Talking Race, COVID-19, and Health Justice with Dr. Denise Davis
WATCH: Davis tells Be’chol Lashon’s new executive director, Marcella White Campbell, about her efforts to make healthcare more equitable.
Dr. Denise Davis is a trailblazing physician and educator who has dedicated herself to making the healthcare system more just for all patients. She teaches workshops in the United States and abroad on diversity, equity, and inclusion in the field of medicine. In addition, she mentors minority students at the UCSF School of Medicine and sees patients at the San Francisco VA Medical Center.
Davis has also been involved with Be’chol Lashon since its inception, attending the very first Hanukkah party for ethnically and racially diverse Jews held in San Francisco in 2000 with her daughter, Aviva. She has served on the organization’s board for 15 years and is its current president. She also helped to launch Camp Be’chol Lashon in 2009. She is an inspiring leader, and a true gift to our community.
Recently Davis joined Be’chol Lashon’s new executive director, Marcella White Campbell, for an important and timely conversation about the ongoing COVID-19 pandemic and concerns that have arisen, especially in Black and brown communities, about the vaccine. They also spoke about more systemic problems in the healthcare system relating to race and representation. The conversation was conducted in partnership with the Marlene Meyerson JCC Manhattan.
Below are edited excerpts from the conversation, which can be watched in its entirety above.
Marcella White Campbell: Dr. Davis, thank you for joining us today. This is a momentous time in our country. For the past year COVID-19 has disproportionately affected communities of color and Black communities. Now there’s a vaccine available, and yet many Black people are reluctant to take it. I wonder if you could help us understand why that is and how Black Americans relate to the American medical establishment.
Dr. Denise Davis: I want to first locate myself as a Black Jewish woman and as a mother and as a physician, as an educator, as the daughter of a nurse, who inspired me. Her name was Grace. She’s now of blessed memory. And her warmth and respect and deep humanism continue to inspire me. On my best days, I channel my mother Grace.
I’ve been a physician for more than 35 years. And my dedication to the health of my patients, families, [and] community continues to motivate me. And I want to say that putting skepticism about the health system in a social context is so important. Although people talk about Tuskegee and the heinous experiment that was really torture for Black individuals, there is data that indicates that even people who identify as Black who don’t even know about Tuskegee have significant skepticism because of in-the-moment, real-life experiences with exclusion and disrespect. So this is so important for me to keep in mind as a person, as a physician, as a Jew, as someone who loves health justice, that every interaction people have with the healthcare system has an impact.
We know that skillful, respectful, empathetic communication also results in more sharing of decision-making. Dr. Lisa Cooper at Johns Hopkins has done all this work and has actually video recorded encounters between patients and clinicians. The meetings that are highly rated by Black patients are a little bit longer, and there’s more positive affect. So if I said to you, “Marcella, it is such a pleasure to see you again. I wish that we could be face-to-face safely during the COVID era.” That’s very different than saying, “Well let’s talk about your blood pressure.” It touches a different place in the mind and in the body. And that’s what I’m aiming for, that’s what I’m agitating for, that’s what I’m pressuring for, that’s what I’m imploring.
So I think we have a long way to go in terms of respectful, curious conversations that are not dominating and disrespectful of what people know about their minds and their bodies. And one last thing I wanna say is it’s not just the African-Americans or Latinx or Indigenous people who are skeptical. There is a large population of people who are skeptical, and that is a national crisis.
Why do you think that greater group are also skeptical of the vaccine?
Well, if we look at the erosion of trust from the highest levels right down to public education, to the lack of accountability and a lack of apology for when we fail. And in health professions, [we] make errors, [we] make mistakes, we’re all human. What we often fail to do is to take into account the impact of our errors, make an apology, and rebuild trust.
From a personal perspective, my grandfather just passed away at the age of 97. And in the last 20 years of his life we spent a lot of time in emergency rooms, in hospital rooms, in urgent care. And we would often all come to help advocate for him. Many people in my family would come and take shifts. And whenever a Black doctor or a doctor who was a person of color walked into the room, the stress level lowered. With my grandfather in particular, he was just always so thrilled to see a Black doctor. And I wonder, have you had that experience? How does that feel from the perspective of being a Black doctor?
Yes. I’ve had similar experiences in walking out into the waiting room at the VA where I practice, where African-American patients are overrepresented here in San Francisco compared to the population. And I’ll introduce myself, “I’m Dr. Davis, it’s a pleasure to meet you.” And the smile and the words that sound something like, “Oh it is SO nice to see you.” And I know that I’m representing equity. They don’t know me yet; [they are imagining] that our shared identities will allow for more health justice. It is so important in medicine, in nursing, in physical therapy, social work, occupational therapy to have a cadre of healthcare professionals who represent the people that they are treating in order to have just the first layer of trust.
