On Sept. 18, I was on the traditional territory of the Songhees and Xwsepsum Nations to stand with my Indigenous physician family as the Canadian Medical Association (CMA) delivered its apology to Indigenous Peoples in Victoria, B.C. This wasn’t the first time that we have stood together to witness a collective apology.
In June 2008, many of us were at a gathering of the Pacific Region Indigenous Doctors Congress in Kauai, Hawaii. Our hosts ensured that we had time and space to watch Prime Minister Stephen Harper issue an apology on behalf of Canada to Indigenous Peoples for Indian Residential Schools.
As Harper said sorry for the federal government’s attempt to “kill the Indian in the child,” Canadians had a range of reactions from ignorance to collective humility to ongoing residential school denialism.
That day, we hoped the apology signalled a turning point and that a new day was coming. What we’ve seen since, as evidenced by multiple reports on progress on reconciliation, is that it takes a long time for that new day to come, and progress on reparations and reconciliation is not linear or always forward-moving.
I carried the lessons from that 2008 experience with me to Victoria to witness the apology from CMA — Canada’s national association of physicians — and knew this would be different for me. My experiences of racism in the health-care system are significantly more direct than my experiences of residential schools.
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Racism in health care
I navigated medical education as a Cree-Anishinaabe woman, experiencing significant amounts of both non-malicious and malicious racism. This ranged from being asked if there were polar bears where I grew up (the North End of Winnipeg) to being asked by an attending emergency room physician if I had to “jump out of the Indian Posse” to transfer from Winnipeg to Saskatoon.
I have experienced racism when seeking health care myself (like when a training physician commented on my reading ability even though I was already a practising physician and national Indigenous health leader) and when my father needed emergency care while having a massive heart attack.
Collective apology
What would this collective apology for systemic racism in health care mean to me, an Indigenous physician, who has and continues to experience racism from my physician peers?
So when the CMA said “we are deeply ashamed” for the deplorable racism that Indigenous patients and health-care providers face I wondered who was included in that “we.”
Did/does the ER physician whose behaviour escalated to include putting his hand in the back pocket of my jeans when I was on call to both grope me and “check if I had stolen their reflex hammer” feel deep shame? Probably not, and that disconnect impacted how the apology landed.
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Within “the national voice of the medical profession” are those of us who have experienced and continue to experience anti-Indigenous racism; those we work with in consensual solidarity or allyship to dismantle white supremacy within the profession; and those who are actively perpetuating the spread of false and harmful anti-Indigenous stereotypes that contribute to the unequal health care we receive. Many of these behaviours are described in British Columbia’s In Plain Sight Report
A collective apology cannot speak to this range of experiences or contributions to harm. As racism operates at multiple levels, so must accountability.
This is why on the day of the apology I was apprehensive and feeling somewhat pressured to respond positively to it, to make a show of unity. Since the apology hadn’t really spoken to the breadth and depth of experiences of racism I’ve had or that I know many of my Indigenous physician colleagues have had, I was not ready for that. I suspected some of my colleagues felt the same.
After the apology was delivered, in a small group that included many of the Indigenous physicians who were there, I shared my feelings. I said, “An apology has been offered. Whatever your reaction is to what was said today is valid. You don’t have to accept this apology today, tomorrow or ever. It’s okay to wait and see what comes next.” I saw people nodding and tears being shed.
I sat with that feeling, and then a couple days later I was reading Cole Arthur Riley’s This Here Flesh. Riley is a Black American author and founder of the incredibly popular Black Liturgies Instagram account. Her writing of Black liberation and the reparations needed for the Trans-Atlantic Slave Trade and other injustices strongly parallel the need for Canada’s ongoing truth and reconciliation work — which we will be recognizing on Sept. 30.
This passage from This Here Flesh resonated with me when reflecting on this latest apology:
“There are some of us who have grown weary of talk of reconciliation. This is probably because it comes to us on the tongues of men who have paid no time to the process of true repair. It is both ego and shame concealed in shallow unity-speak that regresses any progress that has been made.”
Racism, reconciliation and repair
Anti-Indigenous racism is embedded across and within all institutions of the Canadian state, and the medical profession is no different.
Based on the fallout after the Indian Residential School apology, we can accurately predict the actions following this apology will not be linear with forward progress.
As Indigenous physicians we know both ourselves and our relatives are vulnerable to ongoing harms while the organizational level actions unfold.
If we are hesitant to fully accept this most recent apology, it is because we have learned the hard way that our safety, and sometimes our survival, depends on first seeing the integrity of the other party we are in union with.
There is a deep social contract between the medical profession and the public we serve. There is an individual contract between each physician and each patient they see. There is also a contract between physicians as colleagues, teachers and learners, embedded in our Modern-Day Physician’s Pledge.
This apology is meaningful because it addresses a tragic breach between the medical profession and the public. The CMA has committed to followup actions.
This, however, does not offer “true repair” for the past breaches, and the ones still to come, in all of these contracts. That is a gap that remains to be closed and without it we will not see the end of anti-Indigenous racism in health care.
Marcia Anderson received funding from Health Canada to develop Indigenous Cultural Safety and Anti-Racism Training.
