Anti-Racism Reading Group #5: Seeing White

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read summaries of previous discussions by following these links: one, twothree, four.

For the fifth anti-racism reading group, we listened to Seeing White, an excellent podcast hosted by John Biewen at the Center for Documentary Studies at Duke University. In it, Biewen and regular guest Dr. Chenjerai Kumanyika explore the history and consequences of White racial identity in a way that is both extremely accessible and intellectually rigorous.

This was a particularly ambitious project because the podcast series is fourteen episodes long, meaning there were many hours of material to discuss. For the purposes of our discussion group, we focused on the first three episodes which cover the history of Whiteness and the last two episodes on anti-racist action. However, I encouraged the group (as I encourage you) to listen to the full series, because every episode is worth your time.

Given the expanse of the source material and the conversation, I don’t have a thorough summary of the discussion, but rather three items of conversation that I found particularly interesting.


The purpose of racism

Something that was especially impactful to me in the podcast was the discussion with Ibram X. Kendi regarding his book Stamped from the Beginning and the relationship between slavery and racism. In particular, I was surprised to find that I had the causality between the two backwards. While I had previously thought of slavery as a progression from underlying racist beliefs, this turned out to be inconsistent with the documented history. Rather, it was only after the establishment of a highly profitable slaving economy that Europeans invented racial categorization.

As Chenjerai Kumanyika points out in that episode:

“You know they [Europeans] didn’t say like “oh man here’s these people, they’re like subhuman and like three-fifths of a human being so what can we do let’s create slavery.” No. I mean that’s kind of like what I grew up on and what people think, they just didn’t know. And it’s like, no. What they knew was that there was an economy there, like rice and cotton and other things, sugar, that had to be produced to make this economy go. And they wanted cheap labor and they enslaved people and then they later sort of deployed the science and all these other cultural forms to match and support the idea that they could exploit these people because they were inferior.”

This paradigm is important because when we understand racism in this way—as a tool to maintain structures of human exploitation that would otherwise be unsustainable or indefensible—we better understand racism’s power and persistence. From chattel slavery in the historical American South to the abuse of immigrant laborers in modern American agriculture, it is only by dehumanizing our perception of the Other through racialization that we (White people) can sustain these awful enterprises.

While many White people recognize this dehumanization, at the end of the day we find ourselves sustaining these awful enterprises because we are addicted to the material advantages that they bring us.

The interaction of race and class

In Part 3, Biewen and Kumanyika build on this understanding of race to explore its interaction with class in U.S. history.

This begins in a conversation about the armed uprisings in the American colonies in the late 17th century during which African slaves and European indentured servants fought side by side against the wealthy elite that governed the colonies. This series of rebellions triggered the enactment of the Virginia Slave Codes of 1705 which existed in part to break the back of this class-based alliance.

Kumanyika breaks this down in-depth:

“If you look at part 23 of the Slave Act, it was also, it was encouraging, encouraged white free people to hunt down and capture escaped slaves. And there was this whole reward system that involved tobacco and rewarding people with tobacco so you’re now incentivizing free whites to try to capture free black folks. And there’s also this part that 14 deals with marriage. So any white man or woman who marries a person of African or Indian descent is now going to be committed to jail for a period of six months without bail and has to pay 10 pounds as a fine. So, what you really can see there is like, you can really see the intensification of any racial division really happening there through these laws.”

And later, Kumanyika quotes a speech given by John C. Calhoun (a wealthy slaver) in 1848:

“With us, the two great divisions of society are not the rich and the poor, but white and black. And all the former, the poor as well as the rich, belong to the upper class and are respected and treated as equals.”

Again, we see racial categorization used as wedge to disrupt nascent class consciousness in the United States.

This is a recurring theme in American history and indeed, racism may be the main reason that the socialist public policies supported in most of the United States’ peer countries (e.g. universal health care or a robust welfare state) never caught on here. Indeed, as attempts are made to de-segregate America’s existing public services you see subsequent aggressive disinvestment, as has been the case in America’s public education system.

The politics of teaching history

It was both remarkable and unsurprising that most of the history discussed in the first three episodes was not a part of the grade school or high school curricula for any of the people present. Whether our schooling was public or private, religious or secular, the relevant history of race went mostly unaddressed in our respective formative educations.

I for one was taught that the classification of the races was a scientifically impartial affair, driven by the same presumably neutral Enlightenment-era curiosity that led Carl Linnaeus to attempt his classification of the species. Of course, as already discussed, the classification of the races was actually a political action meant to support existing structures of exploitation and falsely cultivate an illision of “natural order” to a system of extreme inequality and dehumanization.

Having two teachers in our discussion group was extremely helpful as we broke down some of the reasons that this kind of disinformation enters into our curricula:

  1. There is inertia to curriculum and many teachers pass on the same content and framing that they themselves were taught during their own primary and secondary education.
  2. Educators are disproportionately White and there is an understandable aversion to teaching a history that implicates one’s own group as aggressor or oppressor.
  3. Even for those willing to teach history in a way that challenges White Supremacist mythology, there is a realistic fear of public backlash such as was seen in this recent case in Oconomowoc, Wisconsin.
  4. Such pushback is likely to be stronger and more harmful for teachers of color.
  5. In some states, there are explicit attempts by Boards of Education to censor or bias history curriculum such as has been the case in Texas.

This is not even close to a complete account of our conversation, but rather just some of the topics I personally found most interesting. I’m opening up a listserv to disseminate invitations and readings for the discussion group, and I’m hoping that it will also be a place where people can share their own reflections on the discussions. With authors’ permission, I may cross-post some of those reflections here. If you want to get in on that listserv and you know me in real life, please get in touch. Otherwise, feel free to leave your thoughts in the comments below!


