Transcript - Dr. Fitzroy Dawkins
Increasing African-American Cancer Survival Rates - Oncologist Fitzroy Dawkins, M.D.
Rahbin Shyne: Thank you for listening to 365 brothers the podcast. I'm your host, Rahbin Shyne. I am so excited that you are here listening to these amazing collection of brothers that I have curated by reaching out to men from various professions, all parts of the United States.
We hear their wisdom, their triumph. We hear their perspectives on life. Please remember to subscribe wherever you get your podcast because you don't want to miss even one of these.
Follow us at 365 brothers on Instagram. You can also find us on Facebook. Check out our website, 365 brothers.com. today we're speaking with a gentleman who has 30 years of experience as an oncologist and teaching at Howard University's College of Medicine.
He has done research in various fields and it's an advocate for clinical trials and has worked in the biotech industry. He's written a book, which I've read, and I can't wait to talk a little bit about it.
The book is entitled fighting for Survival, Conquering Cancer, and the African American Patient. I'm going to bet that some of you have read medical apartheid. I know I have. And when I read our guest book, I had that in the back of my mind as almost like a contrast.
And really what our guest today, whose name is Fitzroy Dawkins. What he's about is having more of us have better cures available.
And so with that, welcome, Doctor Fitzroy Dawkins.
Fitzroy Dawkins: So wonderful to be on this program with you. I'm very excited that you've delved into the book and I really look forward to chatting with you about it. I'm very passionate about healthcare in the african american community in many ways.
We have come through so much and we have made so much progress. And in my mind, healthcare, and especially in the area of cancer, is the next frontier that we must conquer if we're going to move forward in terms of occupying our space in this larger patchwork that we call America.
So thank you very much for allowing me to be here. Much appreciated.
Rahbin Shyne: I think most folks are aware, especially with breast cancer, that there's this great disparity, maybe because it just gets more attention. I also know with prostate cancer, there's a huge gap in both of those.
And so I love what you're about. We kind of do a little get to know you, and then we're going to weave in conversation about your work. But the first question is about words.
What are your favorite words?
Fitzroy Dawkins: I would say challenge. My life is all about challenges. My life is all about overcoming challenges, challenging the norms, pushing the boundaries, asking new questions.
Rahbin Shyne: Okay, what is one of the challenges you are most proud of overcoming.
Fitzroy Dawkins: There are few, of course, but you did say what. So let me confine myself to,
as you said, I'm a medical oncologist, and one of the biggest challenges for me was to see the cancer patient as a worthy patient of my best professional efforts in trying to find a cure or to try and push the envelope, push the boundaries of what was possible among cancer patients.
Because the backstory for me is on the way to becoming a physician. I couldn't imagine myself. Taking care of cancer patients seems almost far beyond hope. So this is a young physician to be in his twenties, and I saw no hope for them.
And over time, that thought changed, and it changed for a number of reasons, but I really felt that I had to overcome that challenge, the apparent difficulties that they have, the apparent hopelessness, to a place where I began to see that treatment for cancer is possible and even cure is possible.
So it has been a journey for me to move from that place of absolutely not to an absolute. We must.
Rahbin Shyne: What caused that shift for you? Was it a particular patient? Was it a particular experience in the hospital?
Fitzroy Dawkins: I was trying to figure out what kind of doctor do I want to be? I know I want to specialize. So I'm trained in internal medicine, and I want to go a little bit deeper, to have a specialty that I feel that I could master, that I could become an expert in.
So it was in those early formative years of being a medical student, a resident.
And so we're talking about the late 1980s, early 1990s,
and the field was making progress, but just painfully slow.
And the fear of cancer was paramount in people's minds who had cancer. And so when I did my fellowship at George Washington University in Washington, DC,
I thought, you know, obviously I'm black.
Sickle cell disease is predominantly a black disease, at least in this country.
And so it made sense if I'm going to do hematology and oncology, then I would focus on sickle cell disease and hematologic diseases.
So the fellowship was both together,
but they were in many ways very distinct.
And I got to George Washington University with that mindset, and I met a medical oncologist, Doctor Jim Algren, a H L G R E N,
who himself was interesting because he was a rocket scientist, one of the few rocket scientists I've ever met. He was a rocket scientist.
Rahbin Shyne: So when. So let me get that. Must have happened a lot when people would say, does it take a rocket scientist?
Fitzroy Dawkins: Yeah, I am that rocket scientist.
Rahbin Shyne: Yeah.
Fitzroy Dawkins: And so he was very impressive. But the thing about him that was unique for him was that his mom had breast cancer, and I think she died from breast cancer.
And he went from being a rocket scientist to become a medical oncologist. He went back to school. He went to medical school, and because of that drive of seeing what his mom went through, he decided that he would take on this challenge on a personal level.
So he went from being a rocket scientist to a medical oncologist. And I met him. And his view of the cancer patient was so profoundly transformative for me that I said, when I grow up, I want to be like Jim Algren, not the rocket scientist, but Jim Algren, the medical oncologist.
There are others in my three year training that also influenced me, but he stood out as somebody who said to me, Fitzroy,
it's not about where you stand in terms of taking care of the patient. You have to see a future. You've got to look beyond where you are now to the possibilities, the challenge, if you would, of what is possible and your role in making that happened, because I saw this transformative behavior in his life,
from being a rocket scientist to being a medical oncologist and taking on that challenge. And I thought, my goodness, you know, this is something that is worthy, is worthy of my efforts to challenge that, continue to push the bounds of what is possible.
