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Ep 95 - LiveWell Talk On...Medicine: Color, Culture and Equity Pt. 1 (Marcus Cooper, CST)

episode 95

Ep. 95 - LiveWell Talk On...Medicine: Color Culture and Equity Pt. 1

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Host: Dr. Dustin Arnold, chief medical officer, UnityPoint Health - St. Luke's Hospital

Guest: Marcus Cooper, certified surgical technologist, UnityPoint Health - St. Luke's Hospital

Dr. Arnold:
This is LiveWell Talk on medicine, color, culture and equity. I'm Dr. Dustin Arnold, chief medical officer at Unity Point Health - St. Luke's Hospital. Today's podcast is the first installment of a mini-series highlighting our team members' diversity, backgrounds, as well as cultural, and quite frankly color and how that fits into the healthcare team. With Martin Luther King day coming up, and black history month next month, in February. We're going to focus on essentially being black in medicine, what it means, the struggles, the role models, the challenges, the successes and the historical aspect to that. And my guest today is Marcus Cooper, who is a member of the diversity and inclusion committee, as well as a certified surgical technologist at St. Luke's welcome Marcus.

Marcus Cooper:
Thank you, sir.

Dr. Arnold:
Thank you for coming. First of all, tell me how'd you get into surgical technology?

Marcus Cooper:
Well, it's actually, it's a long story, so I'll try to keep it short. I actually never thought about being in medicine, never thought about doing what I do. I actually got into it by a freak accident. I tore my Achilles and I lost my job and I laid in bed with a blue cast on, and I asked the question: what am I going to do now? You know, what do I want to do with my life? I've worked pretty much labor jobs, pretty much dead end jobs, since I was 18. Married, two kids, house, car, you know. And as I laid there and I said that, my wife looked at me, she said: why don't you go back to school? And I told her, I said, I'm dumb. I was like, don't you see what I did in school? I barely graduated high school. Went to college because everybody said: go to college. Didn't know what for, dropped out and just worked. And she said, what interests you in your time of living between then and now what has interested you? And I sat back and I thought about it. And I said, watching my kids more, I got to see the C-section. I mean, I literally walked down at the end—and, you know, cracking jokes with the doctors and things like that. She said, the people in blue, you'd go to school for that, and that's about a year. It was like, okay. We sat down, muddled it over, and I was like, you know what? I'm going to do. I went to school. And with the desire that I had to do something with myself: got on the Dean's list, got on the president's list, got scholarships and got into the surgical tech program. Graduated in 2014. And then I worked at Iowa ortho right after that, in the morning. And been doing that ever since.

Dr. Arnold:
So then you just, kind of, stayed with the orthopedic/spinal.

Marcus Cooper:
Just stayed with it.

Dr. Arnold:
I tell young people all the time that, you know, if you want to go to medical school, it's a long road, but it's worthwhile. I said, look at surgical technologists, MRI technicians, ultrasound technicians. I mean, it pays decent and it's really exciting.

Marcus Cooper:
Yeah. But a lot of it is, I didn't know. You know, I wasn't exposed to it. My mother wanted me to get into something and wanted me to be a physical therapist. And you know, being young you kind of, "whatever, I want to play football."

Dr. Arnold:
Right, right.

Marcus Cooper:
I want to do this. I want to do that. But as you get older, you know, you don't think about there's more besides the four year programs, right?

Dr. Arnold:
No, absolutely. I mean, I think we could do another podcast on junior college and trade schools and how you need those. I mean, you know, you want a mechanic and a plumber in your family before you want a doctor, right?

Marcus Cooper:
That's right.

Dr. Arnold:
So that's just that there. I want this series on diversity in medicine, being black in medicine, and particularly coming up with Martin Luther King day, as well as black history month—I really want to have some conversations that just quite frankly will be uncomfortable for some people, but it's not intended. You and I, as we were discussing putting the series together, that whether you believe it's racism or systemic racism or not, the facts are that black people have a higher instance of cancer, black people are more likely to die during childbirth. I mean, those are facts. You can't deny that. And you need to be aware of those facts and adjust appropriately and make some strides to equal that.

Marcus Cooper:
Right.

Dr. Arnold:
Tell me about some of the challenges that you've faced in your journey.

