Could DEI (or its successor) save lives?
Sara Sidner's breast cancer fight makes Bill Ackman's anti-DEI crusade hit differently
“I have thanked cancer for choosing me.”
CNN’s Sara Sidner startled us with her announcement on Monday. She is being treated for stage 3 breast cancer.
Sidner is a longtime CNN anchor and correspondent, now co-anchoring its rolling newscast CNN News Central. She says breast cancer does not run in her family. She is in her second month of chemotherapy, with plans for radiation and a double mastectomy. Thankfully breast cancer survival rates are much higher now than in the past. According to the American Cancer Society, from 1989 to 2000 death rates dropped 43%.
But some still die far more often than others.
ACS says that Black women have a 4% lower incidence of breast cancer than White women. However, Blacks die 40% more often. Researchers say this is regardless of where in the United States they live, and it’s not that Blacks have more aggressive cancer cases. Socioeconomic factors, like access to medical care, are a major factor. Sara Sidner’s revelation could be a lifesaver if it inspires more women to get checked.
Which makes America’s debate over DEI —diversity, equity and inclusion — a matter of life and death.
If that sounds like a hard left turn to make, think about it: Sara Sidner chose, as a woman of color, to speak about the racial disparity in cancer mortality. Don’t miss the moment, though: she’s not just speaking to other women of color. Her message is especially vital for non-POC people to hear so that they can (A) be sensitized to the disparity and (B) help those trying to address it. Messages about equity are for the majority as much as the minority, because it takes all of our resources to solve big problems like this.
And how do you marshal these resources? It begins with starting conversations about issues of disparity: what they are, how they happened and what can be done. That’s why DEI is so hard to deal with: because it’s hard to talk, listen, be emotionally vulnerable and connect. You can’t just parachute in and have those conversations; comfortable spaces have to be curated where trust can emerge. Hearing from people within your cultural group can make all the difference: in this case, Black women who have breast cancer warning other Black women to stay sharp about it. (We used to say “stay woke” about it, but… never mind.)
Hedge fund founder Bill Ackman has been deeply antagonistic toward DEI lately, mostly through his successful push to unseat Harvard’s President Claudine Gay. Last week Gay resigned that post, remaining at the University as a professor. The last straw seems to be accusations of plagiarism fomented by conservative journalist/activist Christopher Rufo. Soon afterward Ackman’s wife Neri Oxman apologized for her own instances of plagiarism unveiled by a reporter at Business Insider. Ackman is calling out BI for its reporting, and the outlet’s parent company Axel Springer says it’s looking into the reporting. And what does all that have to do with diversity, equity or inclusion?
Not much. And that’s the problem.
Substance has slid into squabble, and no one is better off.
Consider the split-screen image we now have: the noble quest to make America a freer, fairer society — the existential struggle of our republic — and an insular debate over academic purity at elite institutions. This started off big, with students facing off over the war in Israel & the future of Palestinians. With each day it gets smaller. Each day it gets to be a little less about all students, and a little more about one alumnus: Harvard graduate Bill Ackman. A little less about you, and a little more about a few.
On top of that, Rufo & Ackman might get away with destroying DEI and not building anything better in its place. To be fair, there may well be better ways to achieve the same goals without calling it “DEI” or doing in the way it’s currently being done. Everything can improve, and everything needs to. But why destroy it without replacing it first? That’s like saying “I hate this car!” and blowing it up, when you’re still 100 miles from home (and far from a dealership).
The truth is that DEI amplifies the Sara Sidners at organizations across the country. It’s where people can get conversations going about issues that affect them, and help others empathize. It’s a connection across differences, not just for huge controversies like the future of Israel, but also for universal causes like fighting cancer. It’s a form of education that can illuminate aspects of our lives we thought we knew but only saw from our own perspectives and, thus, saw so much less than we imagined. All of this is damn hard to do, but it’s vital to try and try again.
Who knows if Sidner’s announcement could have happened in this way at all if, years ago, CNN’s founder Ted Turner hadn’t decided to make it as diverse and multifaceted as the world it covered? To include many types of people in that endeavor, and to hold them to rigorous but fair standards? That is literally what DEI is. And now that Butterfly Effect may get someone to screen for breast cancer and save her own life.
Ackman ended a recent post on X with, “I can’t believe this is happening,” lamenting the scrutiny into his wife’s record. Honestly, I feel for him. If someone I loved got dragged into a public controversy because of me, I’d be a wreck. Still, that hasn’t humbled him at all. He’s steadily holding court online with supporters and detractors, sometimes posting lengthy clapbacks. A blue-checkmarked Premium account on X, like his, can allow 25,000 characters per message. Remember when 280 characters felt like a lot? Good old days.
