Transcription
Hello, my name is Joseph Jones, and today is my very last day in the US Army. It's been a very long time. In fact, this is my very first day in the US Army, 1996, at West Point. In this video, I'm actually a Cadet candidate, not even a new Cadet, because we haven't been sworn in yet.
I actually took my first breath in a US Army hospital. My father was stationed at Ramstein, and my mom gave birth at Landstuhl. My father himself was also born in a US Army hospital. His father, Jones Senior, was an infantryman who fought in World War II and was stationed at Fort Bragg. And so his mother gave birth in an Army hospital. And one step further, both of my children were born in a US Army hospital. Even my inspiration to go to West Point was in large part due to my uncle Chip Jones, my father's brother, who was a class of 1982.
All that to say that the Army has been a huge, huge part of my life in one way or another for 28 years. I've been in uniform, and uh, today it ends. The Army has done a lot for me. Uh, it's taken me from a boy to a man, to a warrior, to a doctor. I've gone to far-away places, I've done interesting things, I've earned three degrees and taken on no debt. Uh, my family is much more prosperous today than I think it would be if I had not gone into the Army. I'm very thankful for what the US Army has done, or what I was able to do inside of the US Army.
But the truth is, as much as the US Army has given me, the US Army has also taken a lot. One may wonder why I would choose to talk about what the Army has taken on my final day in the US Army. Uh, and a lot of it is just that, a retirement ceremony, awards, people saying things that may or may not be really true or could be exaggerations. It doesn't mean a lot to me. What means the most to me is that what has happened to me several years ago never happens again to anyone.
These events took place in 2011 to 2012. So you might ask, why would I bring this up almost 12 years later? And there's a couple of reasons. Number one is that at the time that the events were happening, I couldn't really talk about it for fear that it would negatively affect the outcome, not to mention all the facts were not available until several years later. Number two, and most importantly, the events that I'm talking about, the series of events that I endured, are happening right now, both in the Army and outside the Army, to Black doctors. It's a very specific series of events that happens in almost the same way, decade after decade, generation after generation, to Black doctors. And someone needs to speak out about it. I think the Army is in a great position to do something about it, and so this is perhaps the best audience.
Number three would be that my message is best delivered by people, Black doctors who have done well, who are prominent, who have succeeded in everything they've done. But the problem is, those doctors themselves are very vulnerable to attacks. And if they say something that people don't like, they will lose their position, they will lose their prominence. And of course, those doctors who've been absolutely devastated by this phenomenon, well, they can't speak out most of the time because they just want to go into hiding. They don't want to talk to anyone, they don't want to be seen. They're humiliated, embarrassed, and most of all, they need a job. So speaking out could negatively affect their ability to get a job. So me, someone who's lying somewhere in the middle, I kind of make my money off the beaten path now, and it's not like I can say anything, but I can say a lot.
So at this point, you may be wondering what am I even talking about. And the gist of it is this: A study published in 2023 showed that for doctors undergoing orthopedic surgery training, if you are a white female, you are twice as likely as a white male to not graduate from that orthopedic surgery program. If you are Black, male or female, you are eight times more likely to not graduate from that program. I knew this back in 2012. I didn't know the specific number, but I knew my identity and the way I was being treated were related. I just couldn't prove it, but now I can.
The way that this was done is very sophisticated. It's rather complicated, and it's not as simple as racism. It's not as simple as unconscious bias. It's not quite as simple as tribalism, although I would say that's the majority of it. Uh, it's workplace bullying, it's hostile workplace, it's all of these things wrapped into one. But what it has in common is that when it comes to residency, and more specifically, a residency in a certain specialty, it happens the same way, time and time again, decade after decade, generation after generation. And we need to do better. The Army needs to do better.
And the Army is not a person. The Army is an institution that consists of a changing cast of people and a series of systems, regulations, rules that are meant to govern and bring out the best in those people. But what I found in my experience was that that system did not even have the means and did not have the will to recognize or give a name to what was being done to me. Because equal opportunity doesn't even scratch the surface. And so there needs to be a new system. There needs to be a new way of understanding how we operate in group environments and how power is actually managed and how the group is capable of destroying the individual for no particular reason.
Now, the good news in all of this is that in October of 2023, I was permitted to speak with every residency director in the Air Force, Army, and Navy at the Joint Services GME Selection Board in Bethesda, Maryland. Uh, also in attendance were all the leaders in the DHA, which is Defense Health Agency, the agency that's been stood up to manage medical assets across the Army, Air Force, and Navy to prevent redundancy. So I had a room full of key leaders, and I was able to tell them my story in hopes that this will prevent it from happening in the future.
