The performative actions of institutions, corporate America, academia, and hospitals among other entities have made me highly dislike the acronyms DEI, EDI, DEIB, or whatever other fancy acronyms the C-suiters come up with. I remember hearing from a colleague that their institution did not want the words “anti-racism” included in the title of one of these phony task forces because it was too “violent”… Hmm, violent? Sort of like the atrocities committing against Black people, American Indian people, and many others in the U.S of A.? That is most certainly a topic for another blog (or twenty, at minimum).

When organizations say they care about diversity, they really need to invest time in understanding what diversity means. Including white women on panels is, in fact, not diversity. I mean, it was in 1849 that the first woman (Elizabeth Blackwell) was granted an MD degree in the U.S. at Geneva Medical College. She was also the first woman on the medical register of the General Medical Council for the United Kingdom. A mere 174 years ago.

Besides, some of the women in cardiology who are popular on #CardioTwitter are the most vicious against other women. These are women who run journals, societies, research labs, divisions, and “women in [whatever]” interest groups. But again, this fraudulent behavior is a topic for another blog or Tweet exposé. I need to be in the mood for this, but trust that I do keep all my receipts, just like my Mama taught me to.

In 2021, I Tweeted about a heart failure conference in California that had a lineup of twenty-one male speakers. Yes, you read that right, twenty-one. Most of those men are powerhouses in the world of heart failure, and many are my mentors. It felt good to read that many of them had no idea they were joining this bro squad. Oh, and the organizers were, drum roll … both men. The absolute coolest was getting an email from The Godfather of Heart Failure himself, Dr. Clyde Yancy, telling me he was proud of me for causing “good trouble” and inciting change. Dr. Yancy led the dismantling of that conference lineup, and it was beautifully rebuilt. Disrupt and dismantle.

Fast forward to 2023, three years after the brutal murder of Mr. George Floyd by the despicable Derek Chauvin while his fellow gang members assisted. Three years after all the kneeling with #BlackLivesMatter signs outside of hospitals, the “calls to action” by journal editors in chief, the “our diversity is our strength” videos, the newly created “DEI” task forces and leadership positions,  the newly designed websites to “reflect our diversity,” etc. a circus, if you may, I am watching my #CardioTwitter timeline and barely see a single Black speaker (again speaker, not a moderator or panelist, a speaker) at the European Society of Cardiology (ESC) annual meeting. Not even one! Until boom, I saw none other than, The Godfather again to the rescue, pop up on my timeline. He was schooling the ESC attendees on creating a roadmap to achieve health equity. Not an easy task whatsoever.

So, of course, I Tweeted and asked what was up with that, and you guessed it, crickets, even though my Tweet was viewed 18.6K times and my follow-up one 45.4K times to date. What really struck me were the women “of color” (another ridiculous term, but again, a topic for another blog) in my DMs and replying to my Tweet wanting me to pat the ESC on the back because they included women on their speaker line-up … Please be serious. Also, re-read paragraph two above.

The ESC has zero Black people on its board. Zero, zilch, nada, nothing. It’s laughable, really. So unsurprisingly, the diversity of their annual conference speakers is dismal. Even the ESC social media ambassadors did not include a single Black person. Again, laughable.

I’m not an expert in diversity, far from it. Others have dedicated their entire careers to researching it and creating mechanisms to disrupt and dismantle the systems that prevent diversity from improving life as we know it. However, I do know that including white women (and yes, most women who call themselves “women of color” are white) is not diversity. If the ESC cared, and I am certain they don’t because Europe’s systemic racism is on par with the U.S.’s, they would hire individuals to serve as consultants to address this embarrassing issue.

And for those telling me I’m just mad I didn’t get invited … I could care less to buy my own plane ticket and pay for a hotel during Europe’s high season to attend a conference that does not elevate Black women and men in cardiology. I am speaking up on behalf of those who cannot or will not due to fear of retaliation. I, on the other hand, truly do not care because when you speak up for the most oppressed in any situation, you can never be wrong.

So, what does diversity mean to me? It means that everyone gets a chance. Whether you went to the University of Cincinnati for every part of your training or whether you were born and bred in the Harvard system. Whether you are Black, Hispanic/Latinx, American Indian, Pacific Islander, Alaska Native, or whatever race and/or ethnicity you identify with, everyone should get a chance. Women, LGBTQIA+ individuals, individuals with physical or intellectual disabilities, first-generation college and medical students, refugees seeking asylum, immigrants (undocumented included), and formerly incarcerated individuals. Everyone should get a chance. Low-income, non-native English speakers, the movers and shakers and the quiet ones, the misfits and the rebels, and the ones who march to the beat of their own drum. Everyone deserves a chance. Everyone.

Do I think we are doing well in cardiology? Absolutely not. I have never seen a sign language interpreter on stage at any of the big cardiology annual conferences nor seen stages with wheelchair access. Most cardiology societies and journals are led by incredibly non-diverse presidents and boards. Give people a chance. Pull up extra seats to the table and add extra positions on your boards. Train people so that you make them “good enough” for your organization.

Do I think we have the tools to do better? Absolutely.

So, I hope my generation and the one coming after mine continue to create the kind of trouble the late great Congressman John Lewis recommended we create.

Speak up. It’s so worth it.

Nasrien E. Ibrahim is a cardiologist.