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- Hello everyone.

Welcome to "Crosscut's Northwest Newsmakers".

I'm your host, Monica Guzman, and today we're gonna be talking with Dr. Ben Danielson.

Before this year, Dr. Danielson was known mostly to the patients and families he served at Odessa Brown Children's Clinic in Seattle's Central District.

And to the folks he got to know, as a respected community advocate.

When he resigned as medical director of the clinic, a position he held for 20 years, in protest of what he claims is a pattern of disproportional treatment of people of color, his story sent shock waves through the city.

It put a critical spotlight on Seattle Children's Hospital, which runs the Odessa Clinic, and it raised big questions about health equity in our city during a global pandemic, and a national reckoning with racism.

Before I say more, I wanna thank the dozens of you who sent in questions ahead of this event.

It helped us prep what we hope, will be an illuminating conversation about some complicated things.

But the real conversation isn't between me and Dr. Danielson, it's among all of us.

So I invite you to stay curious during our discussion, and share what you wanna know.

Use the comments section on your right to submit your question for Dr. Danielson.

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Now, several things have happened since news of Dr. Danielson's resignation broke.

Local leaders from Macklemore, to former Sonics coach, Lenny Wilkens, penned a letter demanding action.

There was a rally, a petition, with more than 30,000 signatures, Seattle Children's responded, asking one of it's leaders to step down and accelerating it's work, it says, to become a quote, "More diverse, equitable, "and inclusive organization."

Most notably, an assessment committee convened by Seattle Children's has hired none other, than former U.S. Attorney General, Eric Holder, to lead an independent investigation into allegations of systemic racism and discrimination at Children's, raised by Dr. Danielson.

Who will be interviewed in that investigation later this week.

It's findings are expected by summer.

Now in preparation for today's event, we asked Seattle Children's what they would pass on to viewers ahead of this conversation.

First they said, "We'd like to say that we believe "Dr. Danielson's departure was a huge loss "for Seattle Children's, and we are grateful "for the decades of service he provided "to patients and families at OBCC."

Along with details about their response in the investigation, which you, our viewers, can read more about at assessmentcommittee.org.

The hospital also added, "As an organization, Seattle Children's is clearly "not immune to systemic racism "that persists throughout our healthcare system.

"And we recognize this.

"However, we are committed to holding ourselves accountable, "fighting it, and acting to dismantle "the institutional barriers that allowed racism "and discrimination to occur.

As for Dr. Danielson, he joined the pediatrics department at the University of Washington Medical Center in January.

He got his medical degree at UDUB, and has practiced here in Seattle ever since.

Helping to start a clinic for low-income community in White Center, before taking what he called his "dream job", at the Odessa Brown Children's Clinic, becoming it's director in 1999.

Since his departure from Odessa, his former patients have come out in praise of his practice, and his community advocacy, calling him, a quote, "Pillar in the community", and saying that his departure felt, in the words of one woman, "Squarely like a gut punch".

Dr. Ben Danielson, welcome to "Northwest Newsmakers", and thank you for joining us today.

- Thanks for the invitation, I'm honored to be here.

- Well, before we jump in, I wanna give our viewers a layout of our conversation.

We'll start with the path that brought you, Dr. Danielson, to your decision to leave Odessa in protest.

Then, we'll dig into the implications of what you saw.

The reckoning on racism for Children's, for other institutions, for yourself, and for local families.

We'll then talk about what you see ahead on this issue, and then open it up to all of you, our viewers, as I ask Dr. Danielson your questions.

So don't forget to drop them in the comments section, I will be reminding you later.

So, Dr. Danielson, Macklemore wore a sweatshirt that read, "I believe Dr. Ben Danielson" to a flag-raising at the Space Needle earlier this year in support of you.

The big public reaction to your departure, both in the black community and the region at large, is it what you expected?

And has any of it surprised you?

- All of it has surprised me, I have been overwhelmed.

You know, even in the moments of greatest tragedy, there are often these equally powerful moments of humanity, and community, and I don't feel deserving of all of the support and attention I've gotten, but I'm sure thankful for it.

It's really been moving from every corner of this area.

Really amazing.

- And so it sounds like you were, it wasn't what, you didn't expect this level of support?

Is that what I'm hearing?

- Absolutely, yeah.

I had no idea people would reach out, show up, put their own voices out there, make sacrifices and call out what's happening.

- What did you hear from your patients once the decision was announced?

Did people reach out to you?

- Yeah, it's been really difficult.

There were messages like, "Just tell me where you land, "so we can go there."

There have been just messages of support.

And just community, if you know what I mean.

And I think there's been these layers of common, shared journey and perspective.

And I have to say it's especially, and I guess humbling, because I had the privilege to be able to make a statement to resign from Children's Hospital, and I know that there are a lot of families, families I work with, families that go the clinic, families from other parts of this area, who don't have the privilege of standing up in that way.