And I'm so very glad that I met Jim Alger.
Rahbin Shyne: I'm glad I asked what was the shift because of the training to be a rocket scientist? Marellanton and then to go back to school. Complete switch in medical schools, four years, plus a minimum of three years residency, I'm sure for him, you know, for more.
Fitzroy Dawkins: And a fellowship after that, and a fellowship.
Rahbin Shyne: And so to turn your life around because of your own personal experience with someone dealing with cancer, that would leave an impression on most of us. And so I totally get how that opened up.
What is significant person, one or event that either changed the trajectory of your life or had a significant impact on your life besides Doctor Halgren,
I grew.
Fitzroy Dawkins: Up in the West Indies. I grew up in Jamaica.
And as a young boy, I was really quite sick. Somewhere around 1011 years old. Sick enough to spend five months continuously in a hospital. That's sick. A little bit of a backstory around that is that at the time, growing up, then to get from primary school into high school,
it was not a given. You had to win a government based scholarship.
You had to compete against your colleagues to get a limited number of spaces to go to high school. At that time, I was sick.
I've been through multiple surgeries,
and at that time, I was being cared for by Professor John Golding. He's a surgeon. One day he walks into my room and he turns to either the nurse or the social worker, and he said,
isn't this boy supposed to be taking the common entrance examination to get to high school? And she said, yes, he's at that age.
But the day for sitting at examination has passed. And he said to her, you write a letter to the Ministry of Education where this is all managed. Explain to them why Fitzroy could not see the entrance examination and ensure that he gets an opportunity to compete.
That was life changing, because had he not done that, my parents did not have the means for sending me to a private high school.
Had I not sat that common entrance examination,
I would not be in high school. If I didn't get to high school, there's a high probability that I would never become a physician. So for me, this was this great example of being more than just a physician, just a doctor,
somebody who saw the whole person and who went beyond what was asked of him to say,
this kid needs to get a chance of a lifetime because it could change his life.
Rahbin Shyne: I moved by that. I've had experiences with doctors that are very singularly focused and not necessarily, at least as it occurs to me, interested in the whole story. You know, I'm sure anyone listening is thinking, I wish all doctors were like that.
You know? And I do get that in our current medical system, and I guess that's really where the pet peeve is in our current system, with the insurance billing and all of this, that there's, you know, there's.
You got this much time. Yeah, exactly. And. Yeah, right. So I understand that it's quite often not that the doctor is not interested or would not. Not the kind of human being who would be just like this doctor was for you.
But what an ideal. And I love that that's the model that you saw as a doctor, says a lot about your practice and your passion,
excluding your parent, who was the first person to earn your respect. And I say that knowing that we generally respect adults as kids growing up, oftentimes there's an adult that really stands out, and we're just like, whoa, respect.
Fitzroy Dawkins: You will enjoy my answer. It was a teacher.
There was a teacher in high school.
So one for the team,
misses Campbell, to be exact. So obviously, that story I just told, I did get the common entrance examination. I did pass. I did go to high school. I met her in high school,
and she was a history teacher,
and she made history come alive for me. She made history something more than just memorization of dates, times, kings and queens, and presidents and whatnot. And it became alive for me.
So it's fascinating that I end up becoming a physician because I'd want to be that even before I got to high school.
But one of the competing things in my mind over time was maybe I should become a history professor because of Misses Campbell. I love history. And as we get into the book, you'll see that I weave a tremendous amount of history into the book because I'm still fascinated by history and what history tells us about where we are now and the possibilities for tomorrow.
And I think that that influenced came directly from her. Now, in my fantasy moment, still think, gosh, you know, it would be nice to have a history degree.
So misses Campbell.
Rahbin Shyne: Well, kudos to Miss Campbell for making that difference.
Now that you shared that,
your book makes even more sense and especially in terms of the structure. And so we might as well just kind of go there a little bit. Now, I know that many of us are very familiar with Gege experiment and that history, like, you really bring that alive in the book.
You address it in the book and its impact on us today.
Right. Even though it ended, what, nearly 50 years ago now, but it's still in the cultural consciousness.
Fitzroy Dawkins: Very much.
Rahbin Shyne: Very much so. And so I thought that that was very thoughtful,
your message. I'll let you share in more detail,
but the message that you have lands on deaf ears,
perhaps even angry ear,
without going into the history and looking at it squarely again, most of my listeners are probably familiar with it and they can look it up. But if you wouldn't mind, Doctor Dawkin, you could maybe a short paragraph version of what that was and the impact and how that led to your message and what your message is like.
I'm just going to turn it over to you for a little bit.
Fitzroy Dawkins: Okay? Thank you. Thanks. So, picture, if you would,
hardscribbled dusky Alabama after the roaring twenties were over.
Great excitement,
happiness. World War one was over.
Great joy, great fanfare,
and Wall street crashing in 1929 or thereabout,
hard, tough times where cotton, the crop of the moment,
you could essentially give it away because the economy was so poor, at picking cotton as a sustainable lifestyle was just not worth it.
Everyone in Alabama and throughout the United States was impacted by the depression.
Yes, white folks, black folks, all sorts of folks now, white folks who barely are getting by.
And the question becomes, if they're barely getting by, what about the black folks who are already at the bottom of the scale. Picture syphilis, a sexually transmitted disease that had no treatment at the time and how it was ravaging communities, not just black communities, all communities, but particularly black communities.