But if there's one thing I know, saying one thing in one place at one point in time will never be enough. It has to be said again. It has to be understood, and it has to be shared from people who, without any knowledge, may do this again. So I've created an audio recording of my presentation, and I've synced it with the slides that I was using during that presentation. And if you care anything about the future of the Army, the future of medicine, I dare say even the future of America, I would ask that you please watch a presentation that follows this introduction.
As a final note before the presentation begins, just want you to understand the toll that this took. Enduring this, there was a point where I had had my residency taken, and then I was stripped of my promotion to Major. So I was a Captain in the Army with no residency, with a basically what was equivalent of a demotion, and eventually I faced separation from the Army because two bad OERs were created to separate me. So I was facing separation from the military, had no residency, and uh, had no way to work outside the military. I was even told by someone who thought they were being helpful that I would have to work in Africa. That would be my only way to be a doctor. You can see that didn't happen.
I was badly damaged. Some family members even asked why I would stay in an Army that had done this to me. And the answer was that I had to. With so much damage to my reputation, simply by men putting pen to paper, my only choice was to stay in the Army for another decade so that I could repair my reputation. You could imagine staying inside of the organization that had done these things, hearing people talk about right and wrong, wrong. It can make you angry.
Um, the last part is that if you're not in the medical community, or you're tangential in the medical community, I would emphasize that what happened here, it isn't just in medicine. I've talked to Black Navy SEALs who told me they had similar issues being in the Navy SEAL unit. Black Rangers, and I'm not talking about Ranger qualified, although every Black Ranger qualified soldier and officer from the 1990s will tell you, going through the Ranger School was different for Black guys. We could be seen from anywhere. Hostility was palpable. Not a good experience. But Black officers from the Ranger battalion have had a similar experience. And of course, the attorney that saved me in Hawaii has also represented Black Navy fighter pilots and their lawsuit against the Navy for the same exact issues. So this issue isn't just medicine. This is a human problem. This is a group behavior, group psychology problem. And I think we, we need to gain a greater understanding of the complexity of it and how it affects individuals and how it suppresses the actual abilities and progress of individuals.
So with that said, I thank you for your attention. Here's my presentation.
All right, thank you, Dr. Wyatt. Thank you, Dr. Sturges, and Dr. D for letting me speak today. Um, so yes, today I'm going to talk about being African-American, residency. Um, I want to just clarify my motivation is, uh, to speak on behalf of those residents, you guys already have, or African-American, as well as the residents or medical students will be selected today. I'm going to tell you the things that I wish people had told my program director about our experience in this country and how it affects us while we're in residency. Um, because when I tried to explain it while I was going through everything, exactly zero people were receptive to what I was trying to tell them.
So first, I'm going to introduce myself and tell you what's happening to Black physician residents in and out of the military. What happened to me during my orthopedic surgery residency? What are the root causes of these issues? And then what can we do to make this better? So I'm a former orthopedic surgery resident. I started in '08. I was terminated in 2012. I was placed on probation for failure to complete notes, and then I was terminated for failure to progress. There was no malpractice, no misconduct, just failure to progress. So, uh, after my termination, I filed an EO investigation or filed an EO complaint, which was investigated, and they recommended that I be reinstated. However, the GME director at the time of Tripler told everyone to ignore that, as did the hospital commander. Uh, a year later, the program director and chairman were relieved because a video made by my own classmates from my own orthopedic surgery class, depicting a Klan member throwing a dart at a picture of my face, was shown at a den. And this young Black girl saw it, who was a cast tech, and didn't know what she was looking at. And so she filed an EO complaint, and then that brought down the Surgeon General, who investigated and relieved them of duty. Uh, during that investigation, a one-star general inquired as why I wasn't reinstated, and everyone just stood silent. They said nothing. I was never reinstated. That's been 10 years trying to return. I never did.
So, um, in 2012, I'll be honest with you, my rage was uncontainable. I started the, the website residencyrehab.com in an effort to try to sublimate some of my anger and help other residents who've been dealing with the same thing. So I, it's still up now, 10 years later, 11 years. So, um, right now, the residencyrehab website is still up. It gets 3 to 400 unique visitors a month, which, in my opinion, for a topic like residency termination among doctors in North America, is a pretty high number. I usually get one to three telephone consultations per month for the last 10 years. It's anything from emotional support to advice to reviewing their documents. Some people are just trying to get back into residency. They're wondering how I can help them do that, and I'm just kind of taking it from there.
So, um, part of the website also includes a legal review of all terminations that have taken place since the 1970s. So I just sort of was able to, uh, understand the pattern of how this happens to people by reading these legal cases over and over again, and it became clear that there's no recourse. Once, once a residency has decided that you got to go, you're going to go. It doesn't matter why they decided that.
