Education equity for under represented minorities
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Candice Blacknall, Dr. Qaali Hussein
As you all know, these motivation Monday conversations are all about normalizing the human experience along the journey to medicine. This is all born out of the movement that GABA currently has to make everyone aware that you don't have to be perfect. And you don't have to be this cookie cutter person in order for you to be successful in medicine. Okay, I'm so excited. I feel like it's been like ages since I last talked to you. But I'm happy that you're here. To everyone that's listening. Thank you so much for joining us for our first ever motivation Monday, you're about to be super intelligent. Great. Dr. Hussein has been out here changing the world, one conversation at a time. And so today I'm very excited to have her on to talk about diversity and the importance of pipeline programs and where we can just go from here, how can we can be better? How are we gonna be, you know, great. So document is saying I like can't even do your introduction, justice. Tell everybody that's listening, how you've been taking over the world?
Candice Blacknall 00:03
Dr. Qaali Hussein 01:07
Well, I don't know if I'm there just yet. Working on that. Well, my name is Barry Hussein. I am a trauma surgeon. I practice in the state of Florida. I trained in Texas. And actually, no, I'm in the state of Arizona. I was in Florida. And I trained in Texas. We have a lot going on. And I'm originally from Somalia, and came to the States as a nine year old. They started in fourth grade here did all my schooling in Texas. And now I do trauma and acute care surgery. And I'm also a mother of six little ones.
Candice Blacknall 01:53
Yeah, so you stay busy.
Dr. Qaali Hussein 01:56
Yes, very, very busy.
Candice Blacknall 01:58
Yeah, next time I complain about being tired, I will think of you and be like no, no, you don't know tired? You have no idea. So naturally, both of us, you know, melanin, Exhibit A our background. Yeah. Why don't you share? Like, what was your journey to medicine? What made you go to trauma surgery? And how was that journey may be different for you than some of your peers.
Dr. Qaali Hussein 02:23
So I, I've always been interested in medicine, and surgery came into the picture. Because as I grew up, I realized I really liked working with my hands. I like fixing things. I like building things, you know, with my dad and with my brothers. And so the technical aspect of it of surgery really attracted me. But, you know, when we were in Somalia, we had a civil war breaking our Yeah. Unfortunately, my grandmother was shot in the war. And I was one of the people who observed that I was in the same truck as her. And in her legs were shot and I was one of the people who was holding pressure. And so that was my first exposure to actual trauma that happened within my family, thank God, she survived. And she was able to, you know, rehabilitate, start walking again, when we were in Kenya, and then we came to the US. And so I really saw her go through that and how long it took her to recover. And so as I started, you know, pursuing medicine, she was one of the people that really, you know, had a really life changing conversation with me to tell me, you know, to not listen to the naysayers and to really pursue what I wanted. When I got into medical school, and I started doing surgery, trauma was one of those things that automatically clicked for me. And it really, you know, at the time, it didn't, you know, it wasn't those two things. Oh, you know, I saw my family go through this. Now I can, you know, save lives. It was just like an instinct, like a feeling that I really couldn't explain, but I was automatically drawn. And so that's one of the reasons why I went into surgery.
Candice Blacknall 04:10
Oh, wow. Like, that is an amazing story. I naturally didn't have this. I love trauma surgery. But let me tell you, I don't know how y'all stay up for as many hours as y'all do.
Dr. Qaali Hussein 04:21
It's the adrenaline. It's the adrenaline like you could be sleepy and a trauma comes in and it's like, you know, nothing else matters.
Candice Blacknall 04:34
Maybe it's different from the medical senior perspective, because I'm just standing there retracting the whole time that Nah, nah, nah, but, yeah. Yeah.
Dr. Qaali Hussein 04:45
But when a trauma comes in, when you're the trauma surgeon when a trauma comes in, it's, you know, you're trying to figure out figure out a puzzle, right? Yeah. What is killing my patient? You know, where are they bleeding from, you know, how can I stop it? So I that's how I tend to go and you're trying to solve it. And so until your patient becomes stable, you're trying to figure out, okay, where is it isn't the head is in the chest is in the belly, you know, how can we save this leg? So it's, I think that part of it is what's really intriguing. And that's how you how you can easily forget the fatigue of being up for 20.
Candice Blacknall 05:25
Yeah, 24 hours is a long time. But yeah, I can definitely see that. And so you've, you've like, taken your commitment to healing and to, you know, fixing the problem into the conversation in the context of talking about diversity, and diversity education, and I just love that I love. Of course, that's what we talk a lot about it Gala. And so I will just love it if you share, like, you know, what inspired you to do that work, and really take that conversation to the next level.
