interviews
Call It What It Is
by LaShyra Nolen
July 1, 2020
This interview with LaShyra Nolen, Harvard medical student, and the first Black woman to become class president, was conducted and condensed by franknews.
frank | You've written and spoken about your experience within a dual reality – of being both a medical student at Harvard, and a person committed to your own identity and equity.
LN | The dual reality is you're training at the best medical school in the world, but there is so much suffering going on in your community. And whatever knowledge you gain still isn't going to necessarily translate to the improvement of the condition of Black people. For example, I could go on to become the best surgeon in the world. I could save the life of a Black patient. But they can go outside, drive home, get stopped by a police officer, move too fast, and get killed.
That is the dual reality. You're learning, but you're not necessarily getting to the root cause of the suffering of your people.
You always have to think about it from both of those perspectives, that of a student and that of a Black person in America.
In addition, you go into class and you are expected to maintain professionalism. You are expected to just talk about the science and to talk about the assignment at hand – when that same morning you watched yet another police lynching of a Black man. You're trying to deal with those emotions, and you have no idea how it's going to be taken if you say, "Hey guys, I'm really not doing that well. Another Black man was killed. Racism is pervasive in our country and we're all complicit in it." It is a challenge that all Black professionals have. You have to walk in and put on this face, even though internally you are dealing with the turmoil and hurt of your community.
What does this moment feel like at Harvard, as a student?
As a medical student, I feel like I can speak out more than my mentors or faculty members who are more ingrained into the system of medicine. Academic medicine is very hierarchical. The higher up you go, the more you have your hands tied, and you can't speak as much truth because you're trying to move up to an associate professor position so that you can finally start to use your voice. I know that there's a risk that comes with speaking up, but I, personally, can no longer just pretend like everything's okay, and allow people to continue to suffer in silence. Even the most brilliant people have been complicit in racism, and some of them genuinely have never even thought about it.
They've grown up in a bubble, their entire lives, and all this is happening and they're just like,
"Oh my gosh, I'm a good person. I'm not racist." And you kind of have to be like, "No, but you really are though."
These brilliant people who are excellent in their field, are just now realizing they're complicit in this system.
Again, I am happy that's occurring, but I'm always just like, look how much it took for us to get here. NASCAR is just now removing the Confederate flag. Suddenly now I have Juneteenth popping up on my Google calendar. I'm like, what?
My classmates and professors have really been amazing actually. We are all from different backgrounds. Some are fourth-generation physicians, and some grew up on reservations and are bringing medicine to indigenous folks. All of them realize that the system needs to change, and they have been so supportive. Beyond just talking the talk and posting the black box on Instagram, they've been reaching out to me saying, “Here are the notes from class today. I got this recording for you because I know you've been putting in work on the advocacy front.” That's true allyship to me. I've really been pleasantly surprised and happy to see the support that I've gotten from my classmates.
There has been a widespread acknowledgment that COVID is affecting communities and people of color at much higher rates. I am curious if you think there has been an appropriate conversation around why that’s the case?
I think that in order to understand that we have to look at our history, and at policy. The original ill was, of course, chattel slavery. This country has not valued Black lives. The policy reflects that, and policy ties into our healthcare. That history of systemic discrimination is important to look at to examine the current landscape of COVID-19.
Redlining decided where people live in this country, and which communities our government and our local city councils were going to invest in. Black communities were not invested in. As a result, Black communities have not had access to the basic resources that they need to survive and thrive. They don't have access to healthy food. They don't have access to safe places to exercise. They are exposed to environmental pollution. They have less access to education. I mean, then you look at who is more likely to be an essential worker - Black people are overrepresented.
It doesn't end there. Once people get into the clinic, they have to deal with the biases and systemic racism in the hospital system. There are studies that have shown there are medical students and residents who still think that Black people have a higher pain tolerance.
We can take maternal mortality as an example of treatment differences. Black women, at all income levels, are dying disproportionately compared to white women. When they get to the hospital, doctors don’t believe their pain. I mean, it happened to Serena Williams. It is safer for Black women to not engage with the healthcare system because of the violence and harm it causes.
How do you think mistrust of the medical system compounded the COVID crisis?
