Dialogue across differences: A Q&A with Roy H. Hamilton, MD

A multiracial Black and Asian self-described secular humanist, who was raised as one of Jehovah’s Witnesses and is now in an interracial, interfaith marriage, walked into a Passover seder.  
It’s not the setup for a groaner of a joke, or an epic fail of an evening. Rather, as Roy H. Hamilton, MD, tells it, this was his experience this spring as his Jewish in-laws—the family he has loved as his own for over two decades—came together to commemorate the universal human themes of freedom and deliverance from oppression reflected in the Passover narrative. Though he does this every year, this year he had some trepidation. In a time marked by tragic conflict and with tensions both abroad and at home, it seemed like having a frank discussion of these themes might invite acrimony. But what emerged instead was a profound opportunity to listen, to appreciate each other’s perspective, and to “exercise empathy for trauma that’s happening to everyone.” 
It was a bit of a revelation for Hamilton, Penn Medicine’s new vice dean for Inclusion, Diversity, and Equity. “In the moment that you would have thought would be the worst to open up certain topics, we all ended up having a great dialogue across differences,” he said. Why? “Because we all felt connected enough to give each other respect, compassion, and grace, even when our thoughts and opinions differed.  It made me think about how we can further cultivate a culture of empathy at Penn too.” 
Today, as Hamilton begins his third decade on the faculty at Penn’s Perelman School of Medicine, he is devoted to making academia a safe, supportive space for students and colleagues alike. He serves as a professor of Neurology, with secondary appointments in Psychiatry and Physical Medicine and Rehabilitation. Hamilton is also director of both the Laboratory for Cognition and Neural Stimulation; and the Penn Brain Science, Translation and Modulation (BrainSTIM) Center. Previously, he was the Perelman School of Medicine’s assistant dean for Cultural Affairs and Diversity for almost a decade, and launched similar efforts in his field, serving as Penn Neurology’s vice chair for Diversity and Inclusion from 2017 until his recent elevation to the role for Penn Medicine as a whole. 
Given his own diverse background and personal life, Hamilton wants everyone—trainees, faculty, patients—to feel valued and included. “I touch enough spaces in my personal life that when groups are being clearly systematically disadvantaged, it often feels like it’s touching on some piece of my own identity,” he said, in discussing his background and hope for his new leadership position. “I bring a lot of myself to this role.” 
In a recent discussion, Hamilton shared perspectives on why supporting inclusion, diversity, and equity matters—particularly for an institution training future doctors—and what Penn Medicine is doing in this sphere. 
My mother is a Japanese immigrant who worked as a seamstress out of our house when I was a child, and my late father was African American and worked in a brewery. It is not commonly part of the culture of Jehovah’s Witnesses to pursue higher education, but I loved learning and went to college thinking I was going to be a psychologist.  
When I got to Harvard [as the first in the African-American side of my family to go to college] I started learning about brains and decided to be a cognitive neuroscientist. It turned out, though, that I could do experiments in cognitive science, but it wasn’t clear that any of them would result in anyone feeling better; I realized no one’s ever going to come up to me and say, “Professor Hamilton, you really changed my life when you discovered that you could show pictures on a screen that make eye movements 50 milliseconds faster.” 
I thought I really should apply my neuroscience skill set to people with problems and decided to go to medical school. Shortly after I got to Harvard Medical School, I attended a lecture by a neurologist who had just arrived there from the NIH. He showed that he could stick a magnet on your head and change how you think. I thought that was the most amazing thing I’d ever heard. From that point onward I knew I wanted to be a behavioral neurologist and that I wanted to do brain stimulation. Indeed, to this day, my research focuses on using noninivasive neuromodulation—magnets and electrodes—to manipulate and improve mental abilities in persons with cognitive problems due to neurologic disorders. Most of my work focuses on aphasia, acquired loss of language ability. My goal is to use brain stimulation to help strengthen and reorganize language circuits to help these persons communicate more clearly. 
I don’t come from people who know how to develop a scientific or medical career. No one in my family—no one in my community—has ever done the things I’m doing now. Not knowing how to go about it myself, I always benefited from having great mentors. 
Because of that, I’ve always been about making the ‘activation energy’ lower for people who are earlier in their career path: They should not have to do all the things I have, with the same full retinue of difficult feelings and struggles that I experienced every time I achieved a new training position or professional role. If I can make that process easier for someone else, I will. 
