I always thought life is a battle. But I’ve realised this week, I know nothing about battles.

From the time I first appeared at Birmingham’s Dudley Road Hospital sometime in the 50’s, I’ve struggled through life’s vicissitudes, manfully. For a start, I know for a fact there was NO social isolating on the maternity unit I was born on and I very much doubt there was such a thing as an N95 mask or injectable disinfectant.

Nor was there any hydroxychloroquine available in those days. I know this for a fact, because I was always being dragged to the doctors by my mother because for most of my childhood, I had a persistent cough. The best the doctor could come up with was an allergy to a budgie. The fact that my parents both smoked like Drax Power Station wasn’t even taken into vague consideration. In fact, I can even remember when I earned pocket money as a child (and I’m talking from about eight years of age) by fetching my parent’s cigarettes from the corner shop – the order was: “Twenty Park Drive and ten Embassy Tipped please.” Mrs Carol, the shopkeeper never thought of checking who the fags were for. I think she probably assumed they were for me since I would guess I coughed all the way through my errand.

And you can imagine how it’s been for me during the pandemic, walking into the Co-op with the persistent cough that’s followed me into adulthood. As I’m marching into the supermarket from the car park, I usually ram a Jakeman’s Throat and Chest sweet in my mouth under the mask to suppress the cough so I don’t cause a stampede out the shop when I start hacking in the hair products department while trying to find my favourite brand of hair mousse.

Aside from my cough and chronic health problems such as volcanic Irritable Bowel Syndrome, insulin-controlled diabetes and a Prolonged P-Wave which gives me occasional Paroxysmal Atrial Fibrillation, I seem to be in a constant battle with – well, everything. It’s almost like I can’t really rid myself of the hassle presented by dentistry and have to substitute it with getting annoyed with drivers who hog the middle lane on motorways when lane one is clear, or getting vexed with the owners of grey cars who emerge suddenly behind you at dusk without dipped headlights on.

As a mature student I had a battle to find a place which presented evening courses in the right science ‘A’ levels. Then I struggled to find a place at dental school – one dental school blatantly said I was too old for undergraduate entry, though they would have taken me if I’d already held a degree. And when I did get into university, I then battled - trying to juggle my studies with having a wife and young family. Of course, when you get into dental school, you then have various battles getting to grips with various subjects – for me, biochemistry was a complete mystery. And of course there the inevitable battle with lecturers. I know very few dental people who didn’t have problems with lecturers at some point during their courses.

Then when you get into practice, if relatively unscathed, your problems really start. Earning enough money to pay off the student loan is one of the battles, and of course over recent years, you bet on at some point having to battle with patients or the lawyers representing them, or worse, the General Dental Council. I had all of that and more, as I’ve written about previously.

A REAL Battle

But NONE of my ‘battles’ bear comparison to those wars fought by other individuals. My battles become mere skirmishes in comparison to those who battle every day against racism.

It was early last week that I was taken aback, but not terribly surprised, that a UK dental school appeared in the headlines following accusations levelled against it of “Racist behaviour and unconscious bias” among its teaching staff, some students, and even patients.

Students at Cardiff University’s School of Dentistry wrote in a letter, seen by BBC Wales: “We are writing to urge you to take action against racist behaviour and unconscious bias that takes place within the dental hospital and Cardiff University environment,” said the authors, according to BBC Wales and gair rhydd, Cardiff University’s student paper.

The letter also reportedly highlighted a wider issue of racism within the ‘dentistry industry.’

Gair rhydd reported that a Cardiff School of Dentistry spokesman confirmed they had received a letter from its students. The statement said

“The letter raises a number of extremely concerning issues and alleged incidents. As a University and a School of Dentistry we take allegations of racism extremely seriously. We have measures in place to ensure that allegations of this type can be investigated, and appropriate action taken”.

Gair rhydd also reported that a message was also written to all dental students disclosing that the School of Dentistry is “committed to a community based on dignity, courtesy and respect” and also remarked, “Racism has no place in our school”.

The student paper reported that “The interim Head of the School of Dentistry told students that the Senior Management Team would be meeting daily to consider the issues raised by the letter and find appropriate ways of addressing these issues.”

I was particularly triggered by this story since I have been made aware by dental professionals I follow on Twitter, and Asian friends and friends from overseas recently, that racism and discrimination is alive and kicking in dentistry. And I really, really wish it wasn’t.

On the day the Cardiff story broke, I was sent a message on Twitter which has to remain anonymous. It read: “I didn’t feel comfortable posting this publicly, but I knew exactly which dental school was going to be mentioned in that BBC link before opening the link because I qualified at that dental school 10 years ago and can confirm that racism is a huge issue there among the lecturers.”

