Letters to a Young Medical Student

The following text represents an interaction I had with a young medical student in the first year of medical school. I also include two brief excerpts showing how anti-intellectualism and closed mindedness are sabotaging key institutions, in this case the American Medical Association. The AMA has abandoned its commitment to merit, and the National Public Radio (NPR) system has become intolerant of anything other than Orwellian “Newspeak.” The extent to which this one-sided forced diet is affecting core institutions is revealed in the following brief excerpts. They are offered here to provide a context for what the medical student and many others are experiencing.

The “New Ideology” of the AMA and More Than 171 Medical Schools

In October 2021, the AMA released a guide describing how the concepts indicated in its May 2021 announcement should be internalized by physicians and the medical profession generally. The following passages demonstrate rejecting merit is only the beginning. 

The American Medical Association recently released a guide on “Advancing Health Equity” that promotes how to fight for critical race theory, includes a list of words not to say and their “equity-focused alternatives,” and criticizes concepts like “meritocracy,” “individualism” and the “‘free’ market.” The [fifty-five]-page document released on Oct. 28 cites a guide by the organization Race Forward for how to advocate for critical race theory (CRT), which is called “Guide to Counter-Narrating the Attacks on Critical Race Theory.” The health equity guide argues physicians…must focus on language and collective political circumstances of certain groups.

The guide says doctors should not say “Low-income people have the highest level of coronary artery disease in the United States.” Instead, it says, doctors should phrase the same idea like this: “People underpaid and forced into poverty as a result of banking policies, real estate developers gentrifying neighborhoods, and corporations weakening the power of labor movements, among others, have the highest level of coronary artery disease.” Rather than using the word “fairness,” the guide suggests doctors say “social justice.” This is because, it says, fairness “pays no attention to how power relations in society establish themselves but primarily emphasizes outcomes within a pre-given set of rules.” Tyler Olson, “American Medical Association pushes pro-critical race theory materials in ‘Health Equity’ guide: Document cites AMA guide for how to advocate for critical race theory,” Fox News, November 10, 2021.

Stanley Goldfarb’s Do No Harm organization offers a different approach relative to the AMA. The website states its aim.

Do No Harm represents physicians, nurses, medical students, patients, and policymakers focused on keeping identity politics out of medical education, research, and clinical practice. We believe in making healthcare better for all – not undermining it in pursuit of a political agenda. Do No Harm seeks to highlight and counteract divisive trends in medicine, such as “Diversity, Equity and Inclusion” and youth-focused gender ideology.

Juan Williams responds to editor’s charges of NPR bias: ‘Insulated cadre of people who think they’re right.’ (Charles Creitz, 4/9/24)

Fox News senior political analyst Juan Williams, whose 2010 firing from his longtime perch at NPR came following analysis he offered on Fox News, responded Tuesday to allegations by an editor for the public radio broadcaster detailing rampant bias and absence of registered Republicans in its newsroom…”Not only did they fire me — they called me a psycho. I mean, they said horrible things about me quite publicly. So, no, it doesn’t surprise me what [Uri Berliner] had to say.”

“They are very much an insulated cadre of people who think they’re right, and they have a hard time with people who are different,” he said.

Veteran NPR editor Uri Berliner gave a lengthy rebuke of his employers’ media coverage of major news stories over the last few years in an essay Tuesday for the Free Press. He blew the whistle on the outlet’s coverage and cataloged voter registration records, which he said depicted an 87–0 Democratic bent in its newsroom. Berliner alleged there is an absence of “viewpoint diversity” and avoidance of terms such as “biological sex” in the NPR newsroom. Williams suggested he was not surprised at Berliner’s comments that an “an open-minded spirit no longer exists within NPR… [that is] devastating both for its journalism and its business model.”

I have not included the identity of the medical student who contacted me. This is because our society has reached the point where it is often dangerous for people to share their thoughts openly. This political sickness totally undermines the core spirit of a nation and its educational culture in an America that we long thought was committed to truth, interaction, and honesty. The student’s concerns are captured in the following dialogue.

Medical Student: 4/5/24

Today I came across a review of your book, Conformity Colleges, and am reaching out in the hope that you can give me some advice. Specifically, how can I push back against the Marxist philosophies finding their way into every level of academia?