And picture a system that says,
black folks are at the bottom of the scale, and we can do whatever we feel like,
and who's asking this question?
Or gov, we can do what we want with impunity,
going there and saying, we are going to do an experiment on people with bad blood. That is, syphilis would be under the category of bad blood. 600 black men, 400 with syphilis diagnosed because you could diagnose that very well then.
And 200 who did not have it. Picture being told that you have bad blood, and we will treat it,
a treatment that was ineffective. And the people were saying this, knew it.
And then observing these 400 men with quote unquote, bad blood and 200 men without the bad blood, and observed them over time,
over 40 years.
Rahbin Shyne: 40 years, 40 years, 40 years, 40.
Fitzroy Dawkins: 40 years. To see what the natural outcome would be for those who had and those who had not.
But under the guise of research, picture people who could not read or could not read very well, who are not well educated,
but people who were promised things that anybody would want. You can barely afford to live,
but if you die, we recover the cost of your funeral. Right?
And picture a time when the treatment for syphilis became available. But that treatment was not given to those men in this so called clinical trial.
And what we're saying is, it was not a clinical trial.
It was a natural history experiment to see what would happen over time without treatment.
Rahbin Shyne: So the experiment went 40 years, and they are really just observing the disease untreated. And what will happen to its conclusion?
How long did they have a cure and allow the experiment to go on anyway without curing them?
Fitzroy Dawkins: I may have to double check the dates myself, but I believe that penicillin became available,
widespread sometime in the 1950s, if I'm not mistaken. So the treatment became available. It was not when this quote unquote, experiment started, but subsequently somewhere between 15.
Rahbin Shyne: And 20 years of this being widely available. And instead of offering it when they had been offered a cure at the very beginning that was not made up.
Aha. Okay. Anyway, I just. I. It's so funny because I'm familiar with the story. I've known it for I don't even know how long. It seems so natural. And I'm sure many black Americans feel like they've just always known that.
And yet I feel myself still being angry, like as we're talking, like, I'm still angry. So, anyway, I'll let you.
Fitzroy Dawkins: Yeah,
so. So I. I spent a small part of the book to talk about it, and the other part of the story that I discovered as I was writing the book is that there were a number of persons within the research group who were aware of what was going on,
raised questions about it, and were shut down. They were thrown aside, and one brave person pushed the envelope until he had to go to a reporter who blew the story up and then put a stop to it.
The part of the story that I had not known is that sometime afterward, when Secretary Satcher, who was a secretary of health when Clinton was in office, together, they called the few men that were left behind who were still alive to the White House and gave a national apology.
Bill said,
we apologize. We have committed a great sin against you. We can't repair that by itself. But we want you to know as a nation, we are sorry.
And it doesn't fix the problems of the past.
And what I wanted the readers to realize is that there were those sins.
Another piece of the overall racial sins I've been committed against black people,
but that there was an attempt to at least acknowledge it publicly by the very government that ran the experiment to begin with. And for me, that was a pivotal moment in terms of how we should see ourselves and see the whole concept of clinical trials going forward.
Because the other thing that happened was not only a. Simply a national apology,
but when that story broke of the egregious behavior of our government,
a series of steps were put in place to fix the problems so that people had to be informed about what was being done to them and to their bodies, and they had to get permission if they're going to do a clinical trial.
And that, to me, was another contribution that is not acknowledged of what directly or indirectly black people have done for this country.
Because of that,
there was the Belmont report that changed a lot of how we do things now, what we call a clinical trial. Who can participate, the voluntary nature of things, the need for oversight about what is being done to people, the right for people to start a clinical trial and withdraw if they so feel,
and so on. So a lot of good came out of it for all sorts of bad reasons, but a lot of good that everyone in America is benefiting from.
Because these experiments were not just done on black people, they were being done on white people.
Rahbin Shyne: Yes.
Fitzroy Dawkins: So. So we feel it deeply because it was so outrageous. But they were experimenting on soldiers. They're expending on students at Harvard, because they could.
And this Belmont report began to change that conversation substantially.
And that story also needs to be told, because otherwise we get stuck with Tuskegee. The bitterness, the anger, the frustration, and the mistrust that has continued to follow us to this day.
Rahbin Shyne: I'll be honest with you. When I see apologies by the government, I just go, all right, whatever.
Fitzroy Dawkins: You know.
Rahbin Shyne: Yeah, okay, great. So after the fact down the road,
great.
But I love that you added that it wasn't just the apology and that these new procedures were put in place, that there was a shift in the culture of clinical trials, new standards were put in place.
And the other thing I love is the way you've emphasized who all has benefited from it.
We talk about all the time with the civil rights movement, civil rights movement, and the women's movement and the gay rights movement. And so this is just another of those contributions that we make that we'd rather not have been the one.
But the contradiction is there. And I also appreciate, and you're wrapping that part up about Tuskegee, the reminder that we do tend to lick our own wound and kind of get that there's somebody crying over there with.
With theirs. And I am aware of some of the experiments that were done on women, on the disabled,
Christmas prisoners. And the reason that I am repeating that acknowledgement that awareness, is because we wouldn't think that the disabled would stop going after cures. There's still a need to crust to some extent, and I will be honest with you, it's a little uncomfortable for me to be advocating it just because that book,
medical apartheid, and I do have to counter this part, Doctor Dawkins, which is,
there are still times when groups are taken advantage of. Right. And they're in every field, they're bad actors. They're bad actors. In schools, they're bad actors. So I don't want to leave anyone with the idea that is so cleaned up you can just blindly trust.
