Zonía Moore | Penn Medicine can do better for the people that it has failed

This is part of a series on Juneteenth, the anniversary of the emancipation of enslaved people in the United States. In their columns, members of the Penn community evaluate slavery, Penn’s relationship to it, and how this informs our understanding of race today.

The University of Pennsylvania’s history is inextricably intertwined with that of the U.S. slave trade. The Daily Pennsylvanian reported in 2018 that many of Penn’s early trustees and even its first provost were owners of enslaved people. Benjamin Rush, a prominent 1700s professor of chemistry and medicine, dissected the body of a 16-year-old Black girl for teaching-related purposes without any mention of her consent. As recently as the 1970s, Albert Kligman, a dermatologist at Penn, conducted human subjects research on incarcerated Black men that included exposure to carcinogenic components of Agent Orange. Many of these men were minimally literate.

Obviously, the institution is not able to transport back in time to repair this history and the ripple effects its actions created. The question becomes: How does Penn — or any institution — address this history and manage the ongoing damage (such as a lack of trust and stark health and health care disparities) it created? Penn and Penn Medicine owe it to the Philadelphia community to develop and maintain programs that candidly address the ways that Penn has historically harmed its community.

Any discussion of how to handle past transgressions must begin with an evaluation of their impact. Every individual within a community has their own emotional relationship with this history. Some people feel betrayed and unable to trust the established institutions of our society. Others are shocked and angry, even furious, at how their late family members were treated. Still, some are saddened and feel dejected because they live in a system that has not historically valued the lives of people like them. Other individuals feel indignant, developing a steely resolve to stay as healthy and prosperous as they can. The universal commonality is that these abuses of human rights are emotionally-charged experiences passed down from generation to generation through the art of storytelling. 

Penn must strive to positively alter the stories shared between generations. Isolated statements reacting to current events are necessary but not sufficient to change how communities share the stories of their families. Extending and maintaining a helping hand to start correcting historical injustices can change those oral histories: this can start with developing ongoing open dialogues with the surrounding communities. In essence, this would create a space to candidly reveal the details of prior injustices to affected parties, providing a “group therapy” of sorts where the revelations may be surprising but would provide a platform to build trust going forward. Conducting these sessions in a longitudinal fashion would demonstrate a commitment to the community and the desire to forge a new relationship. In a world where most narratives are written by media and public relations professionals, community members must be granted as much power as possible to define their own narrative. Those in the community who were affected deserve the opportunity to write and share their own story and experience with the trauma at hand.

Large institutions like Penn can further demonstrate their commitment to healing wounds of the past by providing longitudinal in-kind services for the individuals most impacted by their historical injustices. For banks, this could include creating no-fee accounts and offering basic financial planning services free of charge. For museums, this might entail creating open tables of conversation where items and heirlooms that were stolen can be returned. At the very least, the wishes of the original owner can be expressed and incorporated into the treatment that the heirloom receives. For the University of Pennsylvania Health System, however, this may look like providing at-cost medical care and priority booking of appointments for the descendants of the research subjects of Albert Kligman, the family members of the slaves owned by founding members of the institution, and those whose bodies were desecrated without consent for “educational purposes.” 

To further cement the ongoing commitment to equity within institutions, the very memorials, art, and decorations that comprise the location must be evaluated and revised to be more inclusive of the rainbow of people who work at and are served by that institution. The same way that founders and presidents are memorialized with statues and portraits, the Black and brown backs on which institutions were built deserve equal memorialization. 

In a manner analogous to that process, institutions also bear the responsibility of promoting a workforce that walks the walk of diversity and inclusion. A small place to start could be having ongoing one-on-one conversations when staff make comments that appear to colleagues as rooted in racism, sexism, xenophobia, or antisemitism. In addition to the institution-wide implicit bias training many institutions have implemented, these conversations may serve to jetpack communities into becoming a more tolerant and equitable society. 

For example, as Black medical students on the wards, at times we hear medical professionals espouse varied misconceptions about Black people. For instance, a physician explained that they always double check that Black patients are “clean” when prepping a patient for a procedure because of the lotion they use which causes "all the dirt outside to stick to them." They teach to check your alcohol wipes to “make sure they’re not still dirty” when prepping Black patients. Not only is this physician teaching that Black patients are dirty, their analysis fails to account for the fact that pigmented skin cells will always “look dirty” when placed on a white cloth because society associates dirtiness with brown or black color. Furthermore, for a physician who trained and works in a city that is forty percent Black and has devoted their career to helping others, why do they choose to remain so ignorant and judgmental of the cultural practices of their patients? 

While these statements are overtly racist, they alone are not adequate to prove poor care was provided to Black patients. Therefore, this incident is not appropriate for an official report of discrimination. A centralized resource where such concerns can be reported, not for punitive discipline but to foster an open dialogue, would consistently fuel the pendulum of social change. 

As Penn President Amy Gutmann stated in June 2020, “We must, as a country and community, resolve to find better ways forward to understand and address systemic racism and closely related economic, educational, political, and social inequities. We must work together to build more hope for the future.” The work to repair community relationships must be fueled by the faculty and staff, who can forge long-term commitments, and supported by students who are transient community members. 

ZONÍA MOORE is a third year medical student at the Perelman School of Medicine and an activist. She can be reached through her website at zoniamoore.com or you can follow her on Twitter @tzoniaa.