Tag Archives: prejudice

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Anarchy loosed upon the world

It was a warm and sunny afternoon -a wonderful day to find a park bench and read my book. I had the perfect place in mind, too: a lonely meadow surrounded by trees overlooking the ocean just outside the city. I could divide my face between book and breeze, birds singing in the trees, and ships passing quietly on the horizon -retirement pleasures.

It was the middle of the week and the park was almost empty, except for a couple sitting on a bench while their child played quietly in the grass in front of them. They looked up at me and smiled pleasantly when I sat on the bench beside theirs and then continued their conversation. Their little girl, who had been talking to a doll she was holding, stared at her parents for a moment, and then stood up and walked slowly over to me.

She spoke softly, and I couldn’t really hear what she said, but she was obviously more curious than afraid. She couldn’t have been more than two or three years old and her long black hair danced merrily over a grey sweatshirt that was only partially still tucked into her jeans. I had to chuckle at the earnest expression on her face as she examined me where I sat. Finally, after a quick glance at her parents, she raised her ragged cloth doll to show it to me.

I smiled warmly, delighted at the gesture, and nodded my head to show her I liked the doll. Her eyes twinkled with pleasure and she touched the doll’s hand to my knee.

The father seemed nervous though, and I could tell he was watching me closely. “Sorry, mister,” he said when our eyes met. “She and mother just here,” he continued in a heavy accent. He beckoned to his little girl, obviously embarrassed that she might be bothering me. “Haya,” he called, and the little girl ran over to him, laughing, and then began to play with the doll again on the grass in front of them.

I settled in to read my book, but found myself too distracted by the gentle breeze, and the sun glinting off the white collars of waves rolling in from the open sea. When I looked up again, I noticed that another man was sitting on the only other bench and staring rudely at the couple. He seemed upset, for some reason.

“Where are you from?” he asked -although it sounded like the demand a suspicious policeman might issue, rather than a question.

I suppose I am naïve, or perhaps too accustomed to different cultures from my years as an obstetrician, but it was only then that it occurred to me that his wife was wearing a hijab, although the husband was casually dressed in western attire.

The father smiled to diffuse the man’s tone. “Aleppo,” he answered.

But the man screwed up his forehead as if the word meant nothing to him.

“Syria,” the father added, his smile less certain now.

“And do you make your wife wear the headscarf?” The man’s tone was not friendly.

The father seemed at once perplexed, and perhaps offended that a stranger would talk to him that way, but he managed to keep the smile on his face. “I… Eva only just here…”

The man was scowling at him now, and I could see he was about to say something about that, when the woman raised her eyes from her lap and stared at him. “I choose to wear the hijab,” she said in flawless English. “Is that a problem for you, sir?”

The man clearly did not expect that, and his expression changed from irritation to surprise. He shook his head slowly, a little embarrassed I thought. “No…” I could tell he was trying to think of something to say, now that he realized the woman was fluent in English. “But you’re in Canada now… Why would you still choose to wear it?”

She smiled a patient smile -as if she were a teacher dealing with a slow student. “Would you choose to wear something different if you found yourself in Aleppo?”

The man was clearly taken aback, and looked at the little girl for a moment as he considered his answer. “But… But the scarf-thing makes you stand out here…”

Her smile grew as he spoke. “Is it the ‘scarf-thing’, or is it my brown skin, or maybe my husband’s accent…? “ She glanced at her husband and said something to him in Arabic that I couldn’t hear, let alone understand. “We are different, sir.” The man stared at his lap, and I think he was blushing. “So, would you like us to choose a different bench, or a different country?”

He looked up from his lap and stared at her. “I… I’m sorry, I didn’t mean…”

“Yes, you did, sir. And isn’t it interesting that when you actually talk to one of us, you find another human answering back?” She whispered something to her husband and he smiled at her. “You know, we’re grateful to be in Canada, but in truth, we would have gone to any country that was safe if it had taken us in. We were just the fortunate ones that got chosen by your country.”

“I… I really didn’t mean to…”

The woman shook her head vehemently and the floral patterns on her maroon hijab jumped back and forth. “Yes, I think you did…” But at that point her face relaxed and her eyes softened. “I think we needed to have this conversation, you know. Sometimes you have to confront things head on, don’t you think? Clear the air…” She stood up and walked over to the man, her husband in tow. “I’m called Eva,” she said as the man rose to greet them. “And this is Rifat.”

Rifat extended his hand in greeting.