It's been powerful.

So speaking about your patients, when we talked earlier, you had mentioned, you're not currently seeing patients, just yet at UDUB Medical Center, and I wanted to ask you if you could share why.

- It feels a little bit hard.

You know, that first time going to a different place.

I know as soon as I jump into that moment of care, and start seeing families and stuff, it'll be wonderful.

But, I adore the people I worked with, and the clinic at Odessa Brown.

I adore the families I served there, and it is, it is not an easy transition.

- Is that what's holding you back, the fact that you miss the families at Odessa?

What is holding you back?

- Well you know, there's also logistics, paperwork, and all of that.

(chuckling) - That's true.

- Yeah, and been working on some other kinds of projects that have been feeling important in this moment, as well.

So, it's a combination of all of those things.

What do you do after your dream job, you know?

- Yeah, right.

Yeah, and we'll be talking more about the themes around that.

You've hung, I've heard that you hung paintings of your mother, who's great, on the walls at Odessa.

Can you tell us about her, and how she raised you?

- My mom is this wonderful, unrepentant hippie, who, (Monica giggling) got all her chops in the 60s and 70s.

Was out there protesting and ratting.

During that time, spent nights in jail.

And raised me and my two sisters with this idea that, we owe each other in this society a sense of service to each other.

We owe each other the best that we can bring to helping to lift up beloved communities.

We owe each other to be contributors, and so that was a value she pushed.

She felt that from our low-income spaces, the best path to security, also, was by getting an education, and she really pushed on that.

Not just for education's sake, but she wanted us to be thinking people who could kind of have an argument with her.

(laughing) Be able to talk about stuff.

- So was that common in your household?

Like, actually getting into it?

- Yeah.

- Yeah.

- I think in a way, respect, you respected somebody by saying, "Wow, I really wanna get into this conversation with you."

Which might not be a total Northwest thing.

(Monica laughing) - Wait, we have Seattle Knights here.

And some other things.

So depending on who you are, racism is on a spectrum between something you learn about, and something you live with.

How have you lived with it?

- There's not enough time for that.

I guess, I've had different versions of that growing up, in different places.

And spent more time in the back of police cruisers, and things like that, than I care to admit or share.

And I've seen the ways in which people are downgraded, or erased in the society, and that happen.

I think all of us, though, have our journeys and our stories to tell.

And I don't wanna put mine out there as any more deep sage, or intense than, and so many others.

I would say that, you can't be brown or black in this country, and not experience racism.

And maybe the versions of racism in this generation are just so much more subtle, which makes them that much more difficult and painful, and undermine your sense of who you are, if you let them.

They sometimes take away your sense of agency.

It's a kind of thing that you can't call it, the authorities to come arrest somebody for racism in this country, you just really can't.

There's no legal code, really, in my mind, anyway, for racism.

This is a social disease that we struggle with, and it takes different shapes and forms, but it kills people, it changes lives.

It takes away quality years of life.

It effects you in every way.

- You called leaving Odessa, "The most painful sacrifice."

What did you see?

So let's put it in the room, what did you see that made that sacrifice necessary?

What tipped the scales?

- I often want to try to characterize things as this progressive process that are heavier than the straw that breaks the camel's back.

But our loads that you choose to bear on one point, and then get to a point where you can't bear them anymore.

I think that the historic nature of my experiences of racism at Seattle Children's, and the unreckoning.

I make up words a lot, so apologies.

But the lack of reckoning for that, and the sort of desire to zip forward into, we're just gonna be doing great for now on, is it's own trauma, is it's own pain.

- Can you give examples of that?

- Of the history?

- Well of the skipping over, the things that you have in mind as you describe that overall impression.

- Two that come to mind, one is pretty open now.

You know, a hospital leader that uses the N-word in reference to me, and uses other really strongly hateful language in reference to people of Asian descent, and women, is called to the mat by a whistle-blower, and it is odious to me that, that person carried that kind of hate in their heart.

- And this is a person that Children's asked to step down, just so our viewers know.

- Yeah.

But it is more concerning to me that when that was initially a happening, Children's just chose to redefine that language as cussing, or swearing.

And I guess we could have arguments about how to categorize those kinds of words.

I would put it that they carry a particular kind of weight when it's a hospital leader.

They carry a particular kind of harm when it's in different circles, different forms of hateful speech.

And to just re-categorize it, and then, subsequently saying, no wrong doing was found.

It's not that they actually argued in their assessment of his language whether or not he said those things.

My knowledge of how that investigation went, was they decided that it did not count as something worthy of any kind of penalty from a work perspective, it was just cussing.

And that was the kind of way, the previous CEO of the hospital characterized it.