Before I launch into my view of the situation, which clearly has to be thoroughly investigated by Cardiff University, I’ll state for the record that I am white, middle-class and once inadvertently presented a fake £5 note to pay for my petrol in 1973 and the garage attendant just said “Hard luck mate” and passed it off as a joke. There were no serious consequences like those which befell the murdered George Floyd. No police were called. No accusations of attempted fraud. I read recently that the comedian Dara Ó Briain had a similar experience and said there were no consequences for him either “That’s some privilege right there,” he said.

Also, for the record, I need to say that being accurate, I wasn’t a student of Cardiff University School of Dentistry, but I think what has been revealed recently has been going on in dental schools up and down the UK for many, many years. What follows are my experiences of what befell friends and peers during my time at dental school and subsequently.

1982

The first bit of racism I witnessed at dental school was at the fresher’s tea. A very slight, polite, Asian, medical student asked two other white medical students sitting at our table if they would speak in English so they could be understood. They both happened to be Welsh and were speaking their native language. I admired him, because they both looked like they could rip him apart like a KFC chicken wing. Indeed, one of them attempted to, launching over the table to drag the Asian student (whom I later discovered was Indian) by the scruff of his neck. The Welsh chap started shouting loudly in Welsh in his face and the only word that I understood was “Paki.”   Fortunately, a couple of supervising teaching staff were soon on the scene and the screaming Welshman was dragged off his victim. It was a horrible start to a day I had been looking forward to for a number of years - my first day at dental school.

But the next piece of racism I witnessed was while doing 1^st BDS basic sciences. I was in a biology class with two friends, a Sikh and an Iraqi student. They both seemed to be picked on by the lecturer, a white man with a doctorate, in his 60’s. He seemed to be always picking fault with the Sikh’s dissection and practical work and he was constantly criticising the Iraqi when he couldn’t answer his questions in the lectures. Now those incidents could have just been down to personality clashes with individual students, but that theory was laid to rest when, in front of the class the lecturer said, directing his comments at the Birmingham-born Sikh: “I get fed up with you people coming over here and picking holes in my teaching.”

When I got into the 3^rd BDS clinical year at the university hospital, an affable senior student was showing us around the campus. At one point, he gathered us closer to him and quietly said “Whatever you do, keeps your heads down, or they’ll get you.” Someone quietly and naively said “Who?” The senior student nodded towards the dental school. “Them.” He left us in no doubt it was the teaching staff. Now he was addressing our group as a whole, but I have learned in the past couple of weeks that one of my old dental school friends, a Kenyan Indian (he always likes to be different), was told by an Asian student in his final year, to “Stay under the radar and not ruffle any feathers or stand out in any way.”

That same Indian friend was told shortly before finals by a consultant oral surgeon , who I have to say, I much respected at the time: “Oral surgery is a career where Anglo-Saxon males are most likely to get to the top.” My mate (who now works as an oral surgeon) said: “Whether he meant this in a ‘kind’ way in terms of a warning (not to be disappointed) or to put me off, I don’t know.”

When asked by another dental school friend: “Did you experience overt racism at the dental school? There was certainly lots of sexism,” my buddy said “Absolutely! Most was just the difference in attitude compared to other students. In my experience there was a hierarchy as follows: The rugby playing male got away with practically anything. The Asian male (as we didn’t even have any black students ) was bottom of the heap. And I don’t say that just because I am Asian and male.

And I definitely noticed the sexism too. Obviously, it didn’t affect me, but it was so evident.”

Just to emphasise the point, at the dental school we attended, there was not one single black student admitted on to the dentistry course in the five years I was there. This was the early 80’s. You would have thought just one would have been seen in half a decade’s worth of intake, but no. I also have to say that in 31 years in practice, I have only ever worked with one black dentist (a real high flier), and he wasn’t trained in the UK. Even when I ran a practice and advertised for associates, despite interviewing all the applicants, I never had a black applicant. I worked in and around my home city of Birmingham for a few years where there was a huge black and Asian community, yet I never worked with any others dentists of Afro-Caribbean descent.

Until the allegations against the Cardiff dental school came out, I’d sort of hoped that the racist experiences friends had to battle through at my dental school were a thing of the past. The attitude of a select few, but powerful apparently racist lecturers back then seemed to be a throwback to the 70’s an era which had only just rid itself of popular television shows like Love Thy Neighbour and The Black and White Minstrel Show. I hadn’t considered for a second that such attitudes could still prevail, but I appear to be very wrong.

All’s Not Well

A BAME dentist I follow on Twitter has very recently been treated appallingly by a large corporate in the aftermath of the dental shutdown, being offered unacceptable conditions in a new contract that she justifiably felt were racially inspired and an attempt to deter her from working for the corporate. She is still battling with the company over the discriminatory issue, but she also saw racism in her dental school only five years ago.

“…The people who failed a year would be of ethnic minorities and it was on subjective stuff, like the exit case. One time only two black students failed. We all knew it was racism but there was nothing we could do. This was 5 years ago. One black student failed twice so dental school was 6 years rather than 4. He already had an MSc from UCL so you couldn’t say he was thick and he didn’t fail on dexterity either.”

