RFC Essay Contest 2020: 3rd Place, Student Category

Resident Fellow Council, AAP
4 min readApr 15, 2021
Photo by Tim Mossholder from Pexels

by David Underhill, MS IV

As the crane lifted Stonewall Jackson’s newly detached iron figure from his statue base, a light drizzle began to fall over Richmond’s Monument Avenue. A surrounding crowd cheered as one of the peculiar vestiges of Confederate enshrinement was plucked from its formerly esteemed position, no longer towering over one of the city’s main thoroughfares. A few moments after the statue was removed, a thunderclap bellowed as if signaling a powerful message to the world of this moral rectification.

As a medical student at Virginia Commonwealth University, I regularly passed Monument Avenue during my four years in Richmond. On my recent PM&R rotation, the hot-button statue topic came up naturally in conversation with an African-American patient. Immediately, I voiced my opinion that the statues were an ugly smudge on the American landscape, symbols of oppression that required immediate action. His response truly caught me off guard, saying, “Frankly, I’ve driven by those monuments my whole life, and not once have I looked at them and felt any anger in my heart. I couldn’t care less.” We then discussed his chronic low back pain, which he attributed to years working various construction jobs. When chatting about his drive home, he said 15 minutes back to Jackson Ward, a historically Black neighborhood, really wasn’t all that bad.

Initially, one feels pride being part of a community beginning to reckon with the injustices and transgressions inflicted on generations of African-Americans. The fight for a society that provides equal opportunity for people of all races looms large over a generation of millennials who will one day ascend to the roles of tomorrow’s leadership. It is tempting to feel that genuine progress has been made with the removal of symbols of slavery lining our streets, but we cannot let obtaining low hanging fruit satisfy our hunger. Ultimately, we have dismantled a structure of stone and steel, but done relatively little to affect the flesh and blood of the people affected by a fractured system.

When it comes to confronting systemic racism faced by the African-American community, we must ask ourselves whether we are sincere in facing the current roadblocks imposed by America’s troubled history, or do we simply wish to portray the illusion of progress by dismantling symbols of oppression? Redlining, a purposeful and codified segregation of neighborhoods enacted by the Federal Housing Administration in 1934 exacerbated the underfunding of healthcare, educational, and nutritional access for people of color. Is America as serious as addressing these issues, in addition to mass incarceration and stop-and-frisk policing? These are issues on a macro level that medical providers can confront by participating in professional associations and advocating for redress of these past grievances.

Granted, political activism is not always practical for every medical professional. We can recognize, however, that the world of medicine is not insulated from issues of bias. Studies have repeatedly shown that African-American patients receive undertreated pain control and mental health services comparatively to other races. Also, when requested or appropriate, treatment plans should be sensitive to the African-American community as well. While on my brain injury rehab rotation, an African-American gentleman expressed to our team that his hypothetical neuropsychology therapy scenarios did not simulate his reality. When asked what emotion he would feel if skipped over in line awaiting restaurant service, how can acceptance rather than anger be the “correct” answer given the action may have been intentional rather than accidental? We spoke about the recent death of George Floyd, and he described his lifelong practice of being excessively nice for fear that acting any other way may be misconstrued as a Black man. In my opinion, his insight was outstanding, regardless that his reason for admission was a traumatic brain injury.

Removing the statues was the correct decision. A community cannot openly celebrate and idolize the vanguards of slavery. I am not African-American and readily admit I will never truly understand what it means to be Black in America. I do not claim to perfectly understand the complex path we must forge ahead to achieve equality. What I know, however, is that medical professionals must listen receptively to the African-American community expressing their challenges faced. Additionally, we must make sincere efforts to address the causes of systemic racism, including fair housing and healthcare access, education opportunities, and police reform. The mission of creating a just society cannot end with the removal of these statues. It is a good start, but only the beginning of extensive work left to be done.



Resident Fellow Council, AAP

Resident and Fellow Council of the Association of Academic Physiatry (@AssocAcademicPhysiatry)