"There is no greater agony than bearing an untold story inside you." —Maya Angelou
At the 2022 American Heart Association (AHA) scientific session in Chicago, Illinois, I was fortunate to witness Michelle A. Albert, MD, the first Black woman to serve as the president of the organization since its founding in 1924, center her presidential speech on how adversity translates into clinical medicine.
In addition to being the Walter A. Haas–Lucie Stern endowed chair of cardiology and professor of medicine at the University of California, San Francisco (UCSF), Albert is the founding director of the Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center). This subject matter has been central to her research and has defined her illustrious career. In 23 minutes and 51 seconds of eye-opening realities, Albert expounded on the biology of adversity and, most importantly, how economic adversity is at the underbelly of the disparities within our healthcare system.
From the moment she stepped on the national stage, many women of color, like myself, saw her as a superwoman and an aspiration. It wasn't just her on-point lesson on how chronic adversity related to social determinants of health may activate pathogenic pathways, including hyperstimulation of the sympathetic nervous activity, the hypothalamic-pituitary-adrenal axis, and/or the inflammatory system to promote the development of premature cardiovascular disease and its related cardiometabolic risk factors, it was that she delivered this presentation with authenticity.
Albert opened the AHA presidential session with a salute to her Caribbean culture: a celebration filled with steelpan drums and masqueraders. She poignantly closed the session with the words "I owe gratitude to…my mentees, colleagues, and friends, and most importantly my family, who understand the lived experience of this presentation," highlighting how meaningful this topic was to her, a Black woman living in the United States of America.
In a 2018 Circulation perspective piece appropriately entitled #Me_Who, Albert discussed the uncommon place of underrepresented minority women physician-scientists in leadership positions. She addressed the disproportionately higher burden of adversity that they face and the social isolation experienced by Black female health professionals who sit at the intersection of race and gender, where both identities can lead to invisibility. This article is a reminder of why a comprehensive approach to diversity and inclusion is critical. I was privileged to lead the writing of a perspective piece with Albert this past February for the Go Red for Women edition of Circulation. In "Shining a Light on the Superwoman Schema and Maternal Health," we discussed how cumulative psychosocial stress prevented approximately 13% of Black female health professionals surveyed from attaining ideal cardiovascular health. We also discussed how being intentional and increasing inclusion of underrepresented minorities in medicine and leadership as trusted partners who have the lived experiences of those disproportionately affected is critical for eliminating health inequities. I believe that it is Albert's lived experience that allows her to thrive in her leadership roles.
Who we see thriving in the world teaches us how to see ourselves, how to think about our own value, and, most importantly, how to dream about our future. Albert's AHA presidency is just one of the many "firsts" in her career that have motivated me to work even harder on issues surrounding health equity. Albert's approach to leadership is a testament to the dedication of generations before her, including Rebecca Lee Crumpler, MD, who in 1864 became the first Black woman to earn a medical degree. But as a Black female living in the United States, I have to acknowledge that these "firsts" are too few and far between.
Although I celebrate all of the "Black girl magic" and phenomenal women who are making history, like Michelle Albert, within the celebration is the realization that as a society we haven't gone as far as we'd hoped. But perhaps we can?
Perhaps this moment can inspire all medical societies, and healthcare organizations and systems that touted messages of support regarding diversity, equity, and inclusion to now ensure that they look at the structure of both race and gender. Because we'll never end racism unless we look at how Black women and other women of color are so easily left behind. As Albert unapologetically took center stage at AHA commanding the attention of the audience, women of color in the audience knew what it took for her to get there. We know that she had to work much harder and be that much better to beat the odds in order for her to become the "first."
I am motivated more than ever by my friend and mentor, Dr Michelle A. Albert, whose leadership may just tip the needle in medicine for the better because she can never be invisible again. We can never unsee the perfection of what we experienced on Sunday, November 6, 2022, during her 23:51-minute presidential address. I will be sure to talk about it for years to come, and to teach it to my mentees and colleagues alike so we can have the moral fortitude and collective will to ensure that such "firsts" soon become "the first of many."
Image 1: AHA/Todd Buchanan 2022
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Rachel M. Bond. HerStory: The AHA Presidential Address That Could Change Medicine - Medscape - Nov 28, 2022.