Ya know, we all have an Esther moment. And you know, if you think about, remember the story of Esther in the Bible like she found out that there was a plot to kill…annihilate all the Jewish people. And her husband Mordecai came to her and said, you know Esther, you know there’s this plot and don’t think that because you’re the queen that you’re gonna be spared. They’re going to kill us. And so, unless you go in there and talk the king and let him know this is happening, you know, we’re all going to die. And he said who knows perhaps you’ve come to the kingdom for such a time as this. And she knew that it was risky to go into the king uninvited and make a request, but she did. She said if I perish, let me perish. Because she knew she had to go and try to at least save her people and I think we all have an Esther moment at some point in our life where either we can sit in silence or we have to step up and be ready to step forward and answer that call. So that that sort of what happened to me in 2015.
Dr. Sherita Hill Golden is the Hugh P. McCormick Family Professor of Endocrinology and Metabolism and Vice President and Chief Diversity Officer for Johns Hopkins Medicine. She holds joint appointments in the Welch Center for Prevention, Epidemiology, and Clinical Research, in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, and in the Armstrong Institute for Patient Safety and Quality. The author of more than 190 articles, Dr. Golden’s research interests focus mental health complications of diabetes, understanding and eliminating diabetes health disparities and implementing and evaluating systems interventions to improve patient safety and quality of care in hospitalized patients with diabetes. In the community Dr. Golden is a proud member of Delta Sigma Theta Sorority, Inc. and Co-Directs the Health Ministry with her husband, Dr. Christopher Golden, at Clearview Baptist Church in Woodlawn, MD. She is the proud mother of Andrew Golden, a Journalism and African-American Studies major at Northwestern University.
She serves as the Principal Investigator of the Johns Hopkins site of the Diabetes Prevention Program Outcome Study and is an elected member of the American Society for Clinical Investigation and the Association of American Physicians. In 2017 she was the co-recipient of the Walter Reed Distinguished Achievement Award from the University of Virginia School of Medicine, Medical Alumni Association, and Medical School Foundation, which recognizes professional accomplishment, outstanding innovation, and exemplary leadership in the field of Medicine. In 2018 Dr. Golden was named a winner of the 17th Annual Women Worth Watching Awards from the Profiles in Diversity Journal. She was one of 132 winners from across the globe recognized as an executive leading the way to excellence in the workplace, marketplace and the world. Dr. Golden is also the recipient of the 2019 University of Virginia Distinguished Alumna Award. She is a member of the American Diabetes Association National Board of Directors. In the community Dr. Golden is a proud member of Delta Sigma Theta Sorority, Inc. and Co-Directs the Health Ministry with her husband, Dr. Christopher Golden, at Clearview Baptist Church in Woodlawn, MD. She is the proud mother of Andrew Golden, a Journalism and African-American Studies major at Northwestern University.
Kim Crayton: Hello, everyone. And welcome to today’s episode of the #CauseAScene podcast. Today’s guest is Sherita, Doctor Sherita Golden, pronouns she/her/hers. Dr. Golden, could you please introduce yourself to the audience?
Dr. Sherita Golden: Sure. So I’m Sherita Golden, and I am currently—I’m a Professor of the School of Medicine at Johns Hopkins University. And I’m also the Vice President, Chief Diversity Officer for Johns Hopkins Medicine. I’ve been in that latter role for about 15 months. And then, I am also the proud wife of Dr. Christopher Golden, who’s a neonatologist at Hopkins and the proud mother of a son, Andrew, who, is now, I guess, formally an adult, ’cause he’s 21, who is a double major in journalism and African American Studies at Northwestern University.
Kim: OK, All right, so we have academics in the house. All right, so we start this conversation as we always do by asking you two questions: why is it important to cause a scene, and how are you, Dr. Golden, causing a scene?
Dr. Golden: Well yeah, I think that’s a really excellent question. It is important to cause a scene because I think that we all find ourselves at a moment in time where either we can stay silent or we cannot. And, you know, as I reflect on my own experience, for me, the time to cause a scene was in 2015. And that was when the Freddie Gray arrest happened in Baltimore.
And when that happened, after he passed away after being in the hands of police, you know, I remember that our dean in the School of Medicine wanted each of the departments, and we have 30 departments in our School of Medicine, to really bring people together to talk about the issues that were at the root of the riots, because it was clear that it was discrimination, and it was economic disadvantage, poverty, inadequate education, inadequate access to jobs, and many of the people who were impacted lived in our surrounding communities around our hospitals, and some of them worked with us.
So this was supposed to bring people together to have a conversation. My department chair, though, to his credit, said, I don’t want to just have a conversation and check off a box and say we did what we were supposed to to follow up. But he wanted something meaningful and sustainable, and…
Kim: Stop right there. I wanted to ask you before you go on; which department are you?
Dr. Golden: Medicine. So I’m Department of Medicine. So internal medicine, we take care of, you know, all the different organs in the body. I’m specifically an endocrinologist. My focus is diabetes.
Dr. Golden: Yeah. So, in the Department of Medicine, my chair said he didn’t want to check a box, and being white, he said to me, “What should we do? What do you think is important?” And all of a sudden—I had been in Hopkins at that point for 20 years—and I felt like it was time for me to make a scene and tell the truth. [Kim claps]
And so, I was the Vice Chair of the department, I was second in charge, and so I told him my truth. And it’s one of those moments where I can remember, like where I was sitting and what I was wearing that day when I said it, and I said, “So here’s the situation, even though I’m a professor here, when I drive out of Hopkins from under the protection of the dome, so to speak, that my experience as an African American woman is very different than my white faculty colleagues’ experiences.”
So my son Andrew at the time was 15 years old. He was just learning to drive. And many of my friends were concerned about their kids getting in a car accident. And of course I worried he’d get in an accident, but I was terrified that he’d get pulled over by the police and held without cause. And, my husband takes care—he’s a neonatologist—so he takes care of sick and premature babies. He has to drive to the hospital back and forth in the middle of the night to go take care of other people’s sick children. I am petrified until I get the text from him that he’s gotten there; again, worried he’ll get pulled over.
