NEW BOOK BLOG!!!! Caste – the Origins of Our Discontents
Book Blog - A Personal Reckoning with Caste: Reflections on the Impact of Isabel Wilkerson’s Work
Tessa Stecker, MD | AIAMC NI-IX Committee on the Integration of Academics & Quality (CIAQ)
When I first read Caste by Isabel Wilkerson four years ago, I couldn’t stop talking about it. At every opportunity, whether at a cocktail party or casual gathering, I found myself passionately discussing its core themes, often engaging others—willingly or not—in conversations. The conversations centered around the powerful examples, including some personal and vulnerable examples, Isabel Wilkerson uses to illustrate the pillars of caste. As a Black woman and a physician leader, I was forced to confront my own experiences and frustrations within the medical field in a new light. The book was both a revelation and a source of heartache. Since that first reading, I’ve returned to it each year with my community medicine fellows, finding new layers of insight in its historical perspectives and contemporary examples that continue to underscore its central message and reinforce the book’s core principles.
The Enduring Legacy of Caste in Medicine: A Call for Genuine Change
Isabel Wilkerson powerfully challenges the assumption that medicine is exempt from the historical and structural oppression that pervades every aspect of American society. She reminds us that, even within the healthcare system, these pervasive forces cannot be overlooked. In medicine, we are confronted daily with inequities so ingrained that they shape the very heuristics presented even in exam questions, which medical students and residents must navigate to advance in their careers. While social determinants of health have long been recognized as significant factors influencing well-being, it wasn’t until the racial reckoning that followed the publicized and deeply troubling events of 2020 that the fields of medicine and medical education began to address racism, bias, and equity with intentionality and focus.
However, medicine will not dismantle centuries of biased systems and policies any faster than American society will. The reality became clear: posting black squares on social media, revising mission statements to include diversity, inclusion, and equity, and forming DEI workgroups are not enough to drive real change. With the recent backlash against DEI initiatives in education, it is evident that addressing this complex, nuanced issue will require a profound cultural shift—one that recognizes the lasting harm of slavery’s historical legacy and the caste system it created and understanding how these forces continue to affect all of our lives today.
A Journey Through Caste: Wilkerson’s Examination of America's Social Hierarchy
Wilkerson systematically and patiently walks her audience through the ways in which America embodies a caste system, the origins of American caste, the ways in which it continues to affect our lives and comparing our caste system to other prominent caste systems, namely Nazi Germany and the caste system of India. She creates an open and nonjudgmental invitation for us all to learn with the understanding that few of us have received the education requisite for understanding her thesis.
Caste as Essential Reading: Bridging History and Healthcare to Achieve Equity
The education that Wilkerson provides gives us an important missing component regarding the factors that contribute to health. Just as we're required to have a thorough understanding of anatomy, pathophysiology, and pharmacodynamics, so should we understand the important historical events on a local, state, and federal level. These events impact the way we interact with patients, the care we deliver, and the challenges that we face in achieving health and wellness for the populations we serve. I maintain that Caste should be required reading for all medical students and physicians.
But it's not simply the reading of Caste that's important; the subsequent discussion and the confronting of the discomfort we feel as we come to terms with the reality of medical systems of oppression, are truly what makes this book a seminal work and one that can hopefully bring us closer to achieving equity in health and wellness.
Short bio:
Tessa Stecker, MD is a family medicine physician committed to serving marginalized communities, health education, and working with students and residents a teacher and mentor. She recently led a team focused on determining best practices in mentorship, equitable feedback and assessment, and evaluation of DEIA efforts. Her mission is to change the culture of medical education to be more inclusive to serve the needs of an increasingly diverse healthcare workforce and the populations they serve