Perspective

Perspective is everything!

Perspective helps to explain intent vs. impact when conversations or interactions turn sour.  We live in a world that includes conflict and misunderstanding.  Often these misunderstandings occur when we least expect.   Frequently, understanding the “intent” behind the misconception can diffuse conflict.

Be curious. 

When you find that you have unintentionally hurt or harmed someone, don’t be quick to defend yourself.  Remember perspective – you naturally will see the situation differently – we are all unique and come with unique life experiences.  Acknowledge the unintentional harm and apologize for it.   And, if you really want to promote connection, you will declare you will try not to do that again! 

Take a moment to conduct the exercise below that explores the concept of perspective.


Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years.

Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.

The Iceberg and the Mirror

Self-Reflection Exercise

This activity will take 10 minutes.  You will need a piece of paper and something to write with and a mirror. If you have a journal, use it.

As you look at the picture of the iceberg above, you should notice that about 10% of the ice mountain sits above the water line.  This is the part of the iceberg that you normally can see.  About 90% of the ice mountain is below the surface of the water and usually not seen. Now draw a picture of an iceberg on your piece of paper.

Now look at yourself in the mirror.  What do you see?  What do other people see when they encounter you?  Imagine someone who has never met you before – how would they describe you?  Your skin color, your gender, your height…Write your observations about what you see on a piece of paper above the surface of the water line.  This is important, so write down what you see.

Now think about all the personal characteristics that are NOT readily apparent to others who encounter you.   Write those characteristics on the piece of paper below the water line. You might include your education, your employment, your religion, your relationships, etc.

Questions to ask yourself:

  1. Where do most of your characteristics about yourself fall – above or below the line?
  2. Where do the characteristics that have the most importance to you fall – above or below the line?
  3. Do people ever make assumptions about “who you are” using characteristics that they can only see?  If so, how does that make you feel?
  4. What skills do you use to reveal what lies below the surface of the water in your relationships?

Stereotypes abound when there is distance.
They are an invention, a pretense that one knows when the steps that would make real knowing possible cannot be taken or are not allowed bell hooks

Adapted from the Iceberg Analogy in the 2006 publication by the National Multicultural Institute.


Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years.

Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.

Utilizing our Higher Brain in our Thinking: Unconscious Bias

We are more apt to accept someone else’s culture if we are utilizing our higher brain in our thinking. Higher brain thinking reflects attention to rewiring the neural pathways of unconscious bias and negative thinking.

When we are using higher brain function, executive function, our pre-frontal cortex leads the way.  We show up with the ability to process complex conflicting information, have a great sense of self awareness and more likely that choices are more conscious.

Our body can give us clues to whether or not we are using our higher brain state.  We are relaxed and comfortable in our skin.  We are attentive to what is going on around us.  Our thinking is clear.  We feel confident and empowered. 

There are multiple strategies for recognizing and reducing implicit bias. One of the most important practices is to strengthen your metacognition – the ability to think about what you are thinking and feeling.


Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years.

Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.

Your Mother Is White!

Children undergo physical, intellectual, and emotional development as they age and experience the world.  In similar ways, they experience racial development too.  They begin to recognize differences in skin color as early as six months of age.  By the age of five, many children start to not only realize that different groups are treated differently, but also recognize that racial groups can be “ranked.”

At my predominantly black elementary school,  I played on my kindergarten playground.  A boy at my school started taunting and screaming at me, “Your mother is white, your mother is white!”  His loud and angry voice carried across the schoolyard.   My beautiful mother, my favorite person in the world, walked me to school every morning.  Up until that moment, I don’t ever remember registering the color of my mother’s skin; only its warmth and lovely smell. Returning home that day, as I ran into the kitchen, I too began screaming.   While stomping my feet and through tears, I demanded,  “Why didn’t you tell me you were white; why didn’t you tell me?”  Shocked, taken aback and as her eyes also welled up with tears, my mother sat me on her lap. She proceeded to explain to me how black people in the United States could have “white” skin.  That day, on my mother’s lap, with the smell of chicken baking in the oven,  I listened to my first history lesson about the abomination called chattel slavery.  I was five years old.

