a university with so many resources available that may not be available to other trauma centers. We have the business school, the law school and really smart people looking at the same issues of inequality on the South Side. I can call them up for coffee. The possibility to bring all this together for sustainable change that will uplift the community and have transgenerational impact is very exciting. I really believe in what’s happening here. It’s a historic opportunity. There is no place else on the planet that exists like this for a trauma center. We can solve these problems. It’s a matter of looking at the root causes instead of just treating the wounds.”
Focus on social justice
Williams said he hopes to make a difference on the South Side, starting with talking to a lot of the individuals and groups already working to fight racism.
“The whole goal is to educate, hold a mirror up to ourselves. It’s who we are but it doesn’t have to define us. We can take our shared history of racial injustice and create a more just society,” he said.
He recently oversaw a team of graduate students who completed a capstone project regarding gun violence. “Looking at gun violence through different lenses, on a smaller scale, I’m hoping with these students we can tackle one problem and then figure out how to scale the solution,” he said. “But it starts with an idea on a small scale that we can implement, revise, evaluate. My job is not to give them the answers, but to give them my experience and step out of the way and let smart people do their jobs.”
Williams is an inspiration to the residents he mentors, said fellow trauma surgeon Kenneth Wilson.
“He’s like the Pied Piper for people in this program who want to do social outreach stuff,” Wilson said. “When he takes the podium and starts talking, he’s mesmerizing.”
Last summer, Williams moderated Facebook Live panels with UChicago Medicine’s House Staff Diversity Committee to help educate communities of color about the COVID-19 pandemic. The committee, made up of residents and fellows, provides a forum to learn about advocacy, self-awareness, social justice and intercultural understanding.
“It’s important for members of our community to get important information from messengers who look like them, in addition to seeing how they’re working on fighting this pandemic day to day,” Williams said.
On a personal level, the pandemic was challenging for Williams and his family. Working in trauma in 2020 came with a lot of unknowns and the stark possibility that he could contract COVID-19 and die. But the past year also has better illuminated how the effects of racism in a pandemic have left communities of color to die at higher rates and be vaccinated at lower rates than the general population.
“Despite all the deaths, economic downturn, problems with our schools—I recognize within all of it that there’s opportunity to somehow be a positive contributor,” Williams said.
“Moving forward, I’m thinking about what I can do to contribute to society and uplift these communities that are suffering. I believe if we do that, everyone will benefit.”
PHOTOS COURTESY OF BRIAN WILLIAMS, MD
Williams is one of four Black trauma surgeons at UChicago Medicine.
Equity, every day
BY ANGELA WELLS O’CONNOR
The Department of Surgery’s sweeping effort to promote diversity, equity and inclusion
The May 2020 death of George Floyd spurred social unrest as the country grappled with painful evidence of racial inequities, already made stark by COVID-19’s disproportionate impact on Black and brown communities.
University of Chicago Medicine vascular surgeon Chelsea Dorsey, MD ’10, called the moment a “wake-up call” for the Department of Surgery: “I think the leadership realized that we as a department did not have what was needed in terms of support for faculty and trainees who were understandably struggling to make sense of the events of last spring. What we really needed in that moment was an environment that had already been primed to tackle these types of issues.”
Her response was to speak up. “Over the summer, I think many of us made a conscious effort to get out of our comfort zone of the status quo,” said Dorsey, Assistant Professor of Surgery. “As a person of color, you grow up feeling like your job is to put your head down, put in the work and not make waves. George Floyd was a call to action for me personally. I tried to lay out that we, quite frankly, didn’t have what we needed in the department, and that this was our opportunity for us to do more. Luckily, I was met with a Chair who was open to listening.”
Department Chair Jeffrey Matthews, MD, was definitely listening. While the department already had a strong reputation for its recruitment and outreach efforts to improve diversity, equity and inclusion (DEI), Matthews recognized the need to further broaden and better coordinate the work being done across sections and with the Biological Sciences Division—and accelerate the pace of progress and engagement. And, he wanted to capture the enthusiasm of faculty and staff who care deeply about creating a more equitable work and learning environment.
“What really crystallized this past year was the idea that pockets of efforts did not amount to the collective impact that we wanted,” said Matthews, Dallas B. Phemister Professor of Surgery. “We really needed to focus not on what we had done, but on all the space in between to identify the remaining gaps.”
While the department was charged with creating a diversity plan in 2019, Dorsey said the events of summer 2020 “created a sense of urgency.”
Dorsey was chosen to lead a renewed effort in the newly created role of Director of Diversity, Equity and Inclusion and Chair of the newly formed DEI Steering Committee. She had already been serving as the department liaison to the BSD Faculty Diversity Committee, which is primarily focused on faculty hiring and retention. Peter Angelos, MD, PhD, Linda Kohler Anderson Professor of Surgery and Chief of Endocrine Surgery, is the committee’s co-chair.
The Department of Surgery DEI Steering Committee is composed of 17 faculty, trainee and staff representatives across the department’s 12 subspecialty sections. Six subcommittees staffed by 40 volunteers address clinical care, access and continuity; education; community engagement and activism; recruitment, career development and retention; communications; and wellness initiatives.