Dr. Qaali Hussein 05:55
So as I was going through, you know, my pursuit of medicine and in pursuit of a surgical education and training, the most consistent message that I have received throughout my years has been that I don't belong. All right, my, you know, educational achievements, the fact that I was, you know, always at the top of my class didn't matter. You know, my hard work didn't matter. My determination didn't matter. You know, no matter how committed I was, to my work into this field, I was always told that I wasn't welcome. Right. So, you know, I, and I kept pushing myself over and over and over to keep proving people wrong. And every single time I tried to do that, you know, the goalposts has been moved for me. You know, you as a Muslim woman, you're not welcome in medicine, I got into medicine as a hijabi. Woman, you're not going to be welcomed into surgery, which is a, you know, white male dominated field. I got into surgery as a hijabi. Woman, I was told to take off the hijab, I put my foot down and stood up and said, Nope, this is who I am, I have a civil rights that you can't, you know, violate. And so when they become
Dr. Qaali Hussein 07:18
part of your priorities have changed, and you are no longer committed to being a surgeon, right? So, you know, and I, and I kept having kids, and it was, Oh, you know, you're not prioritizing medicine, you're not prioritizing surgery, therefore, you know, you're taking up somebody else's spot, you don't belong here. And so no matter how much I pushed it, it was never, I was never, I never felt welcomed as who I am. And I've never felt like I was being helped. There are a few, you know, people who were supportive along the way who would, you know, support me behind closed doors and encouraged me, but publicly, I mean, there were things happening where I was a chief resident, and by that time, I've had an intern, baby, a second year, baby, my chief here, I was pregnant with my twins. Or I had my fourth year baby, and my chief here was sick, and I was pregnant with my twins. One of my fellow colleagues, male whose wife had a kid, you know, is being praised at Grand Rounds. And you know, how wonderfully he's taking on both, you know, fatherhood and surgery and how we need to go easy on him, because he's not sleeping at night. And I'm standing there two weeks postpartum, and nobody's saying anything. Right, right. And every time I'm pregnant is like, Oh, you know, you're such an inconvenience. So that consistent messaging really took a toll on me. And when I finished, I got to the point where I finished and I passed my boards, and my, you know, program director was shocked at the fact that I actually passed my boards, and, you know, took it upon himself to make me feel bad about the fact that I had, you know, six kids and I would never be able to afford sending them to, you know, private school. Right.
Dr. Qaali Hussein 09:00
everything that you accomplish, is belittled, and is, you know, negated by the next thing that you can accomplish that when I finished, you know, it took me about it took me about three years to really deal with the trauma of going through all that negativity, and I started writing and I started, you know, all this stuff, nobody deserves to have this much negativity in, you know, their pursuit of a you know, of a career in which they want to actually take care of people. And so, as I started sharing my story and sharing my experiences, you know, it just people connected and, you know, felt you know, that they were going through the same thing, but everybody suffers in silence. I've suffered in silence because I didn't want to share with anybody because the message is what you know, We told you so we can't. It's impossible, right? Everything I've accomplished today, I've been told it was, you know, it was impossible. And I've actually had my first job interview for a foreign academic position. I had a chairman, throw my CV across the table and tell me I've accomplished nothing. After having kids in surgery, it's in a surgical training program, multiple kids. And so, you know, you I was told it was impossible to accomplish all those things. And by the time I have accomplished them, they were called nothing.
Candice Blacknall 10:33
Right? Yeah. What, if you just keep going and going doesn't matter how great you are, they just gonna keep asking for more and more and more and more and more, it's to break you down?
Dr. Qaali Hussein 10:45
Exactly. So. So because of that, you know, over the past few years, I've really been documenting all of my experiences and the lessons that I've learned. And, you know, I've turned, I realized that we need to approach this differently, right, we tell people to, to, you know, work hard and prove people wrong, and, you know, be be the best that they can be at the top of their class. But what I've realized throughout the years is that none of that matters. Yeah. Right. Yeah. Because the best matter class, you can be the most determined you can be, you can be the most dedicated, and you're still going to face the same negativity, you're still going to face the same, you know, pipeline issues in the pipe, the pot with the pipeline problem is, is, you know, for diversity and inclusion, what what, all all of these different fields, what they've decided to do is they decided to recruit more diversity, right, right, to recruit more black people, more people of color, more, you know, religious, underrepresented, religious minorities in these different situations. So they've recruited people into these fields, but the fields remain exclusive, that remain racist, the fields remain exclusionary, to people who don't belong, who don't look like the majority. So what happens is people come in, they get harassed, non stop, they get discriminated against non stop, they don't get supported when they need support. So what do they end up doing? They start leaving, right? So you have this pipeline you're trying to get people through, but there's so many holes in the system, that people just keep leaving and leaving and leaving. And what you end up with is the same problem that you started with. Right? You don't have if we don't have enough diversity, we don't have enough diversity. Because yes, you committed to bringing people in, but you you still have a system that remains hostile. That remains toxic. Yeah, right. Yeah. So So what I've learned is how to navigate through the system, how to go into it with your own values, and how you're going to stick to your own values and shut out the negativity that is pervasive in the system. Right. Yeah. So that's one of the things that I teach in my, the taking up space masterclass that I, you know, recently created, is, we need to approach this differently coming in, you know, into a, into a place that is hostile to you and who you are and what you want to accomplish. Unless you're prepared to deal with that. It's, you know, it's like you're being sent in to the wolves. Right. Yeah. That's, that's exactly how I felt. But we need to strategize a we need to approach this pipeline problem differently.