The man finally smiled and shook the proffered hand. “And I’m George. I’m so sorry I’ve been rude…” He was about to say something more when he noticed a tug on his coat. As he looked down to see what it was, the little girl stared up at him and touched his leg with the doll’s arm. Even from my distance away, I could see his eyes brighten and his entire face become a smile.

Are we unreasonable? I’m not a sociologist, but the recent upheavals in the public domain certainly do not reassure me. When the falcon cannot hear the falconer, things fall apart, as Yeats came to believe. And yet, although incivility seems to be spreading like a virus, does this really signal something bad? Something untenable?

I cannot say that the populist trends in societal discourse cause me to fear Armageddon, but I am old now; History is my companion, and Time has perhaps dimmed the consequences that may hide ahead. I was, however, both heartened and intrigued by the essay of Steven Klein, an assistant professor of political science at the University of Florida, in the online publication, Aeon: https://aeon.co/ideas/against-civility-or-why-habermas-recommends-a-wild-public-sphere

‘In democracies around the world, anxious commentators exhort their fellow citizens to be more open-minded, more willing to engage in good-faith debate. In our era of hyperpolarisation, social-media echo chambers and populist demagogues, many have turned to civility as the missing ingredient in our public life.

‘So, how important is civility for democracy? According to one of the greatest theorists of the democratic public sphere, the German philosopher Jürgen Habermas, not very. For Habermas, the function of public debate is not to find a reasonable common ground. Rather, the public sphere ‘is a warning system’, a set of ‘sensors’ that detect the new needs floating underneath the surface of a supposed political consensus. And if we worry too much about civility and the reasonable middle, we risk limiting the ability of the public sphere to detect new political claims.’

‘Consensus is not the highest good… Democracy, according to Habermas, requires a vibrant political sphere and political institutions that are able to respond to and incorporate the energy that arises from debate, protest, confrontation and politics.’

The more I think about Habermas’ contention that argument and disagreement are necessary bricks in societal progress, the more I understand importance of challenging what we have come to believe. We are all unfinished paintings, and unless we step back from the canvas from time to time, we lose perspective; we lose the ability to see what others see. We become the pentimento we are trying to cover up.

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Is there really Something in a Name?

What’s in a name? That which we call a rose, by any other name would smell as sweet.

So said Shakespeare’s Juliet. And yet even then –especially then- it mattered. Tribes have always mattered; we have always been known by our tribes: we are all either us or them aren’t we?” And little has changed despite the agglutination of the numberless tribes into tightly knit societies; there are still passwords.

I suspect I have lived in a bubble somewhere all these years; I really did think things were improving –that we were becoming less prejudiced- but I suspect it is just one more of those parochial shadows obscuring our vision here in Canada. Names, religions, skin colours, gender –appearance– all are code words for acceptance or rejection. We may fantasize that we live in a meritocratic land where Justice is blind and deaf, where we are all judged by our abilities and not our backgrounds, but alas we are deceived –or, rather, we deceive ourselves.

And so, more thoughtful societies have cast about for solutions to those biases so deeply ingrained, and often so hidden that we scarcely notice them anymore. The idea of ‘blind recruitment’ might offer one way to help resolve unconscious (or not) biases that plague many employers. Symphony orchestras were among the first to try it as the following CBC news article points out: http://www.cbc.ca/news/business/blind-recruitment-marketplace-1.3462061 -‘When the Toronto Symphony Orchestra began to audition musicians blindly in 1980, putting them behind a screen, the result was profound. While the hiring committee could hear an applicant’s performance, they not see what he or she looked like. They even put down a carpet so high heels couldn’t be heard. Now the orchestra — which was made up almost entirely of white men in the 1970s — is almost half female and much more diverse.’ Another news article, this time in the BBC News echoes this: http://www.bbc.com/news/magazine-34636464

Talent will out, if that is the sole criterion; but it isn’t. Unfortunately, our judgments are not entirely determined by merit; we sometimes are distracted by other, unrelated issues. Gender, seems an obvious one, but topping the list, is race. Foreign-sounding names seem to discourage interest in the further exploration of a CV: ‘Studies in the U.S. and Canada reveal that job applicants with ethnic-sounding names are less likely to get a response than more Anglo-Saxon names, despite having the same experience and credentials.’ So, unless ‘name blind’ applications are mandated, applicants with foreign-sounding names are at a distinct disadvantage in the job market. This is such a blatant waste of talent and opportunity that –at least anecdotally- some career advisers have suggested that their clients harmonize the names they use on job applications to more societally acceptable ones. Or more pronounceable: ‘Luxshiani Ganeshalingham says her friends automatically change their names when they’re looking for jobs. “We shorten our names to get a better response, or more responses.”’