So it is more concerning, I'm sorry I'm dangling on this point.

It's more concerning to me that the hospital created a space for accepting it.

And then sort of pushing it aside, much, in some ways, much more even, than the hateful speech that was used.

(crosstalk drains out dialogue) I really wanted the hospital to come to account for that.

- And how about, when it comes to patients, and how they were treated?

- Watching the hospital do this strange thing of measuring some things, 10 or 12 years ago, and then not responding to them, was almost hubris or cruel, really recognizing that- (crosstalk drains out dialogue) - I'm not sure I follow you, you said measuring some things?

- Yeah, through their own assessment, finding that security was disproportionately called on families based on the color of their skin, 10 years ago.

And having pretty clear evidence of that.

And then sitting on that.

Those are these kind of smoldering things, that sort of almost, there's a task of acceptance, there's a complicity of like, we know this, and we're not gonna do anything about it.

Now, in the past year, there's been some action on that.

There is a reckoning for the intervening decade of no action.

And I cannot believe that leadership didn't know about that report that was delivered to the leadership's desk.

And it's either in confidence not to know it sooner, or really intentionally allowing that to be part of the reality for Children's Hospital.

These things are not okay, they're not unique.

They're not unique.

I wonder what would happen if every hospital measured when security gets called, what is considered too loud, or too threatening?

But it is this space, this Children's Hospital space that I experienced, and so this the space I am calling to some version of a reckoning around.

You don't get to just move fast-forward into from now on everything's gonna be great.

Because that's how this country has done it's most harm over generations and generations.

- So on that point, you said that you believe that the issues at Odessa are not unique, so- (crosstalk drains out dialogue) - I'm talking about Seattle Children's Hospital.

- Oh, right, right.

- Seattle Children's Hospital.

- I should be clear about that, too.

Yes, thanks, it's through the system that you were talking about.

- Yeah, yeah.

- So when you said that those issues are not unique, tell us, to what degree was your complaint against an institution, and to what degree was it against an industry, or something more?

- Those are completely blended, awesome questions.

It became more direct when the institution itself said, it was doing things about it.

But didn't actually name anything with any true accountability.

Right around the time of George Floyd's murder, by a knee to the neck for nine minutes, like many other places, Seattle Children's put out a statement about how anti-racist they were, gonna be.

And many of us called them to account on that, like, what do you mean?

What are you gonna do?

What's going to be different?

You already have this evidence of treating families based on the color of their skin, when it comes to security.

You already have this other evidence of families who complain about being treated differently.

You already have these spaces where black and brown nurses feel they've been treated differently at Seattle Children's.

So what exactly is gonna be different?

What's the accountability that comes with this.

I guess I still don't even see the accountability, except the word, accountability, in their most-recent statement there, AROC statement.

I applaud them for making progress.

And trying to really come to a closer reckoning.

But, until there's a day when a black mom with a child with sickle-cell disease can walk into the CEO's office, and say you treated my child wrong, you're fired, I guess, maybe that's an over-hope, or something.

But there is not the kind of accountability to racism that there is to financial goals.

Or other kinds of measures that hospitals pride themselves on being so specific and scientific about.

- And maybe that's part of the reckoning, right?

Is kind of reordering some of these priorities?

You said that this has been your reckoning, too.

That you've been complicit in the problems you saw in some ways.

Can you tell us about that?

- If you're in a system, you're complicit.

I think there's sort of a beginning point for that.

I don't know what it's like in the world of journalism.

- Mm, yeah, no, there's plenty we (chuckling) have to reckon with ourselves.

- Yeah, and so, I think it's important, this time of, there's a time for reflection as part of that reckoning.

And really understanding where we all play roles.

All of us have drank the tea of racism and bias, gender bias, and ageism, and ableism.

We are part of this society that bakes all of those things into it's system.

So by that sort of super-broad definition, there's complicity that I just think we need to talk about more, and being willing to say, "Yeah, I am part of this problem."

- And then (indistinct) for you, right.

- On a personal level, there was a story a week ago, or so in "The Emerald" about a child with cancer, and that is a story that's not for me to tell.

It's our, for mom, but, there was something in there about, you know, you try to speak up, but did I speak up loud enough?

Did I push hard enough?

Did I yell loud enough?

I've watched fellow black and brown colleagues get into positions of awareness, and even maybe, sort of authority, about issues of racism, and children's institution.

And back up from really calling things to account.

Because their jobs rely on it.

Or, because of chance for advancement does.

There's complicity that happens at some many different levels.

And I'm sorry to be moving around this topic.

- It's a complicated one.

- Yeah, it's a complicated one.

And I would put it that, what I'll just call sort of, white-dominated oriented community, wants to simplify it.

Wants to make it really simple, wants to, maybe out of good desires to understand it better.

But wants to simplify it.