But your point is well made, that without any trust, without taking any risk in participating in clinical trials, which I haven't even let you share a little bit about yet, but if we don't do that, then it's difficult to complain that there are no medications that address our issues.
Fitzroy Dawkins: Yeah, I don't see it as a challenge. I think it's a necessary cautionary statement to make.
And my response to that, in agreement, is another historical figure, Ronald Reagan, who said, trust, but verify.
Trust, verify.
I will trust, but I need to get the facts. When I've approached patients about doing clinical trials, whether or not it is in my role as a practicing physician at Howard or in my role as a biotech executive.
What we say is you don't have to sign this informed consent giving us permission to do this clinical trial under duress.
You need to take that home.
You need to ask questions. Have you, your children ask the questions. If you don't know, you need to get on the Internet. The Internet is just a treasure trove of information.
If you know where to find it,
you need to talk to your pastors. If that is who your trust is, you need to talk to somebody else other than this guy Dawkins, who is telling you that he wants to do this trial.
He doesn't know if it's going to work or not, but they think it's worthwhile taking the leap. If you would. You need to be able to have a conversation with your doctor about what's involved in this.
And one of the things that I spend my days doing is writing these informed consents in a way that people can understand.
And it's written at the 8th grade level so that it's not so above your head that it is medical ease. That is also a requirement of the Belmont report, by the way.
Right, so that people can understand.
One of the things that I point out is, again, to educate yourself before you sign an adopted line or to educate yourself so you can have a conversation with your doctor.
And I think about your point you made earlier about that you feel like you're just being in a machine.
If you can't find a doctor that you can't talk to, then you may need to think otherwise and go someplace else.
Rahbin Shyne: I love that advice because what I heard was there is a hurdle to get over about the mistrust and being willing to.
And at the same time, it's not blind for right? And there's no absolute responsibility.
And nowadays, my goodness, with Chad GPT,
you ask it in the language that works for you, you know what I mean? Like, it widens how you get that information. And if you don't know exactly how to say it, you can word it around.
Now you can't even speak to chat. GPT and then aside from going through AI, I appreciate your reminder, because most of us, if we live long enough, are going to have something.
It may not be cancer, but after our peak years, things change.
And so we will most likely the vast majority of us will have something that we go to a doctor for. And I really appreciate you putting in. We can choose mostly to find the doctor that we can talk to,
but that also with our responsibility to get in communication not only with the doctor, but with the people in our lives, the people that we trust. And what I take away from that is, and this is something I know that others will relate to.
I know that I tend to approach my medical illness when I have something as me and the doctor. I'll share it with family, but I'm not necessarily having a conversation with them.
I'm not really asking anybody what thoughts are nad more like, this is what I was told, this is what I love, this is what I'm going to do, you know?
And so I think that's really beautiful and brilliant reminder that we exist in network communities, and we should use those, especially when there's something. Again, as an oncologist, your specialty is cancer.
So especially in dealing with something that was at that level. But anyway, I love that. So I'm gonna ask you next question.
Fitzroy Dawkins: If you don't mind. If I could just make a fine point on that business of sharing. So the experience I find,
again, my daughters tell me that I should be careful about not, you know, blanchetting your body.
Rahbin Shyne: Don't hurt anybody's feelings and don't insult anybody.
Fitzroy Dawkins: That's right. That's right. You know, all African Americans are not the same dad. So. But what the fact is that when I have worked in, quote, white institutions and I've seen white patients,
their mindset very often is quite different. They have done their research.
They almost come in saying, just sign here, doctor, because I know what I want.
They also have their family history. They know their history.
They know who are on Susie when she died, what she died from,
and they tend to be, again, I'm generalized, but I think it's something that we can take from that group and apply to ourselves.
And maybe it's a generational shift, right?
So misses so and so, you have colon cancer at age 40. This raises questions about genetics and cancer at age 40. 40 perhaps.
So tell me, who in your family had this, that and the other?
And the story I would get. Now, granted, it's been a while, so maybe things have shifted.
Well, you know, when I was a kid, I heard them whispering in the back room about steam,
and I knew something was wrong, but nobody would say what it is. They wouldn't talk about it because it was. It's almost like a shame.
It's like this thing that I have that cannot be spoken of, cannot be named.
And so you lose that history, because that history then could inform the doctor, the oncologist the hematologist, as to what the probabilities are that this is related to that and how that potentially could impact how you treat that disease and how you educate the patient about their kids and what their risks are and that history getting lost.
Because we. We don't talk about it. We don't talk about it because very often it's. We see it as shame, when, in fact, there's no need for you to look at it that way.
Rahbin Shyne: Well, I I have questions here, but now I got to come back because I was raised in a family that did not talk about things. If you're a kid like you, this is not your business.
You don't need to know the adults are talking here. So there's that part,
but also when you use the word shame, because I never thought about it as shame, but I know my grandmother's passed away over ten years now. But I know that if I had come to her and said, you know, I got this going on, and is there anybody in the family that maybe I don't know about this,
that and the other? And I feel certain the response would be,
I don't know. You know, Aunt Jodine, she had this, this and this, but you'd have to call her. And it's almost like it feels almost protective to not know.
Fitzroy Dawkins: I see the stress of it. The stress.
