From Dr. Locke's presentation “The Color of Normal – Racism Is a System not an Event” at PRACTICE MANAGEMENT 2021.

From Dr. Locke's presentation “The Color of Normal – Racism Is a System not an Event” at PRACTICE MANAGEMENT 2021.

When we use our voice, we encourage others to do the same. After several successful presentations at PRACTICE MANAGEMENT® 2021 (PM), I am grateful for the chance to further engage ASA membership via this article. Both the spoken and written word have the ability to draw people in. Worst case, people will just listen; best case, folks may even be inspired to action.

As I reflect on the overwhelming response to my talk given at the recent PM conference (“The Color of Normal – Racism Is a System not an Event”) I feel optimistic, pensive, and most importantly, heard. In this article (as in that presentation), I encourage all, as my mother would often say, to “listen with one heart instead of two ears.” When I invited listeners into the conversation, I impressed upon them that this is a dialogue that we as Black and brown people have been having with our parents, grandparents, and aunts/uncles for generations. Regardless of whether we wear white coats or suits to our respective places of employment, we do not enjoin the privilege to make, nor to identify with, statements like, “I don't see color.” I wanted my friends/colleagues to understand (or at the very least hear it expressed) that outside of my clinical duties, it is incumbent on my survival and my professional success to learn how to act around white people (i.e., what to say when speaking, when not to speak, how to dance, and until very recently, how not to wear my hair). That being said, organizational behavioral doctrine teaches that nothing great or monumental in our lives comes from living within our comfort zones. In order to be great, we have to challenge ourselves to do things that make us intentionally uncomfortable. This is a powerful premise that I have adopted, continually try to put into practice, and encourage you to employ.

One comment following my PM presentation by an attendee stands out in my mind: “I was amazed how you managed to be so articulate, but blunt and humanistic at the same time.” I meticulously dissected that remark for my own growth. For me, it meant I was well on my way to becoming a leader. The qualities that I had put real work into acquiring, such as emotional intelligence, humanism, relatability, courage, openness and honesty, were becoming part of my armamentarium. Moreover, taking stock of all the moments that led up to the one where I stepped onto that national stage left me feeling very grateful for the mentors and sponsors I had along the way. For example, as a senior resident attending the ASA annual meeting in 2015, I introduced myself to people like Drs. Pat Giam, Jerome Adams, and Chris Diez. I remember feeling completely afraid, small, and like the odd person out. Standing among these seeming “giants,” while being both a trainee and a Black woman, was intimidating. Regardless, at every session I told myself “You are not leaving this room without introducing yourself!” As uncomfortable as it made me to state my name and hand over a business card, I still did it. Years before I encountered the doctrine of intentionally engaging in the uncomfortable, this idea was modeled for me by a sponsor, the illustrious Dr. Michael Lewis, currently a leader in the Henry Ford Health System.

Few of us can achieve career success in a vacuum. Instead, we connect with others and are introduced to new ideas, new perspectives, and tips for advancement. These connections form the relationships that we begin to call either mentorship or sponsorship. The very core of sponsorship is promotion/advocacy. Sponsors act as spotlights, shining a light on the person they are putting forward! They leverage networks and connections to advocate for your advancement in a laser-focused and episodic manner. Mentors are different and can be any senior colleague with whom you share interest; these individuals give us advice along our paths and/or help us cultivate our professional vision(s). In contrast to a mentor, it is vital that a sponsor have some professional “capital” they will use to promote your professional goals (asamonitor.pub/3rOCfMA).

I have been an active member of ASA since residency. Through our society, I learned quickly that sponsors were essential. I saw the need to gather a number of sponsors with varied professional interests as early as possible. While Dr. Lewis is not my only sponsor, he was my first. He exhibits a level of proactive resident advocacy that I had not experienced prior. He took me by the hand and introduced me to Florida Society leaders, including Drs. Jeff Jacobs and Chris Diez, and put me forward as a resident delegate. Dr. Lewis also encouraged me to write and publish my first article for the ASA Monitor. It is he who unfailingly completes a letter of recommendation for my ASA committee self-nomination forms within hours of my request. Other important moments of mentorship/sponsorship include crucial conversations with Crystal Wright, MD, advice received from George Williams, MD, and promotion to Assistant Medical Director of Perioperative Services at a community hospital in my second year in practice, based on the strong recommendation of Zachary Deutch, MD. My first introduction to Dr. Adams came via Linda Young, MD, who brought me along to the inaugural meeting of the ASA's Committee on Women in Anesthesia. This meeting provided the unique opportunity to become a founding member of an important committee, and it all started in the back room of a restaurant in San Diego. Long before I knew the distinction between a sponsor and a mentor, I saw there was something very different and very powerful about the former. While we may have myriad mentors with which we build longitudinal relationships, sponsors remain critical to career advancement.

Everything I have been able to accomplish in my career can be traced back to opportunities afforded to me by someone else. Someone saw something in me, understood an interest of mine, and leveraged their professional “capital” and/or networks to propel me forward. Whether as a speaker for a conference, an author for a book chapter, or member of a committee, someone opened a door for me. It is apparent that the leader, whomever that person may be for you, should be aware which junior colleagues need help in advancing their career. In that respect, individuals in power should not have to be sought out, but realistically that assumption may be “pie in the sky.” So, I would encourage you to own this process and consciously approach leaders with requests for assistance in career counseling and professional development. Career advancement in general (and certainly within the field of medicine) is about who you know and about those individuals' willingness to use their power to sponsor your advancement. At the same time, understand that willingness to sponsor is affected by implicit race and gender biases. More detrimental than consciously having those biases is being unaware of them. As a result, leaders may continue to elevate groups who have traditionally benefited from sponsorship while overlooking underrepresented groups.

Sponsorship and IDEA (Inclusion, Diversity, Equity, Access) are two heads of the same coin when leveraged appropriately. Recall that sponsorship is defined as actions that are “episodic and focused on specific high-visibility opportunities that position protégés for career advancement.” This can be a powerful tool to help join personal and organizational goals around IDEA. As a Black, female, Muslim anesthesiologist, I was put forward by a Jewish, white man! There is so much strength, commitment, and leadership exemplified in that dichotomy. To junior anesthesiologists of color, I again urge you to step out of your comfort zones, for allies will come not only from within our ranks! To be blunt, it is a beautiful time to be Black or brown in medicine! Not only is the world watching, but many hospitals and companies have IDEA built into their strategic plans, and it is likely to become an integral part of the business model. As parts of larger learning collectives such as universities, academic anesthesiology departments are significantly affected by mandates for increased diversity, and many have put actionable items in place to address this (Acad Med 2019;94:94-100).

As I continue to find both my voice and my calling, I urge you to do the same. Challenge yourself weekly to become intentionally uncomfortable. Remember, we are stronger together.

Keya A. Locke, MD, MBA, Assistant Director of Perioperative Services, University of Florida, Jacksonville.

Keya A. Locke, MD, MBA, Assistant Director of Perioperative Services, University of Florida, Jacksonville.