That has always been a central motivator for me. How do we make it easier for people who, for a variety of different reasons, fall into categories and groups where it’s an additional uphill climb for them to achieve in these spaces? 
Further, I’m multiracial in an interfaith and interracial relationship. I’m from an uncommon faith background. I’m a secular humanist now, but I’m raising a Jewish family. One of my kids is LGBT and I’m an ally. My life spans so many spaces that it is impossible for me to feel comfortable unless an environment is inclusive. I would like to make Penn a place where everyone feels like they can belong because that kind of inclusive environment is the only kind in which I’m going to feel like I belong. 
There can sometimes be a mindset that diversity is something extra and separate from excellence—that Penn or another institution is excellent, and we also make space for diversity. But that separation of excellence from diversity is empirically false. Evidence shows that when you bring in diverse talent and create an inclusive environment, people systematically perform better than in homogenous environments. The long-term goal is to advance excellence through diversity and inclusion, and to have a self-reifying system in which inclusive excellence is recognized, valued, and fully supported.  
Among our shorter-term goals, we have to build and sustain pipelines and other programs that enhance our ability to recruit and retain the most diverse talent. That would allow us to draw talent from everywhere and to make people feel like this is the kind of place where they could sustain their career.  
At the level of medical education, one example of a program that already expands the pool of talent from which we draw trainees is the Penn Access Summer Scholar (PASS) program. At the level of trainees in residency programs, we have had a very successful visiting clerkship program, coordinated by the Alliance for Minority Physicians, which draws in outstanding candidates who otherwise might have never considered Penn. At the level of faculty, each department’s Diversity Search Advisors (DSAs) help to ensure that every faculty search process is conducted in a way that casts a net to a broad, diverse pool of talent. While programs like this demonstrate PSOM’s commitment to creating a diverse, inclusive workforce, we know that there is much more that we can and must do to grow a community in Penn Medicine that is more reflective of the communities it serves. 
Another exceptionally important goal is to commit ourselves as individuals and as an institution to the value of empathy, which is at the core of inclusion. In an inclusive environment, it is possible even in fraught times to have mutual respect and dialogue, because we have the capacity to understand and feel where others are coming from even if we do not agree with them. This kind of cognitive and emotional perspective-taking is essential in medicine because we are committed to the care of every patient. We need to exercise the same desire to see the humanity in each of our colleagues, co-workers, and trainees. That’s what I think it means to be truly inclusive. 
In the last several years, the University and philanthropic giving have supported the creation of faculty positions for diverse candidates through mechanisms like Presidential Professorships. I like to think of the current Presidential Professorships as both a great accomplishment and a great start; a down payment on Penn Medicine’s vision of enhancing cultivating a clinical and scientific workforce that more closely resembles the communities it serves. 
Another important area of focus ought to be on how we support and retain the remarkable individuals that we have already successfully attracted. Penn Medicine draws in some of the brightest, most promising students, residents, fellows, postdocs, and faculty in the world. Sometimes what is needed is additional institutional investment to help them bring their vision to fruition, and to make sure they do so right here at Penn. We can’t just think about planting seeds; we also have to make sure we’re watering our saplings.  
Finally, philanthropic efforts must also help ensure that Penn Medicine is fully engaged with the communities it serves and treats every patient equitably. Whether through health education and outreach programs, clinics that serve disadvantaged populations, programs that identify and mitigate inequities in our access and care delivery, or many other approaches, philanthropic support can ensure that Penn is living up to its commitment to increase the lifespans and the social and economic well-being of community residents. 
As I mentioned earlier, many people miss the idea that diversity builds and fosters the institution’s excellence in every way. It’s also important to understand that “diversity and inclusion” refers to the entire tapestry of human experience; it is not a euphemism for specific races or ethnicities. We’re often trying to counteract systemic disadvantages, but that doesn’t mean that those are the only people for whom diversity, equity, and inclusion are relevant concerns. Fostering an environment of inclusion is in everyone’s interest.  
For example, a friend who’s an epidemiologist recently showed me an article which demonstrated that increasing the gender diversity of a work environment increased the health outcomes of everyone in it; having more women in the workspace actually made everyone physically healthier. 
Diversity and inclusion benefit everyone and should be everyone’s responsibility.  
What I’m proud of is how many amazing champions and advocates there are here at the University of Pennsylvania in the School of Medicine. If we all work together towards our highly aligned goals across departments, divisions, centers, and physical sites, astounding things are possible. The thing that I’m proud of—my colleagues—is exactly the thing that makes me optimistic about the role.