Marcus Cooper:
Well, it's been interesting? I've honestly been blessed in that, being in the medical field, I've navigated, you learn to navigate being black. This is the truth. You know how to talk, you know not to get an attitude because you become the angry black man or angry black woman. You might seem ghetto or things like that. So I've been very cautious of how I deal with people. And luckily by my natural nature, I get along with people. But, I've also come across situations that ruffled my feathers. People tend to try to speak to you in a certain way, whether you knew or being blind, but you get a sense of: okay, I don't belong. You know, these are my people, these are not yours. Or I might speak in my Black American vernacular, and been mocked for it. And so you learn as being a black man or woman to hold it in, unfortunately comes part of stress. But you can tend to hold it in and just keep moving, and I let my work speak for me. And so, besides that—Oh, I have one story where a guy in Des Moines, he broke his collarbone and he did not want black people in his surgery or touching him. The physician I was working with, he was Puerto Rican, but he was very fair-skinned, so the guy didn't know. But he spoke to him and told the guy, I have a black man in my room. I trust him. Now, you don't like that, you can leave. And from that day, that place I had ortho put in that policy: that if you have any racial biases, you can come here. And so those luckily, you know, I've been fortunate, but things do happen.

Dr. Arnold:
I think that's a great perspective that you give. And I think really people could, I mean, I can sit here and think of times where I've been in a group that I felt uncomfortable. I measured everything I said, I measured how I stood, where I stood, how I reacted to conversation. And you know, whether or not we can all think of those situations, you're giving the perspective that you get in a position where you can feel like that every day.

Marcus Cooper:
Every day. Well, a lot of times I'm the only one in the room, or on the floor, in the classroom, wherever I am. It's not that many of us in Iowa. And so you will likely be one out of the 10 in the room. Now there's two, and then it becomes tribal because we're relying on each other, like you got my back, I got yours.

Dr. Arnold:
Right.

Marcus Cooper:
And so you will see that in medical places, or just everyday life. You know, people ask the question like "why are those two always together?" I've heard that. You know, "why are they always hanging together?" Well, we're the only ones here, you know. I get along like everybody, but there's a difference.

Dr. Arnold:
You know, it sounds bad, but we like our own tribe. That's who we identify with. You know, culture is behavior and beliefs. What do you believe? How do you behave?

Marcus Cooper:
Right.

Dr. Arnold:
And so you gravitate towards people that believe the same and behave the same way.

Marcus Cooper:
Exactly.

Dr. Arnold:
Now, the thing is whether we realize it or not, we kind of share a lot of the same beliefs and values, you know.

Marcus Cooper:
We do.

Dr. Arnold:
We share more than we don't share, that's for sure.

Marcus Cooper:
That is true.

Dr. Arnold:
That is an interesting perspective. Because you're right, I mean, the black population in Cedar Rapids is less than 10%, and nationally it's 12%?

Marcus Cooper:
Yes it's 12%, maybe 13%.

Dr. Arnold:
And it's grown in the recent years. I can remember going to high school—Darnel Webb, he was good friend of mine, I still keep in contact with him—he was the only black person I ever knew until I went to college. So it has grown from that standpoint, which is a good thing. Did you have a role model or a mentor along the way that you could share a story about?

Marcus Cooper:
I've had a lot, I was blessed. I grew up with my father at home. He was a good man. He did the best that he could, but he only had a high school diploma. My mother went on, she got a degree as being a respiratory therapist. And so, you know, as I grew up, I had different big brothers in life that kind of taught me how to be a good person. But as far as aiming for a degree, aiming for some type of career, I didn't have that. You know, I just had "be a good man, treat your family right, treat people right." In my eyes, I'm kind of the front runner, and I'm trying to instill that in my boys. Luckily, one wants to be a doctor, the other one wants to be an engineer. And so, I've got to input in them, what I've learned. And that's the way it's supposed to be.

Dr. Arnold:
Right. Yeah, absolutely.

Marcus Cooper:
But if I don't, they're kind of on their own.

Dr. Arnold:
I had similar in the fact that I had a lot of big brothers along the way, a lot of people and some big sisters, a lot of people that just brought out the best in me. And so just being around them was a good thing, you know. And that just amplified over the years, and I'm very grateful for those mentors along the way. Yeah, you need to instill that wisdom in your boys now, because once they get older, they'll think you don't know what you're talking about. That's where mine are.

Marcus Cooper:
It starts now. "I know. You're only 12 years old. You don't know nothing."

