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But this is an example of how system-wide bias can harm black mothers, who are two to three times more likely to die in childbirth than white women even when you control for factors like income and education, which often make racial disparities disappear.īut while this obstetrician and others see the problems endemic in their field, they’re also alarmed by the dogma currently spreading throughout medical schools and hospitals. There’s no biological reason for race to be a factor here, which is why the calculator just changed this year. That means clinicians are more likely to counsel black patients to get c-sections, a surgery they might not actually need.” And if they’re black, it calculates that they are less likely to have successful vaginal delivery. “You put in the age of the person, how much they weigh, and their race. “There’s a calculator that people have used for decades that predicts the likelihood of having a successful vaginal delivery after you've had a cesarean,” one obstetrician in the Northeast told me. Sometimes it’s overt racism from colleagues or patients, but more often the problem is deeper, baked into the very systems clinicians use to determine treatment. They are largely politically progressive, and they are the first to say that there are inequities in medicine that must be addressed. These aren’t secret bigots who long for the “good old days” that were bad for so many. Most concerning, they insist that it is threatening the foundations of patient care, of research, and of medicine itself. They say that it’s turning students against their teachers and patients and racializing even the smallest interpersonal interactions. This dogma goes by many imperfect names - wokeness, social justice, critical race theory, anti-racism - but whatever it’s called, the doctors say this ideology is stifling critical thinking and dissent in the name of progress. What is happening, they say, is the rapid spread of a deeply illiberal ideology in the country’s most important medical institutions. The members share their concerns about what’s going on in their hospitals and universities, and strategize about what to do. The meetings are largely a support group. Others are dedicated to serving the most vulnerable populations in their communities. Some work for the best hospitals in the U.S. They vary in ethnicity, age and sexual orientation. They meet once a month on Zoom: a dozen doctors from around the country with distinguished careers in different specialities. She is now, along with Jesse Singal, the host of a podcast called Blocked and Reported. I first learned of her work when she was writing for The Stranger in Seattle, covering topics including detransition, the scandal at Evergreen State College, and the impact of what we now call cancel culture on some small businesses in the Pacific Northwest. Katie could have had a career as a stand-up, but for some reason she decided to become a journalist. And Katie Herzog was the perfect person to pursue it.
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It was clear that this was a story that deserved to be told. No truth, no medical progress.įor several months, I have been talking to a group of doctors who are alarmed at what they are witnessing in some of the top medical schools and hospitals in the country. Without being able to discuss reality and take intellectual risks, it’s impossible to get to the truth. In part it’s because the stakes feel so high.īut if any area is more urgent, it is the world of medicine, where the ability to speak truthfully is quite literally a matter of life and death. In part, this is because the legacy press is ignoring or lying about the story. Readers of this newsletter know that I’ve been particularly focused on it. But there are sectors where the stakes of the ideological takeover are higher. This is wrong when it happens at a company Apple or Condé Nast. That’s one of the lessons I have learned over the past few years as the institutions that have upheld the liberal order - our publishing houses, our universities, our schools, our non-profits, our tech companies - have embraced a Manichean ideology that divides people by identity and punishes anyone that doesn’t adhere to every aspect of that orthodoxy. They just require a sufficient number of well-positioned true believers and cowards, like those sitting in the C-suite of nearly every major institution in American life. Revolutions can be bloodless, incremental and subtle. I always thought that if you lived through a revolution it would be obvious to everyone.
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Several hundred health-care workers protest against police brutality on June 5, 2020, in St Louis.