So I'm going to tell you a couple of testimonies and show you, um, a couple of excerpts from news articles and journal articles that have come up over the last three or four years. This coincides right with George Floyd's murder. This has actually created more news for Black doctors than anything else, which is, um, quite unexpected. But I want you to ask, is this happening because doctors are just plain racist? I, I don't think so. Is it implicit bias or unconscious bias? And if it is unconscious bias, why would there be unconscious bias against Black doctors and maybe not as much for anyone else?
Um, I believe the answer is tribalism. And I, I kind of came to that conclusion when I was reading this novel here called "The King of the American Mind." It's actually a book about political discourse on, uh, campuses, college campuses, and it's about how people have become very tribal and how we can't really advance any conversations because of tribalism. So he discusses tribalism in that sense, not really in the racial sense, although he does cover that. But the way he described tribalism, it sort of reminded me that I had seen this before, and I think it explains a lot of what happened to me and a lot of what happens to, uh, other Black doctors.
So some of the good quotes were, "The human mind is prepared for tribalism. Tribalism is our evolutionary endowment for banding together for intergroup conflict." And we just don't feel as much empathy for those that we see as other. Another definition here, "The behavior and attitudes that stem from strong loyalty to one's own tribe or social group." So I think that much of modern-day inequality can be explained in tribalism. When, uh, but I should specify that when you are a Black guy in America, where we have the history of what we do, when you see tribalism occurring to your disadvantage among members of the empowered majority, it looks a whole lot like racism. In fact, it looks almost indistinguishable from racism. And in my conversations with other Black doctors, they told me, "You're just making that up. That's not real. It's all racism." So a lot of Black doctors reject my idea that this is tribalism. They think that it's just plain racism.
Um, the George Floyd murder changed something in America. It seemed to make it easier for people to understand race-based mistreatment. Um, when you saw that man's expression while he was kneeling on George Floyd, you could see that he didn't really see that guy as human, and he was sort of dismissive. And, uh, everyone in America seemed to respond very strongly to that. If they had learned something, however, most Black doctors or Black Americans didn't really discover anything new. We already knew that. But among ourselves, we thought, "Oh, people might listen to us now." Because in general, when we've brought this up in the past, when I say "we" as in Black doctors, uh, we are ignored. We're told, "That's not real. That's not happening." So, uh, a lot of Black doctors saw the George Floyd murder as a chance to begin the conversation again.
But I will say that there won't be a George Floyd moment for Black doctors because this is very complicated. There's a lot of documents, there's a lot of back and forth. When I tell my story, you'll see it. It's not really anything that a single video can capture that was like an 8-minute video that shows you that guy's facial expression and what he's doing to this other guy. It really kind of helps you understand the dynamic between the two. But that there's just not that equivalent in, um, the destruction of a Black attending or resident or anything like that, because it unfolds over months, many documents, conversations, and incidents. So I'll try to show you as best I can. I think what I have here is about as succinctly as you can really do it, right? So that didn't come out quite right. So that was supposed to be a bunch of silos. It looked really good, trust me. But, uh, it's supposed to be a bunch of silos with marbles in it. And the idea was that, yeah, you know, all the Black marbles represent Black guys, Black doctors, and then the white marbles represent everybody else. Okay? And so we all operate in these different silos, general surgery, urology, ortho. And all of us Black doctors are kind of having the same experience. We're sort of on the bottom. I say that because we sort of occupy this bottom rung of society, not to offend anybody, but that's just kind of how we experience life. And so this, the exclusion that we experience, it kind of makes us feel like we're on the bottom.
So if you come into the ENT department, neurosurgery, OB department, and you ask, you know, for a sensing session or, uh, command climate, the consensus is going to be that everything is fine because you're asking everybody in that column. But if you were to ask each one of those Black marbles how things are going, they would all tell you the same thing. Um, as a footnote, 99% of Black doctors I know have had the same experience as me. They didn't all lose their residency because of it, but they either had it in fellowship, uh, as an attending, or maybe just on one rotation, but they've all had the same experience. So, um, up until now, nobody has asked all the Black marbles what's going on. They just asked a department at a time. So no one's really heard this until these articles started to come out.
All right, so this is where I'm just trying to help people understand what it is to live life as a Black person. It, it's sort of difficult to capture if you haven't done it. But in general, this is, um, a Pew Research article where they just asked people questions and they got responses. And so you see people act like they were suspicious of them, 65%. People act like they thought they weren't smart, 60%. So you can see that even if you're another minority, Black people seem to have a special experience over here on the right. And I would say that if you ranked my experiences as a Black guy, that's exactly how I've experienced it. Like I've never been unfairly stopped by the police, which is the fourth one down, but treated unfairly in hiring and pay and promotion, I would say. So that's why I'm me. And then people act like they weren't smart, yes, a lot. And then, uh, people acted suspicious of them. I spent my 20s being very careful in parking lots, as I was terrifying people walking in the same direction of them at night. And yeah, that is a common experience. So you have to understand that we have been sort of excluded, treated as other for a very long time before we get to residency. And that's the main point of this all.