So it makes black communities mono-chromatic.

It makes these issues very hard to navigate, and creates a space where, we're not really having the right conversations a lot of the time.

- So to complicate it maybe even further, you said, we could all be complicit in certain systems.

Are things different at UDUB?

Now that you're there?

- I don't know that they're, there's a maybe, different versions of things.

So by that token, if I'm really kind of hanging specifically on the word different.

Yeah, but I think organizations all around us struggle with these issues.

It makes a little bit of a difference to me, the strength of acknowledgment of those problems.

It makes a difference that different spaces come sometime from a stronger honesty of, I've been a, just had these great conversations with many organizations in the healthcare system, in the education system, in the social services system, that are just ready to say, "Hey, we're not doing this right, we have problems."

And it's a different sound to me, it's a different thing than an AROC statement.

Which is like, hey, we got this figured out, and just wait for it- - So wait, you're saying an AROC statement?

I'm not familiar with that term.

What does that mean?

- Oh, I'm sorry, I thought that you referenced that at the beginning.

The statement that the hospital, Seattle Children's has about it's policy.

- Oh, yeah, yeah, yeah.

I just, I didn't know if you said AROC, or something, I wasn't sure what that acronym was, but no worries.

(chuckling) It might be a technical term.

- And I don't mean to fully criticize Seattle Children's on their AROC.

I think there's a lot of thought and work that went into it.

I wonder if it happened a little bit of a vacuum.

But I still don't see the accountability in it.

I don't see the humility of really acknowledging wrong-doing.

And I think it comes from fear.

I think there's a little bit of a culture of cloaking and privacy.

I think that's caused many problems in addition to the issues of racism.

It's caused other challenges for the hospital, as well.

There's work to do.

I guess I see the hospital trying to begin them, but, I've lost my confidence that this hospital in it's current structure will actually do an honorable job of that.

- So obviously, a lot of folks are tuned in to the problem of race.

We've been talking about this reckoning.

And you know, more and more loudly in the past several years.

So on the pathway to working through big problems, it helps to identify what's behind them.

So for anyone out there wondering, and also from your own experience, how do you separate actions driven by racism from actions driven by incompetence, negligence, or a lack of empathy?

- I wanna answer that in a slightly different way, and I'm not trying to avoid that question.

But, where we're in this moment right now, which is, I'm laughing, because it's so ironic to me that we are very fully acknowledging this.

Systemic racism exists, and is problematic in our healthcare system, in our society, in journalism, in our education system.

And yet, then when we get into it, we do the anything-but-racism kind of search.

We just like, what could it be, otherwise?

- It isn't race.

- It's not racism.

I wonder, could we call it?

Oh, this is about poverty.

Oh, yeah, it's just socioeconomics.

- Why do you think there is that temptation to do that?

- Yeah, I want us to have different conversations.

I wanna challenge us to stop that, to stop it.

That's this forensic kind of approach.

You can't say racism is systemic, and then say, well, but, we're gonna weed it out in a way that you can't prove it.

I hope that's not, or I hope that's an acceptable answer, or at least something.

- Oh!

No, of course, I mean, yeah.

That's one of those questions that I think that folks have in mind, but can bring up lots of different themes around this.

Like we said, this is a complicated issue.

We're here to deal with it.

- And I put it out there that, I don't think with intention, but out of some sub-conscious fear.

The status quo is doubling down on maintaining their status quo.

And we'll do things, we'll use equity language, in order to ultimately just sustain things the way they are.

We'll push out people who are not saying the right things.

We'll try to find a different reason for all of that happening.

That is part of the plan right now across a lot of different systems.

And a lot of different organizations.

I remember sitting in a meeting at the, in the CEO's office, with a couple of other big leaders, and one of them, the CFO, at the time, at one point sort of, I remember, her pounding a fist and saying, "Systemic racism doesn't exist, "I don't believe systemic racism exists."

I looked to our leader to see how that person might respond to that.

There's just quiet.

I saw one of my colleagues starting to try to respond to that.

And I'm thinking to myself, here we are in a table with three or four other top leaders of the hospital, and they're not responding to this statement that this other leader made.

This is the environment I'm in.

That was years ago.

But you can just look on the "The Journal of the American Medical Association", 10, 12 days ago, and you will see a podcast where the topic was, doctors aren't racist, so structural racism doesn't exist in medicine.

These issues are here, and they're deep.

And the more we ask ourselves to contend with them, the deeper people kind of dig their heels in, in some ways.

I don't think they would say that, or even be conscious of it in many ways.

But it feels like there's a double-down happening.

- So a quick reminder for our viewers, a quick pause.

To get your questions in, hopefully we're having the kind of conversation that keeps you curious, and is inspiring more things you wanna learn about and hear about from Dr. Danielson on this very important critical topic to our community.

