Otolaryngologist Discusses What Equity, Diversity Meant to Her Career

In the spring of 2018, Dana Thompson, MD, MS, MBA, the Lauren D. Holinger Professor of Pediatric Otolaryngology and division head at the Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, boldly stood at a podium at the Triological Society’s Spring Meeting and delivered the esteemed Joseph H. Ogura annual lecture. Throughout her address, entitled, “Inspiring Change from Within,” she wove her staunch desire to tackle the issues of bias and diversity in our field with the story of her own journey of becoming the first black female otolaryngologist serving as a full professor at Northwestern University, an endowed chair, and division head of pediatric otolaryngology.

Anyone who speaks with Dr. Thompson will be mesmerized by her unassuming poise, gentle smile, and reassuring demeanor. And perhaps it is because of the composed dignity with which she carries herself that she can draw the attention of a historically male-dominated surgical field to the profound issues of diversity it faces. In otolaryngology, African Americans comprise 2.3% of all trainees. Only 30% of otolaryngologists are female. And men make up 92% of the specialty’s professors.

Despite—or perhaps because of—having personally met and faced down each of these hurdles, Dr. Thompson is now issuing a clarion call that we work together to create a pathway for inclusion in our specialty.

I’m intensely interested in where a leader of Dr. Thompson’s caliber acquires her inspiration. For Dr. Thompson, her family serves as a foundational source of her motivational fuel. “My mom is an incredibly creative person, and what I learned watching her as I grew up was her ability to look at multiple different ways of doing something and creating beauty out of whatever was in front of her.” This ability to generate beauty from circumstances rife with challenges is a talent Dr. Thompson carries with her in all that she does. And she wields it like a superpower.

This interview was condensed and edited for clarity.

SR: How did your personal background inform your career path?

DT: I come from a family of physicians. My dad attended medical school at Meharry Medical College in Nashville, Tenn., one of the country’s historically Black medical schools. When he came to Kansas City, Mo., for his residency in obstetrics and gynecology, he was one of the first Black residents to integrate the training program. Meanwhile, my maternal grandfather had been the only Black physician for about a 100-mile radius where he practiced in Mississippi.

I grew up with their stories about the patients in their communities. Sometimes my grandfather was paid in chickens and eggs! Their history is embedded in my epigenetics; it’s in my DNA. I inherited this drive for pioneering and fostering community-based medical care from my father and grandfather. I carry forward their value system.

SR: Did you feel like a pioneer early in your training and career?

DT: In many ways, I did. I completed my residency at the Mayo Clinic in Minnesota in the 1990s. During my training, I was the first Black woman in the surgical program. Then I became the first Black woman member of the surgical staff. Later, I was the first Black female surgeon to be named a professor at Mayo, and actually the first in otolaryngology in the entire country.

I have a lot of respect for my journey at Mayo. My time there provided me with supportive, principled mentors who believed in me and helped steer my career. The honor and privilege of training and working somewhere like Mayo has also allowed me to lean into that reputational excellence when I have encountered patients with bias or who may question my credentials. But after those “firsts,” I wanted to find a pathway to contribute differently. I wanted to work where my perspective and skills could directly impact the practice of medicine at the community level, as well as open the community’s access to its own medical care.

SR: Did you feel lonely as you accomplished these remarkable “firsts”?

DT: I’m pretty good at compartmentalizing, but yes, it was certainly lonely at times. When you walk into a room, and you realize you’re the only woman and the only woman of color, it’s a responsibility. And it’s one to honor. My dad used to say, “Just be careful carrying the weight of the race on your shoulders.” What keeps me from getting exhausted by this process is understanding that at some point my story is going to have an impact on someone else and remembering those who have supported, [have] mentored, and have provided sponsorship and allyship.

SR: How did you develop the courage to speak out about issues like race and gender equity?

DT: I developed the courage incrementally. I think there were several seminal events I experienced over the course of my career that helped me develop that courage. I do not think that these events were intentional, but, taken together, they were transformational experiences.

SR: Could you elaborate on one of these transformational experiences?

DT: The first occurred when I was a resident. I walked into the operating room one day, and posted on the wall of the room was a piece of paper with a typewritten story with a racial slur. This is a difficult experience to talk about, even now. And as I reflect on it, I ask that you consider it from the context of the time. I was a PGY2 at a residency program in rural southeastern Minnesota. The year was 1993. This situation reflected an insular community’s lack of exposure to diversity and people of different backgrounds and races. I remember reading the written words of the story and feeling disbelief. I could not believe I was reading this while standing in a world-class organization. And I could not let go of it. For days, I walked into that operating room with this sign continuing to hang there. I didn’t feel empowered to take it down. And I didn’t feel empowered to say anything to anybody in the room.

This experience taught me how to channel my anger productively and to ask myself in moments of challenge, ‘What can I do to be productive about this?’ —Dana Thompson, MD, MS, MBA

 

SR: That sounds terrifying—and incredibly upsetting. What did you do?