I am a student in my first year of medical school. I recently moved from a mid-Western state to an East Coast location, and have been quite shocked by the levels at which anti-capitalism is embraced at my school.

Recently during a lecture on “Disability Justice in Medicine,” a particular slide caught my attention. Listed as one of the 10 principles of disability justice (published by SinsInvalid.org) was “Anti-capitalist politics.” I was frankly stunned. In a lecture hall of several hundred students, no other student challenged the assertion that capitalism is somehow at odds with appropriate treatment of people with disabilities. When I reluctantly raised my hand and asked the instructor why capitalism was part of the discussion, I got a response of “We can agree to disagree.” 

I’ve heard watered-down versions of the same philosophies before, however, it seems that the embrace of socialism is not merely one argument on campus anymore, but a fact which is taken for granted. My current program particularly prides itself on being inclusive, and yet I feel totally isolated as it seems that the entire faculty and most of the student body loathes conservatism. 

I sincerely appreciate any advice you can give me.

David Barnhizer: 4/8/24

Your analysis is quite accurate. The mindset has over the past several decades coalesced into a religion of sorts. It has its tenets that are now taken on faith and condemns anyone who questions them or commits acts of “heresy.” And, something of which you must be aware is that the “true believers” see any challengers as heretics and are willing to ruthlessly suppress or cancel with bad recommendations, direct attacks on employment, sanctioning through exercises of administrative power, etc. I do think that there is some growing pushback but we will need to see its development.

For someone in your position I would in good conscience suggest that to protect yourself and family prospects, you play a game in which you don’t overtly challenge the political distortions that have emerged in your educational environment. The ideologues who see themselves as revolutionaries are adhering to a “quasi-religious cause” and are mostly unable or unwilling to entertain or appreciate any other positions. The Woke/Critical Race Theory movement is Socialist/Neo-Marxist and the adherents are seeking to implement that vision. They once tried to recruit me, admitted their political beliefs readily, and I said “No Thanks” and lost some people I thought were friends.

But in saying that you should sort of “keep your head down” in your educational environment—as difficult as it is—doesn’t mean you are otherwise inactive. I was raised as a working class blue collar person and spent most of my life as a Democrat deeply engaged in social justice issues in which I still believe. The Woke/CRT people have totally corrupted the pursuit of the real issues of social justice and done so to gain power and to undermine our values and basic institutions. Their behavior is absolutely contemptible, but a relatively small core of them have brainwashed a significant portion of the population that is decent at heart and thinks they are actually doing the right thing even while helping to destroy our social and political system. Stupidity and laziness represent a large part of what is going on here.

So, I would recommend while you are in med school you focus on the science and work outside that environment to try to support those who are trying to confront Woke/CRT. I am now an Independent but will vote for Trump for two basic reasons. One is that he represents the only real chance to mitigate or buffer the effort to transform America. The second reason is that while I can’t stand the man in terms of his childish name calling and continual self-praise the fact is that from a policy, honesty, and willingness to implement the policies the nation needs he is the only person out there.

Medical Student: 4/8/24

Thank you for this honest and frank advice. What to do has been so much at the front of my mind that it is almost consuming. Today while taking a midterm my thoughts were difficult to keep focused. The science is tough enough to learn (while raising my family, I’ll add), that I don’t know if there is much room left for me to take on a possibly futile fight.

I have found an organization which looks promising, Do No Harm. My thoughts were that I could possibly let them know what I’m seeing in class, without violating any school policies. I won’t share faculty slides with them directly, for example, but I was thinking I could share the ideas and some specific phrases on the slides. What do you think?

David Barnhizer: 4/8/24

I think Do No Harm is a perfect choice. Stanley Goldfarb is doing a great job. If you can track her down, Leslie Neal-Boylan could be a good mentor for you in this difficult time. She was fired from her position as Dean of Nursing at the University of Massachusetts-Lowell because she put ALL LIVES MATTER in an e-mail response. The AMA and medical schools should be so ashamed of themselves. They are mandating a bunch of distorted BS. It angers me for various reasons, but one of the main ones is that they are corrupting the real messages of social justice to an extent they are the actual bigots and racists. As Goldfarb states clearly, they are also harming patients who will have the misfortune to be dealt with by less than fully capable medical professionals. Good luck with life, family, and career.