Dr. Danielson, Seattle Children's, as you mentioned, says it's committed to being an anti-racist organization.

And it's used that term, anti-racist.

You many have already answered this, but I'll ask it again, because there's an opportunity to go deeper.

Do you believe that Children's is capable of meeting that goal?

What does it look like to you for an organization to be anti-racist?

- In it's current form, I am not convinced that it can get there.

- And why?

What's in it's way?

- The triple-whammy of culture, policy, and leadership.

In my opinion, I think those are all problematic spaces around this.

And anyone else could debate differently, or could put up a different argument, I do see those statements as progress.

There's some different formulation, sometimes for understanding the continuum of organizational anti-racism.

And maybe this is signs of Seattle Children's moving from it's club mentality, where you have a few token people, but they have to keep their mouth shut to symbolic change, where more people can be involved, the conversation could include equity more often.

But really try not to make waves.

Maybe there's progress, yeah.

But I think that...

They've proven themselves to be differently-oriented.

And until there is some evidence, strong ownership.

A commitment to transformation, not just sort of, transactional accountability.

A commitment to doing something deeper than playing some numbers games, or- - So what actions would you want to see then?

- Well, I would wanna a reverse some of the things that have been happening.

The board of the hospital kind of like dissolved it's DEI committee like a year or so ago.

Like the direction has been in the, I don't know how you can create an anti-racist organization while you're dismantling the structures they're in.

Either the hospital's hiring new people to be part of their equity work.

And I just hope that those people actually have the authority to call leadership to the mat on these issues.

And I don't know that I've seen that before for Seattle Children's, I'm sure that's probably true for many other organizations, as well.

There's a commitment, but there's not an authority to really say, "Hey, you're not doing this, "and this means your job."

That's one thing.

- You mentioned a story that ran in the "South Seattle Emerald" very recently.

One black mother shared it.

It's heartbreaking.

It's about her experience at Seattle Children's.

She's detailing what she felt to be very discriminatory treatment against her and her dying two-year-old son.

Who ended up passing away, I think, a couple of years later.

She did this, she shared the story despite having signed a non-disclosure agreement, she said.

Because she was encouraged by the example of your resignation.

So clearly, and I think you know this, you feel this, you've become part of a broader complicated reckoning.

You've become for some, an inspiration.

For some, and example, on equity and racism.

What do you feel then, is your responsibility, moving forward?

- Well first, I just have to say, there are many, many more brilliant, powerful, amazing champions for this work out there.

All over, out there.

So, I'm a little bit reluctant to play into exceptionalism even in this role, if that's understandable.

Because I think there are a lot of people who know what's going on, and know what needs to be done.

Second thing I would say, is that this issue of non-disclosure agreements, I recognize is such a corporate challenge now.

That they are used so indiscriminately to assure that never a bad word is said.

And that is not transparency.

That is not honestly.

That is not naming us as flawed human beings working in flawed systems, to try to do our best.

To try to get to a more perfect, not a perfect, but a more-perfect union.

This is just really, really challenging in that way.

- I should mention on that point, real quick to our viewers, that Children's, as part of it's investigation, is encouraging transparency from families and patients, and has said that those agreements do not apply if folks wanna come and tell their stories to the investigation firm handling that.

- Yes, yes, to their credit, to their credit.

I think it took some negotiation for that to happen.

But to their credit, that did happen.

And I hope that really is truly opening a door.

Once you have had a culture of non-disclosure agreements, and threats to your financial security, and things like that, it is a long road back to trust.

Like somebody just says, "Oh, yeah, we're gonna stop.

"You're gonna be fine if you say whatever you want to."

I don't know that you can, I mean, we're all human beings.

Once you have 20 experiences, than the one change doesn't necessarily make everybody come forward in the way that you might expect.

It's kind of an odd expectation, I would say.

I remember Ta-Nehisi Coates, talking about this in his article about reparations.

About you know, you stab a man in the back 10 times, and then you think everything is fixed by not stabbing the 11th time.

What does that really mean for us?

What are we expecting for understanding about the state of racism in this nation?

Today, and yesterday, and tomorrow.

- Which is actually an excellent segue to our first reader question.

So, this is a question sent in by Sprout Hockberg.

And this was sent in ahead of the event.

And after this question, I will also be asking you some questions from the viewers watching live with us right now.

So Sprout says, "Not everyone has the privilege you do.

"To leave a job without another in hand."

- Right.

- "What do you suggest for people who work in places "with institutional racism, "but they cannot leave their position?"

- I think everyone has to make the best decisions that they can.

And I think it's completely legitimate to say that I need to be in this position, if I'm a black woman leading a department of medicine.

I need to be in this position in order to be on the inside making change.