I suppose that was the first day of my journey to understand issues of race, privilege, and oppression.  We need to begin courageous conversations with our children at a very young age.  It is crucial to start our journey to unlearn some of the prejudices we have picked up along the way.  As we develop a culturally competent mindset, our conversations with our children become more accurate and support their healthy racial development.


Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years.

Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.

Identifying my Superpower

I entertained the idea of quitting medicine after my first night on call during my internship year.  On that night, I felt petrified assigned to the Neonatal Intensive Care Unit (NICU).   Joe, the third-year resident camped out in his call room, gave clear instructions.  He should only be disturbed if an infant deteriorated during the night.  In the competitive culture of the residency program where I trained, the senior doctors, known as the “attendings,” supervised the interns and residents from the comfort of their homes. The unwritten rule stopped residents from consulting them in the middle of the night. 

While I was hunched over a micro-preemie completing a procedure, a nurse asked if I wanted to give antacid to an infant who had acidic undigested formula in his stomach.  Clueless, I breached protocol and interrupted Joe’s football game.  Calmly, he approved of the plan to give the antacid.  I researched the dose and wrote the order in the infant’s medical chart.  The nurse informed me in the wee hours of the morning that the infant with the acid issue improved.

The next day as morning rounds began, I reflected on how all the infants and I had survived the night.  Because of exhaustion, I barely noticed the blinking lights of the breathing machines and the beeping sounds of the IV poles.  Before me in one large room stood twelve tiny babies in their respective incubators with their nurses hustling around them, inserting IVs, changing diapers, and dispensing medications.   I began my discussion of each infant’s events during the night to the senior physician, the two other residents, and several medical students.  The attending physician, Dr. T, asked questions, and I answered moving from one crib to the next.  When we reached the infant I’d written the order for the antacid, Dr. T stared at the crib.  Suddenly, without warning, he grabbed the bottle of antacid sitting prominently on the shelf just above the infant’s bed.  While hurling the bottle towards me, he yelled an expletive and followed with the question that haunted me for many months, “What are you doing, trying to kill this infant?” He followed the outburst with a quote from a research journal about the potentially fatal adverse effects of using antacids in premature infants.  Luckily, my years as an athlete helped me dodge the bottle which settled near my feet.  The room seemed to disappear.  The infant’s incubator crib appeared to leap into my vision inches from my face.  I felt hot all-over and my palms felt wet.  No one said anything to diffuse the situation.  Not one nurse revealed that ordering antacid had been a common practice.  Dr. Joe, the supporting resident, had already left the NICU.  Nothing could have insulated me from the humiliation. I quickly scribbled an order in the patient’s chart to discontinue the antacid and jotted a note on my clipboard to find the research article to read later that day. 

As the morning rounds continued, the bottle of antacid rested in the middle of the floor.  Did anyone, fellow intern or senior resident, or one of the nurses have the courage to support me  that morning? Did anyone else see the hurled bottle as an assault?  Maybe not. After rounds, in the privacy of the bathroom, along with my tears and simmering anger, I reflected on the dynamics that would allow one person to treat a team member with such unfiltered anger and disrespect.  What did the Attending physician possess that the rest of the team lacked?  He could claim seniority.  He possessed seniority in a rigidly hierarchical system. He occupied a position of privilege in relation to everyone else.   In the privacy of the bathroom stall,  I identified a future superpower.  I promised myself that when I had the responsibility of being the senior physician in a teaching hospital, I would never shame an intern or a resident on rounds.  I’d always use my superpower of seniority for good. 

Can you remember an experience that revealed a superpower or encouraged you to develop one? Share below.


Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years.

Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.