The Academy Podcast

Welcome

to the Academy podcast,
where our mission is to improve lives

through education, information
and some cool stories.

My name is Dr. Mark Guadagnoli.

I'm the senior associate Dean
for faculty Affairs and a professor

of neuroscience and neurology
at the Kirk Kerkorian School of Medicine.

We have two guests today, Dr.

Irma Corral and Jay Guilford.

Dr. Corral is the assistant dean
for Diversity Equity and Inclusion

she’s also an associate professor

for psychiatry and behavioral health
here at the Kirk Kerkorian School.

Jay Guilford is the founder
and principal at Coworks

and he's had a long history in leadership
development and diversity,

equity, inclusion.

The three of us are going to have
an inviting conversation about a topic

that may be emotionally charged
diversity, equity and inclusion.

Very important topic
that a lot of people have opinions about.

Dr. Corral and Jay will talk about

the perspective of DEI in business
and in health care.

I hope that this conversation
expand your perspective for diversity,

equity, inclusion and your empathy
for others as it did mine.

Thank you very much for being here.

Jay Guilford and Dr. Irma Corral.

Today we're going to talk
generally about DEI

We're going to first define what DEI is,
and we've got a whole variety of topics.

I got to tell you,
because we've already started

this conversation
with the whole Academy team.

It's actually
a really fascinating conversation.

And I know you, Jay,
you in particular have talked about,

you know,
sometimes this can go wrong, right?

The diversity, equity and inclusion
kinds of training,

which have really been around
since the 1960s.

But they've they've escalated
in training in years and years

as there's been a whole host
of more sensitivities and for,

you know, legitimate reasons around them.

So we're going to talk about this.

We're going to talk about your journey

all the way through it
and some of what I think

are really interesting and informed
perspectives that both of you have.

So, Jay, would you mind giving
a little bit of background about yourself

professionally, personally,

however you would like to talk about it
just so the audience knows who you are?

Hey I’m Jay Guilford
and I refer to myself as a leadership

strategist
because I go inside of organizations

and one of the things that I do is
help them with their leadership strategy.

But I guess the shiniest thing.

Mark And, you know this and Dr.

Corral, you know,

is that I worked with the minds of clowns
long ago in a land far, far away.

I was at Cirque du Soleil,

and I developed Cirque du Soleil's
corporate leadership training program.

And so I strapped executives on

to equipment and flew them across Cirque
du Soleil theaters.

And it's really for me, my whole
background is about experiential learning.

So what I do inside of trainings
with organizations

is to help them understand concepts
by taking them through experiences.

Yeah. So, yeah.

So one could argue that you're
still working with a bunch of clowns, Jay.

I don't want to say that.

Dr. Corral
Sure.

So I am a clinical psychologist,
specialized in behavioral medicine.

Therapeutically, the clinical work
that I've done in the past

is to help individuals cope
with chronic illness,

a disease that is sort of debilitating
and terminal conditions.

And so I've been involved
in medical education for 12 years,

and the past four years
have been working in diversity, Equity

and inclusion Administration.

Currently at the Kirk
Kerkorian School of Medicine at UNLV

you're the assistant dean for Diversity
Equity Inclusion.

You're also an associate professor
of psychiatry and behavioral health.

That's correct. Yeah. Okay, great.
Thank you.

And thank you both for being here.

Jay If you could give us a start.

Talk to us a little bit
about your origin story, if you will,

getting into DEI and if you wouldn't mind
giving me your definition as well.

Well, first of all, origin story,
I'm black American.

If people are only listening to me
through the audio.

So it'll make sense
if I say that I actually did

a lot of diversity, equity and inclusion
training back when I was an educator.

So for about ten years
that was kind of like the core of my

what I offered as a trainer.

And then I moved on to corporate America.

I kind of sold out,

you know, I went to the corporate side,
worked with a lot of companies,

and I actually entered the DEI
Arena kicking and screaming.

I didn't want to do it, but I got a call.

My origin story more recently
is that I got a call from an organization

maybe a couple of years ago back,

you know, Black Lives Matter
and unfortunately, George Floyd's murder.

And they asked
they said, Jay we want your help.

You've worked with us before.

Can you help us hire African-Americans?

And they were in another part of the world

where they were not any African-Americans.

And it really concerned me
because I saw generally that people

had a very narrow definition of diversity,
equity and inclusion.

There is a lot of great work
being done out there, but a lot of people

conflate DEI with anti-racism.

So there is anti-racism,
there is gender issues,

there's hetero sexism,
there is ableism, and there

there's a host of opportunities
with diversity, equity and inclusion.

So I wanted to help organizations
look at all of that stuff.

So that's kind of the origins of why
I am now on the DEI train.

So let me know your definition of DEI.

Well I would say and I know Dr.

Corral has a great definition too,
but I would say diversity

is the widest range
of a range of identities.

And your community,
your organization, equity,

is giving each of those identities
what they uniquely need,

not giving everyone the same thing,

but giving each individual
what they uniquely need

and inclusion would be the result
of diversity and equity.

That's my definition Beautiful.
Thank you very much.

That's a great start. Dr. Corral.