Rahbin Shyne: She had something in, and she got better. The doctors, they told her this and this man. And she's fine now. And that's all we don't worry about. She's fine. You know,
but I appreciate what you're saying, because I. And I've shared this one before. But you might find this funny. When my grandmother passed away, the pastor, uh, who did the service, and this wasn't her church.
She wasn't a church member. But I said, well, this is the time. If there's anyone who'd like to say something about ferns, they come on up. And so this is the time where if you have something, you know that boot,
the friend who was with me at the time,
he was like, I didn't even know your grandmother. And I started getting up because somebody needed to say something.
Fitzroy Dawkins: He did exist at one point in time, right?
Rahbin Shyne: And only when he pointed out that I went, oh, my goodness, you're right. Like, we live in a silence.
Fitzroy Dawkins: Yes.
Rahbin Shyne: Don't tell people your troubles.
And if it worked out, then that's good. And so, actually, that does go to the shame part that you're speaking to. You can tell your daughters we're not speaking for all African Americans, but the one you happen to say it to can relate.
So what insights from your career? And you clearly written a book that shares so many of them. But what insights from your career can you share with the listeners that can help them get more out of life if you were to hone it down to one piece of all of your message?
Fitzroy Dawkins: Don't be afraid. Don't be afraid of the things that you fear most.
My general philosophy approach to life and something that I've shared with my two kids is just because you're afraid doesn't mean you should not do it.
So you say, well, you know, so if your daughters decide that they're going to run across the street to dare, that traffic won't hit them. No, I'm not talking about that.
I'm saying that in my own personal life, there's been a lot of things that I've been afraid of, a lot of things that I dread.
Principal among them was, frankly, coming to America. I didn't want to come to America. I was afraid. New culture, different place. I came on my own. My mom says, you're going.
I said, I'm not going. She says, fitzroy, you're going to America. And I said, you don't understand. I'm not going. I was afraid.
I was afraid when in many ways, when I gone to medical school, it seems like everybody and their grandmother had doctors in the family and they had PhDs and mds and this and that.
And in many ways I was terrified. I was in a new culture again,
predominantly white culture, predominantly middle class and up middle class folks among people who didn't want me there to begin with to a large extent. And I was terrified. And at times I thought, I'm going to go back home to my mom.
Yeah, I was afraid at so many points in my life.
But breaking through that fear and working through that fear, even as you're afraid,
even as you're terrified, even as you feel like you're an imposter, that whole impostor syndrome, even while you're feeling that way, keep pushing ahead, keep working through that. Because if the goal is important enough to you,
and hopefully your goals are good ones, don't be afraid. Just keep going.
Rahbin Shyne: I love it. Apart from the Obama presidency, which pivotal historic event from your lived life had the most profound impact on you, and.
Fitzroy Dawkins: How has that shaped your perspective in that context?
The civil rights movement in America?
I would say that because even though the early years I was not even here in this country.
I was a little jamaican boy running around concerned about nothing but having fun.
The civil rights movement allowed me and a non american to walk into this country and say,
I want to be a doctor and I want to go to any medical school that would accept me, whether or not it was an HBCU. And had it not been in my mind for the civil rights movement that took place before I got here, I would not have had that opportunity.
I don't want to keep on harping on it, but I tell a story about a man I met when I was in practice at Howard university.
And I almost broke down and cried when he told me his story again. He had colon cancer. That's why he came to see us.
I saw the gash on his calf and I asked him, this does not look like a surgical scar. How did you get the scar?
And he said, doctor Dawkins, I was at Selma,
and when Bull Connor turned those dogs on us,
that's how I got that gas.
And I still get very emotional about that years later. I said, my God,
I owe this man something.
Rahbin Shyne: Thank you for sharing that.
We forget that history is still living with us right now. Yeah,
there are people alive today who participated and were beaten, bitten by dogs. These things happen, and they've happened to people that are still breathing the same air in the atmosphere with us.
And so I appreciate reminder that history is still present.
So this gash, it sounds like it was like flesh taken by bite.
Fitzroy Dawkins: It was a deep scar. It was not something that you would sort of see it. And it said, well, you know, maybe he got scratched.
This was a deep wound. This was a deep wound.
And he said to me, no one has ever asked me that question before,
really. And.
And frankly, it wasn't like the first time I saw.
I'd seen him before in consultation in the hospital. And, of course, I was zeroed in on why he came to see us. He has colon cancer. What are we going to do about it?
And I remember I had an entourage of medical students and residents and blah, blah, blah, and I was trying to make an impression on them about the importance of doing a complete examination.
And so I went from talking about this colon cancer to who was in front of us, because it's a teaching hospital. So, you know, you examine this way,
you see this, you ask questions about that, and you ask. So I asked the question, not realizing what the answer was going to be, because again, it was clear to me it was not a surgical scar.
It wasn't straight.
It was jagged.
It was a jagged scar enough so that it had to be suture.
This is not something you put a couple band Aids on and say, you know, be on your way. It was deep,
and it then reflected the deepness of the emotional wound that came tumbling out when he was telling me the story.
Rahbin Shyne: So glad you added that. Well, the last thing I just note about it that stands out for me is that he then said to you that no one had asked him before.
And because I do this podcast, I know that sometimes being asked a question or asked before provides an opportunity for healing something you didn't even know was there to be healed or to be soothed.
And so my suspicion is that it offered something to him that you asked.
Fitzroy Dawkins: Yeah.
Rahbin Shyne: What is a moment or an event that highlights your experience as a black man in the United States?