Now he’s not just defending his argument about coverage of his wife; he’s also going back and forth about journalistic integrity. Elon Musk says he should sue; Ackman replied, “Thank you Elon for your support.” All the while the rabbit hole gets deeper. Ackman sinks further, and his loving wife feels her foot slip below the surface. Substance has sunk into squabble. No one is better off. Remember when this was about fighting antisemitism and making students feel heard? And then someone let this get personal, only to find it could get even more personal?
Today’s politics are poisoning DEI, perhaps fatally. It might be beyond saving, but something has to take its place if we’re going to keep learning to live with one another. Perhaps the remarks of Sara Sidner hint at a path forward. As remarkable as her announcement was, so was her take on how fighting cancer has affected her.
“I have thanked cancer for choosing me,” Sidner said.
“I am learning that no matter what hell we go through in life, that I am still madly in love with this life, and just being alive feels really different for me now. I am happier because I don’t stress about foolish little things that used to annoy me. And now every single day that I breathe another breath, I can celebrate that I am still here with you.
“I can love and cry and laugh and hope. And that, my dear friends, is enough.”
So much here to process - and I so want to. As a 2x cancer survivor, who has lost others to cancer, I know a fair amount about that subject matter, but where I am balanced on the brink of an exquisite indecision is whether we are ready for a discussion about what race is as it might affect disease outcomes.
Hispanic is a term where it is easy to demonstrate the baked in fallacies. Legally Brazilians are not Hispanic, because they do not come from a Spanish speaking country. However, they self identify as and are, for non census bureau purposes, Hispanic. See https://www.pewresearch.org/short-reads/2023/09/05/who-is-hispanic/. My son-in-law, from Guatemala, is treated as Hispanic, even though the majority of his genes show up as Mayan. It's not easier to draw clear lines with African Americans, just more DEI dangerous to do so: https://reason.com/volokh/2020/08/11/is-kamala-harris-legally-african-american-indian-both-neither-or-something-else/ .
May we talk about what we ask these race labels to be proxy for, without being called a racist for identifying a confounding factor? Are we ready to go back and talk about Justice Jackson's dissent in the affirmative action case, which relied on a factually flawed amicus brief about infant mortality? We touched on it here a bit at the time, IIRC. The WSJ had the most detailed explanation, but not all readers may have access behind the WSJ paywall, so here's a link to a discussion of the problem that is not pay walled: https://jonathanturley.org/2023/07/07/crunching-the-numbers-does-justice-jacksons-dissent-on-affirmative-action-not-add-up/. There was also a follow up article: https://jonathanturley.org/2023/07/31/justice-jackson-accused-of-second-glaring-false-claim-in-affirmative-action-dissent/.
Are we ready to move on from the DEI chorus in order to evaluate the worldwide issues in cancer treatment outcomes across races in ways that are scientifically rigorous? Factually we have known a lot about what needs studying for over 15 years: https://ascopubs.org/doi/full/10.1200/JCO.2006.06.7918 . I will spot discrimination one claim: US clinical trials rarely include folks with lower socio economic status or who are in a group unlikely to have a cancer. Lower socio economic status has a high correlation with a lack of technical skills to give meaningful feedback and a large number of comorbidities, so the slots may be filled with folks who are not going to be good at discovering if the drug on trial is safe and effective. The bias against including folks who are rare victims of a cancer comes from the idea that the patient may introduce a rare random cancer factor, that might send care for most folks down the wrong track.
To give that some context. Male breast cancer is rare; putting men with breast cancer in an early clinical trial may introduce a random and poorly understood factor that isn't useful for determining if a drug should go forward with more testing for safety and effectiveness. There are ways of tiering the clinical trials to solve some of these issues. I did a clinical trial after definitive treatment for my second cancer, because they were recruiting female patients to balance out their final presentation (the researchers ARE trying); it was grueling in the amount of extra testing and record keeping required. I was delighted to take the risk and do the work, because of where I was in life and what I had received from medicine. I would have counseled against it for someone who had an hourly job, children at home or a life expectancy of more than 25 years. That's just one drug and one person. The plural of anecdote is not data, but it is an aspect that we should be willing to look at
I hope we are ready to decide that DEI was a splint/cast, but that going through life with a healthy leg being immobilized is not the way to win any race worth running.