Medical Student: 4/9/24

The pressure I am facing to conform is almost more than I can handle right now, as I have so much science to digest and new skills to master. That I am also being asked to pledge allegiance to viewpoints that are not mine is making me question whether I can hold out. On Friday I’m expected to show up to a small group discussion about Medicaid expansion advocacy. It is required that I share ways that I as a physician will contribute to said advocacy. I’ve considered emailing the professor to ask whether I will be required to agree, or if there is an alternate assignment, but I’m frankly afraid that doing so will severely hurt my chances of finishing. 

Do you know whether it is legal for a school to require that its students share the political beliefs of the school? If I am professional and respectful, and don’t disrupt lectures or discussions, would I have legal protection for disagreeing with their politics?

Thanks again,

David Barnhizer: 4/9/24

You are welcome. The issue of the degree of legal protection for other than religious reasons is still up in the air. The problem is widespread. My 2021 book, Un-Canceling” America, presents a wide ranging record of all the institutions that are being captured. Education of course, but journalism, economics and corporate management, government at all levels, the medical and legal professions, and much more. The book has 599 pages with over 600 examples of “canceling” in critical institutions. Pushback is building, but it will take awhile. This year’s election will be critical in determining what happens. But first, at this point concentrate on doing well in school and focus on those medical issues. Good doctors are incredibly important.

Medical Student: 4/10/24

I might add that what perhaps bothers me most is that it is taken for granted here that anyone who subscribes to conservative principles is intolerant, unkind, devoid of empathy, and unbecoming of a healthcare provider. 

A large part of the reason we moved our family here is because we wanted them to experience greater diversity. We adopted our two youngest children through foster care, and they are of Hispanic heritage. They didn’t get to see many mixed race families in the location from which we moved and we’ve been pleased that they see many more diverse people here. 

I don’t fit the stereotype most other students seem to believe is representative of someone opposed to Marxist ideals. I have never even voted for Trump. I wish we had better options this election as well. 

With the broad range of political perspectives in our country, why is one particularly narrow view being elevated, almost without opposition?

On a more positive note, I have recently spoken with several other students who also are opposed to DEI indoctrination (and one student told me there are others). I had also heard that some of the professors disagree with students being required to spend loads of time on political material when we should be studying medicine. That was so good for me to hear!

David Barnhizer: 4/10/24

The article I copied to you involving how Juan Williams was treated by NPR in 2010 pretty much sums up what you are facing. See the NPR situation described below. NPR might claim it has 87 journalists, but the reality in terms of diversity is that there is only one since the political ratio for NPR is 87:0 in terms of the staff’s political beliefs. Harvard’s faculty and administrators are much the same and so are many Ivy schools and other colleges and universities. Many of our institutions are being controlled by people basking in their self-important virtue. They see any other views as obstacles to their power and privilege.

The irony is that in accusing others of being part of a system of “privilege” and condemning them for its perceived abuses, the ones at the top of the particular institutional pyramid—whether journalism, a university, or a medical school—somehow manage to ignore that they are intensively recreating a power system more insidious and intolerant than what they claim suppressed them or denied equality to others. 

An important thing to keep in mind is that most of the people in that situation are what I term “poseurs.” The people most benefitting from the “new norms” are the worst because they are gaining power, privilege, and profit from controlling the dynamic. Many of them, Ibram Kendi, Nikole Hannah-Jones, Al Sharpton, Hakeem Jeffries, Maxine Waters and the like are what civil rights pioneer Booker T. Washington called “Grifters” a 100 years ago who profit from racial dissension . They keep stirring up the discord and strife and get rich off racial tension.

But you said earlier that in a lecture hall with 300 medical students you were the only person who asked a question, and received only an abrupt “agree to disagree” response from the instructor without any explanation. That is not uncommon because the people are basically working from a script of assertions, accusations, and slogans. They don’t want to engage in real analysis and discourse concerning their major premises both because many don’t actually understand what they are talking about and because honest discourse would weaken their ideological positions. It is like Mao Zedong wrote in a 1937 tract against honest Liberalism. He explained you couldn’t tolerate it in a revolutionary movement because Liberals asked questions, challenged authority, and did not automatically obey orders.