One of the steering committee’s first actions was to survey the needs, concerns and experiences of the surgery community and identify the gaps in past efforts. They collaborated with UChicago Medicine’s Urban Health Initiative, which helped to conduct a similar assessment in 2016 of the entire University community.
Survey results were shared throughout the department during town hall meetings last fall. “One of the biggest takeaways was that people have a really hard time talking about DEI-related matters,” Dorsey said. “They didn’t feel that the Department of Surgery was a safe space to be able to have those conversations.”
For several months, the steering committee and subcommittees worked to formalize the DEI plan, which they submitted to the BSD Office of Diversity and Inclusion in September.
In the meantime, through training and workshops, the department has worked to build understanding around such topics as implicit bias, cultural competence, inclusive language and confronting microaggressions—subtle experiences of bias and racism that can include jokes and inadvertent slurs. DEI discussions are now integrated into quarterly grand rounds and the department’s weekly morbidity and mortality conferences, where discussion of surgical complications may also include DEI considerations: Was implicit bias a factor in this surgical outcome?
One of the challenges for the committee is to infuse the values of DEI throughout the department, taking into consideration everything from what’s hanging on the walls to how faculty is promoted.
“It’s a conversation that Dr. Dorsey and I have all the time—how to make DEI part of everyday processes,” Matthews said. “How we think about teaching and training, how
Brandon Baird, MD, left, Chelsea Dorsey, MD’10, and Jeffrey Matthews, MD
we develop the careers of our faculty—that’s all deeply related to DEI.”
As part of the DEI plan, the communications subcommittee created a diversity webpage within the Department of Surgery website and is planning to change displays on the department’s walls and alcoves to reflect the accomplishments of a more diverse set of surgeons.
The subcommittee on recruitment, career development and retention, led by laryngeal surgeon Brandon Baird, MD, Assistant Professor of Surgery, plans to create a formal mentorship program for faculty—a measure designed to retain top talent. This subcommittee and the newly formed Promotions Committee are also working to create better transparency around open leadership positions and pathways to promotion, particularly for junior and mid-level faculty.
The community engagement subcommittee launched a webpage promoting volunteer opportunities at more than 50 organizations, including several on Chicago’s South Side. Other plans include policy advocacy at the medical center and on the local, state and national levels to address health disparities and improve health outcomes of the medical center’s patient population.
“Our department has realized how important these issues are to our work as surgeons and as educators,” said Matthews. “The DEI efforts have created connections between our students, trainees, residents and fellows, and the faculty—within the department, across generations and across specialties.”
Dorsey is also encouraged by early signs of progress, noting that during DEI-related Zoom lectures, “the chat window has been lighting up more and more—a sign that people are a bit more comfortable talking about some of these topics.”
Still, she acknowledges the incremental nature of cultural change. “I think I’ll know that things have changed when I can walk down the hallway and see more surgeons who look like me. We’re not there yet as a broader surgical community, but I remain hopeful and committed to helping our department be an agent of change.”
Microaggressions at work
In fall 2020, the Department of Surgery conducted an environmental scan and needs assessment. The 100 qualitative and quantitative questions explored perceptions and experiences related to microaggressions (subtle real or perceived demeaning experiences relating to race, gender, culture, etc.), macroaggressions (defined as overt acts of racism and sexism, for example), heightened vigilance, experiences specific to the surgical workplace, long-term effects of micro/ macroaggressions on behavior for people of color, white privilege/fragility, and general questions about the climate in the department.
The majority of respondents agreed that racism is a problem in America, contributes to poor outcomes and needs to be addressed. Also, some female and BIPOC (Black, Indigenous and people of color) colleagues reported facing bias regularly — both inside and outside the Department of Surgery — with a high prevalence among Black colleagues.
Questions that explored microaggressions in the workplace included:
■ In surgical conferences, when different opinions would be helpful, how often is your opinion not asked for?
■ How often are you watched more closely than others?
■ How often have you been mistaken for someone of the same race?
■ How often do others assume that you are not a surgeon or work in a lower status job than you do, and treat you as such?
■ How often have you felt that there are different evaluation standards for you because of your race, ethnicity, gender or sexual orientation?
Trauma chief Selwyn Rogers Jr., MD, MPH, receives first James E. Bowman Professorship
BY JAMIE BARTOSCH
PHOTO BY EILEEN RYAN
Selwyn O. Rogers Jr., MD, MPH Shortly after the University of Chicago’s inaugural James E. Bowman Professorship in the Biological Sciences was announced, Selwyn O. Rogers Jr., MD, MPH, received a congratulatory note from one of his mentors.
