Teaching attendings: Are we Dolores Umbridge?

As luck would have it, I flew (figuratively speaking, of course) down the highway to work this afternoon while listening to the sweeping saga of Harry Potter.

As you may know, not unlike the medical students we teach, no student enters the hallowed halls of Hogwarts without a gift. All possess the potential to master — after years of study and practice, of course — the art and science of magic.

Despite an institutional history checkered by prejudice and conflict, students are now welcomed at Hogwarts regardless of social class, sex, appearance or the purity of their bloodline. Wizard- or Muggle-born, all those endowed with the capacity for magic have a place there. Headmaster Albus Dumbledore, a wizard of scrupulous integrity, is rightly and deeply beloved. Not only does he model an inspiring commitment to the triumph of life over death, he’s funny.

In Harry Potter and the Order of the Phoenix, the volume most currently cued up on my phone, the Ministry of Magic, an agency of the wizarding government, has become obstructive and destructive. Whether they are merely oblivious or allied with the forces for death is unclear. I white-knuckled it as our hero Harry and his friends, Hermione and Ron, came face-to-face for the first time with Professor Dolores Jane Umbridge. Let me tell you, it’s not pretty.

Charged with the life-saving task of teaching “Defense Against the Dark Arts,” Umbridge quickly reveals herself to be the teacher students universally despise. Rather than prepare her students to save lives, she spends her time demeaning her students’ burning desire to embark on the practice of magic. Through aggression, covert and overt, she makes it clear that her aim is not to empower them in all their glorious variety, but rather to enforce her view of how things should be. She will go so far as to scar students painfully and permanently in order to make them conform. It is truly a wonder that the young Harry does not lose his mind.

As I listened, I found my mind drifting to an extraordinary essay, one I read recently, from the Scientific American. This piece, entitled “Diversity and Inclusion in Medical Schools: The Reality,” simultaneously broke my heart and made me furious. I cannot recommend it to you highly enough.

In it, Jennifer Tsai, herself a fourth-year medical student, details the contrast between the modern American medical school’s active search for much-needed diversity in the student body, which is to say, the future physician workforce, and the reality encountered by students who fall in some way outside the old-school norm for a “doctor.” While a recent essay on KevinMD illuminated the modern expectation that medical school applicants submit a “medical school diversity essay,” ”these students (of varied experiences and identities),” Tsai writes,”many among my friends, aren’t getting what they bargained for. This admission comes with a cost. Once … in school, they are told to (hide the truth of their identity, and) leave precisely what they bring to the table at the threshold of the hospital.”

I hope I speak for all of us who teach medicine when I say, how shamefully disingenuous of us!

Not unlike Harry Potter, medical students have come to us precisely because they have innate gifts. Without exception, they have demonstrated the academic potential and personal commitment to life over death required to master — after years of study and practice, of course — the art and science of medicine. Additionally, they bring a diversity of personal qualities and life experience.

Despite an institutional history checkered by prejudice and conflict, medical schools now actively seek students of every social class, sex, ethnicity, religious creed or lack thereof, gender identity and sexual orientation, without regard to disability or the occupation of their parents. These students bring us all of that glorious variety in sacred trust. Their distinct qualities — on every front — are not ours to squander; they are the precious inheritance of the next generation of patients, many of whom will yearn for a physician a lot like them.

We who are their teachers, have a crucial choice to make. And, as Dumbledore notes, “It is our choices, Harry, that show what we truly are, far more than our abilities.”

Will we teach our students “Defense Against the Dark Arts”? Or will we, like Professor Umbridge, waste their instructional time and attention attempting to deny the reality of the future they know to be on its way? Will we be obstructive and destructive, employing overt and covert aggression to enforce some outdated view of who a doctor should be? Will we choose to scar them painfully and permanently in order to make them conform? In this moment when we all find ourselves repeatedly stunned by medical student and resident suicides, we have a holy obligation to ask, is it any wonder that some of them lose their minds?

Our students come to us after years of preparation and sacrifice, often burning with a desire to “pick up a wand” and begin the practice of medicine. We who teach them are in a position of power and hold important keys to their success. As their teachers, can we not channel the dignity and generosity of Dumbledore?

Like Dumbledore, we certainly won’t be around forever. I wonder, do we have it in us to embody scrupulous integrity, embrace our students in all their diversity; stand up for their right to be themselves in the classroom, the OR, and the halls of the hospital; and keep our sense of humor about us to boot? Isn’t our commitment to them an essential part of our commitment to life over death?

Stacia Dearmin is a physician and founder, Thrive.

Image credit: Shutterstock.com

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