Dr. Arnold:
Right. Let's talk about the COVID vaccine. You had a nice article about your decision to take it. And some of the historical aspects of that with black population. You know, they came out and said, "Oh, well, we're going to—we need to give it to the minorities and people of color first." That hasn't been done in the best motivation historically, has it?

Marcus Cooper:
No, it has not. History and facts, you can't change these things. When it comes to preserving the population, they always went with the poor or black or brown people. That's what history says, because they know either—we were enslaved, we didn't have a choice.

Dr. Arnold:
Right.

Marcus Cooper:
You did what you were supposed to do, or what your owner told you to do. And a lot of those owners through history, were physicians. They kind of had to do patchwork and things of that nature for your chattel, is we would call it. And so you have that going through—so to preserve them on the popular majority, which is white folks. They'd practice on us, to get the technique right. It's been without anesthesia, it's been being held down by three or more people, even incorporating other slaves to hold you down. And so that history is with us. And we're taught this once we are able to read and understand. So my 38 years on this earth and the history that I know, you can't change.

Dr. Arnold:
There is a significant history in medicine of it being very Eurocentric. Or, you know, a lot of our medical discoveries were out of Europe, particularly Germany prior to World War I. And that doesn't necessarily—a lot of it applies to everyone else, but sometimes you have to think about it a little bit differently when you have different cultures that you're encountering. And you have to—so if you're a physician and you walk into that exam room, and you're not saying to yourself: okay, I need to build some trust with this patient of mine, because historically they might have some doubts whether or not I have their best interest.

Marcus Cooper:
Exactly, exactly. It's big. Seeing that there's about 13% of us in the U.S., it is maybe 3%, like doctors, maybe. And so, we still talked about this a little bit the other day, when you come into an operator or in a room, if you see somebody who looks like you, that's a sense of comfort. It's like, he knows who I am.

Dr. Arnold:
Yeah.

Marcus Cooper:
And there's an unwritten rule, unwritten trust, like: okay, we got each other. And so for a white physician, or maybe even Asian, you have a lot of Indian doctors and things of that nature, Asian, Chinese doc. You know, you have to build that rapport. You have to build that: I really do want to know how to help you. You know?

Dr. Arnold:
Right, exactly.

Marcus Cooper:
And that takes, you know, multiple visits over time. We don't have to have a beer or go get a burger together, but it's just setting the tone. Like with any situation, with any date, any first date you have to set the tone.

Dr. Arnold:
Trust is hard to build.

Marcus Cooper:
Easy to break.

Dr. Arnold:
And it's easy to lose. You know, and once you draw on that trust account, if you lose it, it's hard to get it back. And so, but if you don't, if you're not cognizant of whether it's a person of color, whether it's someone of a disability, whether it's somebody that might be transgender, you still have to be cognizant of that and adjust how you are approaching to deliver healthcare to them. So you have part of your patients that might have some mistrust with healthcare, but then you have the flip side of that. So it is difficult, you know. As much as people are different, they're also the same.

Marcus Cooper:
That's right.

Dr. Arnold:
And we have to keep that in mind. Marcus, why do you think there's not more people of color, specifically black people, in medicine?

Marcus Cooper:
Well, I think there are various reasons. So you have, unfortunately, if you have a person that graduated cum laude, you know, done everything right, but their name is funny. They have a Deshaun or, you know, a Tacarra or whatever. Those names, unfortunately, based on stereotypes, based on what you have seen on TV or whatever, it throws people. So though he has the skills, he has what he needs. He's gone through the training, you know, but he might be a thug. He might, you know, there's something about him that's not right. But you know, Terry that, you know, he does just as well, same training, but he will get the job based on his name. Maybe because he has some ties on the inside, which a lot of people do, or just he fits the idea of the company.

Dr. Arnold:
It perpetuates system that you have.

Marcus Cooper:
He has the crew cut, he wears a polo, you know, he fits it. But you know, Deshaun, he might, you know, he comes with his suit on, but he has a high-top fade or he wears an afro. Or Nicole, she graduates, she's fine but she likes to wear her hair natural. She doesn't wear a perm. You know, those things which may seem small, are big because we know we have to look a certain way. We have to be this way. Somebody can come with a 5:00 AM. We can't really do that because "Oh, he's lazy." I'm not lazy, I just didn't feel like it. You know? But that stands into, you know, the idea that black people are lazy or things like that. Which was an actual science by Dr. Samuel Adolphus Cartwright. He came up with that theory, which was eventually debunked. But, a lot of people used it and they took away slaves' food. He said you can be cured by beatings. You know slaves, they didn't want to work or want to escape for their freedom. No, they're just mad. You know, we'll beat it out of them. It'll be fine. So those stereotypes as weird as it is, it travels. More things change, the more they stay the same.