Do you think it’s possible to a draw parallel between Black Americans’ mistrust of the medical establishment and many older Jewish Americans’ mistrust of the medical establishment?
It’s a matter of proximity to trauma, isn’t it? [For] my patients in my private practice who are Holocaust survivors, the proximity to that trauma is in the body and in the mind. And we become, if we are really listening, respectful witnesses…taking into account how that trauma is an indelible part of that person’s experience.
Jews who identify as white have found increasing acceptance [in American society]. Not 100%. Antisemitism is real and a threat. But there is a social advantage to whiteness, and I think opening conversations about that in the Jewish community is an important way of illuminating the social context in which we currently live in the United States. Those social advantages do insulate from ongoing trauma, and [with] distance from the Holocaust and the pogroms, healing does happen.
For African-Americans who have seen Rayshard Brooks, George Floyd, Breonna Taylor, just within recent memory, violently killed, unarmed, at the hands of law enforcement, that’s an ongoing trauma and lives actively, charged, in our bodies and in our minds. I had an intern who identifies as Black recently tell me that they now go into the medical education environment with suspicion about who is for them and who is against them, especially based on the violent actions of a white mob in the United States Capitol recently. So adding injury to injury, of course the social compact has been broken and trust with it.
So much of what you’ve said today has touched on listening, I think, and on conversations. And do you think about that in a Jewish context? I just immediately, I always think about the Shema, but these conversations and this listening, do you think about them that way?
I attended a week-long retreat twice on listening given by Rabbi Phyllis Berman. She continues to be a teacher and mentor to me. And some of my patients, when I told them I was going to be away for this training on listening, said, “But you’re already a good listener.” And my response was quite authentic: “There is much more to learn.” I think Torah study for me each week is also a deep listening. What is the text saying this year, which is different than previous years?
I also think listening is really important as healthcare professionals engage and partner with patients around COVID safety, which is the vaccine, but it’s not just the vaccine. It’s also wearing masks when out in public, it’s not spending time with other people indoors with whom we are not living in a primary residence. It’s hand-washing. That engaging and first just asking, “What do you know about keeping yourself safe from COVID? I want you to be healthy.” And then just listening to what it is that people already know—people know a lot usually—and then reinforcing empathetically what it is that they’re doing well, and then teaching an additional point: “Would you be open to me adding to what you already have that is actually very wise? May I also tell you that the vaccine, both the Moderna and the Pfizer vaccine are about 94-95% effective in preventing illness and especially severe illness. Were you aware of that?” So then it goes back to the ask: “What have you heard?” Then responding with empathy.
It’s what we call an ART loop: ask, respond and then teach additional points. It’s not a download. Downloads are dominating and disrespectful. I learned in medical school to be a downloader. I’m continuing to unlearn those kinds of dominating practices.
I would love if you could share some of the work you’ve done on fostering conversations around equity, difference, and diversity.
Yes, it’s central. Oh, how I wish, Marcella, that someone had asked me, “What is the climate like here in this group or organization in terms of racial equity, in terms of gender equity?” No one’s ever asked me that. And that’s a loss because it’s a part of my experience that’s very salient to my wellbeing and my sense of inclusion. And so I’m coaching physicians nationally and now internationally; I have a workshop next week with faculty physicians in Israel to talk about microaggressions, the common, everyday slights, verbal or nonverbal, intentional or unintentional, that target marginalized groups and reinforce social privilege. We’re going to be talking about the impact in a medical education environment in Israel of microaggressions, whether they’re related to cultural background, nation of origin, gender, or profession.
Another project I’m currently working on: As VP for DEI at the Academy of Communication in Healthcare, I am offering a 16-week, eight session workshop series on facilitating conversations about racial equity. I’m very, very, very excited to facilitate in a humanistic, deeply-listening way while still holding my colleagues to a standard of respect and equity, taking into account the current social context, as well as historical social context. And that more can be done for us to lean in and listen to every member of the healthcare team, which includes the patient, the family, the student, the professor, the administrator, so that we better develop respectful relationships and can work with each other in a deeply healing way.
Dr. Davis, thank you so much for taking the time to give us your insights. Do you have any final thoughts?
Well, my thoughts are a refuah shlemah, a complete healing, for those who are ill and whether that be body or soul, as the Jewish prayer says. And that we would be inspired to have deep conversations about people who know their minds and bodies, and with whom we could partner more deeply and more respectfully, in their desire to be healthy and stay healthy. And let us say, “Amen.”