Hiding things on the initial application may allow people the chance for an interview, but it is obviously far from the solution to racial, gender, or religious bias in hiring, however. ‘”… the reality is that people carrying out interviews, at the next stage on from applications, are humans,” says Azmat Mohammed, director general of the Institute of Recruiters. “The thing is for them to be able to analyze their own biases. Everybody has them and businesses are working to address this issue.”’

And nowadays in most Western countries, where discrimination is prohibited by law, or even discouraged by popular media, the biases have been driven underground. ‘”Modern prejudice is the transformation of our biased attitudes,” says the students’ professor Michael Inzlicht. “[About] 40, 50 years ago, one could express overt hostility or antipathy toward a group — ‘No, I’m not going to allow a black person into my golf club,'” he says. “You politically can’t say that any more.” Modern racism is less overt, Inzlicht says, but we see “very clear” biases. “It’s more dangerous … if you’re not aware of it,” he says.’

I can remember sitting on a rather crowded bus last year and feeling grateful that I had found the last unoccupied seat. A young woman with sparkling brown eyes in the adjacent seat seemed to be absorbed in reading and writing notes on some loose papers in a folder, and as she read I could see her sigh, or at times, chuckle at their contents.

Although I tried to be discreet, she obviously noticed my interest and turned to me with a smile. “Students nowadays are so funny,” she said, glancing first at my face, and then back at one of the papers. “They think they are inventing the wheel each time they answer… But, you know, sometimes they come to the question with such an innocent perspective, they really are… The world is different for them –new, exciting… They’re not muddied by the old methods we bring to questions -the old thoughts that channel us like pipes.”

I looked at her more closely when she said that. She was a young woman, in her late twenties perhaps, with dark hair, and a nut-brown complexion. She was actually excited by what she was reading. I smiled at her enthusiasm and, as strangers will, we began to talk of other things as the bus honked and jolted its way through rush-hour traffic. Just before the journey’s end, we exchanged names. Hers was Alice. I smiled at the name –it has always been one of my favourites and I told her so.

She returned the smile. “I have always liked it, too,” she said, almost wistfully. “Maybe it was Lewis Carroll’s influence –sorry, I mean Charles Dodgson’s,” she corrected herself academically with an embarrassed grin. “My mother always read to me in English at night when I was a little girl growing up in Tehran, and I used to ask for Alice in Wonderland all the time…”

“So you mean Alice was a name you chose for yourself? It’s not your birth-name?”

Again, she seemed embarrassed. “No, my real name is Aza; Alice is pretty close though, don’t you think?” The almost childish delight returned to her face and she smiled so brightly, her teeth seemed to sparkle in the sun coming through the window.

“But…” I was confused. “But Aza is such a beautiful name. Why would you want to change it?”

Her expression changed for a moment and she looked puzzled. She tried to disguise it, but her eyes inspected me to determine if I was patronizing her. As if I, of all people, should know why she’d changed her name. For that brief moment, I was one of her less gifted students. But it passed like a cloud and suddenly her smile returned.

Her stop was coming up so she reached up and pulled the cord. Then, in an effort to atone for her doubts about me perhaps, she touched my hand. It was a gesture of friendship at the very least. “Names, not credentials, get you interviews,” she said with a sad smile as she stood up to leave. “And I wanted to teach…”

 

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Stereotypes in Medicine

I suppose we are all, at times, seduced by stereotypes. They are, after all, a simplified way of processing the other world –underlining how they are different from us. Even the etymology of the word, derived from Greek, seems as if it would be helpful: stereos –firm, or solid; typos –impression. But unfortunately it has wandered from its first use in the printing field as something that would reliably duplicate what was engraved on the master plate, to its use in 1922 in a book entitled Public Opinion that suggested a ‘preconceived and oversimplified notion of characteristics typical of a person or group’.  It has grown and metastasized, cancer-like, from there. Now, any attribution is suspect. Any observation, coloured. What was once felt to be useful is now recognized as impossibly simplistic. Naïve.