All right, all right. So right now, there are four different organizations that have been created to stop the unjust treatment of Black doctors. I know all these ladies. I met them separately, uh, by reaching out to them and telling them sort of my story. So Black Doctors Village and National Council for Residents, these are strictly created just to stop the termination of Black residents. That's the only thing they work on. Physicians for Equity, Pringle Miller, she actually does the whole thing, and she made it very clear, she's not here for just Black residents. She's a Black woman, but, and she has a lot of Black people on her staff, but her goal is to stop unjust treatment of all doctors, anywhere it happens. Uh, Dedra DeFoe and Clinicians Equity, they're mainly not just physicians, but mostly physicians, and that's either attendings or residents. So I just wanted to show you how serious this is. Um, it's very possible none of you have ever heard that this is really a big problem, but there's four organizations. And when I go to these meetings, all I can think is, we need to reach somebody higher. We need to reach you guys, people who actually run residencies and have the power to change something.
All right, so now I'm just going to show you a bunch of the articles that have been published. I can't really stop to talk too much about them, but I'm going to highlight the excerpts that I thought were useful. This is published, uh, 2022, so a year and a half ago. And this woman, I actually talked to, and met her story is extremely similar to my own, very, very similar. "So many said they received unclear communication about what they had done wrong. They were written up for transgressions that went unpunished white residents, which was a huge experience for me, and day after day that would just drive my anger that I really wasn't free to express. They were given little chance to address missteps or defend themselves. While Black residents account for 5% of all residents, there are about 20% of those dismissed. They found that people from groups that are underrepresented in medicine make up 6% of residents in orthopedic surgery, but 17% of those dismissed." And why should you care? Because we're destroying the lives of these individuals. And I would say that's very accurate. This is a very destructive course. It, it really affected my family in a bad way. I would say I probably have one less child because of this. It's just, uh, turns your world completely inside out.
This is another one. This is actually in Stars and Stripes. While I was deployed in Kuwait, I saw this article in the paper and I was amazed. So this is about a Black woman in the Air Force who said that she just felt completely isolated in residency, and they just saw her as a Black woman. She made it through residency, though. And then Forbes. This was probably the written article that I read. It was shortly after George Floyd was killed. And, uh, each one of these individuals goes in detail. I would recommend you just Google Forbes and Black Doctors. They go into detail. This guy over here, Anthony Chinq, he almost writes a poem. It's very nice. And they just go into detail as of how difficult it is to be a Black doctor in the setting. And they're just trying to communicate the issues at hand.
This is another article. I also talked to this guy. He's a neurosurgeon who was, uh, forced out of practice after graduating from residency. He was, uh, basically peer-review-banned into not being able to practice at a number of hospitals. So down here, it says, "Too many of us are worried about retaliation. What happens if you say something?" My sister-in-law is a urology or a urologist, and during her residency, she would call us crying, talking about the issues she was having with her residency teaming up on her. At one point, she was, I think, 99th percentile on her in-training exam, and they accused her of cheating. Um, they would, they would always, they would come at her in a lot of different ways. And I would always tell her, "Do not retaliate under any circumstances. Do not complain. Just say nothing and just tolerate it as best you can." So with that, you see there's an issue, but you can't really do anything about it.
So this is the only article that was available back in 2011 when I was really going through it. And I did show this to my program director in hopes that I could help him understand what was being done to me. Um, right here it said, "Any transgression by a Black trainee seemed to be more partially punished than one by a majority trainee." And that was one of my dominant experiences. And in fact, in the spring of 2010, my program director told me that he had sent an email to the staff because he himself had observed it. Now, I had observed it the entire time I was there. It was almost a daily event. But he said at that point he had noticed it, and so he sent an email, which I appreciated. But ultimately, everyone that I showed this article to dismissed it. They just said, "Oh, it's not very scientific. You can find anything on the internet." And it kind of just, uh, fizzled at that. Um, they believed that they had fewer chances to make mistakes than their white counterparts and they felt pressure to perform without errors, which is exactly what I felt. They talk about social isolation and, um, how they felt that the common racial identity of, uh, everyone else made them feel sort of excluded. White colleagues receiving guidance and support from each other to the exclusion of Black members. This is something I realized later as I reflected on it that, yes, they were being mentored by the other residents, the Chiefs, and the attendings more so than I was. Uh, so I don't think I really need to go too much detail on that.
