Chapter 12: Race at MD Anderson: Slow to Make Real Changes for Minorities

Chapter 12: Race at MD Anderson: Slow to Make Real Changes for Minorities

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Description

In this chapter, Dr. Jones provides a portrait of MD Anderson's approach to race and diversity during his tenure. Dr. Jones explains how race became a focus for him then shares his view of racism in America and racial inequality in Houston. He recalls segregation at MD Anderson still had separate eating areas for blacks and whites and observes that when he arrived, there was still a "psychological separation" between the races. He describes a conversation with Dr. Ronald DePinho about race. He notes resistance in leadership at MD Anderson and the Texas Medical Center to seeing race as an issue. He notes that there is "visible diversity" at lower levels of the institution but not in top leadership. Dr. Jones makes a comparison with the situation for women at MD Anderson, a situation that leadership addressed in ways that changed the climate. He observes that this has never been done for minorities at MD Anderson.

Identifier

JonesLA_03_20140130_C12

Publication Date

1-30-2014

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Diversity Issues; Personal Background; Experiences re: Gender, Race, Ethnicity; Gender, Race, Ethnicity, Religion; Understanding the Institution; Diversity at MD Anderson; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; The Researcher; Definitions, Explanations, Translations; Professional Values, Ethics, Purpose; MD Anderson History; MD Anderson Snapshot; Controversy; Personal Reflections, Memories of MD Anderson

Transcript

Tacey Ann Rosolowski, PhD:

And we are recording. So it's 9:07 on the 30th of January, 2014, and I'm here in the Historical Resources Center Reading Room with Dr. Lovell Jones for our third session. Thank you for coming in this morning.

Lovell A. Jones, PhD:

Well, thank you.

Tacey Ann Rosolowski, PhD:

And we were kind of talking a little bit about just where to proceed and choice. Would you like to talk about your health disparities research first, or would you like to start with the National Black Leadership Initiative? What makes sense to tell the story?

Lovell A. Jones, PhD:

I think it all wraps into one.

Tacey Ann Rosolowski, PhD:

That's kind of why I asked the question. (laughter)

Lovell A. Jones, PhD:

Yeah. As I may have alluded earlier, I came to Anderson primarily because I wanted to change the face of cancer. When my mother developed breast cancer, she automatically thought it was a death sentence. And, in fact, yesterday at a policy meeting that I was at in Washington, a young man, Arian Rodriguez [phonetic], who works for the American Cancer Society now, had worked for Dr. Harold Freeman for about twenty years before he went to ACS to help it oversee its Patient Navigation Program, made somewhat of a similar sort of statement about how his job had led to his reconnecting with his mother after a number of years and how, as a seven-year-old when his mother first developed breast cancer, he had to be the translator and the navigator, and the impact of that in terms of as a seven-year-old thinking about losing his mother but also playing a role in trying to get care for her. Fortunately, I was older. But it was seeing that even though I was part of a major research program in terms of breast cancer, that my mom had somewhat similar sort of thoughts about it being an automatic death sentence, and then began to think about where I could make a difference in terms of that.

Tacey Ann Rosolowski, PhD:

Were there thoughts that occurred to you at that time about racial disparities with healthcare at that time?

Lovell A. Jones, PhD:

Really, probably not. I had been involved in working with University of California, then with University of California-San Francisco, University of California-Berkeley, and then University of California-San Francisco in increasing the presence and numbers of minorities in its graduate program and also on its faculty. And as I mentioned, I had been involved early in my life with regards to the Civil Rights Movement, so I guess it was a natural evolution, having then seen the situation with my mom, and then coming to Anderson and being the first African American hired on the faculty in the basic behavioral sciences and being actually the first researcher hired on the faculty at that time, and then noticing that there weren't a lot of patients that were persons of color coming through the halls of MD Anderson. So it began to dawn on me that there was a need to address this in a broader fashion than just trying to increase the numbers, although increasing the numbers of faculty and students would have-or at least I thought it would have-an impact on patient population. It was that there was a need to look at it, as I say, in a broader manner. But one of the things that my mentor, one mentor, R_____ Andy, who at the time was director of the Cancer Center and [unclear] University of California-Berkeley and had chaired my orals committee when I was a graduate student and was the mentee of my mentor, said-you know, as I was getting involved in doing a lot of things at Berkeley, he would say, "Always let your science be the rock that you stand on, that it will allow you to do a lot of things you want to do. But if you don't focus on it and make sure that you're still involved in that manner, then you can easily be discounted as not being able to do something, and this is your way of deflecting that inability." So when I came, my first efforts-although I did ask about the relationship of MD Anderson with Texas Southern and, not surprisingly, there was little to none, other than they had begun with the pharmacy program.