Candice Blacknall 13:32
Yeah, no, and I absolutely agree. I mean, even as I'm thinking back, as you're, as you're talking about, you know, my own experience as a minority student, I'm a fourth year now. And I'm from Flint, Michigan. So the idea of me coming somewhere and going getting to medical school was such a hurdle. I mean, there's a cost obstacle, there's a, you know, you have all these different exams, you have to prep for, like, how do you even begin to know what you don't know. And then you get into this system. And it's exactly like you said, there's not enough support built into the, into the experience for minority candidates who are coming in and they need that support, they're gonna make it and navigate and but I think what's amazing about what you say is that, that support doesn't come from just having more counseling services or more, you know, more study materials, that support comes from building the person on the inside, and giving them that armor so that they can go into those experiences and not only protect themselves, but potentially, you know, change the structure of the institution from the inside, I think and I think that's amazing. And it's clear, you've been able to do that. And I'm just like, how, how did you do it? Because I remember I remember going in deciding I was going to go get my MBA and hearing and having an administrator say like, No, I don't see you as a business person, and me having to really step back and You know, no candidates, who are you, besides what this person is trying to tell you, and go and pursue your goals? And so, you know, for the students that may be listening, like, what would you say helped you get to a place where those things didn't stain, and didn't deter you from your goals?
Dr. Qaali Hussein 15:17
that's what I like to call value based goal setting. Right? Everybody who goes into medicine sets, you know, generic goals of, you know, I need to get this MCAT score, I need to get out of this much research, I need to get this, this, this and that. Right. Yeah. One of the obstacles that, you know, minority students will face is that, who they are, is an obstacle in itself. Right, it's really sad to say, but who they are, who you are, as an individual, you know, the color of your skin, what you wear on your head, as part of a religious, you know, practice is how you carry yourself how you speak, all those things are part of who you are as a person. Reality, like, the reality is, we live we live in a society and we we practice in a in a field where those things are, are defined as abnormal, are defined as unprofessional, right, are seen as less than, right. So want to play a pivotal point, in my, in my journey was the conversation that I had with my grandmother when I was 15 years old. And I was struggling with, you know, taking on the hijab, and you know, practicing it. And, you know, the fact that I wanted to be a surgeon and how I was told that the two are completely incompatible. And she told me this, you know, story of how she basically changed our entire family trajectory. She got married at the age of 13, to my 14 year old grandfather, and she had multiple kids, right? And couldn't go to Yeah, she didn't go to school, she didn't, you know, she didn't get an education. But she was a brilliant woman. Right. So what she decided for her children is they're going to go to school, they're going to get their education, you know, marriage is going to be secondary. Yeah. You know, when they're self sufficient when my daughters are self sufficient, and they can make decisions for themselves, and they can support themselves. They have the freedom to get married. But she never, you know, took up picket signs, she didn't argue with anybody. She ruled her house, like her household with an iron fist, she made that, you know, decision between her and her children. And when people would come and seek her daughter's hands of marriage, she was very respectful of the culture and her people. And she would be like, oh, okay, thank you for coming. And in private, she'll say, No, don't do that.
Dr. Qaali Hussein 17:51
And so because of that. And then when they got to college, you know, age, she told them, you know, they worked really hard, got scholarships, and she sent them abroad, with the women by themselves, right? In a time when women were getting married, right after high school. Back to Allah says Muslim men, you know, who's looking out for them, what are they getting into? So she took, she took all that in, and didn't respond, because she knew what her goals were for her daughter for her family. Right. And so when the war happened, we were all like, we had people abroad to sponsor us. And so we were lucky. Right? And not once did she argue with anybody? Does she, you know, fuss at anybody or say, This is unfair, she just did what she wanted to do, because she knew what her values were. So she told me that story when I was 15 years old, she said, Who are you arguing with? Whether you're going to wear hijab or not? Are you asking anybody permission? And I was like, no. And she's like, and you're in America, right? You have rights you have, you know, nobody's gonna come and take the job boss with you, right? no, and she's like, don't ask anybody permission. Like you. You know what, the only thing you're important to you that's important for you to accomplish is study, make the good grades and see, you know, if you're in a place that will accept you for who you are, and if they don't accept you, then they don't deserve you.
Candice Blacknall 19:26
Yeah, yeah. Exactly. Okay.
Dr. Qaali Hussein 19:31
exactly, exactly I think, my, I'm thinking of, you know, some elders in my family saying, you know, the people that bind don't matter, and the people that matter don't mind. So don't, don't let people tell you who you are and what your value is. And I and I agree with you, as a as a minority, you have to be reminded, you have to remember that you should not go into these systems looking for validation, because they're not going to validate the thing that makes you most, you know, special. And the thing that really makes you a standout doctor and a standout medical candidate, which is, you know, all of this, everything, yeah, all of this. And so if you can't see it, that's okay. People didn't recognize the cost. Oh, that's all right. It's my job later,
Dr. Qaali Hussein 21:24
eventually, they'll catch up, eventually,
Candice Blacknall 21:26
they'll catch up. Yep. Eventually. Um, and I am. So I'm listening. And I think that, I think that that's so important kind of reaching back and thinking about, you know, the people in your, in your background, who have supported you, who have inspired you, and encourage you, even as you're going through situations where people may not be. And so that kind of like makes me wonder, like, Who are your mentors who inspires you
Dr. Qaali Hussein 21:52
every day? Well, as I told you, my grandmother, so first and foremost, she was the first she was the person who set me on the right track to say, you know, what, you're caring too much about, you know, other people, you know, yeah, sit down and figure out what is important to you on what you value. And so because of that, you know, I really came to prioritize differently. And so, you know, number one is family, you know, they're the ones that throughout my, you know, my training medical school residency, that I really leaned on a lot, you know, to, every time I would,
Dr. Qaali Hussein 22:35
I think that's one of the that unfortunate lately, a lot of minorities that I encounter, especially, you know, if you're from a Muslim background, if you're, you know, from communities where families really, really important, sometimes we have that divide of, you know, them telling you to stay, you know, staying true to your values and your beliefs is, you know, it may not be possible for you to, you know, have high ambitions, right. And so a lot of people stray away from that straight away from the family unit and the community, because they have high ambitions. And I think that's one of the sad things that, that I've seen in a lot of young people pursuing, you know, their big, audacious goals. And that's one of the things that I always try and teach to say, you know, what, when, when this ambition that you're reaching for knocks you down, right? Yeah, it's gonna get rough. Guess who's gonna be there for you, right, guess who's going to be there to support you and to really, you know, regardless of what, you know, issues that you guys have been through the people who are going to really support you, and who are going to be there for you, unconditionally is going to be your family. So, so those are the people that are really, you know, hold dearly, is is the family in the community that really has supported me. And I have some wonderful mentors, you know, within the surgical world, that that throughout the years have, you know, told me that I was stubborn, but that they support you anyway. Love you anyway.