I got initially into DEI education
through my work, in my discipline.

So I started one on one teaching concepts
like cultural competence

and structural competencies.

That led me to then work with the
educators and staff who are also involved

in the teaching mission of the
of the educational setting where I was at.

And eventually that led to opportunities
to think more

strategically about
what did we need as a whole organization.

So for the past four years,
I've been working as an administrator

in diversity, equity and inclusion
work, thinking more broadly there

on the kind of strategic side and
the faculty education piece specifically.

So I really like Jay’s definition.

Diversity is really about
who is there and make having

some thoughtfulness about representation
of the community in which you serve.

I think especially in education,
that's something that's important to us

as the aspirational goal is

meeting the

composition of the place
where you practice and work.

But the other pieces are more important,
right?

It's about making sure that people have
what they uniquely need and who's engaged

and active and and are the opportunities
equitable across the board.

So diversity is sort of the floor
equity and inclusion

are actually the main work.

Yeah. Interesting.

And I like what
both of you have said around this

and flip it for just a second
and tell me what DEI is not.

So I think in the past

some of the concerns that people have had

is that this is a calling out
or like we are here to tell

some individuals that you are bad
and it is your fault.

And I think that's not the purpose
of this work at all.

It's really about maximizing
everybody's ability to work

well and to learn well in the environment
in which they're at.

So it's more of a calling in

and it's about thinking
what do we stand for as an organization?

Who do we wish to be?

All of that drives excellence.

And I think when people feel

welcome and included, that's
when they can do their best work.

Yeah, that's great. Jay, how about you?

I would say the same thing.

I agree with Dr. Corral.

What I've seen is that in some trainings
it can be nearly anti-racism,

so it can make white men feel like,
I'm going to go into a room

and get my my finger
wagged at me for a couple of hours.

And when we understand that it's about
a wide range of issues and opportunities,

then everyone feels,
I love that phrase called in

and everyone gets to participate
because we can think about how do we get

more people who have various types
of abilities and disabilities?

How can we think about neurodiversity?

How can we welcome trans
people and nonbinary people

and it's an open conversation
about including

as many people, resources
as possible in the community.

So I really appreciate what you said,
Doctor.

So, you know, one of the things
that's interesting, as we were talking

before we came in,
we before we started filming,

we we were just generally talking about
our own experiences with diversity. And

and both of you told really, I thought,
poignant and interesting stories.

Do you mind sharing

that as well, your story
about traveling to Mexico in particular?

Sure, Yeah.

I was I was sharing with the group
that I sometimes I forget what

it's like to completely blend in
until I find myself in my native

origin when I'm able to travel to Mexico
where I'm from originally.

And so

what's that phrase like?

I didn't know I was waiting to exhale.

I feel that way a lot when I'm there,
just because

there's just absolute comfort
and that disappears again.

I think when I come back into the U.S.

and especially in educational settings
and some workplaces,

there's a sense that I have to sort of
be more on guard.

And so that's been my experience.

Jay, How about you?

Yeah, I remember specifically
in middle school and high school.

High school is what really happened.

I'm black
and I'm from the South and everybody in

my family's got a Southern accent
and I don't have one now.

But it was specifically
because I was an all black high school

and the teachers told me they said,

Guilford, we're going to send you over

to try to get scholarships
from the white folks,

but you can't talk like you’re talking.

So in ninth grade, I had a teacher
who drilled the southern accent out of me

and they taught me to assimilate
and acculturate.

And the beauty of that was that
I got a lot of opportunities.

I went to college and graduate school.

I work with a lot of corporations
and academic institutions.

The challenge was that, you know, it
created a rift in my family

because I became a person
who talked like this,

you know, And, you know, when I
my name is on paper, James Guilford.

So when I call people up
until they show up

or they look at me on LinkedIn,
they kind of don't know, you know.

So it's and we talked about
this is just a trade off.

So I think a lot of people the further you
we are, the further you are away

from the margins in any regard,
the more challenging it is.

And sometimes you have to acculturate.

It's interesting, right,

because there are challenges all over
no matter what.

I mean, this is the
the thing that I hear both of you saying

and we were talking about this
before there for everybody.

There are challenges.

And I think being sensitive
to those challenges and a point

that was brought up
earlier is is being empathetic

and and trying to understand
from other people's perspectives as well.

Can I ask just in general,
what do you think are some of the origins

of a lack of diversity mindset?

I'm talking about a lack

a mindset that is a lack of diversity,
a lack of equity, a lack of inclusion.

Where does that come from,
from your perspectives?

It's a great question.

I think in in health care,

one of the things that I've

seen in a lot of settings
is we have an assumption of benevolence

because we think health care
professionals are caring people

who are here to do good by others.

And we've selected a profession
to be helpful

and so we assume that bias can not live
in this environment

and that no one here is excluding others.

And unfortunately,
that lack of introspection,

I think, leads to some blind spots.

And so it's something that we have to take
a look at more thoughtfully.

And the data would tell us that
that's just not the case.

It is present in our environment
and we have to address it.

I borrow that word bias.

That's the human brain is wired to
be biased and it helps us in so many ways.