And then I said to my chair, “And by the way, it is not uncommon for me to be followed around in expensive stores and have people ask me three times if I need help. Because they’re not really wondering if I need help, they’re trying to figure out if I’m shoplifting, and that’s been happening to me since I was a teenager.” And so I said, “And by the way, these concerns and experiences I have, they’re the same ones as the housekeeper that cleans my office and as the security guard that guards our desk downstairs, because we’ve all talked about this because we’re all the mothers of Black sons.”
Kim: Mmm. Mmm, mmm!
Dr. Golden: And so I said, “We need to understand each other’s journeys because all our journeys are the same…”
Kim: I wanna stop you right there because I just want to pick up, just pull… so before you—my audience is white people, so I will interrupt to pull these strands—because what you just highlighted has been my fundamental problem—and I tell people I don’t care who you vote for—this has been my fundamental problem with Bernie Sanders and Biden until very recently. This cuts across classes in Blacks; it cuts across everything. We’re all having the same lived experience when it comes to policing and white supremacy. So we don’t get to say, “Oh, it’s a class issue, it’s not a race issue.” It is all classes about Blackness.
Dr. Golden: It is all classes, and I even had some of my white friends say, “Well, your son won’t have any problem. He’s so polite and cooperative.” I said, “But they won’t ask a question before they shoot or assume.” He won’t get a chance to say, “My parents are doctors at Johns Hopkins.” They don’t…
Kim: And if he did, the chance of them believing that is suspect.
Dr. Golden: It is suspect.
Kim: Because they will think, “Oh, he’s lipping off, he’s being a smart ass.” And I want you to get back to it, because you haven’t even talked about why or how you’re causing a scene. But this is so important because “good white folx” always got they reasons for why things aren’t as bad as we pretend, or they think we’re exaggerating. Their ideas of the parallel experiences we have are so inconsistent. It just makes… [laughs]
Dr. Golden: No, our experiences are not the same. So what is the same is maybe we’ve had the same education, so I think about my friends in medical school, right? And I had a very tight class. We had the same educational experience, we learned the same thing in the classes, but when we went to the wards, if you were a white male, you were more likely to be mistaken for the doctor when you were the medical student. Those of us who were Black women medical students, we were more likely to be mistaken for the cleaning lady or the dietary staff.
Kim: Hmmm. Not even the nurse.
Dr. Golden: Not even the nurse. So when I became a doctor and that mistake would be made, if someone called me a nurse, I was almost relieved ’cause I said, “OK, well, you know, that’s like a medical professional.” But what I got asked to do, “Can you get the bedpan? Are you here to turn on the TV? Are you here to roll me over?” So that, you’re not even in the professional medical arena.
Kim: And again, it’s not, and this is the thing that I want to tease out, because we’re not saying that there’s something wrong, because somebody needs to turn people over. Somebody needs to change the bedpans.
Dr. Golden: Oh no, I totally agree. And my grandma did that kind of work.
Kim: Exactly, and mine did too. But I want to tease out—because again, I say I have a white audience and they try to… that’s why I don’t give them much room. I don’t give them space. So what the doctor is saying here, spendin’ the same amount of money on loans or whatever to go through the same programs, when she walked into a space, she was thought of as someone to be of service in cleaning.
Dr. Golden: Correct.
Kim: And not to be of service in helping me get better.
Dr. Golden: Correct, correct.
Kim: And that goes back to what I just said: it cuts across classes for Black folx.
Dr. Golden: It does, because no matter…
Kim: And we never… hold on, hold on, hold on, because I’m just pulling this out. Because they never assume that we’re the doctor. So the cleaning lady comes in, they never assume she’s gonna be the doctor. But they assume the doctor comes in, you the cleaning lady? So we never get the bump of the positive. It is always something lower. OK, go ‘head. [Laughs]
Dr. Golden: Yes, yes, yes. And that’s called status leveling. It’s like, “Oh, but you couldn’t possibly be a peer.” It’s status leveling. And it’s called role incongruence. I’m sorry, but I don’t associate Black woman with doctor.
Dr. Golden: Right? And again, and like you said, I don’t have an issue with—everybody in our hospital, to me, we are all there to serve. So we are all doing a service. But what’s really funny is, if I get on the elevator, the cleaning staff would make sure that all the white people in the elevator knew I was a doctor. They’re like, “Hey, Doc, how’s your day goin’?” Like, really loudly.
Kim: I’ve done that before! I’ve done that before to people!
Dr. Golden: Yes, ’cause they wanted to make it clear, “Don’t be confused, just because she’s talking to me, I want you to know that she did this extra education and she’s here to help us.” So they would always make it clear that I was a doctor, my other Black colleagues were doctors.
Kim: And that’s how we’ve been able to take care of ourselves, take care of each other in our community.
Dr. Golden: Correct. Correct. ‘Cause I had that sense of community. My community ended up being all those support staff at the hospital. I walk through the hospital, it’s like, “Honey, how old’s your baby?” I’m like, “Well, he’s 21 now. He’s actually an adult.” [Kim laughs] But they remember when I was hobbling around pregnant, ’cause they looked after me and my husband. And so that is why I had those relationships and I have been talking with them around all these things that happened after Freddie Gray.
And I told my department chair we need to talk about people’s journeys and we need to share it transparently, and I am willing to do that as a leader. We’re gonna launch a Journeys in Medicine series in our department, and we’re gonna talk about very difficult topics. We’re gonna talk about how do our patients experience us when they come into our health care system. How do we address the fact that we may be contributing to biased experiences they have in healthcare? And how can we improve that? What is our relationship as a anchor medical institution to the surrounding community? And how do we establish that trust, and why has that trust been broken? And what are we doing about the fact that there are still more police that are shooting Black men? This is—what just happened this year [the murder of George Floyd by police officers]—it’s not the first time.
Kim: Exactly. They were in a pandemic and couldn’t be distracted by anything else, so you had to watch this man get killed in front of you. That’s the only thing that changed.
