key: cord-0957538-708ibd5k
authors: Potyk, Darryl; White, Cicely W.
title: Another Lesson from the Mockingbird: Institutional Racism in Harper Lee's “To Kill A Mockingbird”
date: 2020-08-09
journal: Am J Med
DOI: 10.1016/j.amjmed.2020.07.008
sha: 33e6ca279fccbe3c8eca9cc52833a956de4acf75
doc_id: 957538
cord_uid: 708ibd5k

nan

Harper Lee's "To Kill a Mockingbird" is one of the most successful American novels in history. (1) Set in the 1930's; it is the story of a fictional white lawyer, Atticus Finch, who represents a falsely accused Black man, Tom Robinson. Told through the eyes of Atticus' daughter, Scout, the book introduced readers to race relations and justice in the south. Atticus defends Tom, and at one point stands up to an angry mob looking to lynch him. As a result, Atticus has been held up as a role model for young lawyers. As previously stated, the book does not have overt medical themes; nonetheless, there are lessons to be gleaned. (2) In light of current events, the book should "serve as a clarion call for racial and social justice."(2) Most significantly and often overlooked, is the fact that the falsely accused Black man is found guilty and imprisoned. As a result of the wrongs heaped upon him, Tom is full of despair and attempts to escape from prison. As he does so, he is shot 17 times in the back.

While the novel has been praised for its depiction of Atticus' moral character, further analysis reveals deep flaws. Careful reading reveals Atticus to be racist and racism, segregation and a caste system are displayed throughout the story.

"The Mockingbird" is written from a white privileged perspective. In acknowledging this simple fact, there is recognition that systemic racism has been present in our society for far too long. In medicine, we have begun to discuss, study, and address disparities in healthcare outcomes. For example, in the current pandemic Black Americans are disproportionately infected and die from COVID-19.(3) Disparities in healthcare outcomes are not new. Black women are three times more likely to die of pregnancyrelated causes than white women, the infant mortality rate amongst Black infants is twice that for white infants and Black Americans are more likely to die from cancer and heart disease.(4) The notion that genetic differences account for these different outcomes has been disproven. We now know the underlying causes to be social determinants of health and systemic racism. We have much work to do to in order to undo the institutional racism woven into our society's fabric. Those of us fortunate enough not to have suffered the effects of our country's institutionalized racism must recognize and acknowledge how hard it is to grow up Black in our society. Everyday reminders include being unfavorably singled out and treated differently, being pulled over while simply driving, being followed suspiciously simply upon entering a store, being subject to unfair hiring and promotion practices, and the everyday panic when a family member comes home late worrying whether the delay is simply traffic or some awful racist act. These are common occurrences for those who have evaded incarceration and murder because of their skin color.

How far have we come since "To Kill a Mockingbird?" Sadly, 60 years later we continue to witness racial profiling, lack of opportunity and prejudice for American citizens based upon their skin color. Targeted police actions and judicial practices have unfairly targeted blacks and has resulted in the mass incarceration of young black men. Institutional racism persists.

Racialization and categorization of our fellow human beings is a social construct, without which certain groups cannot be oppressed. Each one of us, both professionally and personally, must decide what action we are going to take to address disparities in healthcare and its root cause, institutional racism. Doing so will require grace, humility and a growing sense of responsibility.

To Kill a Mockingbird

A Lesson From the Mockingbird: Patient Autonomy in Harper Lee's "To Kill A Mockingbird

Assessing differential impacts of COVID-19 on Black communities

Inequality, and Health Care for African Americans. The Century Foundation