If you think that you're going to get to a space where you're gonna have influence, I think it is completely legitimate for a person who works for a big organization to say, "I see this happening, and yet I really need my job."

And maybe also, you don't escape racism, you just move to another place with it's own version of that.

So I fully endorse Sprout's perspective on this.

And I think that it is, it's both wise and understandable.

And, I put myself to account.

If I am able to make a statement, if I didn't make a statement, what would that had meant?

What would I be?

A person full of privilege.

And yet, not doing what I should be in the name of addressing issues of racism.

I yesterday, got a total knee replacement.

And I was looking at that the other day, and it turns out that if you're African-American, you're 50% less likely to have a total knee replacement.

For three reasons, that sound really similar to this COVID pandemic.

One, you are less-likely to be offered a total knee-replacement.

Two, you have some good reasons not to trust the healthcare system at that highly-complicated level of care.

Three, you have high rates of complications in the African-American community for that surgery.

Which feels very much like this pandemic, that is just revealing all of these kinds of racism.

More likely to die from COVID.

More likely to distrust, with good reason, the systems that are providing different kinds of services.

Less access to the highly-needed kinds of services.

The idea that this continues to be part of our reality all around us, we are choosing, or not choosing, every day, with great risk, black people, brown people are making very hard decisions every day about their health.

I chose to do this because the orthopedic surgeon is a black surgeon.

Don't tell me, don't ask me how many black surgeons are in this country, but, I wanna end, this might not make sense to somebody who's not black, but, I trust his care, and he's more willing to tell me about offering this total knee replacement.

And I feel better about the process and the procedure.

These are the real decisions and choices that, boy, that my privilege brings me.

And that so many other families without privilege, and facing racism, have to make their own decisions about.

I don't know why I drifted into that, but- - No, I mean, that's an illuminating story.

And I trust you're recovering okay?

- (laughing) Yeah, yeah, yeah.

He did a fantastic job, and yeah, yeah.

- Cool.

- I know my life, my quality of life is gonna be better.

The study in 2018 by the American Academy of Rheumatology, measured quality of life year differences.

And found these incredibly great differences.

It's not just whether you live or die, right?

It's about whether you're leading a life that's not full of pain, and allows you to do the things that you care about doing.

So the quality of life years impacted by procedures like a total knee replacement (indistinct) and based on the color of your skin in this nation.

- So we have lots of viewer questions.

I am really excited about that.

So let's get into it.

From Anna Rudd, "Suggest three changes that could get us closer 'to the ideal, or anyone who requires care, "is met where they are starting from, "and it's the care provider "who adapts to the patient, or family."

(crosstalk drains out dialogue) - Say that again?

Sorry, I didn't hear you.

- I think she just named two of them, the person calling that in, right?

(crosstalk drains out dialogue) And yeah, and provide a trustworthy environment.

Trust has developed over time, it's lost way more quickly than it's built back up.

And you have to make strong investments to build trust.

You don't just say, "Starting tomorrow it's gonna be different."

So that process is an investment, and a strong journey, not a flick of the button decision, or a document that you put out.

I think that there are ways in a moment to make better decisions and have better conversations.

I worry sometimes about, tell me the three things I need to do.

There's a little bit of what I perceive is a, make this simple for me, construct, that I referenced before.

I think that we have to have an agenda of transformation, though, in our systems.

Not just make this go away, or do a few things until the energy blows over.

I'm so worried that in this time, that the reckoning that was invited this fall, is already starting to fade in different people, minds, and that all of these sacrifices, and all of these harms, all these traumas that people have faced, now on the anniversary of Breonna Taylor's murder, are we, can we live up to my mom enough to sustain the kind of accountability and reckoning that I heard us say we promised ourselves that we would be doing not that long ago.

I drifted from her question a little bit.

I do think that people who look like you working in this field, sounds so simple, but it makes such an incredible difference.

I think people with lived experiences like you, so I know a lot of people who are great diagnosticians, and decision-makers, who might do terrible on an MCAT, a medical standardized test.

How do we invite a different kind of healer into (indistinct) traditional healthcare system, in ways that other parts of the healthcare system are actually doing better than an out medical school is.

- And by the way, I should ask, 'cause I believe UDUB has said, and you mentioned that, you're working on some projects that are not just practicing pediatrics to address equity.

Can you tell us anything about them here?

- The one of them is just based on some basic questions about what really does harm to people's lives, especially young people's lives.

What detracts from the opportunity to have quality of life views?

To be part of a contributing part of society.

To have opportunities.

To have dreams that can actually turn into things you do.

Like my privilege brought me a chance to do.

And I see the juvenile justice system as one of the worse perpetrators of harm to young people, especially young people of color in this country.

It doesn't work, recidivism rates are high.

It costs a lot of money.

It doesn't address the health needs, the mental health needs, the trauma needs, the experiential needs that, and things that people have had it.