So this is possibly the most important book that I ever found. It was, uh, Virginia Adams O'Connell, is a sociologist. She converted her dissertation from 2001 into a book, and she was, uh, absolutely blasted by the surgery community for doing so, uh, because they did not appreciate her results. She collected data from 556 certified residency programs, and basically what she found is that, uh, white females are 2.5 times more likely to get terminated from their residency, but non-white males, so that does include African-Americans, Latinos, Hispanic, I mean, Latinos, uh, Asian, were 8.74 times more likely to be terminated, and non-white females were 9.87. So you see it is sort of a graded issue there, and you'll see this a couple more times in the data that I have. So, um, her conclusion was that program faculty are less likely to interact with female and minority residents. They're more inclined to encourage minority residents to resign, even when they are objectively performing as well as their white colleagues, and they tend to tolerate poor behavior if made by white males, which was one of my big complaints.
This is a very recent article from earlier this year, and you can see the orthopedic surgery with a star, uh, in both cases. It's, uh, the most homogeneous of all the specialties, and it is also the most, you could say, hostile to African-Americans, with African-Americans being seven times more likely to be dismissed or to leave residency early if they are Black than if they are white. Uh, and you could see that also here. Females are significantly better off than African-Americans in almost every case. So, um, although I'm, I'm sympathetic, I know that females have a hard time too. I'm just pointing that out. So, um, it's about that. And then this article came out one month ago, and it's sort of what Dr. Wyatt was mentioning about the increased scrutiny and the lack of trust. Here on the far right, I did have no trust in my program by about, uh, the spring of 2011. I, I suspected them of trying to destroy me. I became very paranoid, rightfully so, but I was very paranoid, which, uh, affected my performance, although I'll show you exactly what that was.
So, uh, using the Freedom of Information Act, I was able to acquire some statistics from our own system. So this right here is the statistics of racial breakdown at Tripler Army Medical Center between, I think it's 2001 and 2020. And you can see right there in the bottom left, the Freedom of Information Act thought that they should block that part out. They didn't want me to see that. But basically, what it says is this right here. I had to file another act to get this. So essentially, they don't have high numbers because not that many people were terminated. But using those numbers to make a calculation, I found that Black residents were 13.8 times more likely to get terminated at Tripler than white residents during 2001 to 2020. And Asian residents were 6.23 times more likely to get terminated than white residents.
So, um, now to get into my residency experience. All right, so I graduated from med school in '08 at the University of Maryland, and then I began orthopedic surgery at Tripler. I was placed on probation for failure to complete notes in in 2011 as a PGY3. And I had complained to my program director many times that there was sort of this retroactive declaration that I just wasn't good, and they wouldn't say anything. While I was doing surgery, they wouldn't really say anything to me day to day. They would just tell him after the fact, "Joe's not that good." And so I said, "I need something objective that I can work with because I, I can't get better when people aren't saying anything to me and they're just marking me down after the fact." So he actually found this four-point scale rating system for both surgeries and morning report. And so this is actually, that also didn't come out quite right. This is a slide from my probation hearing in 2011. And basically, I was just saying that I was only during surgery, I was getting minimal immediate feedback, but then when they were finishing my rotation grades, they would say all kinds of terrible things. Okay? So I had told them that this is either intentional, which suggests malicious intent and having no desire for me to succeed, or this is unintentional. They don't even realize they're doing it. I couldn't tell which one it was, but I was trying to communicate that to the GME at Tripler.
So these were the daily evaluations that I was given while I was on rot, on, uh, probation. That was 90 days of evaluations, handwritten by the staff of my own residency program. At the end of 90 days, this was the average score. I should mention, I've never been proud of a 2.6 or a 2.9, but they also told me, "You're not going to get a four in anything because that was mean, you're an expert." So they only really gave me a three in anything as high as a three. So these were my average scores. And on the right, right here, from April 2001, this is my old assistant program director telling me that I passed the month. So basically, what you can see from here is a 2.6 average score and a 3.08 average score is passing, basically. Also, they said limited skill was a two, skilled was a three. So based on those criteria, it seems like that passed. And I should also mention, no other resident in the history of the program had ever been subjected to this. So I was the only one being evaluated like this. There was nothing to compare me to other than just the numbers themselves.