Fitzroy Dawkins: There are a number of them, but I will go back to a situation which again, sort of compounds the reasons why I write this book about African Americans taking their place in this larger patchwork that we call America, and to be not afraid to step into it, because this too is their America.
And the story for me is I was in New York, going to medical school there,
1980s Buffalo, New York. I moved into a neighborhood,
little rundown apartment on the somebody's stairs as a medical student, struggling to get by financially. But I had a car because I had to get to the hospital and rotations and whatnot.
And one morning I woke up, my car was parked in the alleyway. And I looked at the car, a yellow car with black scrawl across nigger.
And I thought,
interesting,
because a policeman lived next door. Now, I'm not saying he was the only person there, it was an older colonial, so it might have been multiple apartments,
but nigger was called Aurora, written black.
And, you know, I,
what,
who do I go to for redress? Who wrote this? When was it written?
What message are they sending?
And it reminded me that I am not being seen as one of us.
You are the other one. You're in our neighborhood,
right?
And maybe you don't belong here, and maybe you should leave. And it raised all sorts of questions. Why is a policeman next door and knows nothing about this? Nothing is said, nothing is done.
Was it he who did? I don't.
So those are, those are the, that's a negative. There's not a story I tell about the confederate flag threatening me with a 22 caliber, um, gun. And I thought I was going to die.
What I'm telling,
um, yeah, so, so this was again, Buffalo, New York, 1982, and I studied in medical school in the building. And I walked onto my apartment, it's probably about 02:00 in the morning.
Lots of work to do, lots of studying to do. I was walking home and no one was on the street. Suddenly a car pulls up, the confederate flags flying everywhere.
Four white men get out the car. They surround me and they ask me, do you know how to spell 22 caliber?
And I said my prayers and I sure I was going to die.
And my pressure answered.
After a few minutes,
they drove away.
The historical piece for that is that you can look this up on the Internet, that at the time that I was there,
there was a white man killing black taxi drivers with a 22 caliber gun. And at that time he had not been caught.
Rahbin Shyne: Wow.
Fitzroy Dawkins: So Joseph Christopher was a guy's name. Eventually got caught and he got incarcerated. But again, at the time,
stressed out by medical school,
trying to make sure that I'm going to get to graduation and I have to deal with this additional stress of being the other who's not wanted around here as an example.
But, and I tell the story quite honestly, I tell the story as part of this larger narrative to say,
racism is here, it has been here, it is here, it probably will continue to be here.
But I identify with the struggle of saying,
despite the mistrust and despite the fears and despite the opposition,
we've got to get on,
we've got to get on. And we cannot allow ourselves to be afraid,
or even if we fear, we need to keep going.
And for me, that's the essence of the book. Yes, that happened. Yes, this happens. Yes, this will happen. But at some point in time,
you've got to take hold of your own health.
Face it down, talk about it, demand change and be the change that you want to be. And get some answers for ourselves. Because some answers may not be obtainable without our participation in the story.
In the meantime, trust, but verify.
Rahbin Shyne: What I hear in that is agency.
When there's no agency, it's like they know all the stuff. I'm middle class, I'm poor, I don't know. And the Internet being an equalizer, the fact that we can have agency in our health.
And we were talking earlier about the silence and I was mentioning how maybe it's protective when we only want to know so much about someone's health issue. It makes me wonder if underneath there is almost a not conscious, but being bombarded with so many messages that our health is not deserving of 100% care.
Fitzroy Dawkins: It's an interesting perspective. That's interesting, you know? Yes. Yeah.
Rahbin Shyne: If you could spend 8 hours with any other black man from any time who would you choose and what would you do? Or what would you talk about?
Fitzroy Dawkins: I would spend time with Nelson Mandela if I could. I would spend time with Nelson Mandela. I think his fortitude, his strength, his endurance for however many years, decades that he was locked away in South Africa in prison, and to maintain his dignity in the face of something that seemed insurmountable was remarkable.
And his willingness to withstand the worst, short of death that was thrown at him. And to come out not unscathed. Not unscathed, but to come out of that situation with his held head high and provide leadership not only for his people,
but people in South Africa, white, black, indian, other, and indeed, to provide leadership to the world on some level.
Who can say? I won't forget the past. I should not forget the past.
But I see a brighter day,
or at least I like to lead it to a better day. Southern.
We can be better.
And I don't have to hold on to the past as an engine for moving forward. I can move on with the pain and I can isolate it, if you would.
I can compartmentalize it because I have a bigger job to do.
Rahbin Shyne: Yeah.
I remember being on campus in the eighties. I believe it was 84, 85. Desmond Tutu came to Stanford to talk about the apartheid. And I got the gist of it, but it was probably 510 years later,
after it was over, because I'm pretty sure if I recall shame getting this old. It's like stamp or divestiture, because that's with the marching with Gore. But after apartheid ended,
we're so remarkable to see Nelson Mandela. It was remarkable to see someone who had been imprisoned for 30 years speak so calmly and so focused on creating something and his demeanor.
I love that. I love to be a fly on the wall.
What would you ask him?
Fitzroy Dawkins: I would ask him, how did you do it?
How did you accomplish this?
And with, of course, a selfish goal in mind as to, you know,
how can I also do this with such dignity and with such grace and with such forgiveness?