Anti-Racism Reading Group #4: White Fragility

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group for health care practitioners in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read part one here, part two here, and part three here.

For the third reading of the anti-racism reading group we focused on White Fragility. Our reading was the article White Fragility from the International Journal of Critical Pedagogy which you can download here. Supplementary materials were Dr. DiAngelo’s White Fragility and Rules of Engagement and this comedic White Fragility Workplace Training Video.

What is White Fragility? In Dr. DiAngelo’s words:

White Fragility is a state in which even a minimum amount of racial stress be- comes intolerable, triggering a range of defensive moves. These moves include the outward display of emotions such as anger, fear, and guilt, and behaviors such as argumentation, silence, and leaving the stress-inducing situation. These behaviors, in turn, function to reinstate white racial equilibrium.

Continue reading “Anti-Racism Reading Group #4: White Fragility”

Do No Harm: A Doctor’s Case For Single Payer

In 2013, Drs. Ubel, Abernethy, and Zafar published “Full Disclosure — Out-of-Pocket Costs as Side Effects” in the New England Journal of Medicine. In this essay, the authors grapple with the ethical responsibilities of physicians when it comes to the enormous cost of modern medicine. If a surgery or a course of chemotherapy is likely to bankrupt a patient, what is our duty to warn them, to ensure that they have considered both benefits and harms? A larger question, however, was left unasked: “How do we as physicians ethically operate within a medical system that forces people on a regular basis to choose between health and financial stability”

To grasp the extent of the issue, consider that even after the passage and defense of the Affordable Care Act, 27 million American remain uninsured. An additional 41 million Americans are underinsured which is to say that their out-of-pocket expenses (such as deductibles and copays) are enough to cause financial duress, despite having health insurance. And as health insurance deductibles increases faster than wages, the proportion of Americans who are underinsured continues to grow.

The consequences of this are grave. Three out of ten American adults report forgoing needed medical care due to cost concerns. One in four were unable to pay for basic necessities like food, heat, or rent because of medical bills. One third spent down all of their savingsContinue reading “Do No Harm: A Doctor’s Case For Single Payer”

Securing Housing For All

As a family doctor in Seattle, I take care of numerous patients experiencing homelessness. The toll this takes on their bodies is impossible to ignore. Sleep deprivation, chronic stress, physical and sexual assault, temperature extremes, and malnutrition all weather the body rapidly. As a physician sworn to preserve and prolong life, it is profoundly disturbing to come up against such profane and preventable degradation on a daily basis.

For this reason, I joined the Housing For All Coalition last night as they put forth a call to action to a packed hall at the Seattle Labor Temple. Speakers from the Transit Rider’s Union, Socialist Alternative Seattle, Nickelsville, SHARE/WHEEL, and DESC each spoke to the urgency of ending Seattle’s housing crisis. While each speaker brought a unique perspective, including the perspective of the formerly and currently homeless, they all emphasized the importance of increasing access to both affordable permanent housing and safe temporary shelter.  Continue reading “Securing Housing For All”

Anti-Racism Reading Group #3: Perinatal Mortality

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group for health care practitioners in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read part one here and part two here.

For the third meeting of the anti-racism reading group, we focused on increased rates of perinatal death (i.e. death around the time of birth) for black women with this excellent piece of reporting by NPR and Propublica. NPR’s Code Switch team produced an excellent podcast on this same story which you can listen to here or read the write-up here.

This is an especially timely reading given Erica Garner’s recent death at age 27 from a heart attack just three months after giving birth. Erica was the daughter of Eric Garner who was murdered by the New York City Police. Since his death, she had risen up to be a prominent and effective activist against police violence.   Continue reading “Anti-Racism Reading Group #3: Perinatal Mortality”

Innovations in Primary Care: Moving Beyond Fee-For-Service

The American medical system has long operated under a fee-for-service model in which only specific, narrowly-defined medical services qualify for reimbursement from insurance companies. This system is reasonably well-suited for procedure-oriented specialties in which services with clear indications, processes, and outcomes such as colonoscopy or knee replacement can be appropriately paid for.

In America’s fee-for-service system, reimbursement for primary care services is limited to short office visits and certain outpatient procedures (such as a joint injection). Many primary care doctors have felt that they could offer better care for their patients if the payment structure allowed for more flexibility in services offered, but opportunities to test this hypothesis have been limited.

Today, three groups in the Seattle area – Landmark, Concerto, and Iora – are independently demonstrating the value of flexibility in primary care to improve patient outcomes at overall lower cost. They’ve accomplished this by arranging for alternative payment models with local Medicare Advantage plans (private insurance plans who contract with Medicare to provide health insurance to seniors). Rather than operating under fee-for-service, these companies get a per-member, per-month payment. This payment structure provides a flexible budget with which they can offer services that don’t necessarily fit into the established fee-for-service structure.   Continue reading “Innovations in Primary Care: Moving Beyond Fee-For-Service”

Bringing Single Payer to Washington State

Yesterday I attended a meeting of Health Care for All Washington regarding single payer legislation in our state. The particular set of bills they are supporting are SB-5701 and HB-1026 which establish a trust fund (the Washington Health Security Trust or WHST) which would eventually act as a single payer for health care services in the state of Washington.

Specifically, this legislation creates the trust fund, establishes a board of trustees and guidance committees to run the Trust, and then lays out in very broad strokes what the Trust is meant to accomplish. As described in the legislation, the Trust is meant to pay for health care for Washington residents not otherwise covered by Medicaid, Medicare, or private insurance including dental and long term care (think nursing homes). Most likely the funds for the Trust would come from a combination of a payroll tax and a sliding-scale premium.   Continue reading “Bringing Single Payer to Washington State”