So, uh, on July, if you look at this, this is April. By July, they decided I needed to be terminated. These are the reasons they give for terminating me: post-op patient wasn't seen at the, uh, no obvious progression in surgical abilities over a three-month period. That was not what was stated in the probation document. I require 100% supervision. They told me I had to be supervised during my probation. Does not feel comfortable with any staff. That was because I didn't trust anybody. Also, if you look, all those other issues, post-op patient not seen, ER, poor handoff of a post-call, delinquent and directed reading, those were all mentioned in the first month that I did pass. So it was almost as if they took the adjective performance, which was a pass, and they just overrode it with their memories, and they all voted on it, and they all put their names up there, and that was it. That was the end of my residency right there. So I always stopped to like point this out that I had told my program, "I need objective feedback." They went ahead and gave me objective feedback and then didn't use it, and instead, they just said, "Let's take a vote," and they terminated me. That was that.
So, adding insult to injury, this is the same department. I obscured his face because I do not wish any harm to this man. It's not his fault, but he was two years ahead of me in the program. He was abusing roxicet. He tricked another resident into giving him his passcode. He was prescribing himself narcotics, and he ended up getting court-martialed. It was like a year-long thing. Uh, so he leaves the military with marks on his license, court-martialed. He's basically on the street at this point. However, he is a board-certified orthopedic surgeon to this day because the staff at Tripler, the same guys that want me destroyed for not seeing a post-op patient or whatever else, they wanted to make sure that this man who was abusing narcotics made it okay. And, yeah, this is all this stuff is from the, uh, Nebraska Board of Medicine. Yeah, I was kind of stalking a little bit.
All right, so the EO complaint in 2012. As soon as the termination hearing was over, I filed an EO complaint. This is Colonel McDonald. He investigated it and determined that I should be reinstated. However, the GME director told everybody, "Yeah, don't worry about that. He can reapply to to residency." Hospital commander chose to say nothing. So, uh, I'll point out that at this point, I remember thinking, why should I have to file an EO complaint to get a fair consideration of the facts? But that's what it took. Then in 2013, an enlisted soldier filed an EO complaint because of that clue, Clan video, and this resulted in the chairman being relieved of duty.
So a lot of people say, "Oh, well, this just happened to you." But it has happened again. In October of 2021, I was contacted by a minority female in a surgical subspecialty, and she was experiencing the same things that I was. She was getting very subjective complaints to justify the request for her termination. She refused to resign, but the GME director of that hospital tried to coerce her into resigning, tried to accuse her of lying, and doing all sorts of backhanded things. In the end, she was talking to me back and forth, and her attorney, and she had managed to get seven letters of support from surgeons at another rotation. Those were enough to make the GME question why her department would try to terminate her, and they actually overruled the termination. So she, despite that, she had to find a new PGY4 position herself, which she did. But that was quite a burden put on her. Now, this woman is so upset by what happened that she doesn't want to help any of the people that I've referred her to. She doesn't want me to talk about her. She doesn't want anything mentioned. She is so angry and ashamed and embarrassed, which I don't think she should be. She should be very proud that she overcame. She did better than I did. But she's extremely angry, so she wants nothing to do with any of what I'm doing here.
So why is this happening? Is a big question. I believe that tribalism among the empowered ethnic majority is powerful, and it's often invisible to people who benefit from it. In-group, out-group bias, pretty much is the most basic thing. As a Black person, or even as a minority, you're kind of like instantly out-group, you're other. When it comes to African-Americans, there's this expectation that we have a low IQ and that we're undesirable workers. And then, of course, the fact that there's subjective, retrospective feedback that relies on the unimpeachable spoken word of attending physicians. There's like very few metrics that can prove that you're actually a good doctor that people are using anyway. I mean, there are metrics out there, but it seems as if when it comes to termination, all they have to do is simply list a number of things you have done wrong.
So closer examination of tribalism. This is a, a Polish psychologist, and he found that he was able to get people to behave in tribal manners just by flipping a coin and assigning them to groups. He would still find that they would distribute resources according to whichever in-group they belonged to. I thought this was very important. So, uh, when the tribe switch is activated, we bind ourselves more tightly to the group. We embrace and defend the group's moral matrix, and we stop thinking for ourselves. I believe that that's why so many people refused to see what I was actually capable of, because they were binding to this sort of ortho department or even white male power structure tribe, and they were rejecting anything that went against that. In tribal mode, we seem to go blind to arguments and information that challenge our team's narrative. So any kind of in-group conflict immediately turns tribalism up, making people attentive to signs that reveal which team the other person's on. And conditions of peace and prosperity generally turn down tribalism. So a few years ago, I did Occupational Medicine Residency, and you know, it's pretty easy. It's low stress. Sorry about that. Occupational medicine, there's like, there's no tribalism there. None. Nobody cares. Everybody's chilling. So, you know, peaceful, very diverse, no tribalism, no problems.
