Cultural Insensitivity Despite the Best Intentions.

To the Editor:

I want to express my gratitude to the Editor, to the Society, and to the authors for acknowledging, post hoc, that the “offensive figure” displayed on the cover of the June 2021 issue highlighting a paper on cardiothoracic surgery trainee burnout was racially charged. Apologizing to the membership and removing the image from the Web site were good first steps. Although unintentional, this incident is emblematic of a cultural insensitivity that is more pervasive than we would like to admit.

As an African American cardiothoracic surgeon who is well beyond residency, I am no stranger to overt, covert, and tacit indignities that are racially insensitive. These so-called microaggressions, which African Americans experience in our society at large and in the academic community, have a toll that cannot be fully measured or minimized. The Annals of Thoracic Surgery June 2021 cover represents an unfortunate example that belies the advances in diversity and inclusion made by The Society of Thoracic Surgeons and the American Association for Thoracic Surgery.

The Society of Thoracic Surgeons has been led by its first African American president, has formed a Workforce for Diversity and Inclusion, and has honored the contributions of Vivien Thomas with a named lecture. Despite these salutary efforts, this incident demonstrates that one lecture, one presidential term, and a workforce report alone cannot bring forth the cultural sensitivity that the Society asserts to seek. Without a constant and unmistakable embrace of diversity, inclusion, and equity by leaders of the major thoracic surgery societies, journal editors, thoracic residency directors, and ultimately the American Board of Thoracic Surgery, there cannot be substantive change.

I urge these above-mentioned leaders to: (1) continue to educate surgeons about the consequences of implicit bias on colleagues, trainees, and patients and (2) commit to increase their mentorship and sponsorship of minority faculty and cardiothoracic surgery trainees. These actions may represent an additional strategy to mitigate trainee and faculty burnout.

The effort I am calling for will require the same attention to detail and constant desire to improve that we seek to instill in our trainees and strive for in our daily practice.