Dr. Ralph Northam and the Culture of Forgiveness

Posted on | February 6, 2019 | 1 Comment

Mike Magee

Within 24 hours of the airing of Governor Ralph Northam’s 1984 Yearbook page last week, commentators were discussing the implications of his history of racial bias on his performance as a physician.

Second year psychiatry resident Jennifer Adaeze Okwerekwu asked in STAT this week, “Why are we less forgiving of Ralph Northam as a politician than as a doctor?” In the article she says, “To be a healer is to recognize that medicine is a fundamentally human enterprise — we are all flawed and make mistakes, and sometimes these mistakes can cost people their lives.”

As a medical historian and social scientist, I spent more than a few years describing the patient-physician relationship and its important role in a civil society. My bottom line was that doctors are neither saints nor sinners. They are simply human beings like you and I. Their behaviors are impacted by the circumstances and events occurring around them, and by leaders who help shape those realities.

As medical educators, we strive to accept into medical school individuals with the values and qualities required for caring for others without prejudice. Compassion, understanding, tolerance, empathy, and a sense of humanity are but a few. Landmark studies in Philadelphia in 1999, published in Academic Medicine, revealed that we at times fall short of the ideal.

In a 2006 speech at the AMA President’s Forum, I shared the view that, “if all patient-physician relationships were to disappear, stable civil societies would immediately notice the difference. Our populations would be more fearful, less trusting, less tolerant, less connected, less compassionate, less productive, and less committed to the future.”

In the same address, I cautioned the physician leaders assembled that we functioned as part of a society, and were not immune to negative influences. Specifically I said that “negative leaders, who view change with fear and leverage that fear as a currency to control a population in order to reinforce existing and past power silos, who attempt to segregate us one from another to maintain the status quo, deserve our contempt. They not only draw down the reservoir of good will locally and globally, but ensure our medium and long term failure.”

Dr. Adaeze Okwerekwu wisely recognized that, “Health disparities persist when no one corrects mistakes and there’s no opportunity to listen, apologize, or learn. We must face bias head on, or risk repeating our preventable mistakes”

At the same time she states, “I’m thankful medicine is a forgiving profession…My wish was for each doctor or doctor-in-training to listen to feedback, apologize for their mistakes, and learn from their lapses in judgment.”

Reflecting on her chosen profession, she says, “It’s a commitment that allows us room to exercise humility when we make mistakes and change our behavior when it both undermines the humanity of others and the promise to do no harm.”

In a society and a democracy being actively tested, and searching for ways to heal our nation, all Americans would do well to consider her final words:

“To be a healer is to recognize that medicine is a fundamentally human enterprise — we are all flawed and make mistakes, and sometimes these mistakes can cost people their lives. Doctors don’t get ‘canceled’ or forced to resign whenever we err. By being open about these mistakes, we can identify the root causes and work collaboratively to prevent them from causing harm again. When we know better, all of us are able to do better.”