Going Out On a (Southern) Limb
Good morning!
Before I get to today’s topic, I’m happy to announce that this week we received notification that our Southern Association of Colleges and Schools Commission on Colleges accreditation has been reaffirmed. Earlier this year, it was announced that our SACSCOC review was stellar with “no recommendations” – which is the highest level an institution can reach. But that early announcement still had to be confirmed by the board of directors at an annual meeting, which is now done, and we are SACSCOC accredited for another 10 years. And special recognition to Dr. Mitzi Norris, executive director for academic effectiveness, who led our accreditation team through this years-long process.
Congrats – and thanks – to everyone who worked on this very large and very important project. This reaffirmation of the earlier review confirms what we all already know – UMMC academic programs and faculty are top notch and on par with any others in the country.
Now, for today’s column I wanted to share with you an article written by one of our orthopaedic surgery residents that recently ran in the Journal of Bone and Joint Surgery. I think it is beautifully written and presents a side of our state that doesn’t get shared often, and we’ve gotten permission from the journal and Dr. Purcell to share it here.
Dr. Kevin Purcell is an orthopeadic surgery fellow at Duke University in Durham, North Carolina. A native New Yorker, Dr. Purcell went to medical school at Wright State University in Dayton, Ohio. While there, he decided to do a one-month sub-internship at UMMC in orthopaedic surgery – stepping far out of what he was used to growing up in the Northeast. But to further his education and experience, he decided to “embark on the journey to Jackson, Mississippi” despite his perception of how hard it is to be Black in the South.
His experience while here – which led him to decide to make UMMC his choice for residency starting in 2017 – was far different than expectations and led him to craft the article below. I think this is a good read for everyone, whether you’re also a southern transplant from another part of the country or world, or you’ve called Mississippi or the South home your entire life. There’s a lot to glean from Dr. Purcell’s account that underlines the importance of diversity in medicine across all demographics – from race to region of origin.
The Orthopaedic Forum
Kevin F. Purcell, MD, MPH, MS
My invitation, while a medical student, for an orthopaedic surgery away rotation at the University of Mississippi Medical Center was striking. I was a liberal kid from New York City who had no clue where to find Mississippi on a map, and I vividly remembered the terrifying stories of what happened to Black people such as myself in Mississippi during the Reconstruction and Civil Rights eras. However, as Mark Twain once said, “never be afraid to go out on a limb, as this is where the fruits are!” I accepted the sub-internship and embarked on the journey to Jackson, Mississippi.
The first time I witnessed a Confederate flag was during this initial excursion. At the time, Mississippi still had the Confederate symbol embedded in its official state flag (the new state flag was introduced in 2020). Some people displayed different types of Confederate iconography, ranging from tattoos to coffee mugs. In the past and in the present day, the psyches of Black and Brown people have been deleteriously affected when confronted with symbols of racism and second-class citizenship. The Confederate insignia is a constant reminder of the gory history and brutality experienced by Black people. I will never forget the first time I heard a White patient refer to a Black person as the colloquial “N-word,” sending shivers down my spine.
My preconceived views of Mississippi were debunked during this sub-internship. There is no question that social injustices and racism continue to plague Mississippi and America in general. However, there were many amiable people who were willing to welcome a Yankee and who sought to rectify the checkered history of Mississippi with their warmth and openness. At the end of my sub-internship, I concluded that the University of Mississippi would be a great place to learn orthopaedic surgery. Alas, following this happy conclusion, I grappled with the realization that I would be the first Black man to train and graduate as an orthopaedic surgeon from the University of Mississippi. One Black woman had previously finished residency at this program; however, the fact that this “first Black man” was a possibility in the 21st century spoke to the dearth of diversity in orthopaedic surgery and troubled me deeply. Nevertheless, I decided to tread into unchartered waters.
Dr. William A. McDade, Chief Diversity and Inclusion Officer of the Accreditation Council for Graduate Medical Education, recently stated in a lecture that 49% of orthopaedic surgery residency programs do not have a single Black orthopaedic surgery resident. It seemed a fearful task to be the first Black male to train at a program. Moreover, Black physicians make up 5% of orthopaedic residents but account for one-fifth of trainees dismissed from residency programs. My feelings of insecurity, fear, and even imposter syndrome were heightened and seemed insurmountable, especially in the first few days of residency.
Dr. Mary-Frances Winters, author of Black Fatigue: How Racism Erodes the Mind, Body, and Spirit, analyzed this concept— specifically, the feelings of additional stress experienced by Black people in new work environments or in organizations where they are the sole Black employee. I purposefully “went the extra mile” in my training, not only because it was the right thing to do but also because I wanted to create a paradigm for any Black colleagues who would follow in my footsteps. I came into work on my days off to scrub into cases, searched for other surgical opportunities when I was relieved of my duties, and strived to publish manuscripts or book chapters or to attend academic conferences when I was not on a rotation. These efforts culminated in an outstanding learning experience, but sometimes I failed to take care of myself, as alluded to in the work of Dr. Winters.
Far too often, Black men fall victim to the ideology of “manning up” and do not openly acknowledge their fears or insecurities. Some surgeons inherently lack the ability to discuss feelings or to be vulnerable. However, the faculty at the University of Mississippi consistently created a safe environment that allowed me and other trainees to be vulnerable. Several attending surgeons and staff members helped me to navigate a path filled with insecurity and fear. Their love and support helped me to overcome these challenges. The orthopaedic faculty and staff provided unwavering support, and I was never a target of unfair criticism or treated differently because of the color of my skin. The program supported me on multiple levels in all academic, diversity recruiting, and community service endeavors. It turned out that many of my initial fears of bigotry or exclusion were, happily, unfounded and inaccurate.
As someone who has traveled all over the world, I can confidently say that I met some of the nicest people on Earth during my 5 years in Dixie. I felt welcomed and valued as a member of the team as we collectively worked toward a greater cause. Mississippi taught me more about myself than all of my previous life experiences. I learned the true meaning of living selflessly and going the extra mile, and I discovered that a simple smile goes a long way. Surprisingly, for many White patients, I was the first Black male doctor whom they had ever met. I found these interactions particularly meaningful. These encounters nearly always produced synergistic moments of mutual wonder and understanding. Although we may possess different skin hues and dissimilar political views, all humans aspire to shared goals of love and meaning.
My story is that of one Black man’s experience in the South. America (and not just Mississippi) has a long way to go in terms of dismantling systemic racism and embracing true diversity within its communities and institutions, including the field of medicine. Moving to Mississippi for orthopaedic residency taught me much about surgery, but it taught me even more about life, race relations, and the importance of interpersonal relationships. The experience broadened my horizons, afforded me the opportunity to bridge gaps in understanding (for myself and others), and helped me to dispel some of my previous biases about a region of the country that I was happy to call home for 5 years. Never be afraid to be the first to tread uncharted waters—it was the best decision that I ever made!
Thank you, Dr. Purcell, for allowing me to share your enlightening words
And thank you to everyone at UMMC who played a part in Dr. Purcell’s positive experience here. He especially names Dr. George Russell, Dr. Matthew Graves and Amy Kraus as UMMC people who most left a positive impression on him.
We all recognize our Medical Center as a special place where the highest levels of learning, research and care are practiced everyday but it’s warming to know – and be able to read – that we can also be an inviting place of inclusion and a catalyst to positive growth and change in medicine. It will take all of us – working together no matter how we may be different – to reach our goal of A Healthier Mississippi.