Tacey Ann Rosolowski, PhD:

And Texas Southern is?

Lovell A. Jones, PhD:

Texas Southern is an historically black university that is right on the other side of Hermann Park, just a stone's throw from here, over in Third Ward. So, interesting enough, Robert Hickey [phonetic], who at that time was the second-in-command here at Anderson under Dr. LeMaistre, was a good friend of Robert Terry [phonetic], who was a senior leader over at Texas Southern, and the two of them got together with me and said, "You know, we could go through and try and design all these formal plans, but it'd take years of going through the Board of Regents, the two Board of Regents, the lawyers and everything else. So, Lovell, what we will do is we will have you appointed to the faculty over at Texas Southern. Therefore, you can have students over here and bring them in and start developing programs that would allow students to do research and that sort of thing." So for a number of years early in my career, I served that role and had individuals who came here to Anderson to go over and speak. National figures who came to speak at Anderson would also fit into their schedule for them to go over and speak at Texas Southern, and then have students come through here and work in my lab and work in a few other individuals' labs here.

Tacey Ann Rosolowski, PhD:

What do you think the impact was of that, both for the students and for MD Anderson?

Lovell A. Jones, PhD:

I think for the students I think it had significant impact on their career. There are a number of students who went on to get their PhDs, who've gone on to do work in other places. I don't know. Well, I think it did have an impact in Anderson looking at smaller institutions. Whether it had an impact on it really looking at the issue of diversity and the benefits of that, that's still to be seen. If I were to give you a quick answer, I would say it's had very little impact, but-

Tacey Ann Rosolowski, PhD:

Why do you think that was?

Lovell A. Jones, PhD:

I think it all goes back to the issue of [unclear]. I was saying yesterday to a number of people at this policy meeting in D.C. that I think America still suffers from slavery and the impact of slavery in terms of the devaluation of the human being, and I don't think we've ever recovered from that. I think we've never really confronted that issue. So I think it's deep-seated in our consciousness that we don't think about in terms of our everyday interactions that come out in a number of ways, that I think fear has a major driving force that sometimes taps into those deep-seated biases that we don't openly discuss, and so that has a bearing on how successful we are in addressing certain subjects. And I think that has been the overriding-and some institutions are further along in doing things, and others are not. Anderson, until they built the new Alcott buildings in the Lutheran Pavilion, before that, was, I think, '78, '77, '78 when it opened, still had separate eating areas in its cafeteria.

Tacey Ann Rosolowski, PhD:

I didn't realize that. So late.

Lovell A. Jones, PhD:

Yeah. So although it wasn't legally separated, it was physically separated, and even when the new cafeteria opened up, it wasn't until it got redesigned, I would say in the 2000s, maybe late nineties, 2000, that that physical separation kind of dissipated and went away. So you have those sort of historical situations that I think had a bearing.

Tacey Ann Rosolowski, PhD:

That's just such a physical visible reminder every day.

Lovell A. Jones, PhD:

Right, right. So then when I came in the eighties, being the first, there was still that psychological separation where the staff, especially staff of color, African Americans, couldn't believe that I was a faculty member here, simply because it just wasn't something that was in their lexicon. So I think all of those sorts of things, and as I've said, who you are and your experiences have a deep bearing on your solutions to the problem. And I often say in situations I'm in-I may have mentioned when I was at the Texas Medical Center strategic planning meeting and bringing to the forefront that I was the only African American scientist sitting in the room of 120 people, in the discussion about direction, discovery, I never ever-until it was brought to the forefront by myself and then some of the women scientists sitting in the room, there was no discussion of the community in terms of how this was going to impact and the bearing. And it wasn't out of some by design; it was just that it wasn't part of their lexicon either, and therefore it wasn't going to be discussed, and therefore it wasn't of value. And I think that's where this all comes into being.

Tacey Ann Rosolowski, PhD:

I was going to ask you at one point, but I think you've answered the question, to what degree increasing the numbers of-increasing the degree of diversity among patients is reliant or connected to increasing the diversity among healthcare-delivery people.