Dr. Qaali Hussein 24:15
Yes. You know, we don't know why you keep why you keep having these kids. But you know what, as long as you're operating,
Candice Blacknall 24:24
why you keep? Yeah, yeah, family. Yeah. I'm sorry. Go ahead. Go ahead.
Dr. Qaali Hussein 24:37
No, and leave and they've been some of the people that, you know, question. keep it you know, we'll keep going and see how things go. And, you know, at the end, they said, you know, you proved us wrong.
Candice Blacknall 24:55
I mean, and you have done it above and beyond. I mean, because you're not just us. surgeon, you have a book, you have a website, you have a master class, you have your family, like you do it all, if there was a person, I was like, You know what? It's possible, you are like right there in my mind, you can do it all. And like just hearing you say, you know, you have people, people were saying, you know, you have too many other things outside of medicine or outside of surgery to actually be committed to this field. It really, it really breaks my heart. Because I think that one of the really big reasons we have such an issue with physician burnout, and just the mental health crisis overall, is because it almost becomes like you have to abandon all passion or interest outside of your field, in order for you to be taken seriously in your field. And you've really shown that, no, that's not only not the case, but you really do help the next generation of leaders when you don't do that. So like, yeah,
Dr. Qaali Hussein 25:54
you know, if I had a dime for every time people told me that I probably be a millionaire by now. It's, it's ridiculous, right? The whole idea that if you're, you know, the whole, you know, what are the legal residency terminology came from?
Candice Blacknall 26:10
Oh, tell me,
Dr. Qaali Hussein 26:12
you know, if I had a dime for every time people told me that I probably be a millionaire by now. It's, it's ridiculous, right? The whole idea that if you're, you know, the whole, you know, what are the legal residency terminology came from?
Dr. Qaali Hussein 26:12
trainees were, what lived in the hospital, they were residents of the hospital, They never left, they stayed in the hospital, and they stayed there for months on end. got home, you know, once in a while, and then they went back and went right back to work. Right. residency is, you know, the whole work our restrictions comes from the fact that residents rarely ever left the hospital and they were worked to death. And, and you know, you weren't, you get worked so many hours, that you don't have time for anything else. And that in that you get so fatigued that you make mistakes. And what's been happening with the whole, you know, work, our restrictions and restructuring what residency is, is because we have decided that as residents and as trainees that you don't have a life outside of the hospital, and when you're there, you're, you know, taking care of patients 24 seven, and that, you know, you're not a human being. Right. So what's happening now is we have a lot of burnout, physician suicide is high, There's like, at least one or two patients one or two physicians killing themselves a day. Right. And we have physicians leaving the workforce and going into non clinical, you know, fields. So, you know, the physicians shortage that we had, is getting worse. Yeah. Right. Yeah. And, you know, and forget about the diversity and inclusion stuff that we were talking about without even doing anything about that, right. Because, yeah, all we're doing is just, we're recruiting more people into the same toxic environment. That's awful for a lot of people. And, and so, you know, the diverse people that we recruit, also leave as well. So it's, it's a multifaceted problem. So the way I've approached it is, you know, one of the things that in addition to my hijab, one of the one of the other personal values that I really wanted to hold on to was the fact that I, you know, love kids and wanted to have a family. And so I actually wanted to wait until I was, you know, chief resident, have my kids just like everybody else and leave, you know, have my kids after I was done,
Dr. Qaali Hussein 28:36
right. So what I saw by accident is that when I had kids, I became better at managing my time, I became better at you know, prioritizing what needs to be done a win. And I, I did better on my app side scores, you know, are in training exams, scores, like the more kids that I had, the higher my score. It was really odd. It was really, really, you know, what I doing it and nobody, you know, is like, what is they like to say it goes either way. It's so really, like, it really opened my eyes up to the fact that when I had you know, when other parts of my life were what were going well, I you know, I would come home and instead of obsessing about what happened at work, I had my little baby to play with, right, all the all the bad things, all the worry, you know, would just like melt away, I would talk to my husband for about, you know, five minutes about oh my god, this happened at work. And then I would, you know, be with my baby, right? Yeah. Oh, my worries would you know, would you know, wash away and then I come back to work, you know, ready for a new child ready? Yeah. And it really hit me and I was like, You know what, you know, we have it backwards in medicine. When we say put your life on hold, and you know, just focus on this. You'll never have time to You know, unwind, and recuperate and recover, and then come back as a, you know, as a, you know, working from a full cup, you know, we're always running on empty, you know. So the more I did that, the better I became like, I became a better resident, I read more, you know, I did question, you know, banks in between cases, I would, you know, stop by a coffee shop for 30 minutes max. And, and, you know, read and then go home and play with my kids guilt free. Because I did my work, right, I took care of, and I took care of my patients, I did my studies. And now I was like, home free. So I saw that, and I was like, there's, there's something we're missing in medicine, when it comes to work life balance, we're missing the mark. And so when I, when I came, when I finished and I started, you know, my work, I decided to, you know, change my schedule to where I do what's called block scheduling, where when I work, I'm working 100%, right, my, my calls are back to back to back. But when I'm home, I'm, I'm with my kids. Yeah, you're with your kids, you're with your family. I'm 100%, mommy. Um, and when they're in school, doing their other stuff, I can do my other things where I do something like this, or I write or, you know, I work on my on my master class. And so, you know, the having that all these dimensions to your life, I think makes you more productive makes you like, when I go back to work, I'm like, Oh, I want to do a thoracotomy, I wouldn't do it.