It is also the case that the context of what you describe is one-sided and intimidating. I will never forget the first time I asked a question as a beginning student sitting in a law school lecture. I was scared I would be made to look like a fool or stupid. It was scary and intimidating. The silence you are experiencing does not mean that others don’t share your perspectives. Many are nervous, “keeping their heads down,” or decide that it isn’t worth fighting about because the teacher is seen as a one-sided ideologue and that nothing good can come of the interaction.

Many of the people who appear to accept the new reality are sycophants seeking to gain from demonstrating their moral and political virtue. Others simply keep silent and seem to be okay with the BS on the surface because they are spending significant time and money trying to develop and gain the knowledge and skills they need for their future. Unfortunately, our academic culture has in many contexts lost its way and abandoned its core integrity of critical thinking, diagnostic skill, and scientific depth. With the AMA and medical schools affirmatively and explicitly rejecting the values of merit and opportunity in the past three years, and mandating DEI courses and loyalty oaths while reducing the standards for admission, they are throwing out the classic oath of “Physician do no harm!” It is truly unbelievable, dangerous and unjustifiable, but you are caught in the trap of an “ideological con game.”

The fact is that as a student you cannot win against the system that has been created. As a law professor I was in a different power position, and even though I often challenged the system that was emerging even then and had little respect for a number of my colleagues, no one really tried to “mess” with me. One reason is that I have a clearly demonstrated record of long term social justice work in numerous contexts. That insulated me to some extent because I probably did more to advance the real issues of social justice that are claimed to be involved in this “movement”considerably more than the people about whom we are talking.

Few others have that kind of “armor.” Certainly students in your position are in lower positions of power and lack leverage relative to administrators and faculty. You are vulnerable. So, although I would never take a pledge indicating I believed in something I did not, I would try to figure out how to take a virtuous stand where I am able to explain why I believe in fundamental issues of social justice and don’t make generalized pledges. That could buffer the responses to some extent.

I’ll give you an example. When I was 14, my church put us all through a study program aimed at explaining church doctrine so that we could become full members. It went on for weeks and at the end we were supposed to take the oath of membership. At that point, however, I told the minister I couldn’t do it. He was shocked and said “Why?” I responded that I did not and could not believe in the doctrines of Predetermination and Predestination that were essential pats of the Presbyterian beliefs. I explained my position that I saw the doctrines as things that no God worth worshipping would impose on people because in essence they sort of made life a kind of game in which it didn’t much matter what you did because your ultimate fate was already set from the beginning.

While he tried to explain the doctrines from his perspective, it was quite insufficient from my point of view, so I never joined the church. For you, however, in my experience the people with whom you are dealing are much more intolerant, vindictive, and less knowledgeable than that minister. The “bosses” of the Woke/CRT movement are basking in their power, privilege, and profit. This creates a situation in which those hired to advance the “new religion” of the “Social Justice Warrior” movement need to apply significant pressure to “non-believers” and “heretics” because the ideologues are making a great deal of money from advancing a political movement that relies on shaming, canceling, oppressing, and expanding their own power base.

As you move through your medical education, feel free to share your thoughts if you desire. I would simply add that the issues that the activists purport to care about are ones that are valid and important aims and questions. The tragic fact, however, is that the manner and strategy being used to advance what are legitimate goals if approached properly and in an honest and balanced way are, as currently being applied, abusive and destructive to the point they are deepening social divides at a time that the nation had been making significant progress. 

The result is that those implementing this strategy have themselves become the “New Racists” and people who can be described as biased “Genderists.” They should be ashamed but they are using the tactic of psychological “projection” to accuse others of what the Neo-Racists and Genderists are doing. 

My last word here is that you prepare to explain you are “all in” on social justice, on true diversity, on equality of opportunity, and on making sure that people who have been unfairly excluded from opportunities through no fault of their own are included fully in society to the extent of their capabilities. That is the most I could say. There are too many twists and turns to the dominant DEI mantras, and I would not take a highly politicized “groupie” oath. I hope that makes sense.