Lovell A. Jones, PhD:

It is. There's a whole lot of literature on racial concordance. In fact, at the meeting that I was at, the two, first on developing core competencies for patient navigation on the national level and then the policies behind that in moving in that direction, that was some of the discussion that look place. And even at those meetings, I brought up that it was interesting discussion because of the lack of diversity at those meetings both in terms of ethnic and racial, but also in terms of professional, and most of the people there were in disease state, most of the people there were nurses, most of them were white females, and most were in oncology. So we were trying to develop core competencies across the health spectrum, from AIDS to diabetes to pediatrics, sickle cell anemia, and [unclear]. So it goes back to their experiences aren't in those areas. Therefore, how do you develop core competencies when your experiences aren't in those areas? Not to say that you can't, but if you aren't thinking about it in a broader sense outside your own world, then the competencies are going to be more focused on your world than anyone else, and I think that if you drill down, that's the same thing in terms of MD Anderson. I had my discussion with Dr. DePinho when he first came, which I think he got very upset with me. Several times he's gotten very upset, but that was the first time. In my presentation, I sent him a note and said I wanted to present to him on the history of the Center and why the Center was important and the direction of the Center. And in the presentation, I talked about the lack of diversity at the institution and the lack of what I perceived as a really affirmative effort in truly addressing it. And I've seen affirmative efforts where, for instance, for a period of time at UC Berkeley, where there was a concerted effort to say, "We're going to make sure we have not only a diverse student body, but a diverse faculty across, and this is something that we feel is important for the university, important for the state, and we're willing to go to bat in the legal sense to say that this is important and present it as such and not cower away from it in terms of that." I said, "There's been no such here at Anderson, and so that's probably one of the reasons why I was the first and the only, and when I left, there was no other, because it wasn't." And his response at the time was, "Well, you know, Dr. Jones, I find it hard to believe in a city that's elected a lesbian mayor that-." I said, "That has nothing to do with it." (laughs) I said, "Because I can point out-and yes, we can go forth and say we have a diverse [unclear] City Council, we've had a black police chief, we've had a black mayor, but the health of the city is like a third-world nation. And that has to do, to me, with the Medical Center being, in its leadership and those that control its direction, not being very diverse, and that's not saying that you are racist in any manner or form. That says you have a bias based on your experiences, and the end result is what we have." He wasn't happy with that answer. Because as I said in the meeting yesterday and the day before, my pointing out things are not to-first of all, one should not take things personally. An editorial I wrote, an Op-Ed piece I wrote was on listening and seeing how that applied, and then if it did, seeing how one can confront it. I'm a-I'm not a fan of-I guess the best way of saying it, I'm not a fan of cultural competence, because there's so many cultures within this hospital and within Harris County Hospital District and different places, that you're never going to be culturally competent in any area. So when we say we're training people in cultural competence, people assume that, "I'll go to class, I'll learn all I need to learn, and then I'm culturally competent." Doesn't work that way.

Tacey Ann Rosolowski, PhD:

It's kind of arrogant anyways, to think you could be competent in someone else's culture. (laughs)

Lovell A. Jones, PhD:

Right. But there's such a thing as cultural humility, and cultural humility is becoming aware that you have a bias and then seeing how you act on that bias and then adjusting how you relate to individuals. To me, I think that's the key, and it's a lifelong experience. It's not something you take in a class. It's not something you finish. It's over your entire life, because you're going to be meeting people, and then even in cultures, there are differences based on individual personalities. So you have to adjust to them in that manner and to put it in that broad umbrella of cultural competency and so forth. But there's a way of having it addressed in a manner that-and I've said to the administration, which went over and out the door, is that this place used to have a difficulty-and still to some extent; it's not totally overcome, a difficulty in dealing with women, so much so that they had to bring in a group to discuss the issue of sexual harassment and dealing with those issues, and everyone had to go through that training. Everyone had to sign on the dotted line a form that went into your personnel file that you had taken this and that you-and several department chairs' heads rolled (laughs) because they did not adhere to certain standards and that sort of thing.

Tacey Ann Rosolowski, PhD:

I can imagine that that was pretty controversial.

Lovell A. Jones, PhD:

Oh, yes. But it changed the climate. We've never done that for ethnic and racial groups in the institution, and we've had the cultural competence training and all of those other things, but when something happens, there's really no repercussions. And I've said, "Why don't we do the same thing that we do or did with women?" "Can't do that. No, no." I don't see why not.

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Chapter 12: Race at MD Anderson: Slow to Make Real Changes for Minorities

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