Rahbin Shyne: I hear a theme, one the word shows challenge, right? And then the advice from your career and life experience being to embrace the fear and move on,
and then your choice to spend time with Nelson Mandela. And, I mean,
talk about perseverance,
right? I hear that as the theme. And really your book is that because your book starts in the past and it does review the. And some other things, but it's very clearly future forward,
very clearly about seizing better health and our future as a collective. And I do hear, and I want to acknowledge this hearing that throughout the interview, you make a very clear point of saying, basically embrace that you're an american.
Like, yeah, yeah, yes. There's a hyphen.
Fitzroy Dawkins: Yes, absolutely.
Rahbin Shyne: They're not hyphen. They say african american, but what you are is an American. And go. Go sit at the front of the table. Go sit at the table. Not the kids table, but the big table.
Fitzroy Dawkins: Yes, yes, yes.
Rahbin Shyne: Your play.
Fitzroy Dawkins: You heard that very clearly.
Rahbin Shyne: I did, and I love it. I feel the same way.
I sometimes think that is every working class, not just african American, either community hoisted american flag on every house.
Outside your window. On your window. Still put the bumper sticker on your car and just go around and make the statement. Like, I think that it would challenge.
Fitzroy Dawkins: Yes.
Rahbin Shyne: A perception that some have of other.
Fitzroy Dawkins: Yes, absolutely. Absolutely.
Rahbin Shyne: Yeah.
Fitzroy Dawkins: And, you know, I'll just tell you a quick story. So, yeah, as I said, I. I grew up in Jamaica. I've spent most of my life here. My wife is african American.
She started the classic product of people who are from DC. She was born and raised, went to Howdy university.
Her mom is from Virginia. Her dad is from North Carolina. That's DC. So we get married,
and we have these two kids, and they said, dad,
you know,
what about Bob Marley? And,
you know, I want to be a Jamaican.
And I said, okay, so what do I do with your mom?
You're a product of an african American and a Jamaican. So does that make you Jamaica?
And so we had a conversation. Ultimately, I landed where I wanted them to land, which is, you are an American.
My wife was raised that way by a very forward thinking african american father.
You are an American, and everything that is due to any american is due you the pain, the good, the bad,
whatever you are in America. And embrace that. Embrace that. Certainly you can love Bob Marley. I love Bob Marley. Everybody loves Bob Marley.
Rahbin Shyne: But everybody loves Bob Marley.
Fitzroy Dawkins: But you're just as american as your blonde, blue eyed friend that you went to school.
Simple.
Don't deny your past. Don't deny the african side of you. But at the end of the day, don't let the african peace prevent you from being an American.
Rahbin Shyne: Oh, I love how you said that. I love. Don't let the African of African American prevent you from. Only from the American.
Fitzroy Dawkins: Yes.
Rahbin Shyne: Yeah. Perfect.
Speaking of, if the United States was a woman with whom you could speak,
mother, lover, stranger, neighbor, friend, what have you, what would you say to her?
Fitzroy Dawkins: I would say to her, why don't you treat me like your own?
Rahbin Shyne: I asked that question. What would you say to her? And I have to tell you,
I most often hear a question to her. Yeah, yeah. Thank you.
This question is similar to one that I asked previously, but a little different. And it is based on your expertise and perspectives.
What excites you about the future of the United States?
Fitzroy Dawkins: My understanding of America is that she it is still experiment that is unfolding. And I look to the future with the hope that this experiment will continue and that it will yield great benefits for all its over time.
Because we are still trying to find the perfect America. We will never get there. But I believe that because it was designed as an experiment, that the future can still be bright if we have people who embrace that understanding and are willing to work for it.
And again, it's rooted in history on where we have been,
where we are currently a bit of a mess, but it's not the America of 19.
And so I hold a great hope that, that as we progress in so many ways,
the democracy will under threat currently,
but it will continue and it will provide for my future generations a better place than it is today,
which is better than it was yesterday, in my view.
Rahbin Shyne: Well, I thank you for your response, because just this week I was like, well, I guess the experiment's over. Looked like it didn't work.
Fitzroy Dawkins: Well, we've had setbacks, right? We.
Rahbin Shyne: And that's why I'm thanking you for your response, because in the way that you spoke about it, I'm technically Gen X, but I'm really like just missed it being a boomer.
And so I have an attachment to kind of the way that even when we've lost our way,
we could rely on the language of law and the language of constitution and the historical way that we. And again, fully recognizing all the things that haven't worked in the ways that it has been used and abused and all of that.
But still, there seemed to always be some drop that you could rely on. And it felt like at time,
in our modern society siloed algorithm, where we have our views and it's not necessarily a shared reality and may not be based on a solid foundation, some of our thoughts, beliefs and opinions.
But because you emphasize the experiment part in emphasizing that,
you remind me that,
heck, let's be honest, Germany went through a really hard time.
This is nothing relative to that. And yet it exists today. It is a thriving economy today. They've had truth and reconciliation. They have not looked away from their past, and they've moved forward.
And again, that's not to say it's perfect, because I know that there is a conservative rise. I get that, folks. If you're like, excuse me, but it's coming back over there.
It's like, okay, but not what happened in the thirties and early forties. So your emphasis on experiment, I think, is, is well timed for us to remember that a setback is just a setback.
Fitzroy Dawkins: So, yeah, so it is a setback. And it's, it's a disturbing series of events that have been unfolding over, I don't know, it depends on where you decide you want to take a cut.
But those who think about history thought that the country was done after the flower children period. They thought was done after the democratic riots in Chicago,
Vietnam was going to bring the country to his knees and so on and so on and so on.