We're creating shortcuts in our brain
so you don't have to learn how to drive

every time you get into the car.

So that bias can be helpful.

At the same time,

we may not understand that we're making
these shortcuts with human categories.

We've created these categories,
and I would say they're mostly fictitious.

I mean, because you lined this all up,
we would be on a color spectrum

or we'd be on a neuro diversity spectrum.

But we do have the categories
and they're useful in some ways

when we don't understand
that we are a shortcutting

and we're biologically wired to do it,
then you're acting out a bias.

And what I've seen in many institutions,
just in terms of

you want to talk about power, it's
just about affinity bias.

You know, I'm this person.

I'm going to grab this person in
my network and that person in my network,

and they all look the same
and they all have the same background.

So it's not necessarily
that there's a maliciousness, it's just

I have an affinity bias

and I'm grabbing for the folks
in my network

and they all have the same privilege
and experience.

And I've got to say, I agree with this.

I mean, I think about things from
a cognitive perspective a lot, of course.

But I we all have biases

and disregarding race, ethnicity
and so forth.

There are biases.

What's my favorite ice cream? Right?

If I walk into a dark alley,
how do I feel?

And based on somewhat on my experiences

and based on a whole host of other things,
I'm going to have a bias towards that.

And and it seems that the bias,

unless it's extreme,
the bias is not the issue per say.

It's the
the inability to let the new data come in.

Right. And inform people.

And I think that to me is a difference
between

having a bias
and an ignorance around the bias.

And I don't mean ignorance
in a defamatory way.

I'm saying,

you know, for anything that we have,
if we don't allow new data to come in

and to be able to interpret that data,
it's going to be problematic for us.

Right.

And we're we're choosing ignorance
in that state rather than informed.

I also think it's important
when we talk about bias to decouple intent

from impacts, because I think that trips
people up a lot.

So they think that I didn't
intended that way.

So it can't possibly be bias.

But what you intend doesn't
actually matter.

What matters is what is the impact
that it had on the other person.

So I think being able to separate
those two sometimes helps and it

it helps people to feel less

confronted or called out.

I think when when you can understand
that your intent

could be neutral or benevolent
and it could still have a negative impact.

It's a
that's a really interesting point to me

because I can see, I shouldn’t
say I can see, I have done this before

where I've said something or done
something with even a positive intent

that's interpreted by the other person
differently than I want to.

And I get defensive about it, right?

Well, I didn't intend anything.

Why are you upset with me
rather than thinking from the other

person's perspective?

And and ultimately,
it doesn't matter what my intention was.

I mean, I don't know that
that's completely true.

If I was going to be an ass about it,
that that would matter.

But. But

my in this case, not

intending to offend the person, in fact,
intending to be benevolent, as you said,

should give me space

to understand
and be empathetic to the other person.

And yet I know that sometimes
our natural reaction

is to be defensive about it
because we thought we were doing something

nice so why are we being punished for that
nice thing?

It's almost like
you want to give someone a fancy meal

so you serve them shellfish,
but they're allergic.

Yeah. Like, why are you smiling up? Is it

because I'm allergic to that?

It's like the words we use
that I'm allergic to those words

you're saying to me.

So it's a great it's
a great example. Yeah.

Absolutely Yeah.

I'm going to borrow that You can have it

Okay.

So you
know, you had you had mentioned this Dr.

Corral about the the medical environment,
the health care environment.

Right.

There's some there are some uniqueness to
the health care environment that I know.

We've talked about this before.

Could you share that
with the audience as well?

Yeah, I think there's there's
been some interesting literature around

sort of like what makes environments
risky for bias to occur.

And so some of the things
are not specific to medicine,

but they definitely occur
a lot in the health care environment.

And so when we are pressed for time,
when there is urgency in the decisions

that have to be made, then that is
when our brains want to go on autopilot.

And so that by itself is a risk for

the automatic processes that happen
and for biases to sort of occur naturally.

And so today's, you know,
medicine is extremely high paced and

health care workers are

also pressed for lots of time in that
they have lots of other competing demands.

And so that time hunger
that they're feeling also puts them

at risk for some of these biases
popping up unconsciously.

It's and you know, it's interesting
because there are so many

opportunities,
if you will, for bias in medicine.

There are hierarchical bias,

you know, based on what the person's
position is and so forth.

So I think it's a really good example.

And you're dealing with highly sensitive,

you know, in some case life
or death situations.

And and we go to the point,
Jay, that you had made before about

we default into certain behaviors

because there's efficiencies around that.

Right?

Those efficiencies become inefficiencies.

If we've if we've guessed wrong,
so to speak.

What's your thought about this?

You know, often think about it.

What's been on
my mind is trans and non-binary issues.

And I think about how it seems efficient
to look at someone's presentation

and assume something about them.

And I can imagine in medicine,

if you don't have

you know, I've been to lots of doctors
and some people ask the question

about your pronouns and your
your gender identity and some don’t.

and that can be valuable information
if you're going to be seeing that patient

because there's a host of

services or questions you may need to ask
in order to service them properly.

