Juneteenth: A perspective on anti-racism in medicine with Lash Nolen

In celebration and reflection of Juneteenth, a company holiday, we hosted medical student and health equity advocate, Lashyra "Lash" Nolen, to discuss anti-racism in medical education and the potential impact of social media on health disparities.

Jun 20, 2022 · Health Equity & Inclusion Strategy at Doximity

LaShyra “Lash” Nolen is a third-year medical student at Harvard Medical School (HMS), where she is serving as the University’s student council president for the Class of 2023. She is the first documented Black woman to hold this leadership position. Lash is a nationally renowned public speaker and leader of anti-racism in medicine workshops where she has led discussions for prominent organizations and served on panels with Chelsea Clinton and Former Surgeon General Dr. David Satcher.

Lash joined Doximity for a fireside chat where she discussed the historical context of Juneteenth, its importance in American history, and how we can use this knowledge to support our Black clinician members.

Could you share a little about yourself and how you got into medicine?

I’m originally from Los Angeles, California. I was raised by a single mother who was the first person in our family to get both her bachelor’s and master’s degrees.

I developed an early interest in the sciences, and the idea of becoming a physician popped into my head despite the fact that I didn't have anyone in my immediate family who was interested nor had studied medicine, and no one who was in the healthcare profession.

I spent the early part of my childhood in Compton before moving to Rancho Cucamonga, and that was the first time that I really started to see inequities. In Compton, there were potholes, and we had to drive 15 minutes to get to the nearest grocery store. But in Rancho Cucamonga, potholes didn’t exist and suddenly there were specialty grocery stores and even more stores.

Why was it that a predominantly Black and Latinx community in LA didn't have as many resources and didn't seem to be as cared for as a community? How did we get here, and what types of policies contributed to these inequities in our society?

As I went through my education, I really started to think about how I could do the work of being a healer and a physician by focusing on social justice and understanding that so much of healing happens outside of clinical spaces. So that's my journey, and how I ended up here at Harvard Medical School.

You have become a leader in conversations around anti-racism in medical education. What influenced this passion?

When I interviewed at Harvard, I realized how great of a platform I would have being a Black woman from Compton, and bringing the voice of my community with me.

When I started classes, I immediately started to take note of deficits in medical education, and how I felt that folks from my community were not being adequately represented. The first tangible example is from a microbiology class. We were learning about Borrelia Burgdorferi, which is a bacterial species that causes Lyme disease.

I remember that the professor had put up an image of what the disease looks like on white skin, and one of my classmates, a Black man, asked, “how would I recognize how that looks on someone whose skin looks like mine?” The professor didn't really know how to give him an adequate answer.

So I went on Google and could not find the way that the rash presented on darker skin, and that's when I realized that medical education had a big problem. We were not learning how to recognize disease in a community that we were very much going to be interfacing with in the future.

As we are approaching Juneteenth, what role do you think the historical context of slavery has had in shaping medical education?

In 2020, the number of Black physicians we had in the United States was just 5% of physicians despite the fact that African Americans make up about 13% of the total U.S. population. There have been many studies that have come out, whether it be maternal mortality or outcomes in different chronic illnesses, showing that ethnic and racial concordance between patient and physician often leads to better health outcomes. This is because there's a mutual understanding of lived experience and communication style, and so many other things.

And yet there's this huge paucity of Black providers, physicians and healers in the United States. And to really understand why that is, we have to first think about the profession of medicine, and who initially had access to it. When we think about those studies and how important it is that we do have diverse doctors and Black doctors speaking to patients in their communities, we know how much of a detriment it is to have barriers for these providers in our communities.

So I think having a conversation about history is so critical because it really informs our present perspectives and helps us see that none of this just happened by chance. There were decisions that were made to exclude certain individuals from the profession, and now this paucity is impacting our communities and their health outcomes.

You have a pretty big social media following. How have you seen the benefit in really using social media and other channels of communication outside of traditional academic medicine structures or models?

I honestly made Twitter like right before I started medical school. The way that I got the first bulk of my followers was when I went to get my ID Picture taken for medical school. I wore a white turtleneck, and to my surprise, when I got to the station to take the photo, the background was also white. So it looked like my head was floating like an emoji, and people loved it. They were retweeting, and it was even on Buzzfeed. I already was very passionate about social justice and equity, and was also naturally tweeting about those things. Fast forward to where we are now, what I think is so powerful about social media is that it really forces us to disrupt the hierarchy that often exists within academic medicine. And I think that having mentors, classmates and colleagues on social media has meant so much because it's really just brought this level of connectedness in this work that can often feel very lonely.

How important do you think it is for all of us to really do that introspective work to create thoughtful approaches and solutions?

I'll first start off by saying that studying and understanding race and combating racism is a scary idea, because it challenges our entire perception of the life that we've lived up to this point. If you identify as someone who is white, for example, you truly might not have ever thought about the fact that Band-aids were the color of your skin.

And I think that when you start to really think about the ways that folks have accumulated intergenerational wealth, all of these things can be really hard to grapple with and to deal with. For example, the net worth of a Black person in Boston is $8. This is compared to the wealth of white folks, which is well over $100,000 in Boston.

You can sometimes feel like “I don't even know which way to go to start to unpack this,” and I think for some folks it might be easy to say, “I'd rather not deal with it because there’s a pandemic going on.” There's all these different challenges that we're dealing with and they can feel like it's too much. But I would say, push against that and understand that when we start to do the internal work, the end result is collective work that moves us all forward. Because if one of us drops out, then that takes away from the collective power that we have. This work has to be continuous and ongoing and introspective because once we start to truly understand the ways that we might contribute to racism in our everyday lives, then we could start to think about how it persists in our workspaces and how we truly want to be anti-racist.

There's all these different challenges that we're dealing with and they can feel like it's too much. But I would say, push against that and understand that when we start to do the internal work, the end result is collective work that moves us all forward.

I just want to thank you so much for joining us and thank you so much for this conversation. I think this was an awesome conversation to be able to have today, and I really appreciate your time and spending it with us at Doximity.

I’m thankful for the space that we were able to create today and the dialogue that we were able to have and just very excited to see where we can go from here to make this world a better place. And to do this work of anti-racism. So I hope you have a great Juneteenth and get the opportunity to do some reflection and some reading.

Interview conducted by Félix Manuel Chinea, MD
Article written by Angelica Recierdo and Oscar Guzmán
Header Image from LashyraNolen.com

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