It labels people as criminals and then trains them to sort of be criminals.

It creates a complete derailment from opportunity.

And so- - Your project then extends outside of healthcare, even to that?

- To health, yeah.

(indistinct) - What does life-long health look like?

So really no, from a social determinist perspective, that so much more of your health is experienced outside the healthcare system than inside.

So what does it mean to life into that?

As a healthcare informed person, what is, again, it's my accounting.

What am I accountable for?

For kids who come through the door everyday in the clinic like Odessa Brown.

Full of dreams and ideas, and possibilities that inspire you way more than you ever provide healthcare to them.

That live their lives while you're watching them grow up.

What is going to allow that young person to be healthy?

- Yeah, and it's a lot more than what happens at the doctor's office.

- Yeah, yeah, and I think you could melt, you can mix, you can incorporate many different things, it can be part healthcare, and part wellness promotion.

- So I wanna, yeah, I wanna get us back to reader questions.

Because we can talk about this much of this for so long, but I wanna make sure that folks get their questions in.

Anu Asnami asks, "If you had the authority to make changes "to the current situation at Seattle Children's, "where would you start?"

- I start sometimes in a very simple place.

With a different kind of philosophy for how you approach your work every single day.

In times when I've been in leadership, if you call it that, I don't even know what leadership means.

The importance of doing the right thing should overshadow every other contingency decision-making process, or things that get in the way of doing the right thing.

We compromise so often, the right thing.

Not because we don't know what the right thing to do is.

But because we don't have the will, to be honest, to do it.

- So you would start with that with some kind of culture change to bring that to bear?

- Yeah, and that involves leadership.

That involves a culture that has to prove itself, doesn't like, just turn around tomorrow.

It involves really looking at policies.

If you have policies that end up calling security on people based on the color of their skin, that's a policy and culture problem.

If you have policies that place black and brown people more at risk for COVID, that's a policy and a culture problem, and it's a leadership decision that needs to really impact those.

I know it sounds like thousand foot ephemeral up in the air, but you have to stand on some values as a leader.

In fact, there isn't much else beside values as a leader, clearly.

Everyone else is doing the work, right?

Like all the processes are happening.

You're the value leader, and it is an indictment of the leader if the values are anything other than doing the right thing, in my view.

(crosstalk drains out dialogue) Any questions correctly tonight, so.

- Oh, please, this is a conversation, right?

Not a test.

From Doug Conrad, "I understand that you will be "developing a program to advance-" Oh, maybe we already answered this.

Let me look at it.

"I understand you will be developing a program "to advance health equity in your new position.

"In a broad outline, what do you hope "that program will look like?"

I think you told us a little bit about it.

You want it to be about healthcare outside the doctor's office, the entire kind of life.

And making sure that's equitable.

Yeah, okay, I think we might of covered that question.

Anything else you wanna add to that?

- Not yet.

- Okay.

- Not yet.

- All right.

From Sharon Frell, "Do you feel patient care is at risk "if you have a black child?"

And to add to her question, what advice is there for a parent navigating that imbalance?

- I know that there are places, and I believe that the Odessa Brown Clinic is a place like this, where the risk of being black, as a child in this country, is greatly reduced because of the people who work there, the front-line people who look like the kids who come through the door.

The providers, the doctors, the nurse practitioners.

So I know that there are spaces where the inklings of the right kind of care can happen.

I've seen that possibility open up in front of me.

But the question is, is there a threat, is there a risk to your well-being by being a black child in this country, and it's incontrovertibly true.

It is, every bit of evidence from Institute of Medicine's, unequal study that complied 800 different studies back in 2002, to just about every study since then, it's people, though, like JAMA editorial leadership that says, racism doesn't exist.

It's people who want to blow by these issues and not address them.

It's people who seek their own comfort so quickly, just makes me uncomfortable to talk about this.

And what's the quickest path to make me comfortable again?

It's people who center themselves instead of those amazing young people around us that can get in the way.

- This brings up, the new acting medical director at Odessa, her name's Dr. Shaquita Bell.

She wrote a "Seattle Times" op-ed recently.

And said, "As a black woman, I would bring my family "to Seattle Children's without a second thought.

"The care that is offered at Seattle Children's "remains unparalleled in this region."

So when you hear that, I'll just ask this, do you think it's fair that your departure is putting so much pressure on Seattle Children's, when as you said, many institutions struggle with the same things.

It's another kind of loaded question, but I'd love to hear your thoughts.

- Well, I'll go backwards on this.

So the fact that many institutions struggle with this, does not make it okay that any institution struggles with this.

And if you are in a place where you have voice, or influence, and mine was sequentially kind of erased, then working in those systems, you should be fighting for change.

I appreciate that line from Dr. Bell, and she's an amazing doctor, incredible advocate for her families.

