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Bias

Lost Cause

Deeply-entrenched racism is not just a relic of the American South.

Josephine Ensign
The former Jefferson Davis Memorial, Richmond, Virginia
Source: Josephine Ensign

My hometown of Richmond, Virginia is a city anchored to its past by bronze and marble Confederate shrines of memory. I was born in Retreat for the Sick Hospital, Richmond's oldest hospital opened in 1877 by Civil War nurse Annabella Ravenscroft Jenkins. The hospital was around the corner from the towering memorial to Jefferson Davis—a memorial topped by Vindicatrix, the symbol of virtuous white womanhood—a woman literally on a marble pedestal.

My paternal great-great-grandmother from a Georgia cotton and slave-owning plantation was a first cousin of Varina Davis, First Lady of the Confederate States of America. I was raised on Richmond's eastern edge, on the relic-strewn Civil War land of Cold Harbor. I am a product of Virginia public schools: Battlefield Park Elementary School, Stonewall Jackson Middle School, and Lee-Davis High School. I went to high school with the son of the Grand Dragon of the Ku Klux Klan who threatened me with physical violence if I did not stop campaigning for Jimmy Carter. The high school's song was the "Rebel Yell" and then, as now, it is called the "home of the Confederates."

During my nursing education at the Medical College of Virginia in Richmond, I mostly cared for homeless and impoverished (and oftentimes imprisoned, shackled to their beds) African-American patients in the 'old hospital,' formerly the 'Negro-only hospital.' The new MCV hospital curled around the White House of the Confederacy like a lover. In nursing school, we were taught that the profound racial health disparities in our country were caused by inherent biological differences of African-Americans, rendering them more susceptible to disease. Therefore, it was implied, we could do nothing to change these health disparities. Racism and its health effects were never discussed.

Starting in 1986, as a newly-minted nurse practitioner, I ran a health care for the homeless clinic in the Richmond Street Center. My first HIV/AIDS patient was an African-American man who became so ill that I drove him to MCV Hospital where, after a protracted and painful month, he died. His hospital chart listed me as next of kin and I was asked to attend a hospital ethics meeting to decide whether to remove him from life support. I was not there when he died but I attended his graveside funeral in the Potters Field area in the city-owned Oakwood Cemetery. Even then, I was aware of the moral pitfalls of white supremacy masquerading as white savior.

For the past three decades, I have lived and worked in the younger and more progressive city of Seattle. It took this geographical cure, living away from and looking back at my upbringing in the American South to understand the insidious and caustic effects of the South's sense of history and of place, including the rigid roles of race, class, and gender. These effects are on me as an individual, and on my family, community, and country.

But my smugness and sense of living in a morally superior region of our country has long since been tempered by experience. Deeply entrenched racism is not just a relic of the American South. It should not have taken the killing of George Floyd by a police officer in Minneapolis to have reminded us of that fact.

I teach public health at a school of nursing founded by Seattle public health nurses and stemming from their response to the 1918 influenza pandemic, a time eerily reminiscent of our current COVID-19 pandemic, including its disproportionate burden on communities of color. Elizabeth Soule, our school's first dean and dubbed the "Mother of Nursing in the Pacific Northwest," banned the admission of African-American students until her retirement in 1950. My students have pointed out that several of our required medical-surgical nursing textbooks continue to erroneously perpetuate a biological basis of African-American health inequities. Our students of color continue to encounter white patients who refuse to be cared for by them. Our hospitals and our school continue to support these patients' wishes, reinforcing institutional racism.

Protestors tore down the Monument Avenue statue of my relative, Jefferson Davis, in early June. As of July 8, Vindicatrix has been removed. These events, and the activism of my nursing students, give me hope that there will be meaningful dismantling of the systemic racism running through our monuments, schools, health care institutions, and professions.

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