DT: I ended up taking my surgical notebook and transcribing the story word for word. I didn’t feel like I could tear it down, so I transcribed it. Word for word. And then I went to my chairman with a copy of what was written in the posted story as well as a letter that I had drafted to the CEO of the hospital. Here I was, at an institution where I was honored to be training. And, as one of the few people of color in the entire organization, I felt a sense of responsibility to speak up. And that decision—to say something—was a transformational moment for me. I sat before my chairman and I asked him for his support in sending this letter I had written.

And he did. He supported me, as did my program director. The CEO of the hospital later sent me a handwritten note, apologizing and agreeing the incident was unacceptable. This experience taught me how to channel my anger productively and to ask myself in moments of challenge, “What can I do to be productive about this?” I think the supportive response that I received, as a result of speaking up, from people who did not share my lived experience as a person of color also helped me reevaluate my own bias.

SR: Can you explain what you mean by your comment that this experience “helped me reevaluate my own bias?”

DT: In 1993, I had my own bias about who could and would be a mentor, and that experience gave me a mindset shift. At that time, it was hard to envision and believe that a white man in a position of seniority could be a mentor and sponsor and supporter and ally of a young Black female like myself. That felt empowering, and I was amazed to discover the kindness of others through this experience. That moment of transformation took courage on my part to speak up, as well as active listening, compassion, and support on the part of others.

SR: Do you think we can change the bias that exists in our field?

DT: Absolutely. It was what I hoped to bring attention to through my Ogura lecture. I wanted to use my opportunity to speak that day to say, “Here’s the lens through which I’ve experienced bias in our field, and here are the ways I think that bias is holding us back as a specialty and what we do for the patients we care for, and here’s how we increase diversity within otolaryngology.” I wanted everyone listening to learn from my experience and use the message as self-reflection to help themselves navigate their own biases.

We’ve reached the stage where we need to implement changes and not just listen to people speak about change. —Dana Thompson, MD, MS, MBA

The lesson I hope they took away was to be as welcoming as they can be, because those moments when people welcomed me, when I wasn’t expecting to be accepted, helped me reach where I am today. I really tried to highlight the support of people who, because of my own biases, I never would have thought would be supportive of me. But they were. Instead of bias, they showed me support.

SR: How have the challenges you faced in training and your early career affected how you mentor others?

DT: I’m an idealistic person. I want to see the best in everybody. Even when I was in medical school as a senior student helping a junior student, I found I had a natural ability to see strength in people and wanted to foster that. As a trainee and early in my career, I had always hoped that others would see the best in me and help develop my potential. I have incredibly high expectations for myself and I value excellence, both of which were drivers to help overcome any question of whether I belonged or not.

Driving excellence and inspiring people to reach their full potential are the core elements of how I mentor others, and people who know me well know I have incredibly high expectations. I think I had to learn over time to be less critical and more encouraging when I observed gaps and places for opportunities. I’ve had to reframe the tone with which I coach and encourage students to help them see my high expectations as a reflection of their potential. My mentees have taught me how to do that, and through that process I’ve grown as an educator and as a leader.

SR: As a trailblazer, you have raised awareness about a need for diversity in our field, and have helped steer us in that direction. What specific changes in our field do you think would make a difference?

DT: To successfully achieve diversity, we must aim to be a welcoming place for diverse people and diverse life experiences. By learning from these perspectives, we can begin to appreciate the beauty and brilliance that diversity brings.

Our leaders and decision makers who can actively listen, ask the right questions, and leverage the strengths of diversity will be positioned to lead in changing our present circumstances by broadening their skills in inclusive mentorship, sponsorship, and allyship. By creating diversity in our specialty, we’ll begin to think more inclusively about the care we provide, the research questions we aim to answer, and who we educate and attract to our field.

The pipeline in otolaryngology is leaky. Our medical schools can help by having a student body that’s more representative of the diverse demographics of our country, so that more students are available to choose our specialty. We also must make intentional efforts to get involved in our undergraduate medical education programs to expose students of color to otolaryngology, because many don’t consider us as a career choice. If we create an environment where learners— students, residents, and fellows— feel supported and welcomed and are inspired to demonstrate how their presence makes a difference, we’ll change how we look as a specialty. Engagement in more community-facing clinical care and research will also show underrepresented minorities who tend to choose specialties with a much more direct community impact that there are opportunities to contribute similarly in our field. They’ll be inspired to see how their presence belongs in otolaryngology.

SR: How do you think we can begin to accomplish this change?

DT: Self-reflection and acknowledgment of the gap with intentional personal and institutional investment in the change, combined with the understanding of the importance of the “why” behind the need to evolve and change, are vital. While we need leaders and participants who will inspire others, without alignment of resources and incentivized support of these efforts, change will remain incremental. Personal and institutional accountability will be necessary to sustain change.

We’ve reached the stage where we need to implement changes and not just listen to people speak about change. I think we’re better at listening now than we were. And that step was important: As a group, we needed to learn how to listen. Now we need to work on implementation.

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Dr. Rapoport is an attending physician in otolaryngology/head and neck surgery at the Veterans Affairs Medical Center in Washington, D.C., and an assistant professor at Georgetown University in the department of otolaryngology.