See, once, uh, people connect with a group, their identities can be more powerfully bound to it. They'll seek to benefit members of their group, even when they gain nothing personally. So this gets into the other part of tribalism. There's this aspect of Black tribalism that also exists. So Dr. Gerard Antoine worked in a department downstairs, Physical Medicine, which was technically part of Ortho, but we never saw him. He heard that I had trouble and he called me in, and he spent hours of his time with me, cons, just counseling me, trying to encourage me, and telling me what I needed to do. He gave me excellent advice. He spent hours for no benefit to himself personally. And I'm pretty sure he wouldn't do that if there was a white guy about to get terminated from Ortho. I was pretty sure. Also, Dr. Kimberly Kelly, she did the same thing. She spent a lot of time just trying to comfort me and get me through the process. And then there was Donell Bowen, now a cardiologist. He, he would call me a lot, even when I was in a different state, just to see how I was doing. And he spent significant amounts of time for a guy who was as busy as he was, trying to help me get through the situation. So the question would be, why would so many Black people help me if tribalism wasn't really a contributing factor to how we behave? You know, I, I think it is. I also mentioned that every step of my life, everywhere I've gone, like when I first got to West Point, like three Black guys come out of the ether and say, "Hey, how you doing? You okay? Could I help you with anything?" And I'm like, "I'm good." And my perception was that that wasn't racist. That they were doing that because I knew they weren't saying that to the white guys in my company. But I thought that that was probably, I know now that that's probably tribalism. It's, you support people who look like you, and that's fine. It's just that when one group is dominant and one group is doing that, it has a negative effect on people who aren't a member of that group.
So now, this is very interesting. So Brigadier General C.S. U. produced a one-page memorandum on what happened to me, as did Brigadier General Dennis Doyle. He was the commander at the time. And if you put them side by side, it's like night and day. Brigadier General C says, "Jones should be reinstated. This bad thing happened." Dr. Doyle's like, "Jones got what he deserved." All right, so he, but while he's saying that, he's also mentioning that this part up here, where 52% of the dismissed were white and 16% were African-American. And just a simple calculation would have told them that, well, 79% of residents are white, so 79% of terminators should be white, unless there's a protective effect to being a white resident. And if 5% of residents are Black, then 16% of those terminated would mean something's going on. But he didn't mention any of that. He just sort of sidestepped the issue and let it be. So it was like two different guys, one who looks like me, one who doesn't, had two different takes at the same rank as to what happened to me at the same situation, which made me think, once again, skin color affects way more than it really should.
And so now I'm going to transition to intelligence. When that first article that I mentioned was published, this was one of the comments. They immediately said, "Well, if you see this is the Black distribution of intelligence, Black people aren't that smart. So why should you be surprised that they're being terminated?" Of course, uh, Black doctors are probably around this area, so that shouldn't really be relevant. What's over here, but that's how people think. Is what I bring that up. People who read this magazine called Stat, which is very new, but it's kind of like a medical magazine. So that's how people think. Also, this guy says, "It's almost as if somewhere up the career ladder, affirmative action almost always runs out, as if you're only a doctor because of affirmative action." So this is how people think in America. I always point out that I know you guys are doctors and you know statistics, so you know those are population statistics and doctors are individuals. But just to drive the example home, 56.6% of women who are African-American are overweight. So you could almost say the majority of African-American women are overweight. That's not very, uh, flattering as a statistic. But also, the majority of women who are super fit and fast and all that kind of stuff are also Black women. So it's like, you can have an unflattering statistic like the bell curve that's not very flattering, that doesn't look good, and it could be true. So you could have both things be true. You could have an unflattering statistic, and you could also have excellence in that same area. But you guys know that. However, what I'm saying is that people's ideas, the kind of ideas that run through people's heads and affect the way they treat me and other people who look like me.
So this is a very sad part of my deal. My program told me that I had to take an IQ test just before they put me on probation. And I told them, "I'm not doing that." I wanted to know why they were doing this. So I, I bought this book called "Assessing Adolescent and Adult Intelligence." And one of the things it said is, on average, African-Americans have an IQ that is one standard deviation, 15 points below the average Caucasian, even when you control for age, education, occupation. I thought, "Interesting. Maybe that's what they think I am. They can prove that I'm just not that intelligent, and they can terminate me based on that." And actually, when I went to take the IQ test, the doctor did tell me, "Yes, if your IQ is too low, I will recommend you be terminated."