Dr. Arnold:
It's interesting that sometimes I have some discomfort with particularly this year in this selection, when people say follow the science, it's the science. Well, yes, there is science, but I don't like how this is just because someone with a white coat says it, you shouldn't question.

Marcus Cooper:
Right.

Dr. Arnold:
You know, and really this doesn't play so much to race or anything like that. It's just, some bad things have happened because of science, because bad people use science to justify what they were doing.

Marcus Cooper:
Exactly.

Dr. Arnold:
And so, I don't like that follow the science, or science is settled. No, it's never settled. In full disclosure the other day, I can't even remember the name, I saw a name of a patient and I just assumed they were African-American, and they weren't. And I was like, wow. You know, it kind of made me laugh in a way. Like, why did you think that anyway? Who cares?

Marcus Cooper:
But, you're trained.

Dr. Arnold:
You're absolutely right.

Marcus Cooper:
It is what it is. You're trained. I assume you grew up in Iowa?

Dr. Arnold:
Yeah, Cedar Rapids.

Marcus Cooper:
So you're trained in seeing: Tim, most likely he's white. Todd, most likely he's white. Marcus, maybe. Teesha, oh she's black.

Dr. Arnold:
Yeah.

Marcus Cooper:
You're trained that way. So when we have a black doctor trying to apply for something, or trying to get into a specific specialty, he can't get that because he doesn't fit or she doesn't fit that. And you know, there's a lot of people who don't want to fall into the same old: I have to be this, I have to look this way, I have to talk this way. It's not who I am. I want to be who I am freely. And so yeah, physicians that can't do that because of their sadly name, their look, they can't get into the medical school unfortunately. My wife, she teaches at the University of Iowa. She's a professor of nursing. She's very into recruiting, trying to recruit people of color. She only gets maybe one in the students of nursing. They don't reach out to get people who want to be nurses, want to be doctors, PA's. It's hard to get in there. They have this curricular where people who may not learn the same way, but have good grades, but they come from a certain population.

Dr. Arnold:
Well, and I think it was, might have been Thomas Sowell, I was watching one of his interviews once. And he said, sometimes then people intervene and make things worse. Because, okay, you have a black student that has good grades, smart, but then they say: well we're going to bring them Harvard, you know? And now you're throwing him in, let's say, he's in the 75th percentile. And you just throw them in with people that are in the 1% that are really super smart. And then they struggle, where if they would go to just a decent state school, university of Michigan or something, they would just flourish. So sometimes the best intentions make things worse.

Marcus Cooper:
And in some cases, it's a set up. Because America, at times, in my opinion, doesn't want to see us flourish. Because if you motivate a group of people that they could actually be something, then you can't really control the herd. You know what I'm saying? And so it's sad, so people become flat, you know, deflated.

Dr. Arnold:
Apathetic, they just don't want to participate.

Marcus Cooper:
Why should I, if this is the headache I've got to deal with it. You know? People don't understand the kind of people that you have. You have doctors, you have pharmacists, you have all these people in the hood that can be something, natural leaders. All they need is an opportunity, but they don't get it because of something stupid. And then if you're stuck in a certain situation, then you feel like this is my situation.

Dr. Arnold:
Yeah.

Marcus Cooper:
And then you hear "why can't you pull yourself up by the bootstraps?" Well first and foremost, I don't have the boots. If I had boots, maybe. But if I got boots, I don't have the straps.

Dr. Arnold:
I think that's great insight. You know, Marcus, I want to thank you for joining me today and sharing these stories. I look forward to having you back and continuing this conversation because I think there's a lot we can learn from each other. And I think when it's all said and done, we'll find that we have a lot more in common than we have different.

Marcus Cooper:
Yeah, absolutely.

Dr. Arnold:
Again, this is Marcus Cooper, certified surgical technologist at St. Luke's. Be sure to join us next month for the second installment of our mini-series. Thank you for listening to LiveWell Talk On. If you enjoyed this episode, don't forget to subscribe. And if you want to spread the word, please give us a five-star review and tell your family, friends, neighbors, strangers about our podcasts we're available on Apple Podcast, Spotify, Pandora, or wherever you get your podcast. Until next time, be well.