Richard Allen Williams - Blacks in Medicine: Clinical, Demographic, and Socioeconomic Correlations

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Statuette of Imhotep in the Louvre, Paris. (Image courtesy of Hu Totya CC 3.0) (By anonymous, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=657268 )

Imhotep, son of mythical creator god Ptah, was born in Egypt about 3000 BCE. During his life, he was renowned as a philosopher, sage, scribe, poet, astronomer, chief lector priest, magician, and architect. He designed and constructed the first man-made stone structure, the Step Pyramid at Saqqara, part of the necropolis of the ancient Egyptian city of Memphis.

He was most famed for his skill as a physician and is generally considered the original author of the content of theEdwin Smith Papyrus, the oldest known surgical treatise on trauma (ca. 1600 BCE), which contains almost 100 anatomical terms and describes 48 injuries and their treatment. (Many historians believe that the text of the Smith papyrus was copied from a much older document originally written by Imhotep.) The first phrases of the Smith papyrus demonstrate that thousands of years before William Harvey, the ancient Egyptians directly associated the pulse with the heart, understanding its importance as the central organ of the body. In the papyrus, injuries are assessed with palpation, described and diagnosed rationally, with treatment, prognosis, and explanatory notes.

Imhotep was the first known physician to extract medicine from plants and is remembered for viewing disease and injury as naturally occurring, not as punishments inflicted by the gods, spirits, or curses. He was known as a medical demigod 100 years after his death and was elevated as a full deity by the Egyptians in c. 525 BCE, paving the way thousands of years before the arrival of the Greek/Roman god Asclepius and the Greek father of medicine, Hippocrates.

The symbol for the new book is the African Sankofa bird, a mythical animal depicted in the Akan (Adinkra) writing system as flying forward with its head turned backward. The egg in its mouth represents the gems or knowledge of the past upon which wisdom is based; it also signifies the generation to come that would benefit from that wisdom. This symbol may be associated with the Akan proverb, se wo were fi na wasankofa a yenki, which means it is not wrong to go back for what you have forgotten.

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Baraka Sasa, an old Swahili expression meaning blessings now.

By ten things is the world created,

By wisdom and by understanding,

And by reason and by strength,

By rebuke and by might,

By righteousness and by judgment,

By loving kindness and by compassion.

Talmud Higaga 12A

The sudden and unexpected passing of Bernard J. Tyson on November 10, 2019, at the age of 60 was a tragic loss not only for his family, friends, and colleagues but for the world of healthcare. As chairman and CEO of Kaiser Permanente, the giant HMO, he had taken corporate responsibility in healthcare delivery to a new level during his tenure at Kaisers helm beginning in 2013. During this time, he presided over an increase in Kaisers fortunes from 9.1 million members and an annual revenue of $53 billion in 2013 to 12.3 million members and revenue of $79.7 billion in 2018. In addition, he remained steadfastly within the Affordable Care Act (ObamaCare) as a member of the exchanges in California at a time when other major insurers bailed out in 2017. I had the opportunity to speak with him about how to deal with healthcare deficiencies and disparities suffered by blacks and other minorities when I invited him to give the keynote speech at the National Medical Association Colloquium in Los Angeles in March 2016. That is when I learned of his plan to build a new medical school in Pasadena, California, that would focus on recruiting disadvantaged underrepresented minority students and providing tuition-free medical education for them. True to his word, Kaiser is set to open its medical school in Pasadena in 2020, and tuition will be waived for the first five classes. (One might say that this is truly putting your money where your mouth is.)

Six days before he died, Tyson published an article in Time magazine (November 4, 2019) titled Where You Live Should Not Determine Your Healthcare. In it, he described his belief that Health is about so much more than the care we provide at a hospital or medical office. He also stated that An individuals ZIP code can be a more accurate driver of health than their genetic code, an opinion also articulated in Chap.of this book. What he was stressing was his belief in the importance of the socioeconomics of health and its impact on communities. In the Time article, he cited evidence that select neighborhoods experience higher rates of certain diseases and went on to show how healthcare organizations such as Kaiser can participate in solving the multitude of problems facing impacted communities. In line with this philosophy, he further stated that It is time for us to engage in the fight for health beyond our walls. and presented Kaisers approach to this by launching a social health network which he called Thrive Local in which their technology partner Unite Us is integrated into Kaisers electronic health record system, which allows healthcare workers to refer clients who are in need of special services directly to community organizations and social service agencies that can help them. And stepping up to the plate of financial need again, Kaiser made an impact investment of $200 million last year to address homelessness and housing affordability.