I think it all comes back to this conversation of access, right? When COVID-19 first hit, the testing centers were predominantly located in affluent communities, and a lot of Black communities were left without access to testing. The lack of Black physicians and Black health care professionals means that when Black patients come in and say they have COVID-19 symptoms, they are less likely to get treatment compared to white people.
If you know there are no testing centers in your neighborhood, you know there is no representation in the hospital, and you know that you are going to be discriminated against once you walk in that door, you know your life is being devalued. That knowledge prevents Black people from seeking care from our healthcare system. With anecdotes of horror coming from your community, of course you are going to be nervous to trust the healthcare system.
What does a better understanding of investment into public health look like to you?
I think we need to turn all of the conversations that we've been having into public health initiatives. Racism was declared a public health emergency in Boston. That is the direction I think we should be moving in.
We need to move beyond equality to think about equity. We need to recognize that not everyone is on the same playing field. We need to truly make sure everyone's specific situation is taken into consideration. We do that by investing in those communities, and by looking at how we make sure they have access to good education, access to health care, access to housing, access to good food. Improving the conditions where people live, work, pray, play will improve their healthcare outcomes and our healthcare system.
Of course, we need things like the physical exam, but often patients go into that physical exam with preexisting chronic diseases caused by disparate suffering. Going as upstream as possible will lead to better healthcare outcomes and in the long run, improve healthcare costs. Even if investing in public health didn't improve healthcare costs, I still think that it's the moral thing to do. I think we're too driven by what's going to save money in our country. We need to do what's right.
Everyone deserves to have the basic resources they need to live out a viable, joyous life. Right now we are doing nothing to guarantee that.
Someone said to me once, we’re too focused on raising the ceiling and not at all focused on raising the floor in the American healthcare system. Do you feel like this starts as a medical student?
I can definitely speak to that culture. As a medical student, I'm really passionate about community activism. I am passionate about making sure that everyone has access to healthcare, and ensuring that we're teaching medical students anti-racism so that they don't go out and further harm communities. I can spend two years doing that – serving on committees, writing up reports, and changing curriculum at my institution. But my peers who are spending the same time publishing papers on very specific proteins and disease processes might have a better chance at residency.
In medicine, you're not incentivized to do work that you don't get credit for. You always want to be able to publish, and activism isn't always publishable.
It has been the responsibility of Black students, students of color, and indigenous folks to improve their institution. They do the work so that they can thrive and survive, and so the next generation can do the same. But at the same time, they still have to do everything they have to do as a medical student to get to the next level. I'm literally trying to improve the very environment that I'm suffocating in, while also trying to handle everything else that medical students are expected to.
There was a letter early on from public health officials advocating for protest as it’s needed to fight racism within the healthcare system. Does that feel new or was it already a part of the conversation?
I think it's always been a part of the conversation for those who have been oppressed.
But that is what is special about this moment. We literally had a global pandemic that exposed the disparate suffering of Black people across the country, across the globe. And then on top of that, you have back to back to back killings of Black people. It's heartbreaking that it took this much for us to start having these conversations, but we are having them, and people can’t run away from them.
There are no distractions. We're not going to get anywhere if people don't name systemic racism for what it is.
We need to say Ahmaud Arbery. We need to say Breonna Taylor. We need to say their names, and we need to name the issue at large.
Big-name organizations are just finally starting to realize that this is something that they need to get on board with. It’s hard to know if it's really genuine or not. I think that people don't want to be on the wrong side of history. Regardless, learning is still happening. I'm very happy that anti-racism is becoming the status quo and that we are having these conversations. We need to continue to push the envelope to get people things they need to live a good life.
interviews
Evaluating Debates From Experience
by David Vincent Kimel
March 13, 2019
This interview with David Vincent Kimel was conducted and condensed by frank news.
Mr. Kimel is a Yale Graduate Student in Roman History, Debate Coach Emeritus of the Yale Debate Association, two-time winner of Harvard's Coolidge Debating Prize, and Founder of the Transhumanist Society.
How has your history as an experienced debater informed your opinion on the subject?