Dr. Golden: Choked out, essentially. But this happened in 2016. People may not recall that there was a week in 2016 where two Black men got shot in the same week. And at that point, my chair and I said, “This is really unacceptable.” He sent out a statement to the department sort of affirming that we stand with our communities, and we had one of our police chiefs for the community division come in and talk about the challenges with policing in the community. So we had these very tough conversations in our department and there were some people, maybe that weren’t happy.
In fact, I remember when he sent out that announcement, someone came up to me and said, “Well somebody said some people were reading this and it seems like he was sort of taking sides.” I said, “Well, he was, ’cause he was standing for what’s just.”
And so I think the other thing that I learned in that, that when you’re making a scene, it’s so important to identify your white allies who are true allies. And that is what he was, and enabled that conversation and didn’t try to shut it down when it became uncomfortable. And so I think we all have these Esther moments—and I say this to the women in particular—’cause I can tell you how I’m really causing a scene now, [laughs] ’cause once I got activated, I just kept going.
Kim: Oh, yeah. Once we start testing the boundaries?
Dr. Golden: Yeah!
Kim: I said, “You can’t put this genie back in the bottle.” Once it’s out there. [Laughs]
Dr. Golden: No, it’s not. And it’s kind of funny, because when you have a 21 year-old in this era, he sort of says whatever, they say whatever they think; this generation’s very clear. And that was something I said when he was home during the pandemic—because he had to come back for about five months when things shut down—but I don’t remember what it was. He’s like, “Wow, Mom, that’s just a new…” [laughs] “that’s a new side of you.”
But I think that we all have an Esther moment, and if you think about it—you remember the story of Esther in the Bible? She found out that there was this plot to kill, to annihilate all the Jewish people. And her cousin Mordechai came to her and said, “Esther, you know there’s this plot. And don’t think that because you’re the queen, that you’re gonna be spared. They’re going to kill us all. And so, unless you go in there and talk to the king and let him know this is happening, we’re all gonna die.” And he said, “And who knows? Perhaps you’ve come to the kingdom for such a time as this.” And she knew that it was risky to go in to the king uninvited and make a request, but she did. She said, “Well, if I perish, let me perish.” Because she knew she had to go and try to at least save her people.
And I think we all have a Esther moment at some point in our life where either we can sit in silence or we have to step up and be ready to step forward to answer that call. So that’s sort of what happened to me in 2015.
Kim: Whoo! OK, so… man, you just… I was takin’ notes, ’cause I so identify with that, “You’ve come to this kingdom for such a time as this,” ’cause I totally feel that. I know 2020 has wreaked havoc on the world, and yet it has exploded, it has decimated so much pretense, so much, so many of the niceties of civility that people have been tryna force people to stay inside, even though we knew that civility is only perpetuating this stuff. This is the time.
And I had been telling my white audience, I was like, “You know, I reckon,”—’cause at first I was talkin’ about, “Let’s get you uncomfortable.” Then I was like, “Oh, I can see whiteness can endure a lot of discomfort; I need y’all in pain.” And people would think I was being masochist. I’m like, “No, no, no, no. I need you to understand that white supremacy’s the parasite that’s now eatin’ its host.” It’s not just us, it’s coming for you. No one survives—white supremacy’s designed only for chaos and destruction. No one escapes unharmed.
It goes back to when you said, “Is it time for you to speak up or are you gonna stay silent and be complicit in your own destruction?” Because how I’ve been positioning this is, “Don’t do it for Black folx, people. You have to do it for your own humanity, because it’s your humanity that needs to be saved. Not ours.” Because the fact that Black people don’t slap y’all on sight every time we see you, says something about us and not about you.
Dr. Golden: Right, right, yeah.
Kim: And I love how you said, “Oh, it sounds like you’re takin’ sides.” That is a default of whiteness. When whiteness is a default, then everything is weighted equally. All debates are the same. Every situation is the same. “Let’s have a conver… let’s have a thought experiment.” Hell, no! We’re not havin’ a thought experiment when it comes to other people’s humanity, especially when you have no lived experience of any of that. So for you, it is a thought experiment, it is for you some hypothetical, “Let’s just throw out and see what sticks on the wall.” No, we’re not doin’ that! And you have to take sides!
Dr. Golden: Right, and the thing is that’s the difference between equality and equity.
Kim: That’s what I love—equity! [Laughs]
Dr. Golden: Right. So equality assumes that we’re starting from the same starting point. So we’re not starting from the same starting point, so that means that we need to engage in equity, which means that we’ve got to take a different side in the name of equity than we might in the name of equality. And so, these are the tough conversations we began having.
And then, maybe three or four years after that we had an opening for Vice President / Chief Diversity Officer for Johns Hopkins Medicine. So my department chair, the same person that we had sort of started causing all this good trouble together, he said to me, “Well, you would be really good at that job because you’ve been here for a long time, you understand the promotion process, you understand the community and the staff.”
And I told him no three times, because I said, “Well, I was trained as a scientist, I’m a diabetes researcher.” I said “Being Black for 50 years—which it was at the time—doesn’t qualify me being a Chief Diversity Officer.” Turns out that’s actually pretty good qualification, [laughs] but he was the one that actually even put that bug in my ear when our last Chief Diversity Officer left.
And so as I actually began to think about it, I was like, “If I’m going to do something really meaningful for this institution and for the community, then I need to sort of step out of my comfort zone.” And I thought, “OK, I do understand the system. I understand the operations. I can go and learn all of the diversity, equity, and inclusion strategies.” I mean, I knew a lot of them. We had done many of those things in our department. I was like, I could I could go figure that part out.
Kim: Your lived experience makes you an expert, right?
Dr. Golden: Right! So as I became comfortable with my own skin and sharing my own lived experience, then I gained the confidence to say—as the interview process went on—”I could do this.” So when I got selected, I was excited but nervous, and I thought “OK, we’ll have a couple of years to gain our footing.”
