Imagine if you are a top surgeon who specializes in brain cancer; and you frequently talk to your patients and their loved ones about their condition, the proposed treatment options, the possible side effects of each option, the prognosis for each, etc.  You must gather family and personal histories, talk about painful symptoms, and impacts to the patient’s lifestyle (and, potentially, their life).  As you can imagine, the conversations are tough – filled with varying emotions and reactions from all involved.

Now imagine, that one day the hospital administrator calls you in for a meeting.  After you exchange the typical niceties she leans back in her chair, folds her arms and places them on her lap, looks directly and says, “Doctor Brown, you are one of the best brain surgeons in the country.  I want you to know how much we respect your accomplishments and realize how fortunate our hospital is to have you as a member of our surgical team.  But, we are a for-profit institution.  It’s sad but the harsh truth is that very sick people are our customers; and to stay profitable we need more customers.  We can’t control how many people get sick; but we can affect which provider they use for their treatment.  To that end, the board and I have come up with a 7-point plan to greatly improve the customer experience at our hospital.  As part of that plan, we are instructing you and the other surgeons to make your treatment-conversations more pleasant for the customer.  Avoid using words such as, “cancer”, “death” and “prognosis”. Also don’t advise people to stop doing things that they love such as “smoking”; or suggesting that they go on a “restricted diet.”  Instead of saying chemotherapy, try using the term pharmaceutic-cure.  Additionally, bringing  up a person’s past medical history and their family’s history may just bring up issues that makes everyone feel guilty or uneasy.  Let’s focus on the now.  Little changes will help to make the entire experience to not be so uncomfortable for our customers; have a more favorable opinion of you and your care; which will encourage them to suggest our hospital to others or to continue to use us should they need additional treatment.”

What would you say?  I imagine that you would sit quietly for a moment, as you would be somewhat befuddled: ‘I must treat cancer, but I can’t say the word, “cancer”?’. 

Your mission has always been to do everything possible to save your patient’s lives.  You have viewed honest conversations with your patients about their condition and treatment options as an important part of this process. You felt as if you and your patient were players on the same team with the goal of beating cancer: you had the medical information and they had the personal information. The two would combine to be victorious in a brutal battle. But now you are being told that those conversations must be greatly diluted; and your reality is that you need to work.  Can you do both: save lives and please your boss? How effectively can you do your job when the information provided and the questions asked must be watered down?  Can you best treat a person’s condition if the bigger focus must be placed on how comfortable they are rather than how effective your treatment is? 

This quandary is what most diversity, inclusivity and equity professionals face.  There is extreme pressure to discuss complex and often emotional subjects such as race, gender, age, body size and ability, privilege, discrimination, sexuality, belongingness, in a way that doesn’t make people, particularly the omnipresent White male leader, uncomfortable.  To do so, the past and the current state of an organization’s culture and environment; and topics like racism, sexism, ageism, discrimination, and privilege must be ignored, sanitized, altered or even glamorized.  Comfort is prioritized over progress.  The lie that if staff members aren’t complaining; they are content is eagerly embraced creating an environment where the leaders are living a dream while many staff members are barely surviving the nightmare.  

How do we, D&I specialists, and all employees, bring about change when some people – many people- aren’t willing to be uncomfortable?  The comfort that is created by denial of bias, prejudice, discrimination and privilege by those in charge causes just insulates and perpetuates the problem.  The only way D&I efforts work is if all involved are willing to be uncomfortable and fight the ailments that are decaying the very foundation of their organizations.