So I mean, yeah, it's is an interesting
I think the biases show up everywhere,

but I think in medicine
it can be especially helpful or harmful.

Yeah.

Yeah it's

I think you know if we
well so certainly medicine

but if we think about situations
that are potentially already

vulnerable situations
those those areas are probably

going to be even more acute
in what we're talking about.

So, you know, with this in mind,
you know, we're in a medical school.

We would love to have a culture
that is an inclusive culture.

Right.

So what are some of the things
that you would do in an organization

to start shifting the culture
in a positive direction?

Um, psychologists
have this idea that cultures

are sort of
in a, in a cycle of mutual constitution

at all times, and what we mean by that
is that in some ways

it comes from the top down,
but it also comes from the bottom up.

So a culture defines behavior
or at the individual level,

but what people do at the individual level
then shapes the greater culture.

So I think sometimes
what what feels hard about shifting

culture is
no one has an idea of how to do it.

It feels untenable,
like I'm just one person

and there's no way I can make an impact.

But in fact,
we all have the power to shift culture

because everything that we do
at the one on one level

is in fact creating the culture
in which we create.

So even a single person shifting

the way that they think, the way
that they act, the way that they model

inclusive behavior,
that has a ripple effect

and it starts sort of spreading
and it becomes the culture.

So I think how do you do it?

You get a group, a critical mass of people
that are on board,

that are excited about this, that,
you know, for for whom it's important.

It's it's genuine and it starts to spread

because it's something worth doing. Jay?

Shifting culture.

I think this is going to sound cliche,
but the mission statement is so important.

I've worked a lot of organizations

and they have mission statements
that are just like, Diversity is good.

We should have diversity.

But when you read, I would encourage
all the listeners to read Netflix's

DEI mission statement and they say,
we make movies for people around the world

and they list some of those movies
and they say, Because we do that,

we need to have diverse people
in our organizations.

And that statement is so specific
to Netflix that no one else can own it.

And Google says,

we're trying to organize information
for everyone around the world.

And because we're trying to do that,
we need to be inclusive.

So when you think about the organization,
if you have the stakeholders sit down

and ask themselves,
and this is going to sound crass,

but I really mean it,
how does DEI benefit us

as a medical institution, as an academic
institution, as a nonprofit?

How does it differentiate us?
What are the opportunities?

So when you clearly define
that for yourself

and you can sit your statement
down on a table and it can't belong to

any other institution,

it needs to be, at least in the industry,
but very specifically, like only UNLV

Medical School could have set this
or only Netflix could have said this.

So I think
you have to start by really understanding

why it's important to you

and you have to think about it
from the missions and the goals

and the aspirations of the
the organization.

And then if you had that clearly in place
and if it's meaningful to you, you

then really believe it,
and then everyone's going to live it.

Not because it's a moral imperative, but
because it's it's the mission it relates.

You know, Netflix is trying
to sell more movies, so it's the mission.

So you got to really tie it
to the mission.

It's so it's interesting.

I just noticed recently that Netflix had

maybe they've done this before,
but I only notice it recently.

They they have their end of year, year
2022 movies

and they'll talk about they'll list
how many countries

this movie is, you know, a top ten in
or those kinds of things.

And so it is so global now.

And and so they're they
are actually standing to their mission

as far as that goes.

It's the other thing
that's interesting to me is when you start

looking at the literature on DEI programs

and institutions that have invested in

DEI programs,
you know, you mentioned Crest.

If you're just measuring by profits,
a lot of these institutions, in fact,

most of them have are outpacing

those individual companies
who do not invest in this.

And in fact, their now
seems to be a negative repercussion

in profits and and,
you know, some of the positive metrics

of those individual companies
who do not invest in the DEI

And and then I'll just say one more thing

about this,
and I'm interested in your thoughts.

And specifically,
it appears that those companies

who do not talk about
the legality of DEI as training, right.

We're doing this because there are
some legal reasons and so forth.

Those are the ones who seem to be really
leading the charge in a positive way

as far as the shift in culture
is concerned.

So thoughts about this.

And I saw this beautiful graph

some years ago
and it came from the private sector,

but it was sort of like a maturity model
in how organizations think about DEI.

So it starts from a place of not even
understanding why this is important.

So just like uncertainty and then it
sort of moves to a compliance place

of like this, it's because of legal things
and we have to do it because of that.

But then it becomes more strategic
and then more integrated.

And the top level
is leading with diversity.

So it becomes
it becomes why you do what you do.

And it's no longer at

those lower kind of floor levels of,
you know, just for compliance.

You are leading with diversity.

And that's, I think, where creativity,
innovation and and success really live.

I'd love to see the graph.

It it almost sounds like it starts from a
almost a punishment

and negative perspective
and it moves into the positive side.

Absolutely. Yeah. Jay?

Yeah, I agree.

I think

I think if it is

intrinsically
tied to the DNA of the organization,

those those organizations
are the ones that are winning.

I think, you know, when I,
when you look at the private sector,

if you look at Uber,
if you look at T-Mobile,

they're all saying diversity is our
they don't say it this way.

He said, don't quote me,
but diversity is our profit motive.