 

In the space of 5 years, 6 black students failed a year and there were only 10 or so in the entire dental school. The rest were ethnic minorities. In fact, I don’t know any white people who failed. It’s desperately sad.”

 

The lecturers who displayed racist traits at my dental school were, it has to be said, relatively few, but they were all in powerful positions and could wreck a student’s chances of completing the dental course with little difficulty. I heard the insidious threat “If you’re to make it through finals” quietly uttered from the lips of teaching staff to students on a number of occasions (including me) and this would account for why students didn’t speak up against racism or bullying in dental schools. Basically, they were scared. And that same fear pervades the profession now, but once you’re qualified, the GDC and dental litigation firms crack the whip.

But those few lecturers didn’t just restrict their venom for the expression of racism. They were also xenophobic. One of my friends was a Spanish speaker and he had an appalling time at dental school, being mercilessly ridiculed by lecturers because of his accent and his quiet nature. I heard one senior lecturer (who I discovered recently, to my horror, does work for a large dental litigation firm as an ‘expert witness’) in earshot of the student’s patient say: “You’ve virtually destroyed that tooth. You ought to be shot.” Fortunately, my friend was made of sterner stuff and passed finals first time. I really don’t know how he shrugged it all off.

But even in practice, I do feel that racism is lying dormant, like arrested caries.

This was some years ago, but I worked part-time at a practice and the boss was planning on taking on a new trainee nurse. The next time I was working, I asked him what his choice was like. He said “She’ll be fine despite having a lick of the tar-brush.” There was no internet then, so I couldn’t Google it, but I worked out when I saw her, that he meant she was of mixed race.

 

Another example? I worked in a small town on the Welsh border not that many years ago and I was told by a nurse that a practice not far away decided against taking on a female Asian dentist “Because the patients around here may not find her acceptable.” (It was a largely white local population).

Even as I write, I have received a text from a Bulgarian nurse I worked with, who has become a close friend. She has returned to Eastern Europe after ten years in the States and the UK. After being promised a head nurse’s post, she was turned down and also had a job offer retracted soon after giving her notice in at a practice, to find herself temporarily out of work. And she is a smart cookie. She flew through her nursing exams and recently gained a Master’s degree to add to her biology degree and teaching certificate. She always felt that patients treated her differently to other members of staff, being reluctant to engage in conversation. Her experiences in dentistry have now driven her to seek a career outside the profession. Sad, because she was exceptionally good and enthusiastic at her job.

 

Some Hope

Now I don’t want to give the impression that racism is pervading the whole of dentistry, because mercifully, it isn’t. But if racism is in our dental schools, it is clearly a problem, particularly if it’s responsible for preventing the development of a fully racially diverse dental population.

Just before I retired, my corporate practice was joined by a lovely black girl – a high flier who had left a job in entertainment management to train as a dental nurse. She took to the job like a duck to water and quickly looked like she was an old hand. She became a popular member of the practice very quickly. I asked her last week if she had ever experienced any racism during her time in dentistry. She said: “No racism. They are a lovely lot at the practice. It felt awkward when the riots were going on in America and London. My colleagues didn’t really talk about it. I thought it was strange as it was all over the news, but I guess they didn’t want to say the wrong thing around me, which is understandable.”

Even though racism isn’t a problem in her practice, it isn’t very far away from her outside. A little while ago, she posted on social media that the same policeman in the small city where we live, pulled her over while driving, four times, in just two months.

 

“Each time he told me it was a 'random stop.' On one occasion he told me to get out of my car and sit in his vehicle while he called the search on my vehicle. (Yes I was scared as it was late and no one was around). Each time he asked for my ID. Each time, he found my car was legal.

Yes, I felt it was strange but I didn’t dare question him. I thought ‘it’s just what the police do.’ But it got me thinking what was the real reason for his actions? This police officer could have just driven behind my car, and called in my number plate to see if my car was legal, without pulling me over. On one occasion he actually turned around as soon as I went past him, and followed me down the street, eventually putting his siren on to pull me over. I couldn't think of any real reason for his actions other than he was just bored, or simply that I was a black woman.  I will never know. Fortunately, I never saw him again.”

So after all that, why didn’t the victims of my dental school or me, for that matter, speak up? Basically, fear. These staff members knew how to utilise it to best effect. The fear of wasting nearly five years of your life for you to be failed at the end because you spoke up, was overwhelming. The same goes for those lecturers who found it fun to bully students. You just sucked it up in the days when I trained. It sounds like it hasn’t changed much in over 30 years. I take my hat off to the Cardiff students who have now stood up for themselves.

Every day, particularly in this moment, dentists and dental professionals battle to make a living. They battle to maintain their patient’s oral health and battle to keep their registrations in the face of an ever increasing assault from dental litigators and the General Dental Council.

Imagine if on top of that daily battle you also had to battle prejudice 24/7 because of the colour of your skin or your place of birth. The sooner we accept we’re all Earthlings, the better.