Candice Blacknall 31:38
Where was that? For me. As a student, I'm like, x lab again.
Dr. Qaali Hussein 31:48
I mean, like, when I when I go back to work, you know, and I'll do that for like two weeks. And at the end of the two weeks, I'm like, Okay, if I do want to retired, I was like, I gotta play with my kids. And then I get off, you know, I'm home with my kids. And, you know, at the end of the two weeks, when they're driving me nuts, I'm like, I gotta go operate. I'm ready to be gone. Again, I'm ready to be done. So I need to go back. And I think that balance is what really makes me you know, productive, right, I have to these two facets of my life where, you know, each one motivates me differently. And each one replenishes me and rejuvenates me differently, to where I'm always excited about whatever it is, I'm doing, right, I'm always excited to try you know, new things with them. I'm always excited to try you know, learning new procedures at work. And like, you know, in the next couple months, I'm I'm going to start doing robotics. Right? Like, very cool. That's what we need. And in order for us to thrive in our work environment, we have to live a value based life where you don't feel like you're neglecting, you know, the whole work life balance thing where you're doing, you know, everything 100% all the time. I think that's a fallacy, right? There are times when you know, when I'm at work, and I'm, you know, certainly I'm more focused on my work than my kids. But you know, what, my kids are not abandoned? They have, you know, I'm home when I'm home, if I'm not my husband's home, right. So, and and the time that I'm not working, you know, it's not that I'm less of a surgeon, because I'm not working these two weeks. Right. I took care of my patients, I have colleagues who I trust who are taking care of my patient you. Yeah. So I think we need to have that balance of, you know, integrating our work, and our life, right work life integration, not necessarily balance. And, you know, being there and 100% for each part of that.
Candice Blacknall 33:41
Yeah, I absolutely agree. And, you know, it's such a strange paradox, because doctors treat humans get the field of medicine doesn't allow doctors to be human. How strange is that? And how and how did we get here? And sometimes I think sometimes I hear, you know, physicians that have been practicing for a little while, and they're like, Oh, you know, they have all this technology now. And it you know, we've learned we're losing the human interface. And I'm like, I don't think it's been, I think it's not been there for a while we've treated it's just that humans have been their machines, we've treated each other like. And we've pushed each other beyond the limits of, of human capability and a lot of ways and it's time to really step back and like you said, establish value based goals so that you can go into practice in a recharged way. I love that. I love that as a person who has a million different hobbies.
Dr. Qaali Hussein 34:48
absolutely, you know, definitely there's there there's hope. And I think, you know, most of medicine doesn't embrace that and that's that's a really sad reality. But I think as individuals, you know, that's why I focus more on the individual level and reaching out to, you know, medical students and those in training pre meds to really say, you know what, you can go into this and you can be the force for change. Right, you can be your own agent of change. And I don't think we give ourselves enough enough credit as to how much power we have, in effecting change that we want to see.
Candice Blacknall 35:31
Yeah, no, I absolutely agree, especially at the medical student level, I think, you know, I remember hearing my peers that maybe I'm not necessarily the best example, because I'm not a traditional student. But I know that there were times as a student, it's hard to speak up, it's hard to self advocate. And it's those moments when you see something wrong or you feel uncomfortable, and you don't speak up those those moments, they kind of haunt you after a while. So it makes sense, when you say it took you three years to kind of pull back the layers of almost like a PTSD, you have to like, pull the layers of trauma back from this.
Dr. Qaali Hussein 36:06
Absolutely, absolutely. And, you know, I think, you know, one of the things that I've seen, that happens very frequently on social media is, you know, we're all going through these multiple levels of discrimination, right? It's, you know, there's implicit bias that we've all seen, there's explicit bias that some of us have seen, and nobody ever teaches you how to deal with it. You know, not not many people are in a place to speak up. Not many people are in a place to, you know, say exactly what they want to see, what would they want to say, without consequences, right, without repercussion. And recently, like, if you go on social media, you'll see, you know, faculty, you know, attendings who are being suspended for speaking truth. Right. Yeah. For for just, you know, talking about their own personal experiences. Right. And, and they're experiencing retaliation. So what, you know, what is the expectation of a medical student, you know, right, President, you know, to, to have fair hearing, or, or someone to actually side with them and listen to them. So, so I think, you know, that, you know, reporting things and, you know, speaking up and saying what exactly it is that you want to say, I don't think those are the only options available, there are ways to be strategic around it. That's one of the things that I uncovered for myself after going through my, you know, dealing with my PTSD, and I, and those are the things that I really, you know, want to empower students with, because I feel like if you can do that, if you can get through this, this toxic system, because I feel like in order to change a system, you have to be experienced with it. So many more people experienced with the ins and outs of the system, get through it to the end, and then be in positions of power, where they can say something, and they can do something about the system. Yeah, right. Our pipeline problem is not going to fix itself and the people in positions of power right now, don't even want to hear about it. Right? at the first sign, you know, of the fact that there is a problem within their, their academic institutions, what do they do, they retaliate against the very people that are victims that are, that are at the receiving end of the problems that we have. Right? So I feel like it's going to take those people that are directly impacted, to to change the system and but they have to be in positions of power to do so.
