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Maoist Thought in Medical School

You might be forgiven for wondering who won the Cold War, so prevalent have Stalinist and even Maoist ideas and procedures become in the West, especially in the academy and among intellectuals. It seems almost as if we are reliving the 1930s, when similar groups of people, in response to the economic crisis and dislocation of the times, were captivated by the supposed charms of totalitarianism.

Recently, for example, there was a paper in the journal Academic Medicine, the official publication of the Association of American Medical Colleges, titled “Addressing and Undoing Racism and Bias in the Medical School Learning and Work Environment.”

The paper is a strange amalgam of evangelical uplift, bureaucratic “langue de bois” (the type of language used by the late Leonid Brezhnev and other such luminaries), and proposals for Stalinist social engineering and Maoist re-education—necessarily leading to the increased power of an apparatchik class of what the authors call “recognised experts in inclusion and diversity,” all needless to say with excellent salaries and pensions, and all with the agreeable task of interfering in other people’s lives and making them a misery.

This task of reforming the way people think is, as they say, never-ending, and so they will have jobs for life, or at least until the revolution starts to devour its young.

The element of evangelical uplift is evident in the predicted effect of their ministrations upon those who were previously members of the oppressor class, which is to say whites. “For those of us who are the White-dominant voice,” say the authors, “it requires a complete reframing of how we think of ourselves and others. If undertaken with a genuine desire to change, it is nothing short of transformative. It is a rebirth.”

We become, if we are white, not born-again Christians, but born-again anti-racists, though whether we shall ever be forgiven is doubtful, for there is the small matter of original sin and pre-destination to consider: “We have to go out there and seek the truth,” say the authors, “part of which is accepting that, if we are White, we are a big part of the problem. We are part of the reason that structural racism imprisons and oppresses people of color every day, everywhere they go, and no matter what they do.”

By accident of birth, we are racist (if we are white), no matter what we do or whatever position we occupy; by accident of birth we are victims of racism (if we are non-white) whatever we do or whatever position we occupy. So change is both necessary and impossible, a perfect recipe for permanent political agitation, guilt on the part of whites and resentment on the part of non-whites.

Happily, there will always be work for the “experts” in diversity and inclusion to do. Now and forever—Amen.

But the bureaucratic strain is stronger even than the evangelical. Only quotation can do justice to the Politburo nature of the prose in which the paper is written: “As we prepared for the long arc of the change management process, our medical education team continued to respond in real time to events of concerns in the learning environment that perpetuated racism… An important step during this phase was to build a strategic network… this included forming a Change Management Resource Team, Change Sponsors, and a Diversity, Equity and Inclusion Resource Team, in support of a powerful, influential, and enthusiastic group of people known in change management parlance as the Guiding Coalition.”

We come now to the Maoism. Who are the Guiding Coalition? They are chosen by the great helmsmen (the authors): “When determining who should be on the Guiding Coalition, we centered marginalized voices; ensured representation from all functional areas of the school; and considered positional power, social influence, credibility and leadership ability. Guiding coalition members attend monthly meetings; work between meetings to accomplish tasks related to change targets; track progress toward the change targets; and increase their personal awareness, knowledge, and ability to address racism and bias.”

It isn’t difficult for them to find racism, of course, because it is everywhere; by definition it is present wherever and whenever it is perceived, by whomsoever it is perceived. A person accused of racism is guilty of racism by virtue of having been accused of it: there can be no such thing as misunderstanding, let alone malice, by accusers: “When anyone—but in particular someone we know, work with, or learn from—relates a concern about racism and bias that we find hardto believe because it is outside the scope of our own experience, we believe it anyway! … we must be prepared to trust when we are told that there has been a breach of… dignity.”

No need, then, for such irrelevancies as evidence, or for the objective correlatives of an accusation. As guilt in communist countries derived from the class ancestry of an accused, so in the authors’ brave new world of racial justice it derives from the racial ancestry of an accused.

The underlying condescension and indeed racism of this should be obvious: persons of color who accuse do not rise to the level of true human beings because they are incapable of such human possibilities as misunderstanding, exaggeration, and lying. They are inanimate truth-telling machines without true consciousness.

Dissension is not permissible from the doctrines of the authors and language itself must proclaim their truth: “Say racist and antiracist. Say White privilege. Say White supremacist culture. Use this language out loud and in public… without a shared language and the courage to use it, there is no hope of making progress.”

If the authors have their way, it will take courage not to use it, let alone to refuse to use it.

In any large population, there are bound to be some cranks, extremists, megalo- and monomaniacs. But the American Association of Medical Colleges, whose journal published this article, has 185,000 physicians and over 180 medical colleges affiliated to it.

Moreover, the authors of the article were not describing a distant fantasy of theirs, but what they claim to have been doing at the Icahn School of Medicine at Mount Sinai, New York, so far in a relatively pale imitation of totalitarian regimes. They describe the direction in which they would like things to move, however, the shape of things to come.

It is boring to have to argue against this intimidatory drivel, but not to do so is to let it spread unopposed, fungus-like, through both institutions and minds until it is too late to stop it.