Well, who knew in my first year that we would have a pandemic that would disproportionately kill indigenous, Black, and people of color. And then that there would be what I’m calling the country’s second civil rights movement. I mean, all of these things have happened in the last year. So then I thought, “I thought you could only have one Esther moment. I didn’t know you could have two.” [Laughs]
Dr. Golden: “I thought you could only have one Esther moment. I didn’t know you could have two.” [Laughs]
Kim: Man. Exactly. Exactly. Exactly. ‘Cause I’ve been rockin’, boppin’ and rollin’ about this work and then all of a sudden, 2020 hits and then I’m getting—and then George Floyd—and then all of a sudden I’m getting emails and DMs on Twitter, “Can I talk to you about being a antiracist organization, a business?”
What, what? Where y’all learn that word from? Where’d that come from?
Dr. Golden: Yes.
Kim: Where’d that come from? Y’all know… what’s antiracist? What do you know about it? It was the year—I could never have predicted a pandemic—but I knew it had to be something huge to get people to pay attention. I knew it was gonna be something that, and it had to be something that… I already knew that the most marginalized were going to be more impacted, ’cause that’s the way it is.
And yet I knew that white people had to be impacted for them to start caring. They had to feel some of this pain, either economically or health-wise, for them to start saying, “This is not what I thought it was. What I’ve been taught, and what I believe, or thought I believed? This has been a lie. This is not the experience of most people. Wow!”
Dr. Golden: Right. Right. And I think the pandemic really brought that out for us. And so, while a lot of my role is focused on diversity and inclusion strategy for our health system and our School of Medicine—so between the two organizations, it’s about 44,000 people—but we also are responsible for health equity operational strategy within our health system.
And so the point is that you cannot achieve true health equity without a diverse and inclusive workforce, so they’re intricately connected. Diversity and inclusion in health care is a matter of life and death. Because if our biases impact our health care decisions, a patient dies. So we’ve been able to get people to see that connection and the pandemic made it so clear because we have in Baltimore City, of course our African American and our Hispanic and LatinX populations were really disproportionately impacted, just like around the nation.
But one of the things that became very clear is the language barriers in our Hispanic population, the fact that they had undocumented status and could not get any federal aid, really crushed them even further. And so we had to activate our bilingual workforce to be able to support that community. And then it becomes clear, we need to actually think about do we have enough bilingual contact tracers in our city health departments around the nation, in our state health departments…
Kim: I wanna stop you for a moment, because people love to thinking silos. We need to think in systems. As a medical doctor, you understand that I eat something, it affects my whole system, not just my tongue and my esophagus and my stomach. It can affect any part of my body, dependin’ on how my body reacts to that. And this is what I love about people who talk about systems. You have to stop thinkin’ in silos because something we do in part A of our business or our health practice always will—it may not be immediate—but it will impact something else.
Dr. Golden: It will. And it’s been really compelling? So this is how I’ve been causing a scene. So, I thought it was very important, so remember, maybe two or three weeks to the pandemic, it’s very clear African Americans were dying disproportionately. The death rate hadn’t quite gone up in the Hispanic community, except in New York. And a reporter asked me, “Well are we doing research at Johns Hopkins to understand why we’re seeing these disparities?” And I said, “No, because we already know why those disparities exist.” I said, “We want to do research to figure out how to avoid them.”
So what I started telling her was, “Well, there are disparities in the healthcare system.” And so, back during slavery, we used to experiment on people, on slaves without their consent, and without anesthesia. So that started this falsehood that African Americans have a higher pain tolerance than other groups. Their pain is inadequately controlled after surgery; even to this day, that’s a bias. There was eugenics theory that said that people of certain races were biologically inferior to others.
Kim: Mhm. And that was coded in our damn constitution, and in laws and stuff.
Dr. Golden: Yes, it was. These are all things written into law that I’m talking about.
Kim: Exactly, exactly.
Dr. Golden: And that theory was around until right after World War II; when Hitler started using that eugenics theory, it lost some popularity, but there is still this thinking that certain racial and marginalized groups have less value. So not just Black people, but other minority groups, those with mental and physical disabilities; all of those groups experimented on without their consent, thought to have less value.
And then there was the 1910 Flexner Report that closed a lot of medical schools in the country because it said medical schools should not be proprietary schools, they should be based on this biomedical model. Which is great; that’s the whole model I trained under. But the problem for medical schools that were training Black physicians is that it means that after the closures under the old system, only Howard and Meharry were left to educate Blacks who wanted to become physicians, and this was at a time when they couldn’t gain access to predominantly white medical schools. So this means that we have been behind the eight ball, and Black physicians…
Kim: And this is why… you are speaking to… this is why equity matters. This is why I tell… you giving a white wealthy person who lives in suburb A of whatever major city $100 to buy groceries and you give that same $100 to someone who lives in the food desert with no car and has to worry about healthcare. To get them to have the same quality of food requires you to do more than give them the $100. They need transportation, they need someone to watch the kids, they need to be able to get to the grocery store that is of equal value, and this is what people don’t understand.
I use this example in my talks all the time. I was like, “You know what? What I need is for white dudes is to go… I need y’all to have narcolepsy. I need y’all to just knock out for a little bit, ’cause this is what it’s gonna take. I need you to be knocked out for a few years. Let me get moving. When you wake up, I need you to crawl on your stomach, because even with you crawlin’ on your stomach, the systems are there to help you, as you crawl on your stomach, and you still would get back in front of me.”
Dr. Golden: Right. Right. Because being so far behind. There’s some stat that if they left those medical schools open, by 2019 there would have been over 35,000 more Black physicians who would have been here. So this is like we can’t catch up.
Kim: And let’s pull that out to the wealth gap. It is in every system. And this is why I wanna pull this out because it is in every system where we have been given a disadvantage and people are like, “Oh, well, pull yourself up from the bootstraps.” Screw you! I ain’t got no boots!