You know, you go all the way back to reconstruction, one step forward, five step backwards. So I am concerned, I am very concerned about where we are now. And the, the conversation I'm having is, is there a statesman, states person,
who can rise above all of this and help us to see a different day? It may not be a states person, it may be us together,
but I would like to believe that the experiment continues and that, or shared understanding of what experiment is,
I would like to believe that we will get through this.
Rahbin Shyne: What I hear and what you just added is when we were talking about the trust but verify and the responsibility on the patient and the opportunity for the patient to get in communication, to have conversation, and whether you think the cancer is the Democrats or the cancer is the republican party or the cancer is this guy or the whoever and whatever,
and what institution. I think the advice you gave as a patient applies to us as citizens, which is to do our research.
Fitzroy Dawkins: Yes.
Rahbin Shyne: To understand fully what our options are, to inform ourselves, to get in communication with the people that matter to us and to then make some choices and.
Fitzroy Dawkins: Then take an action,
because choices, choices are there. Choices are there. The choice in my mind is, is not to put your head in the sand and hope for the best.
So I'm a man of faith, but the, the business of saying,
oh, somehow God will take care of all my issues. He will heal me. And therefore, I don't need to think about this. In many ways, is, for many, is a state of denial,
of not looking at the reality that's in front of us.
And I've had to struggle with that, with some of the patients that I've taken care of.
I will go home. Doctor, I heard what you said. I'm gonna prey on it.
And then you never see them again. Now, maybe they didn't like me, maybe I was not tall enough. Maybe I wasn't short enough. Maybe I wasn't smart enough, whatever. So all, there are those possibilities, right?
But I really wonder,
what did they decide to do?
How. How did they negotiate what I said? They went for second opinion, that that would have been fine, too. I sent many of them for second opinions, and some of them came back.
But I wonder sometimes that sort of a suspension from reality and everything is going to be okay, we just have to believe. We just have to trust that things are going to be fine.
But quite honestly,
I blame ourselves as well. We doctors, in many ways, I blame ourselves and in the oncology community, because a lot of this fear and this mistrust not only comes from Tuskegee and mistreatment of patients and disrespect for patients,
but, you know, the treatment itself can be challenging.
We're changing. The treatments that I gave back in the 1990s still exists, but the treatment is changing, but I don't think it's changing fast enough, one, in terms of effectiveness,
and two, in terms of the side effects that a lot of people dread.
They dread that. And we can only do so much, and we keep changing. We keep improving our treatment paradigms. But there is that old school from the 1960s and seventies that said, when you got cancer,
the next thing to do is to go to the hospital and die. And that day has changed,
but I'm not quite sure that that has filtered down to the general population. And it was part of the point, the book, to sort of say the sentence that, and the people that I did not want to take care of back in the 1980s, because I just thought they would all die.
I was part of that community.
That day has changed, and people are living longer and better,
even if the cancer is not cured, because part of what we do is we create new medicines,
different medicines. So when one doesn't work, you keep on changing it. Like hypertensive medication, this one doesn't work. You add this to it, and you add this to it. You take away this and you put that.
So you get this cocktail that keeps people going.
Whereas 20 years ago,
the game might have been over for many people. So we're curing things, and we need to think differently about what it means to have cancer, to be treated for cancer and the possibility of cure.
I think we need to get that into the body politic, if you would.
Rahbin Shyne: Well, I have one last question, and then we're done. But I want to encourage everyone to read your book.
I enjoyed it. There's a cool story about how you met your wife,
and she doesn't agree.
Fitzroy Dawkins: With that story, by the way.
Rahbin Shyne: Oh,
you know what?
Yeah, I understand. I've had that experience with people before, too. It's like that is how that. No, that's not what happened. Okay.
But I also want to leave you all with this. The book is just as hopeful as this interview sounds. I learned so much about new ways. They're combining what we now know from genetic research to create very uniquely tailored medication.
There's just a lot that I learned, and my prayer, of course, is that I never find out what I would need to know that I never have cancer. But if someone in my life does,
I now feel much more competent and aware of what the options are. And if a doctor were to talk about a possible clinical trial, if the standard medications didn't work, I feel much more informed that I could engage in that conversation, not from fear and emotion after reading your book,
but from curiosity and possibility.
And so the last question I have for you, Doctor Dawkin, is, what did you get out of having this conversation for yourself?
Fitzroy Dawkins: Well. Well, first of all, it is a fun conversation.
Rahbin Shyne: Thank you.
Fitzroy Dawkins: It was a fun conversation. It's always fun when you do this and the person has actually read the book. So that was great. What I got out of it is that you have an audience.
And the whole point of me doing this with you is exploring all media to get the word out. It's not simply about selling a book, though.
That's nice or would be nice.
It's about getting the content of the book to the people,
our people who need to hear this and to hear the message of hope and the message of possibility and an opportunity to engage in the conversation with a book that is written at a non physician level to bring them into the world that I have lived for the past 30 plus years.
So I think that this will do that. And if, in fact, that happens, then it would have been well worth while, the time that I've spent with you. So thank you.
Rahbin Shyne: Thank you for listening to 365 brothers, the podcast. I'm your host, Robin Shang, and thank you so much for listening. Don't forget, if you haven't followed us, make sure you do follow us at 365 brothers on Instagram.
You can also find us on Facebook. Check out our website, 365 brothers.com. and remember, to listen is to love.