So even in nonprofit organizations,
there's still a profit.

There's profit in there you need.

So, you know, thinking about it
from a customer service model, like

for medical professionals,
thinking about it

like you got to run into a trans
and non-binary person,

you might want to think about
how to service that person.

One because you want the customer
to be customer to be satisfied,

but also to we live in a cancel culture
and every organization

and every individual
is one tweet away from disgrace.

So it's about satisfying the customer
and it's also about

protecting the organization too.
I think those are both important.

So, I'd like to admit something
to both of you right now.

So I know both of you.

I think we get along really well.

We've had some great conversations.

I've got I can feel myself
being nervous in this conversation.

And and so I've been sort of

in the back of my head
thinking about why why would I be nervous?

Right.
We we've had lots of great conversations.

We were just having one a minute ago
about this topic.

I think the reason is
because I feel like I'm going to misstep.

It's exactly your point, right?

I'm going to say something

by accident or something that's that
isn't intended to be insensitive.

Maybe it is.

And that's the cancel culture.

It's really interesting that I don't know
that I've had this feeling

as strongly as I do right now
as we're having this conversation.

I really like that you said that actually,
because it brings to mind,

like when we look at like
educational models of how do we get people

to feel comfortable around certain topics,
we always think

we need knowledge, attitudes
and then skills, right?

So a lot of times that fear of the misstep

is what keeps people stuck
at the earlier stages.

Like, I'm

just going to learn everything I can about
diversity there in the knowledge piece,

but they never really get to the skills
part.

It's like if you misstep, you can take
you can take a step back.

There's never like a misstep so bad
that it's going to be catastrophic

the vast majority of the times, especially
if you can correct course in the moment.

And so that's a skill.

It's something that you can practice
and learn.

But there's so much fear around the topic

sometimes that I think we don't think
about this as a skill that I can learn.

But that's the purpose of a lot of these
trainings, is to give us safe environments

to practice so that when you're
in a really high stakes situation

and if you do misstep,
you can also walk it back.

Yeah, it's a really interesting thought.

Yeah, it's emotionally charged
as the other part.

I think when we talk about DEI,
we talk about the issues.

And so when you walk into the room,
what you’re thinking about

is how to avoid the issue.

Yeah,
you're not thinking about the opportunity

for you to learn
or for someone else to learn.

Well, I mean, I don't know this,
but I would think that the feeling

that I'm having right now,
the discomfort that I'm having, is exactly

the feeling some other people have

when they're in an environment
that they're not comfortable with.

Right.

Because of that whole variety of of,
you know,

being disenfranchized in their past,
whatever it happens to be.

Right.

This and I'm certainly not claiming
to understand fully what

what it feels like I know what I feel
like in this situation. But

those types of things, I

think those experiences
provide us an opportunity for empathy

and and I love the idea that we can

we can talk about this, right?

We can talk about this openly
without judgment so that we can move

forward. Right?

Absolutely. And

I think learning to be comfortable with

some discomfort is part of the skill
set that you learn

when you're open to

growing in this area.

It's it's
one of the things we've talked about

several times,
being comfortable, being uncomfortable.

And that's where growth comes from and
that's where you really get to embrace it.

And instead of be being afraid of it.
Yeah.

And I just can admit to myself
that I've had to work with trans

and non-binary people.

And in my first interactions I was like,
What am I going to do?

I'm going to say the wrong thing.

And then I finally said,

I might say the wrong thing
and I got corrected many times.

Yeah, it was very helpful.

So I think being open and honest about
how are you feeling and saying like

I might misstep and having a safe space
where people can do that.

Yeah, yeah, this is great.

What first of all,
I appreciate both of you for being open

to listen to my confession. So

the other thing is, again, both of you

have some overlap in
how you think about it, but you also have

some different ways that you think about
from an explanation, from sort of a

I don't mean philosophical in that it's

not practical,
but you have a philosophy about this

topic in general, and I don't really need
to even ask you a question about it.

You can just talk about this.

Tell me a bit about your philosophies

around the bigger question of DEI.

I don't know.

I mean, I think I think I've been
a student of culture my whole life,

just as an artifact
of being an immigrant in the U.S.

And so when I think, like really early on,
I was fascinated with this idea of

how do people thrive when they are
in a new and challenging environment

that is very different than anything
they've ever known before.

That was the original question
that I had in my mind

that led me to a career in psychology

and down the road I think I can started
to connect that with health outcomes

and what it would mean
to help people thrive with their health

when they were experiencing
a lot of challenges

related to this sociocultural environment.

And so

that was kind of the origin for me.

I definitely admit
that I approach the problem

from my discipline's perspective, but

I also was trained in public health,
and I think that led me to develop a wider

lens, to look further upstream,
to look more at systemic

levels, policy organizations and

institutions and how those impact

and have negative
or positive outcomes down the road.

So my work in this area

is definitely,
I think, driven by my personal experience,

but my professional training
has really developed alongside of it

to help me to do what I can.

Can you go just a little bit deeper
into the idea

of how health is impacted?

Sure. So

in medical education, just as an example,

a lot of times the messages
that we give students about disparities,

just as an example, is
we talk a lot about the deficit.