Dr. Golden: Right. Right. So I think that’s a really important point because that’s the other thing that I’ve been talking about, as it was related to COVID and all the disparities that we see—’cause there’s this whole medical side, but then there’s this whole social environmental justice side—where the other thing that happened in a lot of cities is that as there was the migration of African Americans from the South up North after the Civil War, that as Black families would move into a predominantly white neighborhood, then there would be this white flight out of that neighborhood so they would move to other neighborhoods.
And then loan sharks would come in and they knew African Americans were wanting to get their first home, and they would engage in predatory lending practices. And then there would be this high rate of loan default in that neighborhood. So then they would redline that neighborhood. They did the redlining. So once a neighborhood—and this was law in Baltimore City, this was a part of the ordinance for years—so once the neighborhood was redlined, that means there was no economic development in that neighborhood, no investment in their schools, no investment in public works and sanitation. And so what happened is those individuals end up living in neighborhoods with housing instability, exposure to environmental toxins, poor school systems, and inadequate access to jobs and economic development. And the residual of that is still there today.
Kim: And that’s why I tell people—and people get pissed at me—I’m like, “You white liberal progressives can kiss my Black ass when it comes to talkin’ about climate change, because if you cared about climate change, you would have cared about the fact that these communities have been dealing with environmental issues forever.”
Dr. Golden: Forever.
Kim: Now that it’s—again, the parasite that’s eatin’ its host—now you care about climate change. These conditions have been harming our communities, because they didn’t put the plants in your communities. They’re in our communities.
Dr. Golden: Right. Right. So the air pollution. And…
Kim: That’s why asthma’s so high.
Dr. Golden: The asthma.
Kim: Allergies, all of those things, eczema, all of those things are so high because our air and our water has always been problematic.
Dr. Golden: Which is why we have such a hard time with COVID, because you can imagine it, so you’ve been living in an environment that predisposes you to lung disease, predisposes you to diabetes, ’cause if you can’t walk around in your neighborhood, there’s no parks and green spaces.
Kim: Exactly. There’s no trees.
Dr. Golden: There are no trees. And then, you talked about the access to the healthy food, a lot of people say, “Well if people would just make better choices.” That assumes that you actually have a choice to make. And so, in the area where I’ve practiced, if you want to get to Whole Foods to buy all the pricey stuff, you would have to take three city buses or something if you don’t have a car; it’s not easy to get to. And then when you get there, it’s expensive, right? So if we think about how we have set up our neighborhoods, you’ve gotta have a fire hydrant every so many blocks for safety reasons, there should be affordable, healthy food every so many blocks. It just should be…
Kim: And so now they’ve put in—I don’t know how many different Dollar Stores they’ve put in every Black and brown community—with crap, processed foods. And that’s supposed to be… that’s not equity. I’m not eating the same foods that Joe Schmoe over here is eating. I’m not.
Dr. Golden: Right, right. And I remember one of my research coordinators—this was years ago—she was involved in a asthma study, and they were talking to the students, it was elementary school students, about how to eat healthy. And so she took fruit in and they were going over things. And a little boy said to her, “Bananas aren’t yellow, they’re brown,” because that was all he had ever seen in the store.
So if you go to the store and you have a choice between canned peaches over here and brown bananas, you’re gonna get the canned peaches because even the things that are supposed to be fresh are not as fresh. So from that standpoint, I think it’s been very important to me to talk about that, because as a doctor, you cannot adequately take care of your patient if you do not understand the context in which he or she lives.
Kim: And that is why lived experience… so my space is business, and I’m like, “We are not making widgets anymore. This is an information economy, you need to be hiring people for their lived experience.” But what I’m finding are… that’s what people are considering. So for me, diversity is about recruitment. Inclusion is about retention.
Dr. Golden: Correct.
Kim: So they might be tryna get the recruitment thing—and they screwin’ that up—but OK, let’s say you bring them in, right? You bring these people in for their lived experience, but you want them to leave that lived experience at home when it causes problems on the job.
When I say, “Hey, you’re doin’ this thing and it’s problematic,” then it becomes, “Oh we don’t talk about politics.” When your life is about politics, when everything that is a system in this country is political, and it’s about how you live in the process and the services you received, then my life is political. I cannot turn that off to go into a job.
Dr. Golden: Right. And if you think about product development, if you listen to the perspective that a diverse body of employees brings, you will actually make better and more effective products.
Kim: Yes, exactly.
Dr. Golden: Right? Because there have been times where somebody is working on some new diabetes, insulin delivery device or something, and so if I say, “Well, how does that work for a patient who doesn’t have a refrigerator? Or how would that work for…” then that causes them to think, “Oh, OK. There are some people with the disadvantage, so let us think about a way that this could be done at room temperature.” And then bam, you’ve broadened your whole market right there.
Kim: And that is what inclusion and diversity—I hate being called an inclusion and diversity specialist; I’m a business strategist. I can’t get to the business strategy because you have no inclusion and diversity, to me which is the foundation of a profitable, competitive, innovative, differentiated business. I mean, you are not even at that point.
Dr. Golden: Right. And there are data that show, and particularly in the business sector, that companies that have more diversity, for example, even starting at the board level, more diversity in their boards, they have better economic return on investment in their products, greater creativity and innovation in the products that they develop, they engage in less risky business decisions, so they make better decisions. So there are data that show that this is effective.
Kim: And that’s the thing about why I don’t… the white supremacist model is about competition. So that means, and I use this as an example, let’s say that you put some colors out there and everybody gets to choose one color. You put it out there. Competition is… not competition, that’s not the word I’m looking for. It is compromise. Sorry, compromise. This’s why I don’t like compromise.
So you put all the colors out there, and then it just becomes “I don’t like that, so you gotta get rid of that.” So you end up with something that don’t nobody want, but it’s just these are just the colors that didn’t trigger everybody. Right?