So, if you look, this is the distribution of physician IQs. So if you think that if Blacks have a distribution that's one standard deviation below, this would be the expected distribution of Black physician IQs because I said, you know, one standard deviation when you control for age, education, occupation. So this is science. This is a very reputable book. I mean, that's what Amazon says. So, but seriously, I mean, somebody was from Harvard, it's good. So, um, you know, I don't like this. Really made me uncomfortable. But at the same time, it's science, right? So, um, they ended up, oh, my IQ ended up being 135, right? So it was a standard deviation above the average physician IQ. But when I mention this to my staff, or I mention this to anybody, the psychiatrist who ordered it didn't say a word. Everybody wanted to forget that it ever happened. No one wanted to talk about it. So they wanted it to hurt me, but when it appeared to help me, it didn't affect anything. It didn't change their opinion of how capable I was. It didn't change anything. No one talked about it again. And I got a memo card. Yeah, memo is kind of silly because, you know, I mean, who's going to believe that, right? But anyway, so this is kind of wrapping things up.
Undesirable workers. African-Americans have the stereotype that we're undesirable workers. They, this is just a study about how they submitted a bunch of names that sounded stereotypically African-American and a bunch of names that sounded stereotypically Anglo, and then how there's a 50% more likely to be contacted if your name sounded Anglo.
It's just sort of, and there's been a number of studies that have done that. So the bottom line for this whole presentation was this: that there's subjective standards and environments that are dominated by tribalism. If we understand that tribalism is our baseline human behavior. So this isn't like a "hash white people are evil," this is a "hash people are evil." We're all like tribal, this is what we do. But if we're in an environment where everyone's tribal and everyone looks the same except for that guy, then that guy's going to have a problem. And then if we use a lot of subjective standards, even worse.
So the U.S. Army, uh, Equal Opportunity complaints, IG complaints, and Congressional inquiries cannot provide protection for black doctors. How do I know? 'Cause I did them all twice, and no one cares. No one listened to anything I said. But black officers and positions and positions of authority are more likely to identify mistreatment of black residents. All those people I showed you who did the investigations and who supported me, they could all see that there was a problem here. They could see it. However, everyone else couldn't, which still doesn't exactly make sense to me. But, um, they could see it. So it's almost like that's the benefit of diversity. People talk about diversity all the time, but they never really get to the nitty-gritty of it. Diversity is about protecting the people who are different at the bottom, in my opinion.
So anyway, the Army already knows this because they have show CS boards. Whenever you're getting kicked out of the Army as an officer, by the way, I went through one of those. As, um, I didn't mention this, but they gave me two referred oars back to back to make sure that I would get separated from the Army. And so I had to face separation. And when I went to face separation, it was mandatory. The one black guy would be on the hearing because one out of three has to either be a minority or, if you're a specialty, they have to be a specialty. So that one bad guy, I assume, helped me out. But that's a rule from the Army. They already know this. They, the Army already knows about tribalism. They've been through this.
So what should be done? In my opinion, is that it should probably be something like a jury. You know, jury selection is a huge part of any trial, trying to ensure that they're eliminating bias from the pool of people who are going to decide what is actually fair. So, um, they said that, um, uh, oh yeah, if the juries were mixed race, then, uh, they were less likely to presume the defendant's guilt and more thorough in examining the evidence, which makes sense.
So I also like to clarify that I don't think that we should increase those numbers of residents passed, or I don't think we should increase the number of doctors. Currently, the number of surgeons is 2%, or, and the number of doctors is 5%. I don't think that 133% of doctors should be black because we're 133% of the population. That would be equal outcome. I just think there should be equal opportunity. I think that the doctors that do enter the system should really have a fair shot. And I just want to make it clear. So when there's a, a situation where you're 13 times more likely to get terminated because you're black, I don't think that's really equal opportunity.
So, uh, one of my biggest gripes was that Army Equal Opportunity training was solely focused on very basic ideas like, "Hey, don't leave a noose on your co-worker's desk," or, you know, "Don't spray paint the N-word in the bathroom," or something like that. And I was like, "That's not what's happening." So I think that it needs to focus on ingroup, uh, numerical superiority and things like that and relationships.
So, all right, this kind of goes beyond the scope of this. This is an adapted lecture from another one. So that is about it. Um, I'm a cartoonist also. This is a cartoon that I put on my website. Uh, this was sort of to show you, like, the effect psychologically that this had on me. That's supposed to be me, you know, with my mouth all agape like, "Oh my gosh, I'm in so much trouble." And then the spotlight is here because they're, you know, they got the spotlight on me, they're examining me, they're all bigger than me, more powerful than me. These guys in the shadows, these are like, there's a lot of problems you have in this setting. Also, that nurses will say things about you, administration will say things about you, other people will start to whisper behind your back, and you don't even know who they are. That's what the shadow person is supposed to be. And then this alien is not really there. See, he's so paranoid that he's seeing aliens blowing us. So that's about it. Anyway, thank you guys for your attention. I really appreciate it. [Applause]