David Soybel, AB’78, MD’82, recalled how passionate Bowman was about the University’s responsibility to the South Side community and to increasing faculty diversity. A medical student when Bowman was on the faculty, Soybel later mentored Rogers at Brigham and Women’s Hospital in Boston, while Rogers was a surgical resident at Harvard Medical School. “I know Dr. Bowman would be incredibly proud to have you as the inaugural Bowman Professor,” Soybel wrote. “It’s such an honor for you to be associated with his name. The passion you have for health equity, addressing social determinants of health and standing up for the trauma center at the University of Chicago—those are the things he stood for.” The gravity of the professorship and Bowman’s contributions to African Americans on the South Side and in the field of medicine are not lost on Rogers. He admires Bowman not only for being a pioneer in genetics and bioethics, including sickle cell anemia research, but also for being the first tenured Black professor in the Biological Sciences Division and an advocate for members of underrepresented groups seeking careers in academic medicine.
It’s a legacy Rogers has been building upon in his roles as Director of the Level 1 adult trauma center, Executive Vice President of Community Health Engagement and Professor of Surgery.
“I can’t imagine how it felt for Dr. Bowman to walk the hallways here as literally the only African American professor. There’s no doubt he experienced racism. He pushed through with his sheer excellence,” Rogers said. “Dr. Bowman walking through the halls of U. of C. made it possible for me to walk through the halls. To be linked with him through this professorship is an incredible honor.”
Rogers credits Bowman with being a catalyst that prompted the University of Chicago to embrace diversity and community engagement.
“He was ahead of his time thinking about things like health access, healthcare disparities and equity. Things that we talk about now. But he was actively engaged with it 30 years ago,” Rogers said. “The diversity we have at the University of Chicago now is a testament to his legacy.”
Since joining UChicago Medicine in 2017, Rogers forged ahead with diversity initiatives, recruiting four Black trauma surgeons. Rogers made it a priority because 80 percent of the trauma center patients at UChicago Medicine are Black males.
Rogers also encouraged UChicago Medicine to recruit diverse candidates from medical schools across the country to do their residencies at UChicago Medicine. He teamed up Iris Romero, MD, Dean for Diversity and Inclusion, and other leaders to make the hospital system more inclusive by recruiting more diverse faculty. This will help to improve the health and well-being of people in communities surrounding the hospital.
“I’m doing everything I can to carry Dr. Bowman’s mission forward,” he said.
James E. Bowman, MD
Selwyn O. Rogers Jr., MD, MPH
Attracting young physicians to serve Chicago’s South Side
BY ANGELA WELLS O’CONNOR
As Associate Dean for Graduate Medical Education (GME), Anita Blanchard, MD’90, helms a team that draws top talent to the resident and fellows programs at the University of Chicago Medicine on the Hyde Park campus, currently 1,000 participants strong.
While Blanchard celebrates this success, she laments the small number of graduates who ultimately go on to serve South Side communities like where she grew up. In 2020, of 330 graduates, 55 chose to practice in Chicago. And only eight decided to practice on the South Side, where scarcity of healthcare providers—particularly those of color— contributes to health disparities and affects health outcomes and life expectancies for predominantly Black and brown communities.
In February 2021, GME launched the Community Champions program to strengthen the connection between resident physicians and these underserved communities, providing participants with outreach and service opportunities. Thirty-three Community Champions were selected from 19 residency programs, including 21 people of color and 25 women.
The program is structured to leverage the robust community network and partnerships of UChicago Medicine’s Urban Health Initiative (UHI).
Community Champions have mostly been deployed for COVID-19 vaccine outreach efforts organized by the UHI. They have served as panelists on virtual community meetings, guest hosts on a community health radio program, spokespersons for public service announcements, and even participants in a cooking demonstration. Edwin McDonald, MD, and Stephen Estime, MD, Faculty Directors of Diversity for GME, work with UHI to coordinate the efforts.
Several Community Champions volunteered to administer vaccines at a pop-up clinic serving the Roseland and Washington Heights communities. UChicago Medicine is working to overcome vaccine hesitancy and promote access and education in these South Side neighborhoods hard hit by the pandemic.
“It is rewarding to see the strong interest and participation in the program right from the start,” said Blanchard, Professor of Obstetrics and Gynecology. “The Community Champions are making meaningful and immediate contributions to South Side communities.”
Chidimma J. Acholonu, MD, MPH, a second-year pediatric resident, said she appreciates the opportunity to serve and learn beyond the medical campus. “What makes residency at UChicago Medicine unique is the identity of the neighborhoods we serve—not just the need, but the rich history and
unique potential to impact change,” Acholonu said. “The long hours of residency can make it hard to remember the humanity of the work that we do, but the Community Champions program has created a space where community engagement is more intentionally part of my purpose as a physician.”
PHOTO BY GREG YAMAMOTO
Anita Blanchard, MD’90 Anita Blanchard, MD’90, received a 2021 Diversity Leadership Award, which recognizes members of the University of Chicago community who demonstrate leadership and a sustained commitment to justice and equality.
The 2021 UChicago Medicine Main Match was one of the most diverse with 171 residency positions on the Hyde Park campus.
9%
increase
in residents with backgrounds underrepresented in medicine
25.7%
identify as Asian
16.9%
identify as Black
7%
identify as Hispanic
43.3%
identify as White
7% did not self-identify or identified as “other”