But when you do collaboration, you start puttin’ colors out there and everybody gets their hands, and you can create something together that you could not create on your own. And this is what is required in the information economy. And this is why…
I wrote a note here, it says “trust broken,” and they’re seein’ it with this vaccine they keep talkin’ about, all this back and forth. I’m gonna let y’all know: Black people ain’t about to take this vaccine off the bat, and it’s gonna be a problem, because we’re the most impacted, and we understand that. But we also understand what the history of medicine has done to our communities. And then to have a president and an administration that continues to make light of this and make it some political—again, you talk about, “Don’t bring my politics in.” How can I not bring my politics in when they’re making masks and everything else political?
Dr. Golden: Right. And these are not political things. They are public health strategies.
Kim: Exactly. Exactly.
Dr. Golden: You are your brother’s keeper. You are your fellow American’s keeper. Wearing a mask protects your fellow American.
Kim: And so you’re talkin’ about “Oh, we’re going to rush through…” No, that’s not gonna happen. I would rather you be honest, it ain’t coming til the fourth quarter 2021. Then I could make a plan, I’m gonna stay my Black butt in the house until they get it out there. But when you talkin’ about rushing stuff, no! The Black community, we have no trust in the medical system. And that is sad.
I want you to talk about, because the reason I came across you was, as I was sayin’, I watch so many different things, and I was watching CBS Sunday Morning and it was a segment about COVID and how it’s impactin’ the Black community, and you were on there as an expert and you talked about—this is what really hit me, not the COVID thing, but this goes back—you talked about stress plus infection, and then you talked about structural racism. Can you please, let’s have a conversation, because everybody wants to blame Black folx for where our situation is. Can you please talk about how stress impacts our body?
Dr. Golden: Yes. So I think this is incredibly important. I think in the last 50 years or so, we made a lot of headway in recognizing that stress does impact our physical health. There is absolutely a mind-body connection. In fact, the whole way I got into that body of work was that I was noticing a lot of my patients with diabetes had depression. And then we were able to do studies showing that if you have depression and don’t have diabetes, that if we follow you for years, you’re at an increased risk of developing depression. [Correction: diabetes]
Kim: Oh wow.
Dr. Golden: You’re at an increased risk of developing heart disease. Right? And there’s a couple of reasons why…
Kim: It makes sense, though. It makes absolute sense.
Dr. Golden: It makes sense. Because you think about it, there’s two things: if you’re depressed, people who are depressed generally don’t like to exercise. They’re not gonna be motivated to exercise. Not gonna be motivated to eat as healthy. Maybe smoke more, not follow the doctor’s orders. All those things are risk factors for diabetes and heart disease. But then, we also know that depression in particular and other mental stressors—and this will get to the question you’re asking—activates our body’s stress hormone system, right?
Dr. Golden: And so, there’re stress hormone called cortisol and adrenaline. So, if you’re being chased by a bear…
Kim: You’re always in fight or flight.
Dr. Golden: Right. So you’re in this flight that says “I’m being chased by a bear,” your cortisol and adrenaline are up, you’re pumping out glucose, you have the energy to run from this bear. And then once you’ve escaped the bear, it’s a very tightly regulated system, it feeds back to your brain and says, “The bear’s gone, shut this off.” And it shuts off, everything returns to normal.
If you were under chronic stress because you’re like, “OK, my son is out later than he should be. Shoot, should I start calling or be concerned? I can’t decide whether I should let my hair go natural in the pandemic, so they’re going to still think I’m professional. Oh, God, what if I say the wrong thing in the interview.”
So if you have all of these stressors that you’re chronically dealing with—this is regardless of socioeconomic status—that means that you’re going to constantly be in this low level flight state all the time. And you can imagine if you have that, and you’re living in poverty, and you’re working two jobs, and you’re not sure where your next meal is coming from, that just adds to that level of stress.
And so generationally over time, what happens is that it’s almost like we’ve got to survive this stress, right? So even in utero, our body starts reprogramming itself to be able to survive those stressors because this has been passed down generationally since slavery. But then—that lets us survive in utero—but then what it means is that it really results in some abnormalities in how our metabolism works, that increases our risk for diseases in adulthood. And then—so you’ve already got this pre-programming, if you will—and then you’re living these stressors every day.
Kim: Every day, exactly. So not only are you gettin’ it because you’re pre-programmed from being in utero, but the environment that we live in perpetuates the fact or even makes it real, like, “Oh, this makes sense that I have this thing,” because it’s constant. And this is what my white guests don’t understand, it is a constant—I mean, you’re talkin’ about some extreme stuff, even the hair stuff, ’cause, I mean, we had to have laws this year about hair.
I tell people this. I say, “If you knew the energy it took for a Black woman to write an email to a white colleague, it makes absolutely no sense.” [Dr. Golden laughs] The amount of energy we have to take to make sure the tone is correct, and folx won’t get in they feelings, even if I’m your superior, you’re my subordinate in that position and I need to correct yo’ behavior, it has to be more about yo’ feelings than me correctin’ yo’ behavior. Do you know how much effort and energy that takes to go through that every.. and you’re writing emails all day long?
Dr. Golden: Right. Right. I mean, it’s just extra energy, and there’s this extra level of concern that white colleagues don’t have. And I think the key is—and I’ve been sort of teaching my institution about allyship—when we share those experiences, don’t negate them. That is somebody’s lived experience. You can’t explain it away.
I mean, there was one evening recently where I know I spent 20 minutes composing an email tryna prevent misunderstanding, and my husband said, “Are you still sitting at the table on that one email?” Because you don’t wanna come across angry, you don’t wanna come across uncollaborative. And so, these are issues women have to deal with in general, but Black women, brown women deal with them at a magnified level.
And that kind of stress has an impact on health. And I remember when we were talking with some of our students not too long after the George Floyd unrest and someone said, “But everybody worries about getting pulled over by the police.” So I went, “So let me explain the difference.” I said, “If you’re white and you get pulled over by the police, you’re worried about getting a ticket or a citation, maybe getting arrested.” I said, “If you’re Black and being pulled over by the police, you worry about dying. So getting a ticket or getting arrested would almost be a relief.”
[Note: a section of the conversation from earlier in the podcast repeats here due to a technical glitch. The repeated section has been removed from the transcript.]