So this population has this condition
at higher prevalence rates,

but then there's
sort of a void in the why.

And so in that absence,
students have to create their own

explanation of why that is.

And I think accidentally,
what we do is we end up

creating stereotypes.

We sort of blame
the individuals for their conditions

in the absence
of any kind of socio cultural explanation.

So the upstream factors
that we have to include in medical

education is understanding
how does health even begin?

How far back does it go?

How do we build healthy communities
so that people have the opportunity

to have equal health outcomes
their whole life?

That's a pretty

big call, right, to go all the way back.

But that's necessary for people
to have a sense of health

in full context
as opposed to health in the abstract.

So how do we build healthy outcomes?

So it begins,
I think, when if we think about policy,

equal neighborhoods, equal institutions,

and that is how people have access
to equality down the road.

So, for example,
if you live in a neighborhood

where the school is underfunded, that's
going to significantly impact your ability

to maximize
your educational opportunities, right?

That's going to determine
where you end up.

Go in high school,
where you go to college.

That's going to determine what employment
opportunities you have down the road.

So it starts really at the grassroots
neighborhood level and thinking about

how much are we investing in neighborhoods
in the cities where we live.

And so I think that's a big place
where health care professionals

can have an impact with advocacy
and really thinking

about investing in neighborhoods
more equally.

Yeah, it's one of the one of the things
that I think is

fantastic about the charter of
of our medical school, the Kirk Kerkorian

School of Medicine,

is that we're located

in impoverished, near
impoverished neighborhoods.

We have a commitment to service
in those neighborhoods as well.

And and it becomes a very,
very rich experience

for the students
to go work in those neighborhoods.

And and then combined with what you just

said, it's not just a rich experience
for the students.

It's a necessary experience for the people
in the neighborhoods as well, too.

So I think hopefully what happens
when students have those experiences

and they have a good foundation
of understanding how neighborhoods

become impoverished is that you
stop accepting that as the outcome

that we de-naturalize inequality

and that we see the opportunities
for changing that in the future.

So this neighborhood
does not have to stay that way.

If we can look upstream farther enough
and figure out

how to change the conditions
so that that can change with time.

So it's interesting,
we're in Las Vegas and several years ago,

Tony Shea, who was the CEO of Zappos
at the time, started

what's called the Downtown project,
and it was to revitalize the downtown

area and and create a, you know,
commerce area, neighborhoods and so forth.

And one of the biggest issues
that he ran into was

people didn't want to start grocery stores
downtown.

And, you know, never occurred to me
one way or the other.

But there were no grocery
or places to buy groceries downtown.

And that was a deal breaker
for for a lot of the growth.

Right.

Because you couldn't do it.

Well, then you start thinking about,
well, hold on.

People have lived around here
for a long time

and they haven't
had grocery stores. Right.

And it's
you know, we take that for granted.

Right.

But it is something so fundamental
and so important

that if you don't have that,

what are you going to do, especially
if you don't have transportation?

Right.

I mean, Dr.

Carroll said it best, like when I think
when people get what they need,

they can succeed. And that was my story.

I was first generation
low income college student

and I had scholarships
and people gave me what I needed.

And I was able to acculturated
for better or for worse.

And I've seen it in education.

I was a teacher for many years,
and I have seen students

who have been exported to private schools,
which is great,

you know,
because their first generation low income.

I remember a specific time
a student was in a private school

and he was not succeeding
and he was poor and he was black.

And it was
because he didn't have a laptop.

And I was at the school and I said, Well,
of course he doesn't have a laptop.

He can't afford to come to the school.

He's taking the bus 2 hours every day.

But I think my philosophy is
that the equity part is really important

when give individuals uniquely
what they need, they can succeed.

Why did you become a teacher?

Well,

first,
I think I thought I defaulted into it.

So but what I realized
was that I had the unique capacity

to communicate abstract concepts and ways
that people could understand.

And that's how I approach a DEI training.

And the same thing like bias is a concept
that seems so amorphous.

Like,
what does it mean? What does it mean?

But when you take people through a
simulation that's not about this identity

or that identity or this person's right
or that person's wrong,

but when you show them
that we all have it,

then people can really understand it
and they buy in.

So I think if you asked me first,
I would say it defaulted into it,

but it really became
a part of my superpower, really

my superpower
lens, my lends me to do that.

I mean, you know, having known you
for years, you're a natural teacher.

Like that's what you do.

You teach in a lot of different things

that you do in your life,
not just in a formal setting.

So you're one of the things
that jumps up to me in

in listening to what you're saying, is
we've got institutions

that are responsible
for for providing opportunities.

We've got individuals who are responsible
for their own opportunities

and hopefully those too,
you know, coincide with each other.

But can you talk a little bit about this
in more depth,

the institutions responsibility versus
the individuals responsibility

as far as people,
you know, moving forward?

Um, one conversation that

I have seen had a lot in medical education
when we have a student

experiencing academic difficulty
and I think maybe this

gets at your question a little bit
and so what do we assume

when a student is having trouble,
we often blame the student, right?