Candice Blacknall 38:47
Yeah, I agree. I agree. And I wonder sometimes, you know, what's the fear, you know, with within these institutions? Like what is what what does it do for you, if you hear a problem and you fix it, you would think that it would speak you know, higher have you as a as an institution as a leader to be able to take that feedback and, and grow. But you're absolutely right, you were seeing that all around the country, especially because of COVID now, we're learning weirdly like seat COVID is really like rolling back the layers and showing the true realities about how our healthcare professionals are not supported and a lot of different ways. And I think people are watching now we're watching how do you as an institution support you know, our heroes, the people that allow our family members and our friends to have to live and have dreams and health and you know, vitality, how do you support those people? And I sometimes wonder, what are they afraid of? Like what what's so bad about saying we have room to grow?
Dr. Qaali Hussein 39:51
Because I think one of the one of the problems that I've seen with when the issue of, you know, racism and sexism you know, I think those are the most, the two most common things that come up is the emotional component of it. Right? Every time you you hear people talk about that, they automatically feel like they're being they're being directly called out. Right, that they are being called racist if they're not dealing with racism in the right way. So I think it's the emotional response that's overriding everything else. Right. They feel like they feel compelled to protect themselves from being called racist. And so they, you know, their automatic response is retaliation or, you know, saying know, that it's not, you know, this is not true, we, we can't be racist, because we're, you know, we tweet about, you know, you know, diversity.
Dr. Qaali Hussein 40:46
you know, how dare you call us racist? when we, when we tweet out the that, you know, there's only 3% of black men in medicine? Right. So, yeah, I think that we have to uncouple the emotional aspect of, you know, the fact that, you know, racism is killing people, right? The social determinants of health racism as part of it, right. Within our healthcare system within, you know, our, how our society, politics, everything, how is how it has impacted communities, we see the impact that racism has on the health of our populations, right, yeah. So, you know, why can you not be objective? We can be objective about, you know, medical error, right? We've had a culture change in medicine. Absolutely not a cultural change in medicine in how we deal with medical errors, right? Because that's an emotional thing, too, because I don't make errors. I don't, you know, foreign nations. So we've had that change, right, we've approached it from an from a systematic way. I hope, hoping that we can do that with racism, but it's going to take a lot of, you know, brave leaders to really, you know, check themselves and say, you know, what, I understand this is an emotionally charged situation, but we can do better the same way we appaled. You know, medical errors, you remove the individual responsibility out of it. That's, that's how we deal with with errors. Right? No point. Yeah. Or what individual is, say you did this, we say, How did the system fail? You know, you know, if there are tools that need to be retrained, we do that if it's if it's a system thing where multiple people missed it, then we fix that, right, we make we make it safer for us to provide medical care, we can make our our institutions less racist by ended up identifying where racism happens. Right. salutely. But absolutely, you know, it's been 400 years of, you know, this country dealing with that. So it's, it's going to take a lot more than, you know, a few, you know, diversity inclusion workshops and speaking engagements for us to really deal with this, but I think I'm hopeful. I'm really hopeful, but it's going to be a long way.
Candice Blacknall 42:58
Yeah, yeah. No, and I agree. One of our, one of our viewers, Dr. Swallow Salaam, said, I think one issue is that people don't think something exists until they experience it themselves. And that's, that's absolutely true. I mean, people, you know, especially with police brutality, and it was interesting, it all happened at a time when we were all held captive at home, we had no choice but to watch the news and watch the media. And people, I was blown away by the number of people who were so surprised, and I and I felt kind of sad that I as a minority wasn't surprised. But it was like it. It wasn't real until it was real. And I think COVID is highlighting especially this we're seeing that communities of color in particular are negatively impacted by COVID. COVID is really highlighting that diversity in medicine is a health care issue. It's not about just one person, like you're saying it's a system that ultimately feeds in hurts a larger objective, which is to protect our patients and improve health and wellness.
Dr. Qaali Hussein 43:58
It does. It does. And we've had we actually have recent studies that show that, you know, improve diversity improves mortality. You know, there's there's a recent study that came out, I think, out of Minnesota, where they looked to add infant black infant mortality, when they matched, you know, the race of the infant in the doctor, right, black infants survived with, you know, more when they were cared for black by black physicians. Right. That means there is something there, right. There are issues that are, you know, important within the Somali community that, you know, I and other Somali physicians talk about and bring to light. One of my, you know, colleagues who's in who's in Seattle, creative Somali Health Board, highlighting the issues within the Somali community that nobody else you know, identified. Why because she connects with that community.