She understands issues of racism in ways that many others can't even come close to, maybe including myself.

I would challenge her on that statement.

Based on things that she has told me.

- What part that statement, what do you challenge?

- Well, I'm questioning trusting, bringing in a child to Seattle Children's.

- Why?

- I don't think history bears that out.

I'm questioning, really, I don't think what she said about her experiences bears that out.

I need to stop there, because I'm not speaking for her.

She is wiser than me in just every way, and she's got so many different approaches that she's really taking on.

But I would, that's one of those journalism moments that needs more unpacking.

And more honest, transparent unpacking in my view.

I'm not blaming journalism, but I'm just saying sometimes we have compressed time, and you know, you can say sentences.

I can also see why it's important to want to restore a sense of faith and things like that.

- Well, thinking, too, about the families that have been going at Odessa, for whom it was a gut-punch that you left, would you tell them not to go?

Where would, what would you tell them to do?

- I would tell them a reality, that goes back to the question you asked.

It is not, you don't have the same health risks when you're a person of color, and a child of color than when you aren't.

And those health risks come from the societal impacts that create maybe greater toxicity, greater opportunity for harm, it has a health implication, and we also know that within our healthcare systems, there is systemic racism.

Again, you can't say that you acknowledge that systemic racism is occurring in these institutions, and then say, it's absolutely trustworthy.

I don't think those are aligned statements, right?

Or am I missing?

Tell me what I'm missing in those two statements, 'cause maybe it's just more about nuance, or something.

- No, I mean, it comes back to, these are complicated decisions for everyone, for sure.

And a lot of folks watching right now, have a lot, kind of swimming in their heads, too.

- Can I say one more thing about this complicated?

- Yes, please, and then I think we have time for maybe one more question.

- Okay, this is so even more complicated.

I think in some ways, with institutions like Seattle Children's.

One, because they are a non-profit, and they get to forego paying taxes that would have gone to the communities around them.

Maybe, particularly, the most harmed communities by issues like racism, and toxic capitalism, and things.

And from that comes a responsibility in my view, in addition, they are an incredibly talented place that serves not only a state, but a region.

And I think with that, also comes an incredible obligation to function in a way that is incredibly responsive to the many different kinds of cultures and communities, rural, indigenous, LBGTQIA plus, disabled, medically-complex, there's a higher bar of responsibility for that particular institution than maybe some other institutions.

That's part of the complication.

I also think, I think black folk and other parts of the BIPOC communities, understand complexity a lot better.

You know that you can be black and be racist.

You can be, you know, you can make the least bad choice, and be okay about that, and maybe call it a good choice.

You can really need your job.

You could really, really need your job.

And that's part of the complexity, too.

- So for our last question, this comes from Susan Johnson.

"Given the pervasive nature of systemic racism, "how nervous might you be to discover it again at UDUB?

"And if so, what would you do, then?"

- It is everywhere, it is everywhere.

It is in all of those institutions.

When I was talking with my smarter-than-me beautiful wife about making these decisions early-on, and early in the months of trying to negotiate with Children's and getting no response from them about all the the stuff before it was public.

You know, we talked over and over again.

I'm not trying to escape racism, 'cause that's not really possible.

I'm just making a choice to not be part of that, Children's Hospital version of racism, any more to the extent that I can.

Those are maybe, meaningless decisions, or choices, to some people, but it's some level of agency for me.

And it's a call-out.

It's a call-out to one organization to do their work, just like every other organization needs to do their work, starting with a reckoning.

- Well, thank you so much, Dr. Danielson for the conversation today.

Thank you for joining us, thank you to all of our viewers.

(deep breath) - Thank you, oh, big breath is right, right?

There's 25 thousand more hours of talking about this, that would, for even get to a space of feeling like we're kind of closing in on things.

But, I have so much faith.

I love Seattle Children's, I do.

Which is why I expect more of it.

I love the people that I've grown up with professionally.

I love their ideas of care.

It's just, it's a wonderful opportunity to be a much better place.

- We look forward to talking with you again, Dr. Danielson, thank you.

- Thank you.

- To our series sponsor, Waldron, thank you for making tonight's event possible.

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That relies on the support of you, our community, to ensure that our events in journalism remain free for everyone.

Thank you so much to everyone who donated to this event today.

If you'd like to make a donation, or become a Crosscut member, visit us at Crosscut.com/Support.

And we hope you'll join us at one of our upcoming Crosscut events, including the Crosscut Festival, May 3rd through the 8th, that features a week of sessions with speakers like Dr. Ibram Kendi, Jane Goodall, Alicia Garza, Carmen Best, Pramila Jayapal, and so many more.

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Thanks again to Dr. Danielson, and to all of you for joining us today.

And we'll see you next time.