Dr. Golden: So that’s where the difference in the anxiety…
Kim: Because even in… so, I live in a open carry state, right? And I just purchased—I’ve been wantin’ a gun for a while ’cause I like target shootin’—but I just purchased a gun, and I do have—and in this state you don’t need a permit to carry guns, but I wanted to be legal because I’m a Black woman—so I can conceal carry. Even in that—and I live in states where folx drivin’ around with Confederate flags, they got shotguns all in the windows, they’re takin’ them into Walmart—but even that, I know if I get pulled over with that gun in my car, that’s the first damn thing I need to say something about before people get trigger happy.
So even in my quote, unquote “followin’ the rules,” it doesn’t follow rules. I can’t remember—because I read so much, so many different media outlets—but there was a recent study that—well, I don’t know if it was a study—but an article that said that Black people would take their chances with someone breakin’ in their house before they call the police; that there’s a percentage of people. So think about that, we would rather take our chances with someone breakin’ into our home, than call the people who are supposed to be charged with that, to protect us. And even in that, particularly in the state that I live in, I’d still be concerned, because if I shot somebody, I’d still be concerned that I would be targeted and it would be my fault even though this person decided to come in my home.
Dr. Golden: Yeah. No, and I mean, that’s very chilling. It’s sort of always feeling like you’ve got to do these extra measures to prove that what you’re doing is OK. I mean, I have to…
Kim: It’s the very reason… go ‘head.
Dr. Golden: I actually carry a mini copy of my medical license in my wallet, because if someone needs medical assistance and I get questioned, I at least have that, because female physicians of color have basically gone to help somebody—it happened to a colleague of mine on an airplane; I won’t mention…
Kim: Happens on the airplane. Yes.
Dr. Golden: Yeah, I won’t mention the airlines’ names, but this happened to two Black women physicians. And the first time it happened, she didn’t have the medical license. The stewardess said she wanted a real doctor. So they dismissed her, and let the white doctor take care of this gentleman. So then I started telling my Black female younger colleagues, you guys should carry your medical license in your wallet; I’ve always carried it in my wallet. That way nobody questions. Well, one of my colleagues did carry it in her wallet. And then they asked her, was that her real license?
Kim: And see, that’s… the fact that we have to not only “follow the rules,” air quotes, to be above board, our credentials are still not…
Dr. Golden: Right. Believed.
Dr. Golden: Not believed.
Kim: There’s still questions. There’s still… I mean to this day, people have no idea why I know what I know. I’m spendin’ a shitload of money and getting a doctor’s degree on business administration, focusin’ on technology businesses. That’s why I know what I know. And that’s what my company is: I helped build tech companies. But Bob here never has to, can never have worked anywhere, never has any credentials for anything, but he gets the benefit of the doubt, and people like, “Well, he’ll figure it out. Just let him figure it out.”
Dr. Golden: Uh-huh. Uh-huh. Uh-huh. So, I think we have to reach a point where we give others that same opportunity and stop sort of assuming, based on stereotypes that have been created to be oppressive, basically. This is a time where everybody can begin to educate themselves and read for themselves. I was thinking about all of the very interesting books that my son has read, as an African American studies major, on our history and our literature. I said to my husband, “Golly, I wish I had taken more AfAm, I said I don’t remember any of those.” My husband said,”Honey, ’cause those books weren’t written when we were in college.” [Laughs]
Kim: I was about to say, because—and I tell people all the time—this is why basically—and I’m sure you and I are about the same age—we had the encyclopedia, and that was all the knowledge there was.
Dr. Golden: Yeah, it was either World Book or Britannica.
Kim: There you go. And that was all. And you were privileged to have that in your house, if you had it in your house. But even when you went to the library, the encyclopedia was all the information that was ever created. That was it.
Dr. Golden: Right. Right. So there weren’t writings on African American authors, all these things. So all the things on the medical history I mentioned to you and some of our social history, I’ve read that on my own. My family was very much making sure I knew my history. My brother and my father were at the ’63 March on Washington, so they heard the late Congressman Lewis’ speech and Martin Luther King Jr.’s speech in person. So that was always in my blood. But it’s just, you can only learn what’s out there in the literature. And so…
Kim: Well, this is one of… those handed down stories are why Black folx still are here, and can tell some of these stories, because it was never written down. No one cared about our… our history in the US, and globally, has been whitewashed. And so every time we told a story that corrected the narrative, until now, and even in now, people challenged us, like, “That can’t be true. I didn’t read that in the book.” Well OK, who wrote your book? [Laughs]
Dr. Golden: Right. Right. Exactly. So I think it is a time for education, and with all the difficulty that—it’s beyond difficult, really, in the last seven or eight months—but I’ve been at my place now for 26 years, and it’s like people’s ears are really open and people are digging deep and they’re asking tough questions and they’re not afraid to be uncovered. There are people who are still uncomfortable, but organizationally, we’re ready to ask many of those tough questions, and a lot of our leaders are digging in and reading some really difficult reading and coming to…
Kim: One of the things—so I follow some guiding principles that I created—and you just spoke to one reason this is happening, ’cause one of the guiding principles is “lack of inclusion is a risk and, increasingly, a crisis management issue.” What they’re findin’ out, whether they want to or not, by leavin’ us out and ignorin’ our lived experiences and how we can help you, you are now finding yourselves, when your little racist employee on the Saturday done did somethin’, now you got to deal with a crisis management issue because of what they did. Or yo’ product has done somethin’ because you did not know how it will impact the most vulnerable, now you’re actively causin’ harm, and now you’ve got litigation. Oh, it’s like you either goin’ willingly or you bein’ pulled, or you will be obsolete. Because it’s changing. We are not goin’ backwards.
Dr. Golden: And if I think about my industry—yours is technology, mine is healthcare—we have to have cohesive teams, right? Because that is directly related to patient safety. We can’t have people on the team that can’t talk to each other, don’t know how to resolve conflicts. So we are now suddenly realizing like, “OK, as crazy as the last few months have been, it’s like a crash course on conflict mediation.”