We are far too complex to fit into labelled baskets that purport to describe our essence or predict our opinions. Indeed, to stereotype a group is to consider it different –perhaps not unreasonable as an observation, but also dangerously close to slipping into an us/them perspective with its risk of discrimination and prejudice. As Wikipedia (sorry!) summarizes it: ‘Stereotypes, prejudice, and discrimination are understood as related but different concepts. Stereotypes are regarded as the most cognitive component and often occurs without conscious awareness, whereas prejudice is the affective component of stereotyping and discrimination is one of the behavioral components of prejudicial reactions. In this tripartite view of intergroup attitudes, stereotypes reflect expectations and beliefs about the characteristics of members of groups perceived as different from one’s own, prejudice represents the emotional response, and discrimination refers to actions.’

So, the stereotyping of an individual, or worse, the group to which she presumably belongs, can have consequences well beyond the initial encounter –‘unintended consequences’, as we are so fond of saying in retrospect- and yet we still seem genuinely surprised that things would turn out like that. I am always heartened, therefore, when I read about those who are able to pierce the curtain and see what lives outside the window: http://www.bbc.co.uk/news/technology-34359936

I like to tell myself that all my years in practice have dissolved the last dregs of stereotypes from my psyche, and yet my guilt, my terror of succumbing, is still alive and well –if tucked away. But, if stereotyping can occur without conscious awareness, the very act of trying to avoid it suggests that there is something there in the first place…

Manipulation always reminds me of the danger. Not my manipulation, you understand (and besides, I don’t call it that); no, my patients’ attempts at beguiling me. My mother was a masterful manipulator and I’ve always noticed similar attempts by others. Perhaps the very labelling of their actions as manipulations is itself a stereotype, but I’m getting ahead of myself.

I still remember a time, several years ago now, when I was discussing the pros and cons of vaccination against HPV, the sexually transmitted virus responsible for cancer of the uterine cervix. The woman, a well-educated software engineer at a local start-up company, had asked me what I thought of her daughter being vaccinated in school.

“She’s only in grade six, doctor -11 years old! She hasn’t even thought about…” Loretta hesitated briefly as she sorted through her vocabulary. Clearly, even the thought of her daughter as a sexually active individual was uncomfortable for her. “…being intimate.” She immediately blushed at the word.

It’s a delicate topic for parents and I nodded sympathetically. “Not intimate yet, I’m sure,” I said and smiled to diffuse her embarrassment. “But when she gets older, it would be nice to know she will be protected against the virus, don’t you think?”

Loretta’s face hardened at the thought –or maybe at the fact that I needed to bring it to her attention. Her expression was adamant: her daughter was not like that. She studied my face for a moment, her eyes made short angry excursions onto it, then, finding nowhere to roost, hurried back to safety. “I think I will decide when she is older and more able to understand.”

I tried to disguise a sigh. “Sometimes our children understand a lot more than we suspect, Loretta…”

I could see her stiffen in her chair. “I know my daughter. You may be a parent…” She paused to run her eyes up and down what she could see of me from where she sat, obviously trying to decide whether even that was possible. “But you are not a woman, doctor; you couldn’t possibly understand the mother/daughter bond!”

My only possible response was a smile, so I parried with the best one I could muster under attack. “You did ask for my opinion, Loretta,” I managed to reply in an even voice.

She unleashed her eyes on my face again, this time as birds of prey, and as they circled for the kill, she managed to answer in a polite monotone. “You health practitioners are all the same, aren’t you? You think you have all the answers. You, my GP, the school doctor –even the school nurse- prattling on about anticipated behaviours and how you want to deal with them as if you were all decanting untasted wine from the same expensive bottle.”

My smile broadened at her use of the simile but my reaction only seemed to fluster her more. I shook my head slowly. “Most of us certainly don’t think we have all the answers, Loretta.” Her eyelids fluttered as if I were a politician trying to convince a wary population. “But I suppose we do try to prevent problems when we see them coming. Cancer of the cervix used to be a major problem until we recognized it was caused by a common sexually transmitted virus. The obvious next step was to see if we could develop a vaccine to protect against it like we did with small pox –or polio…” I shrugged as if I had just made an irrefutable point.

She stared out the window for a moment, undecided, and then I could see her body language change. Soften. Her eyes were sparrows again –finches, maybe: curious, but playful. “I just stereotyped you didn’t I?” I hadn’t thought of it that way, I have to admit; the accusation usually comes from the opposite direction. I nodded in pleasant agreement. “But it’s a two way street isn’t it?” she added with an impish smile, obviously unwilling to let me off unscathed. “I saw you rolling your eyes at the mother-daughter bond thing.” She could hardly talk for her smile. “Over-protective mother meets omniscient doctor, right?” She settled back more comfortably in her chair. “Both of us using our unique and non-reciprocable roles to pull rank. To manipulate each other –ad hominem stuff…” she added and then chuckled.

