Subcutaneous scars

Through the latter half of the twentieth century, history will record that the United States engaged in a national effort to promote racial equality. The Topeka School Board decision of 1954, the landmark Civil Rights Act of 1964, the desegregation of hospitals under Medicare, and affirmative action programs in education and employment resulted from the labors of millions of persons of all races. Yet vast differences opportunity and outcome still persist between minority populations and the country as a whole. Social scientists, medical scientists, and politicians have various explanations for the recalcitrance of these inequities, but there is little doubt that racial presumptions-prejudice, preconceived ideas, and personal attitudes-remain omnipresent among us, stamping all of our relationships. In the following essays two physicians write with candor about racism as they have experienced it. Vanessa Northington Gamble, a family practitioner and historian with roots in Philadelphia's inner city, details her experience with racial attitudes and, move perplexingly, the denial of their existence. Neil Calman, a family physician in New York City, describes insights into race as an issue for himself and the health system.