The importance of diversity in ENT has recently been highlighted by ENT UK’s Equity, Diversity and Inclusion Strategy and Action Plan. In this article, Oloruntobi Rotimi discusses the importance of Black role models for those starting out in the specialty.
Surgery is a highly rewarding and challenging field that traditionally attracts the best and brightest, however there is a paucity of Black surgeons in the United Kingdom. According to the Royal College of Surgeons Edinburgh Black Surgeons (RCSed) in the UK report, Black surgeons account for 4.2% of the entire surgical workforce, which equates to about 200 Black consultant surgeons and 800 Black surgeons in training [1]. ENT UK is currently performing a census of their membership, but data for our specialty is lacking at present.
This phenomenon of reduced Black representation in ENT, and surgery as a whole, is not isolated to the UK but across the Western world, and can be traced to the beginnings of modern surgery in the 18th century; it is no coincidence that as the influential John Hunter and colleagues were bringing an educated, empirical approach to the profession, prominent anatomists, such as Samuel Thomas von Soemmerring, were assiduously documenting supposed biological differences between races [2]. Understanding these historical biases, and how they still persist in varying forms, can demonstrate the causes of, and offer solutions to, the current lack of diversity.
"He witnessed David’s passion for medicine and was willing to mentor him, and arrange his studies at P&S, despite technically never gaining formal admission to the college"
The retrospective recognition and celebration of David Kearney McDonogh as the first Black American ENT surgeon [3] illustrates not only the importance of emphasising historical Black role models in ENT, but also the barriers they have faced and their relevance to contemporary challenges. David McDonogh’s early life was coloured with hardships and adversities including slavery, racism, and educational segregation [3,4]. Yet through grit, determination and favour he was able to unofficially study medicine at an establishment that would become Columbia University, and became a highly regarded medical professional in ENT and ophthalmology [3].
Portrait of David Kearney McDonogh by artist Leroy Campbell.
Credit: New York Eye and Ear Infirmary of Mount Sinai.
David was born into slavery on a plantation, where he took the last name McDonogh and worked until the age of 19 when he was sent to study missionary work at Lafayette College in Pennsylvania [3]. During his time at college, David experienced the pain of segregation when he was separated from others in their housing and during meals. However he developed a passion for medicine through learning about anatomy and surgery whilst shadowing the local doctor and pharmacist at the college [3,4].
John McDonogh, the slave master on the plantation where David was born, was a well-known businessman who made a fortune through real estate and the slave trade. He was a member and strong supporter of the American Colonisation Society (ACS), a group that aimed to organise the freedom, education and transportation of ex-slaves to Liberia in West Africa as an alternative to emancipation [3]. Therefore, he was reluctant to permit David’s request to remain in Pennsylvania after he completed college; he even threatened to call slave catchers on the young man should he refuse to comply [3,4]. But David had already been made a free man by Walter Lowrie, his assigned handler on arrival in Pennsylvania. This status, coupled with his passion for medicine, enabled David to remain steadfast in his conviction; eventually McDonogh acquiesced to his request, on the condition Mr Lowrie would observe David, and facilitate his needs, without McDonogh’s support.
However, David still faced the daunting task of gaining admission into medical school which, at the time, was unheard of for a person of colour. Fortunately, David was put in touch with an individual that would change his life forever. Dr John Kearney Rodgers was a professor at New York City’s College of Physicians and Surgeons (P&S), a college which would later become Columbia University [4]. He witnessed David’s passion for medicine and was willing to mentor him, and arrange his studies at P&S, despite technically never gaining formal admission to the college.
"David Kearney McDonogh contributed significantly as a medical professional in the fields of ENT and ophthalmology, and was an advocate for the abolitionist movement prior to his death in 1893"
Unfortunately, this lack of formal admission prevented David from being awarded his diploma of graduation, which made it near impossible to find work as a medical professional. Dr Rodgers intervened again, and David was given a role at the New York Eye and Ear Infirmary where his work was highly regarded. Dr Rodgers was not only a mentor but a dear friend to David, to the extent that, after Dr Rodgers’ death in 1850, David took on his middle name in homage. David Kearney McDonogh contributed significantly as a medical professional in the fields of ENT and ophthalmology, and was an advocate for the abolitionist movement prior to his death in 1893 of ‘congestion of the brain’. For his achievements despite the odds, he was awarded his doctorate in medicine posthumously in 2018 and is remembered through the Dr David Kearney McDonogh Scholarship in Ophthalmology/ENT which aims to increase representation of Black, Afro Latinos and Native Americans in ENT and ophthalmology residency at Mount Sinai, New York [5].
Focusing back on the landscape in the UK, we are increasingly seeing more Black ENT surgeons in senior positions that can inspire others to enter the field. For example, Mr Enyi Ofo, Consultant at St Georges University Hospital, is highly regarded as a pioneer in transoral robotic surgery and established the programme in South London. Ms Ekpemi Irune, Consultant at Addenbrooke’s Hospital, founded the Holomedicine Association, and captivated audiences in the recent award-winning BBC documentary, Surgeons: At the Edge of Life. The example set by these excellent surgeons, as well as many others, have paved the way for future generation of Black ENT surgeons, which will contribute to even greater representation of Black ENT surgeons in the future.
In summary, the struggles faced by Dr David Kearney McDonogh as a child of slavery were immense, and what he accomplished is incredible. The fact that his work has only recently been recognised with his posthumous diploma shows how histories in surgery have often been written from biased perspectives. Highlighting these role models is important to not only bring awareness to institutional structures of old that may still be present, but also to encourage the next generation of Black surgeons. We have seen measures employed in the US, such as scholarship and increased visibility of Black ENT surgeons, to help address this issue. There are several Black ENT surgeons in the UK who can inspire and are ready to uplift the next generation. Using these multiple platforms may help us achieve greater representation in ENT.
References
1. RCSEd Black Surgeons in the UK report. 2022.
www.rcsed.ac.uk/news-public-affairs/news/
2022/september/rcsed-Black-surgeons-in-the-uk-report
2. Schiebinger L. The Anatomy of Difference: Race and Sex in Eighteenth-Century Science. Eighteenth-Century Studies, Summer; 1990;23(4):387-405.
3. Gudis DA, McKinney KA, Lustig LR. From a Slave to a Surgeon: David Kearney McDonogh, the First Black Otolaryngologist. Otolaryngol Head Neck Surg. 2022;166(6):1169-71.
4. New York Eye & Ear Infirmary. America’s First Black Ophthalmology and Otolaryngology Specialist. 2022.
www.nyee.edu/200years/mcdonogh
5. Moore MT. After 170 years, a Posthumous Degree. Columbia Medicine Magazine 2021.
www.columbiamedicinemagazine.org/
webextra/spring-2018/node%3Atitle%5D-2.
All links last accessed July 2023.
