The questions were provocative, the responses insightful. The dialogue – among medical students, their faculty facilitators, and community panelists – united everyone in a spirit of productive inquiry on January 17, 2022, Martin Luther King, Jr., Day, at the Lewis Katz School of Medicine.
“Thanks to student and faculty leaders who inspired us to ‘reinvent’ the way our school commemorates the civil rights leader, we use Martin Luther King Day for deep reflection and education for our first- and second-year MD program students,” says Amy J. Goldberg, MD, FACS, Interim Dean. “The curriculum is stirring and relevant. It ties Dr. King’s teachings, history, and legacy to today’s world – to our community – and ultimately to fundamental tenets of doctoring and physician competency.”
The 2022 commemoration, ‘Creating the Beloved Community,’ gave students the opportunity to examine what Dr. King meant by that term and to explore ways to move closer to that vision.
For first-year medical students, the day began with exploration of Dr. King’s “Letter from Birmingham Jail.”
“We use this piece to launch the day for first-year students because it encapsulates so many elements of Dr. King’s wider journey,” said Abiona Berkeley, JD, MD, Interim Senior Associate Dean, who directs the school’s Office of Health Equity, Diversity and Inclusion (OHEDI).
For most of its history, the school engaged in service projects to commemorate Martin Luther King Jr. Day – always a good thing – but, as Melanie Cosby, PhD, Director and Assistant Professor of OHEDI, explains, “we also wanted to provide students with an opportunity to become better acquainted with Dr. King’s life and legacy beyond a day of service and “I Have a Dream.’”
And it’s Dr. Cosby who facilitates the discussion with first-year students about the 1963-era American social milieu, the events that led Dr. King to organize peaceful protests in Birmingham that resulted in his incarceration for disrupting law and order. (Dr. King was incarcerated 29 times during his civil rights journey, Dr. Cosby noted.)
While Dr. King was imprisoned in Birmingham Jail, fellow clergy of various faiths cowrote him a letter of advice that, despite its good intent, as the students observed, was misguided – and certainly disheartening to anyone who really understood Dr. King’s goal.
Dr. King’s wrote a letter in reply (on scraps of paper that visitors had to smuggle out for him, Dr. Cosby noted). The students discussed both letters. In Dr. King’s, they recognized a well-developed mind at work, a person at a high plane of understanding of the human condition. (Although Dr. King was relatively young at the time, only 34, Dr. Cosby said, his use of language was so facile, so powerful and meaningful as to be prophetic).
First-year medical student Alexis Wright-Spadaro said the clergy’s letter had a “we know best, this is what you need to do” tone, with the advice-givers espousing from a safe remove, not from lived experience. Today, she said, “we need to be mindful that what works in one situation may not work in another.”
A classmate noted “something divisive about fellow clergy impugning Dr. King on the basis of his home ground, religion.” Another classmate said that perhaps Dr. King’s ministerial colleagues “feared even being associated with one of the most hated people in America.” (Dr. Cosby had pointed out that, in those days, mainstream America reviled Dr. King. The FBI called him most dangerous man in America. In President Kennedy’s words, he was an “undoer” of democracy.)
Shannon Trombley observed a telling fact: that the ministers presumed the unquestionable “rightness of the law” without consideration of whom it favors, whom it is designed to protect – “certainly not the oppressed,” she said. (It’s a painful irony, Dr. Cosby noted, that law, ostensibly designed to uphold justice, can be the biggest obstacle to justice.)
From here, the discussion journeyed deeper into equity, justice, difference, and unity. Slavery and its aftermath. Rosa Parks (Dr. King was 24 at the time, Dr. Cosby said.) Emmet Till. George Floyd. Students commented on the striking similarities between Dr. King’s era and today, the lack of fundamental change.
Natalie Kretzing drew a parallel between the acrid response “provoked” by Dr. King’s nonviolent protests in the 1960s and the recent public outcry “provoked” when Colin Kaepernick (a former San Francisco 49er) kneeled at games and did not sing the Star-Spangled Banner. Nonaction can speak loudly.
The discussion then touched on the harm that inaction can harbor. (Extremists are not necessarily the ones to be wary of, Dr. Cosby said.) To be able to distance oneself from issues, hide quietly in plain sight, is a privilege many cannot enjoy. Dr. King was wise to call out the uninvolved, a student said.
MJ Wilson noted that Dr. King definitely recognized “the value of intentionality.”
Perhaps most remarkable (and emblematic of the civil rights leader’s work) is that Dr. King “never drew a line in the sand,” another student said.
Bringing it Home
Next, the first-year class participated in an interactive panel discussion with North Philadelphia community members.
In the spirit of the day’s theme, Creating the Beloved Community, the discussion centered on how medical students can help cultivate hope, healing, and health in North Philadelphia, bringing meaningful change to patients, communities, and the practice of medicine. As medical student José Soto said, “as doctors we will have a lot of agency and can use our power and privilege to help.”
The panelists suggested ways the students might think of their roles and responsibilities in support of building community, today and in the future. Throughout, they drove home a fundamental point: leave your superhero capes at home. Don’t put pressure on yourself to lead a revolution or change the world.
“Every interaction with patients or residents is an opportunity to have impactful moments" said panelist Naida Elena Montes. “In health care we meet people at their most vulnerable times. A simple, kind interaction will have a sustained impact.”
“Be present, mindful, respectful. Ask what you can do. Listen,” said panelist Trinka Klima. “Quality care is composed of actions and processes aligned to respect human dignity. As caregivers we are the healthcare system, creating reputations for those systems one interaction at a time.
” When you meet someone from a community unlike your own, “don’t presume anything. Ask, listen, learn. Begin where they are,” advised panelist Michael Major. A small gesture can leave a permanent impression, effect change. “The people who made posters by hand about neighborhood marches played a very important role in the civil rights movement led by Dr. King.”
“All of us, no matter what our role, have a place in promoting basic human justice,” said panelist Klima. “We need to keep our hearts alive.”
“This is how to change healthcare system, from the bottom up,” noted panelist Tahir Wyatt.
“Take it in, watch for opportunities to build relationships and be a part of community outside of regular ‘service learning,’” said panelist Montes. "Do not miss the moment.”
Behind the Design
While the first-year class program was underway for Philadelphia campus students, St. Luke’s campus students and faculty held their own session. They discussed health disparities that have been heightened by the COVID-19 pandemic – with a focus on rebuilding community as well.
Meanwhile, the Philadelphia-based second-year class was deeply engaged in their own session, a deep dive with community panelists.
Mid-program, a vital piece of advice came their way: People tend to view ‘impoverished’ communities as simply that: impoverished, noted one of the panelists “But poor communities are also incredibly resilient and resourceful. They have to be. What we can learn from ‘poor people’ will make us better clinicians. Do not look at people and just see deficits,” she said.
Dean Goldberg later referred to that statement as “words of gold. All the panelists and students had amazing insights,” she said, “and Dr. Cosby does a fabulous job of leading the journey through Dr. King’s Letter from Birmingham Jail.”
The program shines Dr. King’s spotlight on education – human and medical. “The design behind the day is to give it roots, center it on practical, tangible ways that students can weave themselves into the fabric of community and healthcare on a daily basis,” Dean Goldberg explains. “The program is effective, inspiring, relevant – and continues to build momentum through continuity.”
Mykal Gerald, an MD/MA Urban Bioethics Candidate in the Class of 2022, is one of the medical students who helped design the initiative – in hopes that “it will translate to the students’ future careers and patients.”
In Dean Goldberg’s view, on January 17, program participants really united in the quest for greater shared understanding of self, other, and community. “And I couldn’t be prouder,” she said.