The Volokh Conspiracy
Mostly law professors | Sometimes contrarian | Often libertarian | Always independent
[A]a new case involving Dr. Sally Satel, a lecturer at the Yale School of Medicine, invites the opportunity to review [Yale's] consistent retreat, since 2015, from its advertised promises of free expression. In Quillette, Satel wrote about an online lecture she gave early this year, and the pushback that ensued, including the accusation that she "dehumanized" rural Ohioans by being surprised by their enthusiasm for artisanal coffee.
Like the "trap house" case, Satel's experience alone is not the gravest violation of intellectual freedom we see in a given week; and yet, both are symptoms of a worsening disease. Through its graduates, Yale exerts an outsized influence on the daily lives of most Americans — for example, Yale educated three of the last six U.S. presidents, and eight sitting Supreme Court Justices attended either Harvard or Yale at some point. If Yale has abandoned its commitment to free speech culture, we should either encourage it to reconsider or encourage our business and political leaders to reconsider their connection to Yale….
On Jan. 8, Satel gave a Grand Rounds lecture to the Yale Department of Psychiatry about the year she spent working in a clinic in Ironton, Ohio, treating people fighting drug addictions. In her lecture, she examined internal and external influences that can lead to substance abuse, addressed what she sees as misconceptions about the opioid crisis, and argued that misconceptions and mistakes by policymakers and medical providers may have exacerbated the crisis.
Satel frankly discussed the devastation wrought on the community by poverty, despair, and addiction, while also affectionately recalling her interactions with community members and the relationships formed in her work. (Satel also discussed her work in Ohio at length with Reason's Nick Gillespie in an interview for the April edition of Reason magazine.) Satel is a medical practitioner looking to better understand a towering public health problem, but her empathy and compassion are evident as well. You probably don't choose to work in the environments Satel does (she's also worked at a methadone clinic in Washington, D.C.) if you don't have deep reserves of both qualities.
After the talk, however, an unidentified and unenumerated group of "Concerned Yale Psychiatry Residents" sent a letter of complaint to John H. Krystal, chair of the department of psychiatry, objecting not only to the content of Satel's lecture, but to the idea that Satel, a former assistant professor of psychiatry at Yale who remains a lecturer on the faculty, would be invited to give the address at all:
We, a concerned group of Yale Psychiatry residents, are writing this letter to express our disappointment with the Grand Rounds presentation given on January 8th, 2021 by Dr. Sally Satel. This presentation was given two days after the white supremacist insurrection that occurred at the Capitol and was further traumatizing to us and many of our colleagues.
The language Dr. Satel used in her presentation was dehumanizing, demeaning, and classist toward individuals living in rural Ohio and for rural populations in general. Dr. Satel is known for her highly problematic and racist canon that explicitly blames individuals facing structural inequities for their own health outcomes.
The "dehumanizing, demeaning, and classist" language in question?
The letter gives two examples. First, the title: "My Year Abroad: Ironton, Ohio and Lessons from the Opioid Crisis." Second, the letter mentions a brief, affectionate aside Satel made toward the end of her lecture, highlighting the owner of what she referred to as an "artisanal coffee shop, one I would not expect to find here." This "dehumanization," they write, "should never be given a platform in Yale Department of Psychiatry."
What about that "highly problematic and racist canon?" The students focus their ire on two of Satel's prior published works in particular. In her 2006 book "The Health Disparities Myth," Satel and her co-author argue that socioeconomic status and geography factor far more than racial bias in explaining racial disparities in healthcare outcomes, which she does not deny exist. Satel makes a similar argument in another book cited by the residents, "PC, M.D.," in which she argues that chalking up racial disparities in healthcare to racial bias oversimplifies the problem.
The letter condemns Satel for having "the audacity to challenge Reverend Al Sharpton, an exemplary individual and activist." Sharpton is mentioned briefly in Satel's work as one of many influential figures in the early 2000s attributing racially disparate health care to the bias of providers. The notion that Sharpton or anyone else should be immune from challenge aside, Satel's work isn't directed at Sharpton; she's merely arguing that the evidence is not aligned with his activism.
Satel's conclusions are, of course, fair game for examination and critique. The residents are flatly uninterested, however, in anything of the sort. They write: "we find her canon to be beyond a 'difference of opinion' worth debate." More to the point, they view allowing opinions like Satel's on campus as wholly incompatible with the Yale School of Medicine's commitment to anti-racism and call on Yale to terminate Satel's status as a lecturer.
Fortunately, Satel writes, Yale has not done so. But Yale has also not used this as a "teachable moment" for its residents either, at least not in any public-facing way, and the chilling effect will no doubt disincentivize many potential lecturers from volunteering to be the next punching bag. But what does it say about the culture of free expression at Yale that these are the terms of the discussion?
Disclosure: Sally Satel is a friend of mine, though we haven't spoken much in recent years; she also co-guest-blogged on this blog several years ago. I had not heard of this incident until I saw the FIRE article.