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Partha Kar: Holding up a mirror to racism in the NHS

BMJ 2021; 375 doi: (Published 19 November 2021) Cite this as: BMJ 2021;375:n2832

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Re: Partha Kar: Holding up a mirror to racism in the NHS and then yourself.

Dear Editor,

Is racism the real issue? Part of the genetically determined human condition is the ability to perceive differences in others and to act in a positive or negative manner towards them. This "perception" is complex and persuaded by multiple factors that are in a continual state of flux. In my professional life I have had the privilege of trying to help those with deformity and disability. Such is the unconditioned, ie inborn, discomfort of facing discordant input the prejudice against difference is a very powerful force to deal with. Racism is just part of this; elitism is another; speaking out eg the whistleblower, is another. Trying to remove racism from the human condition is really trying to remove something as fundamental as sexual attraction. Regard it as an inborn error of socialization. This is not the time or place to develop this thesis but speaking as an elderly white male who has lived abroad for many years I know that skin colour, ethnic background, religion, place of birth, gender, all affect social interactions.

However, more powerful than all of these as determinants of the positive or negative nature of the interaction is whether a person is basically "nice". Horrible word but it encapsulates many properties: decent, with integrity, with hope in the heart and a smile on the face. "Nice" people, humans, are a minority group. They are not greedy or selfish and do not engage in corruption, conspiracy theories or lies. Rough rule of thumb:30/30/40. 30% of people are good, 30% are evil and 40% are sitting on the fence but when push comes to shove they will take the easier option. That deals with the individuals. Once individuals join together the whole dynamic changes and the reason why they join together will influence the behavior of the group and the prejudices it might express.

To conclude, racism is a problem but so is dishonesty, so is lack of compassion, so is greed, so is the false sense of entitlement, so is the distribution of wealth. Some problems are inborn and some are acquired. More can be achieved by focusing on the latter.

Competing interests: No competing interests

24 November 2021
Andrew Burd
Retired Burn Surgeon
Hong Kong