We say, oh, well,
their and MCAT scores were too low.

I don't know that they belonged here
anyway or, you know, this.

There's something going on with them.

But we always stop there and we'd
never go to the next level to say, Well,

how is our institution supporting students

that are experiencing these conditions?

Is there anything that we could do
to bolster

support in that particular area?

We we completely absolve the institution

a lot of times in our role
in what we could do to support students.

So we want students that are diverse, but
then sometimes we're not prepared to help

sort of bridge that

gap with the diverse challenges
that they might experience.

So what if we have a single mother
who is trying to go to medical school?

That's wonderful.

Do we have what that person's going
to need to be successful

to have their best opportunity
at maximizing their potential?

And so I think the question we have to ask
after we think

about the individual factors is
what about the organizational factors?

And I would say when you have
that diversity in leadership,

then you can have more diverse
perspectives.

I always think about

those rooms for women
where they go to breastfeed or pump

and if you had more women organizations,
that would have been something

that would have been
thought about years ago.

And you can imagine the levels of stress
or difficulty it created.

So when you say
leadership needs to be diverse,

it sounds like,
oh, that's just the thing you say.

But when you think
about the wide range of identities

and if you're becoming
or you are a global organization,

you need people at the top
who are going to have those considerations

to make those new
and challenging decisions.

Is there a

you've heard. Sure.

People who
who speak the from the other side

right there, No,
we don't need the diversity, etc., etc..

What do you say to them?

I heard somebody greater than myself
recently say diversity is.

It is already here.

It's not something that we can stop.

Today's medical students
are predominantly women

and we have more people
applying to medical school

that are diverse than ever before.

So it's here.

It's on us now to prepare
and to maximize the success

because we need these doctors,
we need them to be successful.

We need them to do great.

The health care workforce

is not keeping pace with a need,
and that's a national problem.

So it's something
I think we need to be thoughtful about.

Dr. Carrol said it all.

So I'm very curious
if you two were talking to each other

about this topic,
what would you ask each other?

And I'm going to let you answer first.

What has been the biggest challenge

in your career
working in academia and diversity?

The biggest challenge.

I'm not sure

how I would answer that honestly,
because I think as

as a clinical psychologist,
I'm kind of like an eternal optimist,

and I always think
that change is possible.

So when people say, Oh,

we can't figure out how to do X, Y, or Z,
I was like, Well, let me try.

Well, can I say, what has been
the biggest opportunity.

The biggest opportunity.

For the optimist?

Yes. Yeah.

I think it's been trying
to figure out how to bridge

sort of the the

attitude and the cognitive gaps,
because we have professors, educators

who care so much about the work

that they do and they are trying so hard,
they're so busy and overwhelmed,

they want to do what's right
by our students.

Absolutely.

And then we have students

really feeling like there's a gap,
even though the intent is good.

And so I see my role as being a bridge,

as someone who has been sort of
on both sides, being a diverse student

a first generation student in particular,
and now being on the part of the faculty.

So it's been a challenge and finding the

how to build that bridge, I think.

But that feels that work
feels very familiar to me in that that's

what I do clinically for patients
is sort of build that bridge often

between themselves and the medical system.

So it's a challenge that I enjoy

and every setting is different.

And so I think
now that I'm in a new setting,

the challenge is understanding
the landscape here.

Seems like you got it down pat.

Well, but

what about for you?

I guess I'll turn the question back.

Biggest challenge for you
in doing the work that you do.

Can I take the opportunity? Absolutely.

The challenge is, as Mark asked, is

helping leaders understand why.

And what I've seen in the work

and the private sector and with academic
institutions and nonprofits

is that again,
it's really about not getting in trouble.

So we just did some work
with a global travel agency

that works with the, that’s all I’ll say,
the global travel agency.

And they were well-meaning,
but they focused on white guilt.

White guilt.

You know, white privilege.

And I'm like, but this is an opportunity.

You're bringing people around the world.

There's a whole host of opportunities.

You're already doing some great work.

So when you approach the work
from a place of guilt,

you can't even see what you're doing,
right?

So in a lot of organizations,
what you will see is that they'll say,

We're all white men
or we're all white people.

But I'm like,
There's a lot of other diversity.

There's a lot of other things
that you're doing right.

And if you look at your yourself
from your brush with bias,

just because you're a white man doesn't
mean that you haven't experienced bias.

And if you can tap into that,
then you can tap into that understanding.

So it's like helping leaders
see why and then helping

organizations understand
that you're already well on your way.

And just taking a few more steps
will get you there.

Yeah.

It's kind of creating those lightbulb
moments.

Well, this.

Looks like it.

I mean, and hopefully that is true, right?

There are those light bulb moments
that really shifts perspective as well.

I'll tell you, one of the things
that's come up several times

in this conversation
that's really interesting to me,

and I hadn't thought about it
until you said it is intention, right?

I love the example that you gave about I'm
serving you shellfish.

My intention may be good,
but you're allergic to shellfish.

I think that

becomes kind of a touchstone for people
and maybe one of the reasons why

in some cases,
when people are well-meaning

or don't believe that they have any biases
and so forth, which we all do.

Right.

