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Chairman's Graduation Remarks on Pandemic, Diversity, and Racism

 

 

Dr. Pulst

Excerpts of Remarks at Resident & Fellow Graduation by Department of Neurology Chair, Stefan Pulst, MD, Dr med, on June 17, 2020

June 17 is an important day in history, marking oppression and rebellion! In 1953, East Germans marched against communist oppression resulting in a violent response by the Soviet army and the death of 34 individuals. It also marks the arrival of the Statue of Liberty in New York Harbor in 1885 to commemorate the American Revolution.

Crises bring out the true culture and values of a group, its foundation, its building blocks, but also its cracks. I am glad to say that the Department of Neurology - in the times of COVID - has shown few cracks and used its strong foundation and core values to weather a storm, in which the attack by the COVID-19 virus has been violent and police violence has gone viral.

In this pandemic, our graduates played an important and essential role and readily adjusted their lives to deal with the challenges posed by the new virus.

What helped in these efforts was our history of involving residents in decision making and our diversity of care delivery models. Family members in attendance may not know that much of initial stroke care in the Mountain West has been performed virtually, on camera, for years. With strong leadership and good communication, this has allowed us to turn on a dime, roll out virtual care for our clinics, and maintain access for patients during the COVID pandemic. I want to personally thank our residents and fellows for exceptional service and performance in these trying times.

Why is racism relevant for a neurology graduating class? Should actions not be left to others? We are all citizens of a great nation, and every one of us needs to feel responsible for what happens to us- or some of us- during a pandemic of a virus and a pandemic of violence. Health care providers have the opportunity and skills to deal with both and address issues of disparity and inclusion.

You may say: the path forward is tortuous, we cannot see the final goal, and a wrong first step can lead us astray. But is that not what we do every day, when we admit a patient? A person arrives in distress and we need to treat while a diagnosis is slowly emerging from the vast sea of possible illnesses.

What role can neurologists play? There is a real and tangible role to protect our patients. What has gotten lost in the reporting about the use of deadly force by police are the cases of injury or death to individuals with mental illness, neurologic deficits, or intellectual disabilities. These incidents often do not make it into statistics because the alleged perpetrator is aggressive or does not obey commands due to motor-sensory challenges, language deficits, or intellectual disability, thus deadly force is deemed appropriate.

We as neurologists can be important in educating the public and the police about brain diseases. We can help in the implementation of de-escalation strategies in dealing with violent individuals as a result of brain disease. 

Hopefully, when you look back at the times of COVID and protests you will realize that your heads have not only been filled with methods and data and acquired ways to reason about disease processes, but also with values and abilities to treat one another and your patients free of prejudice.

The department has addressed the challenges of individual and systemic racism, health disparities, and the opportunities for diversity and inclusion in many ways. Residents have contributed to a reading list, faculty are involved in longitudinal courses in the medical school, and Spanish-speaking staff and faculty have offered to engage in recruitment of a diverse resident class. We have also decided to establish a new high-level position, a Vice Chair for Faculty Development, Diversity, and Inclusion. We have established a new Grand Rounds series to address issues of Equity, Diversity, and Inclusion. Furthermore, in addition to our departmental twitter account, we have established a new twitter account, U of Utah Neurology Against Racism @UNeuroDiversity, to report specifically on our activities for diversity.

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