Reflection on Diversity: Historical Trauma and Cultural Humility

Dr. Vivian Taylor holds such an incredible title of being the associate dean of Diversity and Cultural Affairs here at the Columbia University School of Nursing. Her lecture was a powerful reminder to us, students, that education does not stop in our anesthesia textbooks, but in fact begins again within ourselves. The purpose of this paper is to reflect on her lecture as it reverberated with me when she spoke about historical trauma, her examples when explaining it, and cultural humility.

Historical Trauma

Tuskegee Study of Untreated Syphilis

Historical trauma has been defined as “anyone living in families at one time marked by severe levels of trauma, poverty, dislocation, war, etc., and who are still suffering as a result” (Cutler, n.d.). I have never heard of this concept until yesterday and when she spoke about the Tuskegee Study of Untreated Syphilis, I wanted nothing but to regurgitate the contents of my breakfast that morning. It is shameful to know American history consisted of inhumane medical experimentation on African Americans. Studies have shown that historical trauma, which leads to post traumatic stress disorder often go undiagnosed. Diagnosis and treatment could have prevented vulnerability in such populations suffering from PTSD. The lack of culturally competent providers and referrals for mental health service after such assaults has often lead to a cascade of negative events. This includes “weapon carrying, substance abuse, and further alienation from stabilizing institutions such as employment, education, and healthcare (Rich et.al, 2005).”

The Father of Obstetrics

Similarly, the father of obstetrics Dr. Marion Sims is known to have performed fistula repairs on African women without anesthesia. It is a horrendous to hear that the leader of great medical movement received his recognition after inflicting pain on parturient of color. Whoever had figured out how to perform and repair fistulas, I imagined, would have been a well-deserved hero. A hero who would have thought to treat his patients like human beings and not like caged animals. It is disturbing to me that the literature provides such conflicting tales of his successes and support his human experimentation and say that “evidence suggests that Sims’s original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time (Wall, 2006).”

Cultural Humility

Cultural humility was also something I was not familiar with and its three tenets of lifelong learning, the ability to recognize power imbalance, and institutional accountability is something we must all learn to incorporate into our professional lives and our personal ones as well. In our melting pot of a society this is something we must all learn as healthcare providers – perhaps in a simulation setting, like we did in the classroom. It is not just enough to be culturally competent but to engage in lifelong learning about the changing diverse groups of people around us.

Conclusion

I am beyond grateful for attending Dr. Taylor’s lecture on diversity. It is evident that the United States has a dark history of conducting research on African Americans. It is our due diligence as healthcare providers, with knowledge of historical trauma and cultural humility, to set personal biases aside as well as understand the implications of history and adapt to the changing faces of healthcare today.

References

 

Cutler, M. (n.d.). Multigenerational trauma: Behavior patterns in cultures [PowerPoint slides].

Retrieved from http://edweb.boisestate.edu/instituteforthestudyofaddiction/pp/Historical_Trauma_and_Grief.ppt

Rich, J. & Grey, C.M. (2005). Pathways to recurrent trauma among young Black men: Traumatic

stress, substance abuse, and the “code of the street.” American Journal of Public Health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449260/

Wall, L.L. (2006). The medical ethics of Dr. J. Marion Sims: a fresh look at the historical

record. Journal of Medical Ethics. 32(6): 346–350. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563360/