That really becomes a nice point
of conversation around to talk about.

Let's let's separate out.

You said it beautiful the intention from.

Impact. Impact. Right.

And and talk about it
from that perspective.

I just think that that's such a
that's so important to be able to do that.

And then it doesn't demonize individuals
as much as maybe it could be

if you just make the assumption
that people are doing it on purpose.

Essentially.

It's interesting too,
because it's all about context,

because in America
we're going to talk about white privilege.

But when you when I leave America

and go to other places,
I have American privilege.

So the context changes.

And when you think of it in terms of bias
and you can you can help

people think across contexts,
then they can see that it is not

it's not that I'm a bad person
because I have bias.

We universally have it.

And depending on the shift in the context,
there is lots of intersectionality

and I can either be in power or excluded
or both at the same time.

It's interesting, you just reminded me
I was on a train in Europe one time

and there were three guys
that had on a Canadian

like the Canadian flag and so forth.

And and I said, Oh, where you know,
where are you from in Canada?

They said, We're American,
but we were Canadian clothes

because people hate Americans, right?

It's the same kind of a thing, right?

There are there are biases in there.

And that's a really interesting point,

because there are biases
all over the place.

Right.

And I think if we understand the universe,
if the

the universal nature of this,

then it's not about pointing fingers.

It's about,
you know, opening up perspectives.

By the way, I find it particularly ironic
that an international travel company

has, you know, sort of a narrow
frame of mind around that.

One of my favorite quotes,
Abraham Lincoln said, Show me, a man

often traveled and I will show you a man
without prejudice,

which I don't think is entirely true.

But but I do think it's a good point,
right?

When you've experienced these other
worlds, then it opens your eyes to things.

And I think really, that's
that's what I hear from both of you.

A lot of the training
is really about opening, opening eyes

and opening perspectives.

So yeah, absolutely.

I think understanding that your world view

is only one option
and that there are many other world views

that no one view is the correct view.

And that is absolutely key in what we try
to teach our students as they head out

into a world where they're going to be
seeing patients from all over the world

start from there.

And that's that's a good foundation.

The world view.

It's interesting, you made me
think about this in kind of a literal way

in in communication skills.

A lot of times, if we're going to
if we want a cooperative communication

and someone sitting down
or you're talking to a small child

suggests don't stand over the person
to talk to them.

Right.

You get to at their level
and see them eye to eye.

And that's in a lot of ways what
we're really talking about here as well.

Yeah. I want to thank both of you
for being here.

Before we leave,
we've got a segment that we always do

on these podcasts, one of my favorites,
and it's called Moments of Joy.

So we've talked about a lot of different
topics.

These moments of joy are really yours,
right?

So, so it's anything that comes to mind
when I ask the question,

tell me about a moment of joy
that you've had in your life

or moments of joy
that you can share with us. So

mine is flying kites.

And so

about I would say four or five years ago,
I was having a difficult situation

in my life and somehow
the phrase came to me Go out, fly a kite.

And I. I literally did.

Me and my friend, we went out

and we bought these plastic kites
from the grocery store

and I fell in love with it.
And then I was on Amazon.

The next night
I was ordering kites and then, you know,

probably thousands, hundreds of dollars
later, maybe thousands.

I have a kite collection
and they're like six foot wingspans

And my moments of joy are going out
to the park and flying kites. Huh?

Well, what is it about flying the kite?

I think it's.

There are two things.

I think, one, there's a freedom in it,
but then there's also like a surrender.

You have to kind of.

There's a there's a technique.

You don't just send it out there.
It flies.

If the wind's too strong,
you really need some technique,

or if it's a little weak,
you need some technique.

But then once you get it up through,
there is the surrender

and everything's taken care of for you.

All you have to do
is hold on to the string.

So that's.

Yeah, that's it for me.

I thank you for sharing that, Dr. Corral.

I think I have two answers,
like personally, and I love your answer.

By the way,

my moments of joy since the pandemic,
I've sort of cultivated

a hobby that I had a long time
ago, and that's photography.

So when the world sort of stopped

and there was not a whole lot to do,
I started to just work on my techniques.

And somehow that turned into capturing
the beauty

of ordinary objects and ordinary spaces.

And so it's become kind of a journey
of mindfulness for me, where now I do that

weekly, I try to go out and capture
interesting things,

and it's part of my gratitude practice,
I think.

But professionally, my moments of joy
are always related to representation.

And I think the moment you connect
with a student who says, Thank you

for being here,
it matters to me that you are here

and that you are representing people
just like me, so that I know

that there's a path forward
that's so powerful because it makes me

feel like I am being the person
I wish I'd had when I was a student.

Interesting.

What do those two things have in common?

I think they're both about gratitude
in some ways, and it's about,

you know, despite how hard the situation
may be, there's always that moment of joy.

So you cultivate that and that's
what gives you fuel to keep on going.

Well, I'm very grateful for both of you
for being here.

Your insights and and your vulnerability
around your moments of joy.

Beautiful.

So thank you so much.

Thank you for listening.

And we're grateful
that you spent time with us.

We'd love to have you
as part of our regular community.

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