Suddenly she became serious and I could sense she needed an answer. “Tell me, doctor,” she said, carefully choosing her words, “If I were your daughter, would you advise me to have your granddaughter vaccinated?”

A serious question; a personal question -and I didn’t hesitate to respond. I nodded my head immediately.

She relaxed again. “Then I have my answer, don’t I?” she said and started to put on her coat. She stopped at the door and turned to me with a little smile waving for attention on her face. “Did I just get swept up in another stereotype?”

I had to shrug. I’m just not sure anymore.

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Age Prejudice

I suppose I should have seen it coming. I suppose I should have laid down firmer tracks, taken a more trodden path. I suppose I shouldn’t have been so influenced by Robert Frost’s poem, the Road Not Taken. But I was… ‘Two roads diverged in a wood, and I— I took the one less traveled by, And that has made all the difference.’ Well, at least I think I did -I didn’t mean to, or anything; it’s just something that, as I look back through the years, turned out that way.

All our paths are unique, to be sure, and it is likely the conceit of many of us to think that we, alone, have chosen singularities for ourselves –things, if not incomparable, then at least extraordinary: signatures for which only we could have been responsible.

So it is with some dismay that I came across a BBC News article describing a paper by William von Hippel, a professor of Psychology at the University of Queensland, in Australia in which he suggests that ‘although many people remain unprejudiced throughout their lives, older adults have a tendency to be more prejudiced than their younger counterparts.’ http://www.bbc.com/news/magazine-33523313

Older folks? Now wait a minute… As someone who did not suspect his way of life had ‘fall’n into the sere, the yellow leaf’, I feel almost blind-sided. Of course I didn’t see Harper Lee’s Go Set A Watchman coming either. I have been a life-long admirer of Atticus Finch –someone whose name I even bestowed upon a cat I once had- and Lee’s previous book To Kill A Mockingbird was always a beacon in troubled waters for me. Something that let me believe that we were more than our fists. That we could, if we chose, rise above the curses and anger that so frequently filled our streets. But even her older Atticus slipped beneath those waves it seems…

So is this how the path to maturity -the grinding road to wisdom- ends? An abnegation of all the tolerance that we have learned to espouse? An abrogation of all those principles we fought so hard to enshrine in law? A foretaste of the dark night of the soul that lurks, still hidden, behind the shadowed corners of our ever-increasing ages?

In fairness, if you read the original article in Psychological Science https://www2.psy.uq.edu.au/~uqwvonhi/S.vH.R.PS.09.pdf it attempts to frame the problem as a sort of neurologic deficit, suggesting –that age differences in implicit racial prejudice may be due to age-related deficits in inhibitory ability- perhaps absolving us elders of ultimate responsibility. As in dementia, it’s not our fault. Certainly not our wish… Some things, like grey hair or wrinkles, are merely part of the geography of age the trail runs through. But is increasing prejudice a town along the way, or a detour we didn’t have to take? A ghost town, sporting a few boarded up stores and nobody we recognize on the streets? A place we visited years ago, then left because we didn’t feel at home despite the friends we made?

The BBC report neatly summarizes von Hippel’s neurological hypothesis: The frontal lobes are the last part of the brain to develop as we progress through childhood and adolescence, and the first part of the brain to atrophy as we age. Atrophy of the frontal lobes does not diminish intelligence, but it degrades brain areas responsible for inhibiting irrelevant or inappropriate thoughts. Research suggests that this is why older adults have greater difficulty finding the word they’re looking for – and why there is a greater likelihood of them voicing ideas they would have previously suppressed.

Whoaa! I’m not sure I like that… I’ve always had irrelevant and probably inappropriate thoughts. I’ve always been a loose cannon. And now, I suppose, I should be worried that there is a threshold I might some day cross in which my age would shift me from being considered merely eccentric to a diagnosis of mild dementia –frontal lobe atrophy, no less- by default. Or maybe I should have worried about those mysterious frontal lobes all along –maybe I got a damaged pair from the outset.

Hmm, and I always figured it was the result of getting lost on that less-travelled road. It was, after all, ‘grassy and wanted wear’…