I was privileged to be a member of the top ranked debate team in the country as an undergraduate at Harvard and the coach of the Yale Debate Association for six years. I also did some interviews with CNN and the Washington Post concerning political debates and served as an advisor for several campaigns. Insofar as this is true, I perhaps tend to watch and evaluate debates differently than many others do; for example, I am sensitive to tactics like dropping points, pivoting away from the questions at hand, delivering talking points instead of clear answers, etc. Unfortunately these all tend to be hallmarks of public political debates.
Why is debate as a medium so important?
Debate as a medium is important because at its best, it compels participants to see the world through the eyes of those who feel differently about the world than they do; at least this is true in competitive debate, where you can find yourself arguing any side of an issue in spite of your personal beliefs. In the realm of politics, debates compel candidates to try to articulate answers to difficult questions and to defend their perspectives using hard evidence, which is one indicator of what kind of a leader they might be if elected. Academically, the ability to debate respectfully is essential to progress in the arts and sciences, since debates can poke holes in existing theories and force advocates to diligently defend their beliefs and intuitions.
Do you think public debate should have a larger role in our national discourse?
I certainly believe that debate should have a larger role in our national discourse; when I turn on the news, depending on the channel I choose, I often feel like the priest is preaching to the choir; when I surf online, I can find “evidence” to support any cockamamie theory out there; when I visit Facebook, I see an avalanche of posts affirming my intuitions, and I disagree with my friends at the risk of losing them.
Debate fosters tolerance for difference of opinion, and this is too often sorely lacking in our current political climate. Of course, however, certain issues should not be debatable, and there are limits to the usefulness of arguments divorced from consensus building.
Do you believe debate is crucial to democracy?
At its best, debate is crucial to democracy because it empowers voters to make up their minds after hearing the most articulate arguments for and against various positions rather than going to the ballot box inspired by one sided narratives and propaganda for your favorite candidate. People treat politics like team sports when they should really approach it more like a jury-trial.
How would you adjust or change the current political debate format?
Insofar as this is true, certain steps can be taken to improve the quality of discourse. For example, I see no need for rowdy television audiences distracting viewers from the candidates’ ideas. There should be written debates instead of just oral ones, allowing for deeper levels of analysis. Moderators should be able to stop candidates when they veer into talking points. At the same time, politicians should be challenged more thoroughly on where they disagree with their party’s common platform. There should be more specific situational debates (what would you do if...) rather than just generalizing queries. Candidates should sometimes be asked to judge debates and evaluate expert opinions rather than just arguing among themselves. In some debates, candidates should engage with experts in the field rather than bickering with their opponents. There should be topical debates on issues like climate change and tax policy, and with great frequency too; this would be better than lumping every issue together in three or four events. Finally, perhaps there should be impartial judges who grade the candidates according to various metrics (poise, truthfulness, originality, etc), at least sometimes. Otherwise there’s no accountability for what’s said.
Who is the ideal moderator and what is the moderators role?
The ideal moderator should be a respected and impartial figure. However, much depends on the format. For example, in a debate about specialized topics, I’d like to see experts weigh in with their opinions and even debate the candidates. I’d also like to see more panels of moderators representing not only centrist positions, but a range of political intuitions. The problem now is that our formats for debates are not diverse enough. Sometimes, for example, the candidates themselves should be the moderators and be asked to synthesize and evaluate the opinions of others; we might learn more from how they judge debates than how they participate in them.
You coach collegiate debate – what makes for an effective debater?
There are great qualities which both effective collegiate and political debaters share in common: poise, eloquence, confidence, warmth, and truthfulness. Unfortunately, good college debaters are also experts at flattering judges into voting for them by playing up to their intuitions and exaggerating the flaws of the other side, and effective political debaters can preach to their base and drum up support by avoiding controversy instead of seeking truth.
There also needs to be more questions about compromise and consensus building and how candidates differ from cookie cutter stereotypes of their party’s common platforms.
How can we move beyond argument and bickering towards more effective debate?
For debate to be more than bickering, there needs to be a process after the debate takes place for a judge or jury to weigh arguments instead of pitting them against each other. This is one reason why I think candidates should sometimes be asked to judge debates instead of only participating in them. To democratize debate, there can be formats in which viewers from home can tell their stories and participate, etc.