My reaction to the results of the presidential election — like many, but of course not all, voters — was shock, disbelief, lack of understanding and despair. However, as I read, talk to others, and reflect, I’m beginning to understand what happened. These insights don’t make the election results easier to swallow for me, but do illuminate a path forward for “us”. More than ever, we need meaningful dialogue between people who misunderstand and often mistrust one another. And it is our responsibility to ensure these dialogues happen at professional schools as well. Feinberg, at its best, is a bastion of intellectual acumen and an agent of clear communication and trust. Therefore, we have a moral responsibility to assist our communities with these intergroup discussions — it is crucial for our nation’s progress and health.
In Joseph Conrad’s, The Heart of Darkness, the narrator addresses “the horror” of confrontation between cultures and comes to the inconvenient truth that the dread also lies within us. Our nation has recently experienced the “horror” of clashing American cultures, and, the truth is, we are a nation divided. Deep history underpins our cultural divide, be it racial, socioeconomic class, religious, educational, gender or sexual orientation. The fight for racial, gender, labor and LGBTQI rights, religious freedom and immigration reform has a nefarious history, but we have made progress. This election as also taught us that we ignore extreme socioeconomic inequalities at our peril. Clashes between great civilizations, present and past, have produced violent conflicts throughout the ages, and they will continue to do so unless we find a superior paradigm for creating solutions through interaction and open dialogue.
At the same time we cheered the benefits of identity politics in recent years — the pride and legal progress of disenfranchised peoples in this country — other powerful counter-identity polemics manifested. For some, this majority identity has always existed but, now, again has a name and a face. This push/pull is understandable; however, the way towards meaningful mediation and detente must include a working understanding of this country’s history of structural inequities. Diversity and inclusion does not mean we are all a great melting pot. Virtues and beliefs of different groups don’t easily change, and in some cases, never do. It does mean that cultures have true differences but still need to find a way to coexist. Healing the pain of the 2016 election will mean helping our nation find common ground that respects different perspectives. We need to promote inclusiveness and belongingness of all thoughtful viewpoints. There is strength in the diversity of opinions but we also know that racism, sexism, misogyny and xenophobia cannot be tolerated if we are to move forward. On this we must stand firm, not fall back.
So, what the country needs most is meaningful dialogue. Meaningful dialogue starts with objective “facts” that we can all agree on. Unfortunately, false internet algorithms and memes employed during this past election obfuscated much of the facts that needed priority. This is where the biomedical and medical social sciences, hopefully, can lead us closer to a universal truth. We need to acknowledge that even with a fresh set of facts, multiple interpretations of the truth always abound. It’s in our human nature to do so. However, this does not give responsible people license to simply declare something to be true with no evidence — as many politicians are wont to do, and think it is so. We need humility regarding what we can really know for sure. And although our brains are engineered to make predictions or “guesses” regarding what's going to happen next (for our very survival), best guesses are often wrong. As much as we should value the voracity of our personal, top-down predictions, we also need input from other people or other things to modify our maladaptive beliefs.
Based on Bayesian-type inferences from prior outcomes and experiences, the scientific method takes educated “guesses” and transforms them into formal hypotheses and then subjects those same hypotheses to rigorous investigations to prove them false (yes, I mean false). Despite the inherent uncertainties of scientific assumptions, if we can’t prove the hypotheses false, we have discovered something new about the world, something closer to the truth. In contrast, but with no less rigor, the humanities utilize different methodologies to discover new knowledge and truth. Truth found in the form of symmetry, logic, beauty, authenticity, connectedness and other related concepts. The two respective disciplines, science and the humanities, both offer their epistemologies to the world and contribute to our collective knowledge base. This knowledge, however, is never static. To help ensure that intergroup discussions lead to better understanding and real change in people distant from common ground, we need to let the people know what sort of truth we are talking about (science, humanities) and not conflate the different ways of knowing. This will provide a solid foundation for effective intergroup dialogue, encourage a flourish of corrective knowledge and allow novel viewpoints from other people the chance to seed.
At Feinberg, we have the responsibility and capability to foster much needed dialogues among all community members. The Evanston campus has imported Princeton University’s Sustained Dialogue model. This program engages students of different identities to build trust over time and have open, frank discussions. These conversations can feel complicated, fragile and uncomfortable at times. Effective dialogue, beyond what is just politically correct, happens in the presence of mutual trust and respect. Change Makers is a Northwestern faculty/staff dialogue group modeled after the University of Michigan’s undergraduate Intergroup Dialogue. This program is led by the Women’s Center at Northwestern. It attempts to do the same task of intergroup dialogue at the faculty/staff level. Personally, I have led a Feinberg student dialogue group for several years. Although I must admit working with this group is often “preaching to the choir,” we’ve learned a lot about our own cultures, family backgrounds and personal stories. Currently we are exploring the possibility of beginning a Sustained Dialogue group here at Feinberg. We would be the first medical school to adapt this specific model of structured, longitudinal dialogue for the formal curriculum.
I am extremely concerned with our then president-elect’s New Year’s Day tweet regarding “his supporters” versus “his many enemies.” A New Year’s greeting from a soon-to-be president, you would think, would be upbeat, magnanimous and inclusive. Unfortunately, this continuing rhetoric will only hamper our efforts to promote and facilitate meaningful dialogues between this country’s geographically and culturally divided, Duck Dynasty versus Modern Family people. Politicians currently seem incapable of facilitating and modeling these discussions in our nation. Medical schools need to step up and show the way.
Whatever we decide to do going forward, we must be inclusive and respectful above all; in contrast to the polemics of this past election, we must be purveyors of objective facts. Medical students, trainees, faculty and staff must also be merchants of compassion, respect and meaningful dialogue.
Associate Dean for Diversity, Inclusion and Student Support
Professor of Psychiatry and Behavioral Sciences, Medical Education and Surgery (Organ Transplantation)