Candice Blacknall 44:53
Dr. Qaali Hussein 44:55
You can message more with that community. So the last diversity in medicine, like harms our patients. Yeah, save more lives with diversity in medicine, but a lot of people don't see it that way. Right? People get offended by saying, Well, you know, I as a non, you know, by, you know, black indigenous person of color, physician, um, I can take care of any patient, you know, the same way, as you know, as anybody else. You know, there are patients that may not be comfortable talking to you, but they're comfortable. Yeah, from their own background, right. I've seen that firsthand with a family, you know, who were there from the Middle East. And there was a miscommunication between, you know, our team members and, and the family, you know, issue with the age and a lot of things got missed in translation, and whether the family wanted surgery or not, I came on and the next day, it was like, Well, what happened there, Lester, you know, thank God, sister. I'm glad you're on. I can, I can talk to you. And all of a sudden, yeah. All the miscommunication. You know, that that house away? Yeah, we cleared it up. And they're like, we want surgery. We just had a whole bunch of questions, because he's a, you know, patriarch of our family. And, you know, he had all these questions that we want, and, you know, we weren't refusing surgery. And, you know, you you have to have people who can connect? No, not every single person can connect with everybody. Right. You know, and culture, cultural background. You know, race plays a lot into that language barriers, right? Yes, I can come in. Yeah, someone is Somali. You know, of course, they're going to tell me a lot more than they're going to tell you in their broken English.
Dr. Qaali Hussein 46:36
so unless we accept that, that we as physicians aren't, you know, all powerful and can do anything and everything our we realize our limitations that we can't connect with every patient, every patient, we have to have diversity in medicine to serve our diverse population, then we can move forward with with really dealing with our health inequities?
Candice Blacknall 46:59
Yeah, absolutely. Absolutely. It's, it's the art of medicine. That's the whole thing. It's the art of medicine. Not every artist uses clay, not every artist use oil. So sometimes culture can be viewed that way, it's just not your medium. So you need someone else who was experienced in that medium to make it happen. But we're all we all have the same objective, which is to protect the health and wellness of our patients. So you just like, ah, a long hero that are listening? Oh, go tell me. No, no, I
Dr. Qaali Hussein 47:34
think, um, some somebody was posting something about whether we're taking questions or not.
Candice Blacknall 47:42
I saw that come by the screen. And then I looked into q&a, and I did not see it. So I will say if you have a question. So we have like, we have 10 minutes. If you have a question, please, please post it. Um, my medical school is not diverse at all. And when I look back, I feel sad because that school is the place to start this. I agree. I definitely agree. And that was one of the reasons why I I chose my med school was because I was I thought, you know, med school is going to be hard. I don't want it to be hard. And also be because I'm a minority. I don't know that I can deal with both of those things. I was coming from a BWI and I there was a lot of politics around race at that time. And I was like, I don't want to have to be the Martin Luther King of medical school. I don't have time for that. I don't have time for that. Not enough days, hours in a day to be a civil rights activist and do my MCAT. I mean, I just don't have time, and you're in. So I absolutely agree that that that there definitely needs to be more diversity in medicine. And I and I, I think that's why conversations like this. I'm gonna do a shameless plug for GABA right now platforms like GABA. Co are so important because they really do rally around, you know, bringing in more diversity and supporting candidates of diverse background. Yeah, it's a multifaceted problem. Like you said, let me keep looking here. I didn't see that person's question. Did you see that? Oh, no, it wasn't a question. I think it was just Are you taking questions? Yes. Yes. Yes, we are taking questions. Yes, we are.
Dr. Qaali Hussein 49:36
Yeah, well, I think you know, that's one of the things I'm going to plug for you as well. You know, if I had something like go GABA when I was a medical student, I think it's not only you know, the the fact that it's, you know, resources that are provided for you or you're told, you know, which resources are really good to use. I think just the the support You know, what you're going through as normal of us have gone through it? It's, I think that that that's an very important question, or the important conversation to have is, you know, we suffer in silence, a lot of people in medicine suffer in silence. And I think just acknowledging the idea of acknowledging the fact that, hey, this is problematic, we see that you have to deal with it, but that, you know, some things you can confront head on other things, you just have to go around it to get to your end goal. I mean, we don't we don't teach that we feel like you know, every problem that you come across, you just have to swallow. You know, take all the all the abuse, and just keep plugging along that you have no other option. I think we need to explore other options. And yeah, really figure out how you can you don't only have to survive medical school residency, how can you thrive despite all the negativity? on how do you thrive despite all the negativity come out? A hole? Not in pieces? Right, we call we've all come out in pieces. I came out yeah.
Candice Blacknall 51:29
I'm the same way. Oh, what do I do here? Okay, here we go. Question. How do you suggest engaging people in discussion when they really just don't see it about? Like, they don't see race? Or they don't see the lack of diversity?
Dr. Qaali Hussein 51:45
Well, it depends on who the person is. Whether whether they see it or not really matters, right? If it's a code student, if it's a medical student that, you know, just doesn't see it, and, you know, I've had a lot of ones that will just argue with you for the sake of argument, right?