Kim: Interpersonal relationships.
Dr. Golden: Conversation, restorative justice, bringing people together. I mean, it’s sort of like we’re all kind of laughing on my team because we’re like, “We should have just gone to school last year and gotten a degree. If we’d seen all this coming we could have all…” [laughs]
Kim: And that’s what I talk about, ’cause there’s so many people in my space, the people who are most obstinate about not changing are these tech bros, these white, mediocre, unremarkable tech guys who like to just put they head down and code. But you can’t do that anymore. You can’t, that’s increasingly becoming obsolete. Tech is about humans, we have been trying to code out the human aspect of tech since we started. We’ve seen how problematic and harmful that is. And we have to make a huge swing, swing the pendulum back the other way.
Dr. Golden: Yeah, ’cause we are relational beings. I mean, at the end of the day, it is about the relationships and interestingly, a lot of what we find when there’s misunderstanding is it’s the intention versus impact. Right? So OK, I realize you didn’t intend that, but you have to understand how I hear that in my ear. And when we can get people to begin to take the other’s perspective on that, then we can begin to make progress, because we can’t have people on a medical team for a patient that don’t respect each other, won’t listen, won’t regard each other. And so we’re tryin’ to come at it for people in that way. If you can’t get there because of moral conscience, then at least get there because this is the right thing to do for a patient.
Kim: And that’s what I tell people: I don’t care if the CEO does not believe in inclusion and diversity. If I can make a case, do you want to profit without oppression? Do you want to profit without oppression? OK, then all that otha stuff is just words. Let’s get to—whatever, you can use whatever words that make you feel comfortable—because if we’re talkin’ about profit without oppression, we’re talkin’ about the same… we’re at least goin’ in the same direction.
Dr. Golden: Right, right. Exactly. Exactly. And I think I’ve been really fortunate in this role—because it has been tough, not easy—that our leadership, our executive leadership, is incredibly supportive. So we’ve gotta trickle this down then to the rest of the organization and make it completely clear.
And people often’ll be like, “I don’t understand why we have to talk about race at work, I mean, I don’t understand.” But we have to talk about it because—at least in our industry in particular—the patients you take care of are different races. And that is going to impact their prior experience, their experience in healthcare, and how you treat them. And as you were talking about the trust factor, there are reasons. They’re not not taking the medicine because they wanna be belligerent. It is because of the Tuskegee syphilis experiments, and the Guatemala syphilis experiments, Henrietta Lacks, and all these other things that have happened.
Kim: What’s interesting is the people who ask—and this is gonna be the last thing before I ask you what would you like to close on, because I want people to understand this—the people who ask, “Why do we have to talk about race at work?” have never had a lived experience where race mattered.
Dr. Golden: Right.
Kim: And that’s what you need to understand. You are the default. I know whiteness better than you know whiteness, because you never had to study whiteness. I’ve had to study whiteness so that I could succeed. Because every barrier—if we go by how this country was designed, you and I should still be slaves.
Dr. Golden: Right. Right, right. Yup.
Kim: And that’s why I wanna, I want to put an exclamation point on there. If you are asking why we need to talk about race, you are exactly the reason why we need to talk about race.
Dr. Golden: Right, right.
Kim: So, Dr. Golden, what would you like to say in your last moments on this show? This has been… I told you it would go by quick. [Laughs]
Dr. Golden: Yes, this has been a very stimulating conversation, [Kim laughs] and I think the thing that I would want to end with is that we all have a Esther moment in our lives, and it can be incredibly uncomfortable. But you need to make good trouble and step up and step into it and be courageous because if you don’t, somebody else will. And you don’t wanna be at a point in life later to look back and say, “If only I had, I could have made a difference in.” And I feel like that is the time that we’re in.
And then I also think about, I don’t know, 30 years from now, when my grandchildren ask me, “Well, how was it in 2020? I heard all these things went on and there was a pandemic.” And I wanna be able to have something that I’m proud to share as a part of the heritage and legacy of my family, and the ancestors of mine who have struggled so I could even be where I am. I want to be able to be passing that legacy on to them. So I ask you to do that too, think about what is the legacy that you want to tell your family 30 years from now, when they say, “Golly, that 2020!” You’ll have so many books written about this year.
Kim: Oh, yes. This is definitely a delineating… yep. And what’s funny to me is—and you just hit it again—I was talkin’ to my mom, I was watching John Lewis’s body being taken over the Pettus Bridge, and I’m just crying, and I call her. I was pissed off! And she was like, “What’s wrong?” And I was like, “When the hell did I sign up to be a part of the civil rights movement? I’m trying to build businesses!” And she’s like, “Yeah, that’s what you’re doin’.” And I was like, “I’m from a city where I know I don’t wanna do this!” [Laughs]
Dr. Golden: That is so funny. [Laughs] It does feel like that, I tell you. I mean, I was born in 1968, two weeks before Martin Luther King Jr. was assassinated. So I sort of felt like, OK, I was sort of coming out of that and we went through this whole 70s, 80s thing, and then for a while things were settled and we’re sort of back. I guess everything comes full circle.
Kim: Because we didn’t finish the work. We gonna finish this work this time. Even with white folx, we’re the majority now on this standing. And before we weren’t.
Dr. Golden: Yeah, and my father—I told you he was at that March on Washington—he said, “This time it’s different because we have people of all colors, races, and groups who are standing with us.” And he said it was not like that before.
Dr. Golden: And he’s almost 85, so I’m listening to him.
Kim: And that’s why I’m optimistic. That’s why I remain optimistic, because this moment is different.
Dr. Golden: It is.
Kim: Those other moments paved the way. This moment is for us to stand in and stand up. And create a space for all those people that our world chose to left out, because it was not by accident. They chose to leave us out.
Dr. Golden: Right.
Kim: Thank you so much, Dr. Golden.
Dr. Golden: Thank you. It was a pleasure. A pleasure.
Kim: Have a great day.
Dr. Golden: Bye bye.