Dr. Qaali Hussein 52:05
is it really worth your time educating this person? Mm hmm. Right. You know, if it's, if it's a colleague and I and you think, you know, their actions will actually impact their, their, their patience, then I would definitely say, Okay, this is worth it. Right. Yeah. So I think you have to read to learn to read people a little bit to see what their end goal is, if people are just that there are people that just like to get under your skin, especially when it comes to topics like this, and I've been angered by a lot of these people and let them get under my skin. Don't do that. Okay. But if they are serious, and if they really do want to learn, then I would, you know, I would question one of my favorite ways to, like really engage people is, you know, whatever statements they make, ask them to elaborate. Why do you think that is? Right? Why do you think, you know, it's, you know, I've had someone say, something like, what was it? We had, we had a patient coming in with a gunshot wound or something like that. And they were like, Oh, I bet it's a it's a black gangbanger or something like that. All right. And, like, I'm just like, why would you assume that? You know, okay, if even if it's a black man who shot you know, why do you assume that he's blind? He's a guy who is now why is every man every black man that you that you see? Is he automatically a gangbanger to you? Like, when you ask questions like that It forces people to really question you know, their implicit bias, right. Um, when it's directed towards you, I've had people, you know, I was at a new hospital, and I had, you know, one of the new doctors come to me was like, Hey, did you call the, where's the trauma surgeon? Did you call the trauma surgeon? And I just looked at him like, I don't know. I was like, Who do you think the trauma surgeon is? And he's like, Where is he? Where I was like, Oh, I was like, oh, are they all men? Now? You know, when you question people when you like, instead of, you know, you having to explain, right? Yeah. Ask people explain their bias to you.
Dr. Qaali Hussein 54:14
I think when you when people are forced to look at themselves, and question their own bias and explain their own bias, it forces them to really look inside and think because a lot of times people aren't that reflective. Yeah, yeah. So so that's what that's one of the ways I've always engaged is when I've, on the recipient on the receiving end of, you know, some sexist remark or racism remark or something about, you know, my job or whatever. I always, you know, start off with questioning them before I started lecturing them, right. Yes, they can see where they're at. Right? Yeah. If they, you know, if they're so unaware that they they just have, you know, some random you know, like, tiny little pieces of it. information or awareness of the issue that they just say whatever comes to mind, then you know, you have to start way at the bottom. Right. Yeah. But yeah, you know, if they have, you know, quite a bit of knowledge, but they just have a misunderstanding, then you can correct that misunderstanding. Yeah, I've been able to, you know, reach a lot of people that way and have, you know, really start having conversation, and I've had people who are otherwise, you know, uncomfortable asking me questions about my faith. As soon as I as they see me sharing, like, do you mind if I ask you this? or Why do you want to do this? or Why do you Why do you wear this? When you when people see that you're open to, you know, not just attacking Intel and calling them you know, whatever bias they have that and that you're willing to listen and explain, then I think that you can you can really start having that conversation.
Candice Blacknall 55:54
Yeah, that is amazing advice. I think that's what what do they say instead of calling them out? You call them in you, we kind of invite them to have a conversation. And I love the I love asking them questions. Because one, one thing I get I get tired. I don't know. You know, I think part of the thing is you don't know how to even start it. But if you stole where they are, yeah, if you just say, hey, why did you assume I was the nurse when I walked in here? What made you say that? Then it allows them to go, Oh, I don't? I don't know. And then it's not a conversation you're making them have it's a conversation they're having with themselves. And you're just facilitating facilitating your exploration of this moment. Absolutely. I'm trying to cheat over here. And Oh, goodness, listen, this has been an phenomenal, phenomenal conversation as I knew it would, because you're amazing. Thank you so so much for sharing your time with all of our wonderful viewers and being our first motivation Monday. If people want to connect with you after this, where should they go?
Dr. Qaali Hussein 56:56
They can connect with me on Instagram. I'm not as active as I'd like to be. But I I'm trying, I'm trying. I'm also on Twitter, I think I'm a little bit more active on Twitter. My web page is on my Twitter handle, you can contact me there for any I talked to schools, colleges, medical schools, you know, any any any organization group that that needs, motivation to change the game, because that's really what we want to do. And the links to sign up for my masterclass are also on there. And any other future projects I have coming up you can find on there as well. And I'm always open to people reaching out for advice. So, so we can all continue to change the game. Mm hmm.
Candice Blacknall 57:53
She's not lying, y'all. We found I found her on Twitter. And she responded. Which is a thing people don't respond to you, she actually responded. So reach out, I'm telling you, I'm proof. I'm proof of concept.
Dr. Qaali Hussein 58:08
Seriously, like, I like my main focus, you know, a lot of a lot of my colleagues will do, you know, speaking engagements, and they'll talk to the schools and, you know, hospitals and whatnot. I personally, I personally feel like the people who are going to change this field are the people who are most impacted by its imperfections, right? the shortcomings of medicine, the implicit bias, the sexism, the racism, all the things that we have are going to be changed by the people who are impacted by it, and who are no longer going to be accepting of this nonsense. All right. So that is what I'm here to help to do. So. Let's get it done.
Candice Blacknall 58:51
Yes, let's do it. Y'all. Thank you so much. This is our motivation Monday. If you want more of these, we will be doing them every Monday even even if it's just me trying to motivate you. I'll do my best. But if you want to talk to us on one of our motivation Mondays, I want to hear your story I want to connect your story honestly inspires the next generation of leaders. So even if you think like, Oh, I just make canned goods in my basement, you will be surprised. So please reach out to us and go GABA Co stay connected. You can find us on Instagram, Twitter, website. blahdy blahdy blah, we're there. And see y'all next week.
Dr. Qaali Hussein 59:29